Inside Health Fall 2017

Fall 2017 Primary Care Doctors for Special-needs Kids A Special, Special Unit for Tiny, Tiny Babies Heads Up: Replacing the School of Hard Knocks A Publication of Greenville Health System

De-stressing Breast Cancer Treatment

Winning Combination Behind every great Clemson University sports team is the medical team of Greenville Health System (GHS) Blue Ridge Orthopaedics physicians. These specialists help keep Clemson athletes in championship form and on the path to victory.

On another front, a dynamic collaboration between Clemson researchers and GHS clinicians is paving the way for breakthroughs in healthcare delivery, access and affordability.

Partners on the field and in the lab, on the court and in the operating room, together Clemson and GHS are making advances in athletics and healthcare research—a winning combination.

Greenville Health System: Official Team Physicians for Clemson Athletics Powered by GHS Blue Ridge Orthopaedics

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CONTENTS

Taking Care of the Tiniest Patients 2 GHS’ new Small Baby Unit creates a safe, cocooning environment to support incredibly fragile babies as they grow.

Easing the Stress of Breast Surgery 6

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When Jenene Davis faced cancer a second time, she found the process was improved, thanks to a new technology GHS has adopted.

Ferlauto Center Connects the Dots for Families 9 GHS Children’s Hospital helps simplify medical care for children with complex medical conditions.

Avoiding Concussion a No Brainer 14

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GHS’ certified athletic trainers are helping young athletes use their heads to play smarter.

Departments Message from the President 1 Spotlight 2 What’s Right in Health Care 3 Q & A 16

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Clinical Trials 17 Practice Profile 19 Provider Directory 20

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We welcome your comments, suggestions and ideas. Call (864) 797-7541 or email nparker@ghs.org.

PRESIDENT’S MESSAGE

(Not Too) Close for Comfort Have you ever considered a “staycation”— vacationing at home and taking in local sights and entertainment? I wonder how many of us upstate residents have hiked to the Poinsett Bridge, checked out the stars at Roper Mountain Science Center’s planetarium, enjoyed a Little Theatre show or even know that Greenville is home to the nation’s largest collection of religious art. These attractions and more are on hand here, waiting to be discovered—local jewels that might each be considered the area’s “best-kept secrets.”

At Greenville Health System (GHS), we can relate to that. Many residents of Greenville and the Upstate drive past one of our locations—perhaps daily—without knowing what’s going on in our facilities. We’re glad for their unfamiliarity: It means that they haven’t needed to know.

They haven’t needed treatment for cancer or infertility, a specialist for vascular disease or a pediatric disorder, rehabilitation for traumatic brain injury or any of the hundreds of healthcare services at which GHS excels every day.

For those who do need our services, however, we are here. And we mean here, in the Upstate. When you or your child is facing a serious or longterm condition, you want care right here—without the additional stress and expense of traveling for treatment in Atlanta or Charleston, Charlotte or Durham. You want to be close to home

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and family and support. You want friends around and the comfort of your own bed at night.

That’s been the experience of Jenene Davis, pictured on our cover. Her treatment for breast cancer at GHS was enhanced by advanced technology that located and marked her tumor without causing the discomfort and anxiety she had experienced in a past procedure. And parents of specialneeds children like Thelma Aiken are exceedingly grateful that their local pediatric practice—the Ferlauto Center for Complex Pediatric Care—provides the care they need.

GHS is “here” in our communities in other ways. Highlighted in the article about the Heads Up program are the many GHS certified athletic trainers who work with student-athletes in schools throughout the Upstate.

We hope you never need us. But, if you do, be comforted in knowing that GHS provides comprehensive, high-quality, affordable care close to where you live and work. Keeping you close to home makes care more affordable, improves responses to treatments and promotes recovery.

We are here for you. Please let us know when we may be of service.

Spence M. Taylor President

SPOTLIGHT

Taking Care of the Tiniest Patients The Small Baby Unit at Children’s Hospital of Greenville Health System (GHS) is the first such neonatal unit in the state.

The 17-bed Small Baby Unit is part of GHS’ Bryan Neonatal Intensive Care Unit (NICU), which treats more than 900 newborns each year. The highly advanced unit essentially recreates the womb experience for babies less than 28 weeks’ gestation or less than 2.2 pounds weight and allows them to complete their mother’s pregnancy.

The Small Baby Unit launched in January, and its team of specially trained neonatologists, nurses, respiratory therapists and ancillary staff anticipate treating 80-100 babies in 2017.

“By focusing on evidence-based practices, we can positively change and adapt care to provide the best possible prognosis for our most extremely fragile and high-risk patients,” said GHS Neonatology Medical Director Michael Stewart, MD. “We believe this innovative approach will allow us to decrease complications, certainly helping these children survive—and thrive.”

For extremely premature babies, simply turning their heads could rupture blood vessels and cause bleeding into the brain, resulting in permanent brain injury or lifelong disabilities. The phenomenon is called intraventricular hemorrhage and occurs on average in three percent to five percent of premature births nationwide. The new unit has cut that rate to less than one percent by reviewing evidence-based practices and implementing changes in practice.

To help still-forming lungs, eyes and skin complete their normal 40-week development, each baby is kept at 80 percent humidity for the first two weeks of life in a special closed incubator, recreating the moist, warm, darkened in-utero environment.

“We hope the work we’re piloting here will have a profound impact on the quality of life for these children for decades to come.”

—Michael Stewart, MD, GHS Neonatology Medical Director*

For babies this fragile, too much movement can be devastating. The special unit uses lowgravity mattresses and positioning aids to create “nests” that help the babies feel supported and comforted, while reducing pressure and friction. Mattresses are made of a fluidized medium that, like some high-tech Play-doh, can be molded to fit the baby’s needs.

Other special technology includes a non-invasive ventilation strategy that provides respiratory support while minimizing injury to extremely premature lungs. And the unit provides a dark, quiet environment to decrease the risk of overstimulating the babies’ fragile nervous systems.

While babies can’t swallow until 34-35 weeks, they’re immediately started on human breast milk, which decreases the risk of developing necrotizing enterocolitis, a rare complication in the intestines that can be deadly. The babies are initially fed through tiny tubes in the nose.

Families are encouraged to spend time in the NICU and to celebrate milestones—the first time mom holds her baby or the baby grasps dad’s finger.

“All the babies in this unit are fighters,” said one mother. “Never discount a preemie.” *GHS neonatologists are exclusively contracted by Pediatrix Medical Group.

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W H AT ’ S R I G H T I N H E A LT H C A R E

Here’s a snapshot of what’s going on at GHS as we live our mission to heal compassionately, teach innovatively and improve constantly.

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Patients cared for annually by GHS Hospice of the Foothills, which serves Oconee, Pickens and Anderson counties.

It received the Strategic Healthcare Programs (SHP) Best Premier Performer award for receiving an overall CAHPS (Consumer Assessment of Healthcare Providers and Systems) hospice caregiver satisfaction score in the top five percent of all SHP clients during 2016. ghs.org/hospice

Services listed on the community resource map, produced through a collaboration of GHS, Greenville County, Furman University, United Way of Greenville County and 2-1-1. This “imap” provides users an interactive look at essential services throughout Greenville County. unitedwaygc.org/imap

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Diversity MBA Magazine’s list, which GHS has made for six straight years, that recognizes companies who lead in the hiring and support of women and minority managers.

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Patients each week who can be treated with DigniCAP Scalp Cooling System, available at GHS Cancer Institute’s International Drive site. This new technology can reduce chemotherapy-induced hair loss in patients with solid tumors—many have experienced less than 10% loss!

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Anticipated patients served at the new Ambulatory Infusion Center in its first year at Hillcrest Memorial Hospital in Simpsonville. The center serves outpatient needs for medication administration or infusion therapy, PICC insertions, blood transfusion, central line function restoration, labs and porta cath access and maintenance.

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Clinics for ALS (Lou Gehrig’s disease) in South Carolina, one of which is part of GHS’ Neuroscience Institute. GHS offers the only ALS clinic in the Upstate and the only one in the state named a Recognized Treatment Center by the national ALS Association.

Health conditions for which you can find information in our online Health Center’s A-Z Health Library. ghs.org/healthcenter

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Eclipse glasses given away by the GHS Eye Institute to protect community residents’ vision while they enjoyed the recent once-in-a-lifetime phenomenon.

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Our first priority: taking care of patients and their families.

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Jenene Davis is both an employee and a patient of Greenville Health System.

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Easing the Stress of Breast Surgery GHS is first in the state to offer new technology.

By Leigh Savage

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n a morning in the spring of 2012, Jenene Davis was stressed, facing breast cancer treatment and surgery.

Adding to her discomfort and anxiety, she was traveling from the doctor’s office to the hospital with a wire protruding from her breast.

“It was disconcerting to say the least,” she recalled. “I was terrified the seat belt would dislodge it, or that something would hit it or bump it.”

Thanks to new technology at the Breast Health Center of Greenville Health System (GHS), many women will no longer need a guide wire to pinpoint their breast cancer. GHS is the first in the state to offer a less invasive localization technology called SAVI SCOUT, which uses radar instead of a wire—and no radioactive materials.

SAVI SCOUT is a localization system that allows surgeons to locate and remove abnormal breast tissue, high-risk lesions or cancer during lumpectomy surgery. Brian McKinley, MD, a surgical oncologist with GHS, began using the technique in May and has received nothing but positive feedback from patients.

With SAVI SCOUT, a radiologist places a tiny reflector at the tumor site up to 30 days before surgery. Then, the surgeon uses a SCOUT guide—a small wand—to scan the breast. The wand uses a radar signal to find the reflector, similar to how a metal detector works. The wand emits infrared light and a micro-impulse signal—50 million per second—allowing the surgeon to lock in on the reflector within 1 mm of accuracy, according to device creator Cianna Medical.

While extensive independent studies have not been completed, Dr. McKinley said he thinks the SAVI SCOUT technique will prove more accurate than the guide wire. “It’s every bit as good, and probably better,” he reported. “For patients, it’s more convenient and less traumatic.”

Wireless a Winner

GHS surgical oncologist Brian McKinley, MD, believes that many patients with breast cancer will benefit from the SAVI SCOUT technology.

Davis, a social worker in the Department of Medicine at GHS, found her second experience much less traumatic. Her first surgery, for stage 0 cancer in her right breast, involved inserting the wire into the breast. Though the wire was in place for just a few hours, “being able to see it and feel it— Inside Health 6

it felt like an eternity,” she remembered. “I was so afraid of it hurting or doing something that would move it.”

She beat the cancer in 2012, but when a recent mammogram detected stage 1 cancer in her left breast, she underwent a second surgery in May 2017 and had the SAVI SCOUT reflector implanted a week before surgery.

“It didn’t bother me at all,” she said. “It was a lot more convenient to go to that appointment, live my normal life for

the rest of the week and then go in for surgery. It was less painful, less frightening and overall a better way to pinpoint the location for the procedure.”

At 4 millimeters, her tumor was invasive but small, and she was relieved to find that the margins were clear after it was removed. After a precautionary round of radiation, she expects to be cancer-free once again, though “I’ll continue being religious about my mammograms,” she affirmed.

(Illustration courtesy of Cianna Medical)

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Dr. McKinley’s associates, Wendy Cornett, MD; John Rinkliff, MD; and Rebecca Snyder, MD, also are offering the new technology for most patients with breast cancer. “So far, all of us have been very pleased with it,” Dr. McKinley said.

Specialty Focus Fosters Enhanced Treatments The search for an improvement to the guide wire began with radioactive seeds. Four years ago, Dr. McKinley began training to use the seeds, which emit a signal and work much like SAVI SCOUT, with a wand that picks up signals in the operating room. But because the seeds that marked the tumors were radioactive (though in trace amounts), they were subject to nuclear regulatory laws and became impractical.

Then he and his team found out about SAVI SCOUT when the system won the 2016 Scientific Impact Award from the Society of Breast Surgeons. Dr. McKinley saw that it accomplished the same goal as the seed technique but with radar instead of radioactive signals.

Though there may be some cases where SAVI SCOUT can’t be used, to date Dr. McKinley has used it with almost every patient, with good results and positive feedback. “My guess is we will use it for 90 to 95 percent of our cases,” he commented.

Dr. McKinley values his team’s dedicated breast surgery focus, which allows its members to find the best tools, technologies and procedures to help their patients. “Our specialty focus,” he noted, “allows us to advance care in this and other ways.”

Several patients, like Davis, now have experienced both the wire and SAVI SCOUT, and all report a better experience with the new technique.

“As a patient as well as a GHS employee,” Davis remarked, “my experience has given me a special appreciation of our mission to heal compassionately, teach innovatively and improve constantly. SAVI SCOUT is an example of how our doctors and staff seek to continuously improve treatment for patients— and to heal compassionately.”

Learn about breast health, including breast composition and typical changes from puberty to pregnancy to menopause.

You also will find information about scheduling mammograms, events, seminars, breast self-exams and clinical trials. ghs.org/breast

Jenene Davis rings out the good news when she has finished radiation treatment for cancer.

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Ferlauto Center Connects the Dots for Families Children’s Hospital of Greenville Health System’s Ferlauto Center for Complex Pediatric Care makes medical care simpler for families of children with complex medical conditions.

By Becky Wilhoit

Thelma Aiken appreciates the specialized care son Blake receives at the Ferlauto Center.

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or families in the Upstate who have a child with a chronic complex illness, keeping them healthy is a continuous and stressful job. Consider Daniel, who is profoundly mentally disabled, neurologically impaired and has a depressed immune system. Specialists, therapists and a social worker are involved in his care. But what happens when he catches the flu?

That’s not a condition that requires a specialist, but Daniel does need a pediatrician prepared to treat a special-needs child— and one who understands his case of flu needs aggressive treatment thanks to his immune deficiency.

Families like Daniel’s have new options for comprehensive, appropriate care at Children’s Hospital of Greenville Health System (GHS). The Ferlauto Center for Complex Pediatric Care at GHS operates under a collaborative model that brings together physicians, staff and parents to provide a lifechanging resource for families caring for a child with medical complexity (CMC). Typically, the child is seeing multiple—five or more—specialists.

The center’s model of care is deeply personal for Thelma Aiken of Easley. After her son, Blake, was born in 2009, he began exhibiting troubling symptoms. He became a patient of Kent Jones, MD, who then was practicing with the Medically Fragile Children’s Program in Easley.

Dr. Jones diagnosed Blake with Rubenstein-Taybi syndrome, a rare genetic disorder characterized by short stature, distinctive facial features, moderate-to-severe intellectual disability, broad thumbs and first toes, and organ abnormalities. He worked with the family to establish a care plan for Blake and helped them navigate the world of complex care. For Aiken, having a resource dedicated to understanding her child’s individual needs was a vital part of Blake’s treatment.

“They’ve been with us through so much,” Aiken said of their journey with Dr. Jones and some of his longtime staff.

“When Blake was just 6 months old, he became sick and was in real trouble,” she recounted. “He was not getting enough oxygen, turning blue and running a very high fever. We took him to the ER at Baptist Easley and Dr. Jones came directly to us, communicated from there with the team at GHS Children’s Hospital and then followed through the entire process as Blake was transferred there. We were so thankful to have Dr. Jones with us.”

Dr. Jones joined the Ferlauto Center when it opened in 2015.

According to him, one of the center’s core tenets is engaging multiple parties in a child’s care. The parents—because

they are closest to their child’s situation—along with care managers, home health nurses, physicians and dietitian all participate in each visit.

A Team Approach “This practice is team-oriented,” emphasized Dr. Jones. “These parents know their child the best, and working together is how we believe we’ll make the best decisions. In a typical visit, it’s not simply me and the parents, but all the other people who are part of that child’s care plan, such as a dietitian or a home health nurse. We all come together so we can circle up and discuss what’s going on. We believe that approach fosters more effective and complete care.”

Registered dietitian Kathy Crytser has worked with Dr. Jones for 12 years. “Every one of us has our eyes on a specific area of a child’s care, but together we’re able to cover the whole child,” she stated. “There’s no other way to care for these children but as a team.”

Another tenet to the Ferlauto Center’s approach is continuity of care, or the idea of having the same doctor see the child at every visit so that parents don’t have to re-tell their story each time.

“Parents of medically complex kids frequently complain about seeing a different doctor every time in many other primary care settings. We offer much more continuity,” Dr. Jones said.

“Being part of GHS has afforded us so much support in creating this team and taking this concept of care forward,” Crytser observed. “To me, the center is really the ultimate beautiful morphing of our mission and what we do to take care of these kids, because this facility is what we were looking toward years ago.”

‘Seams Between Blocks’ Named for Jerry Ferlauto, MD, and wife, Natalina, the Ferlauto Center’s future was secured after a $1 million endowment from the couple. Dr. Ferlauto, the first neonatologist in the Upstate, and Dr. Jones share a special connection—Dr. Jones was Dr. Ferlauto’s senior student in 1980. Now in his 34th year of pediatric practice, Dr. Jones has spent the past 15 years focused on CMC patients.

Cady Williams, MD, one of the newest additions at the Ferlauto Center, joined Dr. Jones and his team in 2016. For Inside Health 10

When Chris Aiken (far right) brings his son Blake to the Ferlauto Center for an office visit, they see not only Dr. Jones (left) but also case manager Renee Moore, BSN, RN (second from the left), and dietitian Kathy Crytser, RD (center).

Dr. Williams, the center has a number of advantages for patients and their families, but also for specialty pediatricians dedicated to CMC patient care. She and Dr. Jones are quick to point out that the center functions as one layer within the intricate network of specialists that CMC patients may see, with the ultimate goal of facilitating continuity for both patients and their specialists.

“We do not replace other services our patients use,” remarked Dr. Williams. “We are a small part of the resources our patients need. But what we are finding is that small things can make a big difference. Similar programs have seen decreased hospital admission rates for their patients. We are making efforts to improve transitions in and out of Children’s Hospital for those patients who do get admitted.”

Dr. Jones agreed: “Specialists are the building blocks of this type of care, and so what we do is try to be the seams between those blocks.”

Making their care family-centered is a priority at the Ferlauto Center. That commitment includes offering the option to have patients’ siblings seen in the office.

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“That type of thing saves parents a lot of trouble and running around for multiple appointments, when they can come in here, bring both their CMC and their other children, and handle immunizations or a cold that both kids have,” stated Dr. Jones. “As an example, we see sets of twins where one is a CMC and one is not, because it just makes sense.”

It also makes sense to the families who trust Dr. Jones and the center’s staff.

“The personal care we’ve received, not just for our son, but our family, is astounding,” Aiken said. “Dr. Jones and his staff have always treated me like I’m another part of their team who has gathered around Blake through every challenge. I feel like we’re one big family working toward the same goal.”

For your child to become a patient at the Ferlauto Center, you will need a referral from your current physician. For more information about the center, please call (864) 220-8907.

“This practice is team-oriented. These parents know their child the best, and working together is how we believe we’ll make the best decisions.”

– Kent Jones, MD

Cady Williams, MD, and Kent Jones, MD, spearhead the coordinated care provided to families of children with complex conditions at the Ferlauto Center.

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Avoiding Concussion a No Brainer A new program is throwing a key block against student-athlete concussions.

By Robin Halcomb

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n 2015, Darryl Nance was listening to the Mike & Mike Show on ESPN radio when something caught his attention.

The hosts were discussing football safety and mentioned Heads Up Football, a program aimed at reducing concussions in young players. Concussion had become the focus of nationwide concern in the wake of revelations of long-term injury to players in the NFL (National Football League). Soon to become athletic director for Greenville County Schools, Nance decided Heads Up could be an important addition to his plans.

Team Building A meeting in June 2015 brought together Heads Up instructors and medical partners, along with certified athletic trainers. In the program’s first year, Greenville County saw 73 of 84 coaches become certified.

At the 2015 Spring Conference for Athletics meeting, Nance met Ed Passino, manager of scholastic partnerships and engagement at USA Football, and Peter Vacho, military and football outreach manager for the Carolina Panthers. Nance told the two he intended to bring Heads Up to Greenville County and wanted certification for anybody directly responsible for teaching blocking and tackling. While the Heads Up model typically was not so widespread, Nance was insistent, and Vacho offered a grant from the Panthers’ outreach program to make it happen.

Nance is grateful for the GHS network that multiplied with that meeting. “The doctors, the trainers—they all do such a good job providing care, and yet it’s a very personal touch.”

USA Football, an organization focused on advancing coach and player development through standards and best practices, had created Heads Up Football in 2012. The program emphasizes concussion prevention through using the shoulders during blocking and tackling. Heads Up is supported in the Upstate by Greenville Health System (GHS) and its orthopaedic practice, Steadman Hawkins Clinic of the Carolinas (SHCC).

“I felt that putting all the smart people in a room together would be beneficial to us,” recalled Nance. “A lot of good things happened, and a lot of goodwill was built among everyone involved.”

According to John Thorpe, manager of the Athletic Trainer Program for GHS, an informal safety program began in 1998 after an athletic director at a local high school spoke with a group at GHS. What started as four trainers that year grew into a network that now serves more than 50 public and private high schools, professional baseball, university athletics, recreation districts and national events that take place in the Upstate. GHS team members provide care for more than 20,000 South Carolina student-athletes at no charge to the organizations.

“This is a large commitment for GHS to put our trainers out there,” said Thorpe. “We’ve had outstanding support from the president and on down.”

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Because concussions typically do not involve damage to the brain that can be seen in medical imaging, diagnosis focuses on functional symptoms.

“Concussion is a functional problem,” said Franklin Sease, MD, medical director of Steadman Hawkins Sports Medicine.

“When players have symptoms of concussion, the trainer evaluates them and, if he or she has concerns, follows our established protocol.”

Playing by the Rules with Concussion The International Symposium on Concussion in Sports defines concussion as “complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.” Sports concussions generally present as disturbances in normal function, rather than physical damage to the brain. Because of this distinction, standard medical imaging usually does not show concussion-specific abnormalities.

As more children play sports, concussion rates are on the rise and not only from football crashes. Even activities that technically are not contact sports, such as soccer, carry the potential for the condition.

“Some latest research says it’s not necessarily one high-velocity or high-impact hit, but many sub-concussive blows or impacts over time that can create a change and long-lasting impact,” explained Ellen Shanley, PhD, PT, OCS, lead researcher at the S.C. Center for Effectiveness Research in Orthopaedics.

“Sometimes, concussions occur because of a series of little impacts over a shorter period with no full recovery in between.”

Signs and symptoms may include a dazed or stunned appearance, clumsy movements, loss of consciousness (which may be brief), headache, nausea or vomiting, dizziness, confusions or just not feeling right.

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That protocol includes a period of rest, followed by reintroduction to the classroom and exercise and a graded return to play.

Graded return proceeds from exertion drills to contact drills, to sport-specific drills to contact and, finally, back to live play.

“GHS always is searching for innovative ways to improve the health of our communities,” Dr. Sease remarked. “The depth and breadth of the Athletic Trainer Program, which includes a strong research component, is a good example of that commitment.”

Thumbs Up to Heads Up The S.C. Center for Effectiveness Research in Orthopaedics, closely affiliated with GHS and SHCC, conducts an ongoing study of Heads Up. “Our study shows fewer concussions with the group that had the program running throughout the season versus ones not trained,” Dr. Shanley commented.

“There were about two fewer concussions per group per every 100 athletes, monitored over 2,500 athletes for a full season.

With Heads Up, you have ‘back to sport’ almost 30 percent faster, which implies that, in some way, if you use these guidelines your concussions will be less severe. We’ve seen about a 34 percent reduction in practices and a 40 percent reduction during games.”

Brandon Harris, certified athletic trainer at Wade Hampton High School, sees Heads Up as a return to training basics. “They weren’t reinventing the wheel with this program; it‘s the fundamentals,” he noted. “Since the program reinforces what football coaches already know, they’ve jumped on board and love it.”

GHS’ Athletic Trainer Program is another example of our commitment to cleats-on-the-ground involvement in the health of our community.

Q & A

The ABCs of ATCs

Through its Athletic Trainer Program, GHS helps keep upstate student-athletes in winning form.

What is the role of an athletic trainer who is certified (ATC)?

An ATC is a jack-of-all-trades. Our role is to provide care for and prevent athletic injuries through exercise and rehabilitation. If an injury does occur, we can determine if the athlete needs to see a doctor, and then, when appropriate, rehab in the training room until the athlete is at playing status again.

What are an ATC’s qualifications?

At Greenville Health System (GHS), our athletic trainers have a bachelor’s degree through a four-year accredited program, have passed the National Athletic Trainers Association boards and are certified by the state of S.C. Many also have a master’s degree.

(Qualification requirements recently changed, and trainers now must have a master’s to become board-certified.)

With what sports do GHS athletic trainers work?

ATCs are involved in every sport at the schools that GHS serves (which includes middle schools, high schools and colleges). The national association ranks sports according to risk of injury, and we prioritize our coverage

accordingly. That means football, basketball, soccer and lacrosse will have the most ATC presence at practices and games, but we are available to help all athletes.

How many trainers does GHS have?

When we fill current open positions, we will have a total of 47 ATCs.

What is a typical day like for a GHS athletic trainer?

Every day for our ATCs is different, as we are working with multiple teams and different sports. Generally, we arrive at the school before 1 p.m. to prepare fields for practice, complete documentation in our electronic medical record and work with any athletes needing rehabilitation (if it does not interfere with class schedules). As class ends for the day, we prepare athletes for practice and/or games. We are present on campus throughout all events each day, monitoring the safety of our athletes and providing medical care in case of injury.

What is the most unusual situation with which GHS athletic trainers have been involved?

We’ve seen two separate occasions when our ATCs responded with an AED (automated external defibrillator) and CPR to save the lives of two athletes from cardiac arrest.

Why does GHS provide this service?

We believe this service is needed in the community. Our student-athletes require high-quality care to help avoid injury. The more injuries we can prevent now—and the better healing we can promote when injuries do occur—the better health and lives these studentathletes will have in the future.

Gil Gilliland

GHS Athletic Training Network Manager

What are typical injuries?

Each sport has its increased risk for certain injuries. Currently, the most publicized injury is concussion. We also see many shoulder, knee and ankle injuries.

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CLINICAL TRIALS

Participants Needed

Hundreds of clinical trials are conducted throughout Greenville Health System on a variety of drug therapies, surgical devices and other treatments in all areas of medicine.

Cancer Survivors for Registry GHS Cancer Institute’s Cancer Survivor Registry is a database of demographics, contact information, and tumor and treatment information. Survivors can receive helpful information about moving forward. Contact Matt, (864) 455-5119 or molinger2@ghs.org.

Survivors of Breast Cancer As Advisors The Breast Cancer Patient Engagement Studio is looking for women who have experienced breast cancer or their family members to help review projects designed to provide better care for patients. Patient opinions are needed!

Participation involves meeting as an advisor (not a research participant) with a group of similar patients, researchers and clinicians to review projects as they are proposed. If interested, a patient application is available at hsc.ghs.org/ pes/application. You also may call (864) 455-8894 or email the Studio at PEStudio@ghs.org. If selected, you will receive compensation for taking part on the patient advisory board.

Survivors of Cancer with Insomnia Sleep disturbance, particularly insomnia, is a common problem for survivors of cancer. This study is open to patients who have completed all scheduled surgery, chemotherapy and/or radiation therapy for cancer within the last 2-60 months and have some type of sleep 17 Inside Health

disturbance. Because there is no ideal standard of care for effectively treating sleep problems in survivors of cancer, the purpose of this study is to compare the effectiveness of three different treatments for improving sleep problems and determine which is best. The three treatments are yoga, survivorship health education and cognitive behavioral therapy. Call Claudette, (864) 522-4263 or cphinney@ghs.org.

Survivors of Lung Cancer Having Anxiety The purpose of the Reducing Lung Cancer Survivors’ Anxiety (RELAX) research study is to compare the effects of device-guided breathing on anxiety and shortness of breath in survivors of lung cancer. This study is open to survivors of early-stage lung cancer who have completed treatment and are experiencing anxiety. The study will involve using a breathing device daily for 12 weeks and filling out patient questionnaires. Call Claudette, (864) 522-4263 or cphinney@ghs.org.

Survivors of Lung Cancer A lung cancer support group has been formed through the collaboration between GHS and Lung Cancer Alliance (LCA). The support group meets the third Tuesday of every month, 11:30 a.m.-12:30 p.m.

This group meets to connect, have open discussion and provide resource opportunities. Focus groups take place

within the support group facilitated by an LCA facilitator annually for two years. The focus groups allow participant feedback as well as evaluate the effectiveness of the group. Contact Matt, (864) 455-5119 or molinger2@ghs.org.

Survivors of Head and Neck Cancer with Dry Mouth After Radiation The purpose of the study is to see if acupuncture can decrease excessively dry mouth that can be caused by radiation treatment. The study is open to patients who had radiation treatment to both sides of their head and neck at least 12 months ago and still have extremely dry mouth. The study requires saliva collection and patient questionnaires; some patients will be given twice weekly acupuncture for four to eight weeks. The acupuncturist office is located in Greenville. Contact Jennifer, (864) 455-2860 or JCaldwell@ghs.org.

Survivors of Ovarian, Fallopian Tube or Primary Peritoneal Cancer The purpose of this study is to determine if lifestyle can influence survival and quality of life in persons with ovarian, fallopian tube or primary peritoneal cancer. The study is open to survivors treated for stage II, III or IV disease who have completed all treatment within the past 6 weeks to 6½ months with no evidence of disease. This 24-month study requires diet and exercise telephone coaching,

CLINICAL TRIALS

patient questionnaires, wearing a studyprovided pedometer on selected weeks and blood work. Contact Jennifer, (864) 455-2860 or jcaldwell@ghs.org.

People with Bladder Cancer In this trial concerning high-grade bladder cancer, the treatment given to patients randomizes to 3 groups: Group 1 (standard treatment group) BCG (Bacillus Chalmette-Guerin) LIVE bacterium (TICE) solution; OR Group 2 (experimental group) BCG Tokyo-172 strain solution; OR Group 3 (experimental group) BCG Tokyo-172 strain solution plus BCG Tokyo-172 vaccine injection before BCG Tokyo-172 solution.

BCG is a non-infectious bacteria that may stimulate the immune system when instilled into the bladder. BCG typically is tolerated well by patients with normal immune system function. The study will compare the good and bad effects of each treatment and allow researchers to know which treatment version is better.

The study also will look at these three treatments and see how many people receiving each treatment are free from high-grade recurrence of their bladder cancer after one year of treatment.

If you are newly diagnosed with bladder cancer, the cancer is confined to the bladder and your doctor is recommending treatment (vs. observation), you may be a candidate for this trial. Contact Anna, (864) 522-2063 or apolan@ghs.org.

Adults with Type 2 Diabetes This study is investigating a new generation of fast-acting insulin to see if it can provide improved blood sugar control in adults with type 2 diabetes.

If you are at least 18 years of age, have been diagnosed with type 2 diabetes

for at least 10 years, have been treated with both mealtime insulin and basal insulin for at least one year, and have an HbA1c value between 7.0 percent and 10.0 percent, you may be eligible to participate in this study. Participants will receive comprehensive care, including regular health checks and medical testing, access to study medication and blood glucose testing equipment, and possible compensation for time and travel. Call Shirley, (864) 455-3261.

Young Adults with Type 2 Diabetes The purpose of this study is to evaluate the effects of dapagliflozin on children diagnosed with type 2 diabetes who are taking metformin. Throughout this study, participants will be tested to see if the combined effects of the study drug and metformin can reduce average blood sugar levels. Participants in this 52-week trial will receive study drugs at no cost. Contact Lisa, (864) 454-5168 or llooper@ghs.org.

Relatives of People with Type 1 Diabetes This study is searching for ways to prevent and quickly medically intervene in those newly diagnosed with diabetes.

Researchers are seeking to test family members of people with type 1 diabetes to determine if they show signs of developing the disease. Parents, brothers, sisters and children of those who have type 1 diabetes (ages 1-45), and cousins, nieces, nephews, aunts, uncles and grandchildren (ages 1-20) can be tested for their risk of developing type 1 diabetes free of charge. Benefits of participation include finding out your family members’ risk level for developing diabetes, determining eligibility for an ongoing interventional trial, possibly receiving an early diagnosis of diabetes that would allow for early treatment and

contributing to the fight against type 1 diabetes. Adult patients or their relatives may call Shirley at (864) 455-3261.

Relatives of pediatric patients may call Lisa at (864) 454-5168.

Teens and Adults with Eosinophilic Esophagitis (EoE) Currently, there is no approved medication for the treatment of EoE. The purpose of this study is to test the effectiveness of an oral budesonide medication as a treatment for teens and young adults who have EoE. Participants in this 16-week study will be evaluated for reduced symptoms of EoE and will receive study medication at no cost.

Contact Amy, ayes@ghs.org or (864) 454-5591.

People with Interstitial Cystitis/ Bladder Pain Syndrome (IC/BPS) This study is evaluating the safety and effectiveness of a new medication for the treatment of IC/BPS. IC/BPS is a disease (not an infection) that causes bladder pain, the feeling of always wanting to urinate, and frequent urination day and night. The reason why IC/BPS occurs is unknown.

AQX-1125 is an experimental new drug therapy that may help to reduce the bladder pain and symptoms associated with IC/BPS. AQX-1125 is under investigation and is not approved by the U.S. Food and Drug Administration (FDA) for use outside of research studies like this one. Please contact Leesa, (864) 797-7306 or RBradley@ghs.org.

To learn more, visit ghs.org/research.

Inside Health 18

PRACTICE PROFILE

Pediatric Associates–Spartanburg

The providers of Pediatric Associates–Spartanburg, a practice of GHS Children’s Hospital, are active in the local community: (front row, l-r) Lizabeth A. McLeod, MD; Aqil E. Surka, MD; Jenny Thomas, MD; Ann Marie Edwards, MD (back row, l-r) Troy L. Beavers, MD; Rebecca M. Saul, PNP; S. David Blake, MD; Jennifer S. Colburn, MD.

“At Pediatric Associates–Spartanburg,” said Medical Director David Blake, MD, “our goal is to provide families with exceptional pediatric care in a warm, friendly environment.”

The providers of this practice deliver exceptional care in these and other ways: They make seeing sick kids a priority. They aim to see every sick child on the day a parent calls, even if it’s at 4:45 p.m. The doctors extend hours into the late afternoon and evening as necessary to ensure they have the time needed for sick visits.

They make finding the right match easy. This practice has a variety of providers—men and women, older and younger, quiet and outgoing—that allow parents and kids to find a doctor with whom they click.

They make connections with families. Many patients and parents know these providers from their involvement in local events, schools, churches and teams. Many of the nine boardcertified pediatricians grew up in this area—two of them were patients of this practice!

In Spartanburg, the practice is conveniently located in the Children’s Hospital Outpatient Center–Spartanburg, which also houses GHS pediatric specialists and Kidnetics® (pediatric physical, occupational and speech therapies). The other office is located in Duncan.

“I can honestly say I love what I do,” commented Dr. Blake.

“I want patients and parents to know that I care about 19 Inside Health

them. And I want to be sure parents have all their questions answered. I often end a visit by saying, ‘Is there anything else you wanted to talk about today?’ “ “My colleagues feel the same way,” he concluded. “This community is our home. Whether families have lived here all of their lives or are new to the area, we are honored to be their home for pediatric care.”

Providers Troy L. Beavers, MD E. Lee Belvin II, MD S. David Blake, MD Jennifer S. Colburn, MD Ann Marie Edwards, MD

Lizabeth A. McLeod, MD Michelle L. Prigge, MD Aqil E. Surka, MD Jenny Thomas, MD Rebecca Saul, NP

Hours Mon.-Fri 8 a.m.-5 p.m. (extended hours as needed) Sat. 8-11 a.m.

Pediatric Associates–Spartanburg 249 N. Grove Medical Park Drive, Spartanburg 500 Squires Pointe, Duncan (864) 582-8135 • ghschildrens.org/pa-spartanburg Pediatric Associates–Spartanburg is pleased to sponsor the 20171018 season of the Spartanburg Youth Theatre.

This practice is recognized by the National Committee for Quality Assurance (NCQA) as a Patient-Centered Medical Home. Practices that receive this recognition support the delivery of high-quality care and are built on evidence-based, nationally recognized clinical standards of care. Learn more about what this means for you and your family at ghs.org/pcmh.

GHS PRIMARY CARE PRACTICES Having a personal physician with whom you can establish a lifelong relationship is as important as getting your screenings. If you need assistance finding one, here is a list of GHS primary care practices or call GHS Physician Finder at 1-844-GHS-DOCS (447-3627). To find out more about these practices, go to ghs.org/mydoctor. For a complete list of primary and specialty physicians, go to ghs.org.

CLEMSON Clemson-Seneca Pediatrics 208 Frontage Rd., Ste. 1, 29631 654-6034 CLINTON Advanced Family Medicine* 210 S. Broad St., 29325 833-0973 Carolina Women’s Center 102 Medical Park Ct., 29325 938-0087 GHS Internal Medicine–Laurens 22725 Hwy. 76 E., Ste. A, 29325 833-4545 DUNCAN Palmetto Medical Associates* 500 Squires Pte., Ste. B, 29334 968-5123 Pediatric Associates–Spartanburg* 500 Squires Pte., Ste. A, 29334 582-8135

Children’s Hospital After-hours Care (Convenient Care) 890 S. Pleasantburg Dr., 29607 271-3681 Christie Pediatric Group* 9 Mills Ave., 29605 242-4840 3911 S. Hwy. 14, 29615 522-1340 Cross Creek Internal Medicine* 50 Cross Park Ct., 29605 797-7035 Cypress Internal Medicine–Patewood* 200 Patewood Dr., Ste. B460, 29615 454-2226 GHS Internal Medicine–Maxwell Pointe* 3907 S. Hwy. 14, 29615 522-1300 GHS Pediatrics & Internal Medicine– Wade Hampton* 1809 Wade Hampton Blvd., Ste. 120, 29609 522-5000

Piedmont OB/GYN 890 W. Faris Rd., Ste. 330, 29605 455-1270 3917 S. Hwy. 14, 29615 522-1360 Riverside Family Medicine–Eastside* 215 Halton Rd., 29607 454-2700 Riverside Family Medicine–Maxwell Pointe* 3909 S. Hwy. 14, 29615 522-1320 GREER The Children’s Clinic* 325 Medical Pkwy., Ste. 150, 29650 797-9300 Cypress Internal Medicine–Greer* 325 Medical Pkwy., Ste. 200, 29650 797-9550 Family Medicine–Mountain View* 426 Memorial Dr. Ext., 29651 877-9066

EASLEY

Greenville Family Medicine* 2-A Cleveland Ct., 29607 271-7761

Greer Family Medicine* 1107 W. Poinsett St., 29650 879-8886

Pediatric Associates–Easley* 800 N. A St., 29640 855-0001

Greenville Midwifery Care & Birth Center 35 Medical Ridge Dr., 29605 797-7350

Greer OB/GYN 325 Medical Pkwy., Ste. 100, 29650 797-9200

GRAY COURT

Greenville Ob/Gyn Associates 2 Memorial Medical Dr., 29605 295-4210 1025 Verdae Blvd., Ste. F, 29607 286-7500

MD360® (Convenient Care) 1305 S. Suber Rd., 29650 989-4609

Laurens Family Medicine* 9100 Hwy. 14, 29645 876-4888 GREENVILLE Carolina Pediatrics of Greenville* 200 Patewood Dr., Ste. A120, 29615 454-2670 Center for Family Medicine* 877 W. Faris Rd., Ste. A, 29605 455-7800 The Children’s Clinic* 890 S. Pleasantburg Dr., 29607 271-1450

Gynecology Specialists 890 W. Faris Rd., Ste. 510, 29605 101 Halton Village Circle, 29607 455-1600 (for both) Internal Medicine Associates of Greenville 1025 Verdae Blvd., Ste. A, 29607 242-4683

Pediatric Associates–Greer* 318 Memorial Dr., 29650 879-3883 LAURENS Laurens Family Medicine* 106 Parkview Dr., 29360 984-0571

MD360® (Convenient Care) 1025 Verdae Blvd., Ste. B, 29607 286-7550

Inside Health 20

GHS PRIMARY CARE PRACTICES

PIEDMONT/POWDERSVILLE Heritage Pediatrics & Internal Medicine– Wren* 1115 Wren School Rd., 29673 859-0740 MD360® (Convenient Care) 11402 Anderson Rd., Ste. A, 29611 631-2799 (in collaboration with Baptist Easley) Pediatric Associates–Powdersville* 207 Three Bridges Rd., 29611 220-1110 Premier Women’s Care 209 Three Bridges Rd., 29611 220-4209 SENECA Blue Ridge Women’s Center 103 Carter Park Dr., 29678 482-2360 10110 Clemson Blvd., 29678 985-1799 Clemson-Seneca Pediatrics 109 Omni Dr., Ste. B, 29672 888-4222 GHS Family Medicine–Walhalla Currently located at Seneca Medical Associates 11082 N. Radio Station Rd., 29672 638-3444 Mountain Lakes Community Care (Convenient Care) 100 Omni Dr., Ste. B, 29672 885-7425

Mountain Lakes Family Medicine 10110 Clemson Blvd., 29672 482-3148

Pediatric Associates–Simpsonville 1409 W. Georgia Rd., Ste. A, 29680 454-5062

Dr. Timothy Sanders Family Medicine 100 Omni Dr., Ste. A, 29672 885-7520

SPARTANBURG

Seneca Medical Associates 11082 N. Radio Station Rd., 29672 882-2314 Upstate Family Medicine 12016 N. Radio Station Rd., 29678 882-6141 SIMPSONVILLE GHS Internal Medicine–Simpsonville 727 S.E. Main St., Ste. 300, 29681 522-1170 Greenville Ob/Gyn Associates 727 S.E. Main St., Ste. 120, 29681 454-6500 Heritage Pediatrics & Internal Medicine– Simpsonville* 727 S.E. Main St., Ste. 320, 29681 454-6440 Hillcrest Family Practice* 717 S.E. Main St., 29681 522-5400 Keystone Family Medicine* 1409 W. Georgia Rd., Ste. B, 29680 454-5000 MD360® (Convenient Care) 300 Scuffletown Rd., 29681 329-0029

*The National Committee for Quality Assurance (NCQA) Recognition Programs assess whether clinicians and practices support the delivery of high-quality care and are built on evidence-based, nationally recognized clinical standards of care. †Most insurances accepted, including S.C. Medicaid program and Medicaid Managed Care.

The practices listed here are part of Partners In Health Inc. and affiliated with Greenville Health System.

21 Inside Health

Children’s Hospital Spartanburg Night Clinic*† 201 E. Broad St., Suite 210, 29306 804-6998 GHS Family & Internal Medicine– Boiling Springs 2400 Boiling Springs Rd., 29316 599-0731 MD360® (Convenient Care) 2400 Boiling Springs Rd., 29316 599-0731 Pediatric Associates–Spartanburg* 249 N. Grove Medical Park Drive Ste. 100, 29303 582-8135 Skylyn Medical Associates 1776 Skylyn Dr., 29307 577-9970 Spartanburg Pediatric Health Center*† 201 E. Broad St., Ste. 210, 29306 707-2135 TRAVELERS REST The Children’s Clinic* 415 Duncan Chapel Rd., 29617 522-2600 Travelers Rest Family Medicine* 9 McElhaney Rd., 29690 834-3192

The Care You Need, The Way You Want It Click

Inside Health is published

by Greenville Health System as a community service. This information is for educational purposes solely—it should not take the place of medical advice or diagnoses made by healthcare professionals.

Greenville Health System is known for its comprehensive services and world-class physicians, in addition to being an academic health center and conducting leading-edge research.

However, our compassion and strength come from our people—15,000 dedicated professionals, your neighbors, who work together to care for you and your family.

For online care for common conditions: ghs.org/SmartExam

Walk

Editor-in-chief Jerry R. Youkey, MD Executive VP, Medical and Academic Affairs, Chief Medical Officer, Greenville Health System Founding Dean, USC School of Medicine Greenville USC Associate Provost for Health Sciences Greenville

For walk-in care (weekdays/after-hours/weekends): ghs.org/MD360

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Art Direction GHS Creative Services Contributing Photographers Alan Francis George Reynolds For more information, contact Nancy Parker, Editor, Marketing Communications Greenville Health System 701 Grove Road Greenville, SC 29605-5601 (864) 797-7541 nparker@ghs.org

To find a new healthcare provider: 1-844-GHS-DOCS (447-4627)

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© 2017 Greenville Health System 17-0811 10/17

Healthier Greenville Ahead!

The Greenville Health Authority (GHA) Board of Trustees recently announced the first grant recipients of its landmark $80 million 20-year pledge to help make Greenville County the healthiest county in the nation by 2036.

The initial nine grants amount to $12.4 million and target chronic issues like diabetes, mental illness and obesity. They also address immediate needs like standardizing high-quality training for firefighter first responders across Greenville County and adding life-saving defibrillators to patrol cars.

All told, the nine projects will harness the expertise of 33 organizations or partnering groups. They’re also expected to create 21 new grant-related jobs and strengthen workforce development through enhanced job training for nearly 1,200 positions.

“We believe that implementation of these programs could touch every life in Greenville County,” noted Lisa Stevens, chair of the GHA Board of Trustees.

The innovative initiative will fund projects involving healthrelated care, research and education that improve the health of Greenville County residents. The first areas targeted include access to health care, mental health and healthy eating/ exercise.

To learn more about Healthy Greenville 2036, visit ghs.org/healthygreenville2036.

GHS Vision Transform health care for the benefit of the people and communities we serve.

GHS Mission Heal compassionately. Teach Innovatively. Improve constantly.

GHS Values Together we serve with integrity, respect, trust and openness.