Inside Health Spring 2018

Spring 2018 New Family Birthplace Delivers for You Stopping Stroke in Its Tracks Teaming Up to Treat Infertility A Publication of Greenville Health System

Helping Young Adults with Cancer

Help for Your Health Journey Whether you’ve just started taking the stairs or have been taking a cycling class for a while, you probably could use ideas and encouragement on your journey toward better health.

Greenville Health System (GHS) can meet you where you are—any time of day or night—with these health resources: • Join our online fitness community, MoveWell. We provide monthly workouts from one of our fitness specialists, video of the exercise demos and online forums for participants to connect with each other, plus giveaways, community events and more.

• Bookmark GHS HealthCenter—your gateway to health information and education. View blog posts, our A-Z Health Library, Healthy All Year calendar, podcasts and more at ghs.org/healthcenter.

• Find a primary care provider. If you need help finding Dr. Right-for-you, call 1-844-GHS-DOCS (447-3627).

• Sign up for MyChart and get reminders about important health screenings, communicate with your provider, view test results and medical history—all at your fingertips. Enroll at ghs.org/mychart.

Let us help you get started—or stay on track—toward achieving your best health!

ghs.org/healthyallyear 18-0127

CONTENTS

Off to a Great Start 2 At the Family Birthplace–Patewood, birth days are always special events.

GHS Answers When Cancer Hits Young Adults 5

2

Because of the help and support he found through GHS’ Adolescent & Young Adult Oncology Program, Nestor Cordero survived his experience with cancer—and thrived.

Striking Out Stroke 9 This high school principal learned his lesson when he had a stroke: Getting advanced treatment immediately at GHS was critical to a full comeback.

It Takes Two 13

5

It takes two to conceive, and sometimes it takes two GHS specialists to help when infertility issues affect both partners.

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

9

Q & A 16 Clinical Trials 17 Practice Profile 19 Provider Directory 20

13

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

PRESIDENT’S MESSAGE

Raising Standards of Care Someone once said, “You don’t build a home without a foundation. You don’t build a hospital without nurses.” As a surgeon and president of a healthcare organization, I couldn’t agree more. On the frontline every day, nurses are the face and hands of diligent, vigilant and compassionate patient care. In the 21st century, nurses also must be clinically knowledgeable and technically skilled.

That’s why I’m pleased to announce that Greenville Memorial Hospital (GMH) has been granted Magnet recognition by the American Nurses Credentialing Center (ANCC), reflecting a commitment to nursing professionalism, teamwork and superiority in patient care. The ANCC’s Magnet Recognition Program® is the highest national honor for nursing excellence and distinguishes organizations that meet rigorous standards for delivery of care.

Considered the gold standard, Magnet recognition is granted only to hospitals with exemplary patient outcomes and satisfaction, with strong nurse-patient ratios, and that attract and retain the best clinicians from all disciplines.

GMH joins Greer Memorial Hospital, which received Magnet recognition in 2016. To date, only 8 percent of healthcare organizations in the nation hold this prestigious designation! These achievements affirm GHS’ founding mission to raise the standard of care for our community.

Another affirmation that we are raising the standard of care is GMH’s recent designation as a Comprehensive Stroke Center by The Joint Commission. In this issue of Inside Health, you’ll read about how our quality of stroke care meant a full recovery for one local high school principal.

You’ll also meet Nestor Cordero and his family, featured on the cover. When cancer hits, it ripples out to affect everyone in the patient’s circle. That’s why our Adolescent and Young Adult Oncology Program, created to help those age 15-39 with cancer, addresses the needs of family members as well as those of the patient.

And we’ll introduce you to a new pair of GHS specialists finding fertile ground in working together to help couples conceive. Young parents themselves, they are passionate and compassionate about what they do.

You’ll see other areas in which we’re raising the standard of care through the certifications, recognitions and awards found in the “What’s Right in Health Care” pages that follow. The last message of that section remains constant in every issue— Our first priority: taking care of patients and their families. That goal is ever before us.

We would be honored to care for you and your family. Please call on us if we may be of service.

Spence M. Taylor, MD President

1 Inside Health

SPOTLIGHT

Off to a Great Start

The Family Birthplace–Patewood offers moms-to-be a special delivery experience.

Since last fall, women with low-risk pregnancies have been delivering at the new birth center in Patewood Memorial Hospital, conveniently located on a quiet campus in the heart of Greenville’s Eastside. Many of these women otherwise would have delivered at Greenville Memorial Hospital (GMH), the bustling downtown regional referral center of Greenville Health System (GHS).

The Family Birthplace–Patewood offers a homelike environment. Large windows provide ample natural light, and each bathroom has a spacious shower with a bench, big sink with glass tile backsplash and mirror. Each labor and delivery room has a tub should a woman desire water therapy during labor.

While well-designed rooms and a peaceful setting are valuable, the quality of care women receive has not been compromised. “We’re maintaining the same standard of care that we deliver at GMH,” said Mary Beck, MD, lead physician at GHS’ Piedmont OB/GYN practice.

Even though Patewood doesn’t have a neonatal intensive care unit (NICU), pediatric hospitalists with specialized training in neonatology and newborn care are in-house around the clock. “We do our best to predict when a mother is going to have risk associated with her delivery, but we can’t always be sure,” explained Rebecca Wright, MD, medical director of Newborn Services at Patewood. “Our hospitalists spend several intensive weeks at GMH learning newborn care specifically, spending time with the Bryan NICU delivery team, attending deliveries of infants at all risk levels. They’ll continue to rotate through with the NICU delivery team during their time at Patewood to keep up that skill set.”

In addition, Patewood participates in Delivery Buddy, GHS Children’s Hospital’s telehealth program that brings the expertise of neonatal nurse practitioners into the labor and delivery suite via secure video when needed. This program helps the nurse quickly determine whether the baby needs to be transported to GMH. Patewood staff members prioritize keeping a calm environment for every mom, baby and family. “We limit interruptions, so moms can recover after giving birth,” Dr. Wright noted. “We bundle interactions in single visits, rather than interrupting for tests.”

Future plans include concierge services to further individualize each woman’s birth experience. Patewood intends to offer special packages such as food delivery service for a special meal for mom and dad, or a spa-type package where the mom is pampered with fresh flowers, magazines and a plush keepsake robe. Also incorporated into each woman’s prenatal care will be parts of the birth plan that relate to the baby’s care, as these decisions often are not given much thought during the prenatal period.

The two GHS practices whose low-risk patients deliver at Patewood are Greenville Ob/Gyn Associates and Piedmont OB/GYN. Joining them is Highlands Center for Women.

“The facility is lovely,” Dr. Wright summarized. “It’s a peaceful campus, and the offerings present a good hybrid between the minimal intervention that families are moving toward, but also the safety and evidence-based care of a hospital.”

Inside Health 2

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.

745

Babies born at Greer Memorial Hospital in 2017.

Greer has been named a babyfriendly birthing facility by BabyFriendly USA, joining an elite list of U.S. hospitals earning this designation.

The Baby-Friendly Hospital Initiative recognizes facilities that encourage and support breastfeeding. Greer joins GHS’ Greenville Memorial Hospital and Oconee Memorial Hospital in earning Baby-Friendly designation.

1,200

4

Number of facility dogs in the Canine F.E.T.C.H. (Friends Encouraging Therapeutic Coping and Healing) Unit. Kalle, Vivi, Kenzie and King, part of the animal-assisted therapy program for patients and families of GHS Children’s Hospital, bring special skills in cuddling, comforting and caring.

Follow them on Instagram: thecaninefetchunit

Patients projected to be served in 2018 by expanding Vascular Lab services at Laurens County Memorial Hospital (LCMH). LCMH houses the lab within the Department of Radiology. The new home lets patients get other diagnostic tests on the same day as vascular studies without traveling to multiple sites. This lab is accredited by the Intersocietal Accreditation Commission, signifying it provides high-quality, standardized care.

3 Inside Health

5%

Patewood Memorial Hospital has sustained performance in this top group of Press Ganey clients, for which it was named a Press Ganey 2017 Guardian of Excellence Award™ winner in Patient Experience.

$250,000

Donation from Clement’s Kindness Fund for Children to help build a children’s garden in honor of William Schmidt III, MD, PhD, for his many contributions to the care of children with cancer. Dr. Schmidt is VP of development for the GHS Health Sciences Center and former medical director of GHS Children’s Hospital.

1,000

Milestone number of stem cell transplants GHS Cancer Institute reached last fall. The Blood and Marrow Transplant program— one of just two statewide—is accredited by the Foundation for the Accreditation of Cellular Therapy. It is the only one in the Upstate accredited for both autologous (self) and allogeneic (non-self) transplants.

30+

Exercises in GHS’ MoveWell fitness program. To view them, visit our YouTube playlist. Create a workout of your own!

4

GHS hospitals that earned “Certified Zero Harm Awards” from the S.C. Hospital Association for excellent work in preventing hospital-acquired infections: Greenville Memorial, Greer Memorial, Hillcrest Memorial and Laurens County Memorial.

1

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

Inside Health 4

With his cancer in remission, Nestor Cordero and his family enjoy an outing at Spill the Beans in downtown Greenville.

5 Inside Health

GHS Answers When Cancer Hits Young Adults For patients age 15-39, the Adolescent & Young Adult Oncology Program, part of the Cancer Institute of Greenville Health System (GHS), provides support for medical—and non-medical—challenges.

By Anne Smith

F

or many, young adulthood is a time to finish studies, launch a career or start a family; cancer isn’t something they expect to encounter. In the U.S., however, over 70,000 people age 15-39 receive a cancer diagnosis annually.

Troublingly, these patients lag behind other age groups in successful outcomes. This population is underrepresented in clinical research and has distinct biologic and psychosocial needs that require specialized care.

To address these issues, GHS Cancer Institute launched an Adolescent & Young Adult (AYA) Oncology Program in 2016. The program brings together specialized care providers from both the pediatric and adult worlds. And while it’s not a patient’s primary source for treatment decisions, the program’s doctors and caregivers believe they can help improve outcomes among patients in this age group.

but we do meet needs, add a voice, and give information and insight to our patients.”

Psychosocial Supportive Care Dr. Cull explained that the program serves as an additional layer of care, often providing assistance for non-medical needs—which can loom large—in this age group.

“I’d describe our program as a psychosocial supportive care clinic,” she noted. “Patients who see us may not seem to have these needs at first, but if we spend an hour with them, a lot comes out. Can they make it to their appointments?

Can they afford their medicine? From a medical perspective, accessibility and compliance are crucial.”

While in the program, patients continue to be cared for by their primary oncologist. But the program’s co-directors— pediatric hematologist/oncologist Aniket Saha, MD, and adult hematologist/oncologist Elizabeth Cull, MD—aim to see every GHS patient in that age group diagnosed with cancer.

Dr. Cull recalled that during the first appointment a patient reported being charged a full semester’s college tuition when the cancer diagnosis had forced that person to leave school after just one week; AYA staff helped pursue reimbursement.

For other patients, the program handles aspects as varied as transportation, cancer genetics referrals, and fertility preservation and sexuality.

“Once a patient has received a diagnosis, he or she is referred to us,” Dr. Saha said. “We don’t make treatment decisions,

The AYA Oncology Program team brings together a handful of disciplines to effectively meet needs. That team includes

Inside Health 6

(l-r) Pediatric social worker Kerri Susko, adult oncologist Dr. Elizabeth Cull, pediatric social worker Amy Bowers, and pediatric oncologist Dr. Anket Saha discuss a patient in the AYA program.

pediatric social worker Amy Bowers, adult social worker and counselor Kerri Susko, and nurse practitioner Heather Bowers.

Other tools include support groups, social media outreach, cancer-focused counselors and social outings such as AYA nights with the Greenville Drive. For patient Nestor Cordero, a 31-year-old father of four, these aspects have made his diagnosis far more manageable.

“Dr. Saha reassured me from the start that we were going to be okay,” Cordero remembered. “The team walked us through each step and had activities that helped us talk about what we were experiencing. Our boys look forward to AYA events around town; it is good for us to see other families who know what we are dealing with.”

Dr. Cull agreed: “We hear daily that patients felt alone and disconnected until they found us; our team is able to fill in the gaps.” She said the AYA cancer population has historically not enjoyed the benefit of the abundance of resources, clinical trials and philanthropy dollars dedicated to pediatric cancer programs, but these patients—in the midst of their own transitions to adulthood—need at least as much support as younger children.

7 Inside Health

“The AYA population can feel like something of a lost group,” Dr. Cull pointed out. “They receive less attention, funding and support; but if anything, they need more support than anyone to juggle new financial responsibilities and growing families.”

Cordero is grateful for the support his family has received.

“We feel taken care of—that the clinic can help us no matter what we need,” he offered. “It has played a great support role in our journey.”

Patients who experience social and emotional support are likely to have better medical outcomes. Dr. Cull added, “If their psychosocial needs are not being met, they may not fare as well, so I see our role and the primary oncologist’s role as approaching this issue from two sides.”

No Need to Start from Scratch In its first year, the program saw 65 patients. It was less of a launch of a new program, Dr. Saha noted, than an adaptation of many offerings already available at GHS, made possible by visionary leaders such as William F. Schmidt III, MD, PhD, then-medical director of GHS Children’s Hospital, and Larry Gluck, MD, medical director of the Cancer Institute.

“We didn’t need to start from scratch; we just adapted GHS’ many offerings, honing them more toward AYA patients,” he stated.

Dr. Cull said the program’s multidisciplinary nature aims to help make a challenging time easier: “So much already was in place—nutrition, genetics, reproductive endocrinology—and we can support and complement what our colleagues are doing.”

Another benefit is access to both pediatric and adult cancer specialists and social workers. “The AYA program allows for a seamless transition,” emphasized Dr. Saha. “Pediatric patients benefit, for example, from the fertility issues and genetic components we address, and adults who may have pediatric tumors are able to access specialists from both sides.”

Pediatric tumors also can be seen beyond the window of childhood. Dr. Saha remembered a young adult diagnosed with an embryonal rhabdomyosarcoma, something almost exclusively seen in small children. Pediatric oncologists, he noted, have far more experience caring for such patients, using a specific combination of chemotherapy.

“Through the AYA program, we connected that patient with pediatric specialists who were able to address the issues seamlessly,” Dr. Cull recounted.

Unmatched Access to Clinical Trials GHS is the only upstate facility, and one of just three in South Carolina, to be a Children’s Oncology Group research base of a National Cancer Institute Community Oncology Research Program. This designation gives GHS patients, particularly those within the AYA cancer program, access to front-line treatment trials led by the world’s oncology experts.

“We try to educate our patients about the importance and value of clinical trials, screening AYA patients weekly for supportive care or treatment trials that could benefit them, in an effort to increase enrollment and give them access to new and novel therapies,” Dr. Cull explained.

“We feel taken care of—that the clinic can help us no matter what we need. It has played a great support role in our journey.”

– Nestor Cordero

Some trials—even though they are through the Children’s Oncology Group—accept patients up to age 50, pointed out Dr. Saha, so they still can benefit those who fall outside the pediatric age range.

“We’re setting up patients to have the best possible outcomes,” Dr. Saha reported. “Referring physicians can know they have sent their patients to the best place in the region for this kind of care.”

“Coming here,” Cordero summed up, “is about more than just treating my cancer. It’s about me.”

For more information, call (864) 454-AYAC (2922) or visit ghs.org/canceraya.

Inside Health 8

Michael Thorne and wife Cindy Cambron are grateful for the advanced care he received at GHS’ Cerebrovascular & Stroke Center, which restored him to full health after a serious stroke.

Striking Out Stroke

M

Greenville Memorial Hospital is first in the Upstate to be designated a Comprehensive Stroke Center.

Thorne recalled that he didn’t feel ill, but the next thing he remembered was an EMT (emergency medical technician) saying, “Mr. Thorne, you’re having a stroke and we’re transporting you.” Thorne later woke up in the intensive care unit (ICU) at Greenville Memorial Hospital (GMH).

By Robin Halcomb

ichael Thorne, 61-year-old principal at Greenville’s Eastside High School, was taking a student to class last October when the plant manager looked at Thorne’s drooping face and said, “Mike, I think you’re having a stroke.”

Thorne’s wife, Cindy Cambron, an attorney at GMH, was in a staff meeting when the call came. “I was scared to death,” she remembered. “I didn’t know if he would be alive when he got here.”

Following the 9-1-1 call, GMH activated a stroke alert, one of several that day. The alert assembles the stroke team, who are prepared to start an evaluation, including CT scans, as soon as the patient arrives. The first CT scan identifies what type of stroke is involved, which dictates the treatment plan.

If no evidence of bleeding exists but symptoms look strokerelated, the safety of administering the clot-busting drug alteplase is evaluated. Another CT (computed tomography) scan is performed if severe symptoms suggest large-vessel blockage to evaluate whether removing the clot via a thrombectomy would benefit the patient. A thrombectomy uses a catheter and a stent to remove clots from a blood vessel.

As Cambron waited for news, Mahmoud Rayes, MD, interventional neurologist and medical director of the Cerebrovascular & Stroke Center at GMH, came to tell her that her husband had a clot in his brain and had scored well below the range usually considered a candidate for a thrombectomy. Even so, the thrombectomy offered a greater chance of a positive outcome. (Meanwhile, Thorne had been started on alteplase.)

Sharon Webb, MD, Cerebrovascular & Stroke Center surgical director, and Mahmoud Rayes, MD, the center’s medical director, confer about a patient.

Their combined expertise was integral to GMH receiving certification as a Comprehensive Stroke Center.

After a quick discussion of the risks involved, Cambron made the decision to go ahead with the procedure, and Dr. Rayes Inside Health 10

“As a neuro nurse for 20 years, I’m so amazed to see patients I thought would not be able to live alone again be able to walk out the door on their way home a few days later.”

– Shannon Sternberg, MSN, MBA, RN, CNRN, SCRN, GHS Cerebrovascular & Stroke Center Manager

(l-r) Kayla King, RT (R); Melissa Mull, NP; and Dr. Mahmond Rayes begin a procedure to remove a blood clot.

11 Inside Health

hurried to the angioplasty suite. About an hour later, Dr. Rayes reappeared, smiling, and told Cambron, “Come see your husband.”

When she entered the room, Thorne raised his left leg and arm and talked to her. “During that hour of waiting, I had wondered how I was going to tell our kids that their dad died,” said Cambron. “Now, you’d never know he had a stroke.”

She continued, “With the addition of Dr. Sharon Webb in 2014, we could provide endovascular treatment to people suffering from ischemic stroke and other cerebrovascular diseases. Then, when Dr. Rayes came on board the next year, we could offer around-the-clock coverage. All the pieces came together, and, in 2017, we fully met the criteria to be certified as a Comprehensive Stroke Center.”

“Thorne’s case was remarkable,” recounted Shannon Sternberg, MSN, MBA, RN, CNRN, SCRN, Cerebrovascular & Stroke Center manager at GMH. “His stroke scale was 18 out of a total of 42. Usually, people with that much neurologic deficit are permanently disabled.”

CSC certification includes all components of a PSC and adds advanced imaging techniques; personnel trained in vascular neurology, neurosurgery and endovascular procedures; around-the-clock availability of personnel and resources; neuro ICU facilities; and experience and expertise in treating complex strokes.

Dr. Rayes stresses the importance of quick evaluation and treatment after the onset of stroke symptoms: “Early detection and early treatment cannot be overstated,” he stated. “People think it can get better if they don’t do anything about it or that they’re too young to have a stroke. But we can better help these patients if they call 9-1-1 right away, as was the case with Mr. Thorne.”

GMH has made a significant investment in diverse resources, including highly specialized physicians, nurses and therapists; advanced imaging; and imaging staff. A dedicated neurologic ICU opened in January 2016. A neuro nursing unit allows patient monitoring so that only severe cases need be put in the neuro ICU. A stroke research center also has grown out of GMH’s experience.

Stepping Up to the Plate for Complex Cases

Hitting a Home Run

Thorne benefited from the work GMH had been putting into ramping up stroke care to be designated a Comprehensive Stroke Center (CSC). GMH achieved that designation—the highest level of stroke certification available—in December.

The designation is earned by hospitals that meet stringent standards to treat the most complex stroke cases.

Sternberg is seeing positive patient outcomes from GMH’s investment in complex stroke cases. “As a neuro nurse for 20 years, I’m so amazed to see patients I thought would not be able to live alone again be able to walk out the door on their way home a few days later,” she pointed out.

GMH is one of only 200 hospitals in the United States that has or is expected to meet CSC certification in the next few years.

GMH sees about 1,200 stroke events annually. Because of the high volume and its location in the “stroke belt,” the hospital sought and received Primary Stroke Center (PSC) designation in 2009. When studies in 2015 showed catheter treatment also could benefit patients with severe strokes, GMH began thinking about where the most complex cases should receive care and what would be needed to treat them.

“We have an at-risk population, so we know strokes are going to happen,” said Sternberg. “We want to make sure we are prepared for those patients.”

Thorne and Cambron are beyond thankful for the care they received. “Michael’s experience from the stroke being first detected by one of his employees, to EMS, to the Emergency Department, to Dr. Rayes and the amazing stroke team, to ICU, Neuro floor, and rehab, was better than we could have hoped for,” emphasized Cambron. “If we didn’t have GMH’s people and technology, we would have had to travel to another state. I can’t imagine that stress on top of the stress of the event.”

The couple was overwhelmed by the outpouring of support from students and faculty at Eastside, other district schools and the community. “It’s great to be an Eastside Eagle,” noted Thorne, who is known as the Big Eagle. “I lost a tail feather, but I made it back.”

Learn the signs of and risk factors for stroke and find more information about GHS’ Cerebrovascular & Stroke Center.

Inside Health 12

3D rendering of IVF (in vitro fertilization)

It Takes Two Two GHS doctors team up to address both sides of infertility.

By Leigh Savage

W

hen a couple is struggling with fertility, medical interventions often are focused on the female partner. But a new partnership between Blake Wynia, MD, MPH, of GHS Department of Surgery–Urology and Lisa Green, MD, at GHS’ Fertility Center of the Carolinas is creating a more comprehensive approach that may help couples achieve their family dreams sooner.

About half of infertility issues stem from the female partner, while a male issue is the cause in 30 percent of cases. In 20 percent of cases, both partners have a contributing factor.

“It’s understandable why, historically, the emphasis has been on the female aspect, considering women carry the baby,” Dr. Wynia said. “But we feel that focusing on the couple as a whole helps us comprehensively identify issues that are potentially correctable.”

According to Dr. Green, when she and Dr. Wynia both began working at GHS in September 2017, they quickly realized that they had a common interest in collaborating to improve patient care.

13 Inside Health

“A lot of people don’t realize,” Dr. Wynia noted, “that around 50 percent of couples do have some form of male factor involved, and male infertility has been an underserved need.”

“Since orientation, we started this collaborative relationship,” she explained. “His male reproductive clinic is right across the street, so we’ve been solidifying the relationship to create a one-stop shop.”

She says fertility issues have a unique dynamic, with a couple as the patient instead of one person. “You don’t have an infertile male or female, but an infertile couple,” she observed. Being able to address female and male issues “makes us a strong, fully functioning reproduction center.”

To the best of their knowledge, they are the only upstate team offering this full gamut of reproductive health care working in close collaboration. While GHS has long been known for its robust reproductive endocrinology group (the female side), there have been only a few doctors specializing in male infertility, and none in close coordination with the fertility center.

Now, when new patients call with infertility issues, appointments are scheduled for both partners in both Drs. Wynia’s and Green’s offices. The doctors ask that both partners attend all appointments, though Dr. Green focuses more on the female and Dr. Wynia the male. “I’m mostly interviewing the male partner, though the female partner can fill in the gaps,” Dr. Wynia said.

A Powerful Collaboration Dr. Green graduated from the University of Maryland School of Medicine before completing her residency at Howard University Hospital and her fellowship at the University of Michigan Health System in Ann Arbor. She chose to pursue reproductive endocrinology because it offered her a chance to focus on science, clinical care and surgery. “I found out I wanted to do all of those things,” she recounted. “I love the field.”

She appreciates the challenge of helping patients who may have hormonal issues or rare disorders, and using leadingedge science and research to solve the problem.

“It’s so rewarding,” she said, “to help a couple who want to build their family and help them achieve their dreams.”

Dr. Green was drawn to the Upstate because she loves the culture, food and weather, and has family in the South. “I love our center’s approach to care,” she commented. “We place the patient at the center of what we do, and we focus on helping them meet their goals and build their family.”

Dr. Wynia graduated from the University of North Carolina at Chapel Hill School of Medicine, completed his residency in urology at New York University and then did further training with a fellowship in andrology, or male infertility and sexual dysfunction, at Albany Medical College.

He was drawn to the field because it makes such a difference in people’s lives. “Some people have been told they might not have a chance to have a genetically related child, and they’ve been trying for quite a while and are frustrated,” he explained.

“It’s really satisfying to offer couples some sort of hope, and some sort of treatment that will increase their success and make a big difference in their lives.”

Now that he and his wife have a 16-month-old son, he has a more vivid understanding of what couples are hoping to achieve. “Having a child is not like anything else,” he asserted.

After attending school and training in New York, Dr. Wynia was excited to return south, as he is from North Carolina and his wife is from Columbia and attended Clemson University.

“We identified Greenville early on as a desirable location, and GHS seemed like such a great organization that was going to be really supportive of everything I wanted to do,” he commented. “They have been ambitious in extending the scope of infertility services for the entire Upstate.”

Finding Answers Numerous factors contribute to infertility on both the male and female side, and recommendations and solutions for couples vary widely. Dr. Wynia said he takes a holistic view of the male partner, who may need to consider overall health and address diet, smoking or drinking. “All kinds of things affect fertility and the quality of sperm,” he said. “Sometimes it’s easily correctable if someone is drinking quite a bit and not exercising.”

Issues that aren’t lifestyle related often can be corrected via surgery. Options include microscopic testicular sperm

Inside Health 14

Lisa Green, MD, and Blake Wynia, MD, MPH, are committed to helping couples overcome fertility issues.

extraction and microscopic varicocelectomy, or the repair of varicose veins in the scrotum. Dr. Wynia is the first in the Upstate to offer the microscopic technique, which improves sperm quality. He also offers vasectomy reversals that can be done robotically, which improves accuracy.

On Dr. Green’s side, women also may have lifestyle factors, or they may need to address any number of issues, such as Turner syndrome or premature ovarian insufficiency. Focusing on the full scope of endocrinology—the endocrine glands (pituitary, pineal, thyroid, adrenal and others) as well as hormones—is the best approach to address infertility. “They go hand in hand,” she noted.

Medications or surgical procedures can solve the problem.

Options include intrauterine insemination, ovulation induction, intracytoplastmic sperm injection and in vitro fertilization.

The key is using both doctors’ skills, knowledge and training to help patients on the complex journey to parenthood.

“A lot of couples feel alone, and it’s very isolating,” Dr. Green said. “But 15 percent of couples have an infertility diagnosis.”

15 Inside Health

She said the media are telling more stories now about infertility after spending years focusing on avoiding unwanted pregnancies. While that’s an important message, it ignores the many people who may try for years with no success.

“We believe that everyone who wants a child should be able to have one,” Dr. Green emphasized. “That hope should be a reality for everyone.”

With the power of both doctors and their teams focusing on every aspect of infertility, Green and Wynia say the chances for success are excellent.

“Whether to improve male or female fertility, we look at all of the options available,” Dr. Wynia said. “And we can help the majority of patients achieve their dream.”

Q & A

Your Medical Records—and More—at Your Fingertips

Play an active role in your health care with MyChart.

What is MyChart?

MyChart is a free, secure online portal where you can view parts of your medical record, communicate with your care team and more. Use it at your convenience—any time of day or night.

What GHS practices offer MyChart?

All primary care (“main”) doctors and specialists have MyChart at GHS.

What are some MyChart features?

With MyChart, you can check upcoming appointments or visit summaries, view lab and test results, and check health history records. You can send messages to and receive them from your healthcare provider, including nonurgent medical questions. You also can complete questionnaires online to save time at the doctor’s office.

With all primary care practices, you can request appointments through MyChart.

By 2019, all GHS primary care practices will be able to schedule appointments through MyChart as well (more are phased in each month). Currently, you can use MyChart to schedule mammograms at any GHS facility.

What about prescription refills?

MyChart is a great way to request refills.

And MyChart keeps a registry of all your medications.

Can I pay bills through MyChart?

Yes. You can view your billing account summary and make a payment online.

How do I sign up for MyChart?

How secure is MyChart?

You can sign up at a GHS practice or anytime you are receiving services at GHS, including admissions, outpatient surgeries/procedures and tests. You also can use an activation code from your after-visit summary or billing statement, or request an account online at mychart.ghs.org. To access MyChart on the go, download the free app to your mobile device.

MyChart takes great care to ensure that your health information is kept private and secure. Access to information is controlled through secure activation codes, personal usernames and passwords. You control your password, and your account cannot be accessed without that password. Further, MyChart uses the latest 128-bit SSL encryption technology with no caching to automatically encrypt your session with MyChart. Unlike conventional email, all MyChart messaging is done while you are securely logged on to the website.

Can my minor child have a MyChart account?

Yes, it’s called a proxy account, and you can access it through your own. Use it to keep track of your child’s health information.

A proxy account also can help with monitoring the health information of an aging parent. In any case where you’re seeking to access the MyChart account of another adult, that person’s permission is required.

Mark L. Wess, MD

GHS Chief Medical Information Officer

Ask about arranging proxy access at the patient’s office visit, and his or her healthcare team can assist you.

Inside Health 16

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 Advisers 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) 522-4255 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 those 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) 522-4255 or jcaldwell@ghs.org.

Pregnant Women This study will screen and identify women who have a primary maternal cytomegalovirus (CMV) infection by testing their blood. CMV is a common virus spread like a cold or flu virus.

Approximately 1 percent of women will become infected with CMV for the first time while pregnant. If this happens, there is a 40 percent chance that the fetus also will become infected.

Fetuses infected with CMV are more likely to be born earlier than expected, have low birth weight or small heads.

A small number will develop problems like hearing loss or learning difficulty or, rarely, the baby may die.

The study’s purpose is to see if giving CMV antibodies (substances that target and help the immune system destroy the CMV) to pregnant women infected with CMV for the first time will result in fewer fetuses being infected with CMV. Contact Anthony, (864) 455-1295 or afaso@ghs.org.

Women with Endometriosis This study concerns the safety and effectiveness of a new investigational medication for treating moderate to severe pain associated with endometriosis. To qualify, participants must be age 18-49, have endometriosis diagnosed through surgery within the last 10 years, experience moderate to severe menstrual and non-menstrual pelvic pain, have regular menstrual cycles, and use only pain medication permitted by the study protocol.

Participants must not have undiagnosed abnormal uterine bleeding, chronic pelvic pain not caused by endometriosis, any chronic pain syndrome (fibromyalgia, back pain, irritable bowel syndrome, chronic headaches that require chronic analgesic therapy), major depressive disorder (bipolar disorder or post-traumatic stress disorder), history of drug or alcohol abuse within one year, and uncontrolled diabetes or high blood pressure. Please call Cheryl, (864) 455-5951.

Adults with Nonalcoholic Fatty Liver Disease (NAFLD) These studies evaluate the effect of novel medications for the advanced form of NAFLD called NASH. You may have NASH if you have a fatty liver and elevated liver enzymes with any of the following: hypertension, diabetes, high cholesterol or cirrhosis. Studies last one to seven years. Study drugs, lab tests, X-rays, etc., are free. Participants receive a small stipend. Contact Donna, dwest3@ghs.org or (864) 455-2846, or Alicia, Ajones1df23@ghs.org or (864) 455-2043.

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. Â

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 (age 1-45), and cousins, nieces, nephews, aunts, uncles and grandchildren (age 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.

To learn more, visit ghs.org/research.

Inside Health 18

PRACTICE PROFILE

GHS Family & Internal Medicine–Boiling Springs

A new practice housed in a new building, GHS Family & Internal Medicine–Boiling Springs offers a new approach to the care of patients. Its providers, with board certifications in pediatrics, internal medicine and family medicine, bring complementary training and outlooks to the team, enhancing patient care.

“It’s exciting to be part of a new, growing practice,” said Katie Spinks, MD, “and a group of caring providers.”

“We seek to care for our patients, from newborns to elders, by addressing both their acute and chronic illness while helping them seek wellness through prevention,” Dr. Spinks emphasized.

Family & Internal Medicine–Boiling Springs is a patientcentered medical home. “We respond to the needs of the patient—the whole patient,” noted Dr. Spinks, “while practicing evidence-based medicine.”

The practice offers extended hours (7 a.m.-7 p.m.) three days a week. Another convenience factor is its location in Boiling Springs Medical Center, which also is home to services such as pharmacy, lab, X-ray, gastroenterology, pain management, behavioral health and after-hours care through MD360®, a convenient care facility open seven days a week.

“The best part of my job is partnering with my patients for their health and well-being,” Dr. Spinks asserted. “Whether it is treating strep throat or working with patients to achieve their weight-loss goals, seeing patients become healthier and happier is most rewarding.”

19 Inside Health

(l-r) Katherine Spinks, MD; Gertrude Cotiaux, MD; Erica Gardner, NP; and Edward Mea, DO, each bring complementary training to their team, enhancing patient care.

For an appointment, please call (864) 599-0731 or request an appointment online at ghs.org/boilingsprings.

Providers Gertrude P. Cotiaux, MD Edward J. Mea, DO Katherine M. Spinks, MD Erica L. Gardner, NP Hours Mon., Wed. & Fri., 7 a.m.-7 p.m.

Tues. & Thurs., 8 a.m.-5 p.m.

GHS Family & Internal Medicine–Boiling Springs 2400 Boiling Springs Road Spartanburg, SC 29316 599-0731, option 2 • ghs.org/boilingsprings

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 450 Old Greenville Hwy., 29631 653-8964 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 Mountain Lakes Community Care (Convenient Care) 100 Omni Dr., Ste. B, 29672 885-7425 Mountain Lakes Family Medicine 10110 Clemson Blvd., 29672 482-3148 Dr. Timothy Sanders Family Medicine 100 Omni Dr., Ste. A, 29672 885-7520

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 Pediatric Associates–Simpsonville 1409 W. Georgia Rd., Ste. A, 29680 454-5062 Simpsonville Family Medicine 1336 Hwy. 14, 29681 522-4700

SPARTANBURG 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 TAYLORS Palmetto Family Medicine 3551 A Rutherford Road, 29687 522-4750 TRAVELERS REST The Children’s Clinic* 415 Duncan Chapel Rd., 29617 522-2600 Travelers Rest Family Medicine* 9 McElhaney Rd., 29690 WALHALLA GHS Family Medicine–Walhalla 103 Whitetail Drive, 29691 638-3444

*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

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—16,000 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

Call

Art Direction GHS Creative Services Contributing Photographers Alan Francis David Pence George Reynolds

To find a new healthcare provider: 1-844-GHS-DOCS (447-3627)

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

ghs.org

© 2018 Greenville Health System 18-0167 4/18

GMH Nurses Achieve Gold Standard: Magnet® Recognition Greenville Memorial Hospital (GMH) of Greenville Health System has been granted Magnet recognition by the American Nurses Credentialing Center (ANCC), reflecting a commitment to nursing professionalism, teamwork and superiority in patient care. The ANCC’s Magnet Recognition Program® is the highest national honor for nursing excellence and distinguishes organizations that meet rigorous standards for delivery of care.

“Magnet designation is the outcome of a commitment to quality and excellence, providing the best care possible for each patient and family we serve,” said Lori Knarr-Stanley, DNP, MS, RN, NEA-BC, GMH chief nursing officer. “We now are among the elite group of hospitals that are Magnet designated, and I am grateful to the clinical nurses and nurse leaders whose relentless pursuit of excellence is apparent every day.”

Research demonstrates that Magnet recognition provides specific benefits to healthcare organizations and their patients, including higher patient satisfaction with nurse communication, lower risk of 30-day mortality, lower fail-torescue rates and higher job satisfaction among nurses.

Beyond words: GMH nurses celebrate receiving Magnet recognition.

Just 471 out of over 6,300 U.S. hospitals have achieved Magnet recognition, placing GMH on an elite list of top nursing hospitals!

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.