June-July 2022 Memphis Medical News

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FOCUS TOPICS MEN’S HEALTH • PAIN MANAGEMENT

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Easing the Toll of PTSD for Military Veterans

Only 10 VA facilities offer the game changing SGB procedure By LYNNE JETER

An intricate shot in the neck has proven to be a much needed “reset” for military veterans suffering from the debilitating symptoms of post-traumatic stress disorder (PTSD). Veterans who have received the treatment – Stellate Ganglion Block (SGB) – call it “a godsend,” “a gamechanger,” with one confessing after learning about the procedure: “I’m bawling. Hope came back.” Another confessed: “I had nothing to lose” by trying it. Used for decades to treat chronic pain, SGB has only recently been tried for PTSD on veterans. Popularity of the treatment gained ground after the VA realized its impact on countering suicide, which affects roughly 20 veterans a day and has become “an epidemic.” However, only 10 VA clinics across the U.S. offer the breakthrough procedure that has a Stellate Institute published success rate of 85 percent. “This treatment’s moving at a snail’s pace,” said Lance Price, a veteran, and director of the Florida chapter For the Love of a Veteran, Inc. “The why is somewhat unclear but if we had to guess, it would be because SGB isn’t

Restoring Function and Confidence Conrad/Pearson’s Dr. Michael Granieri finds fulfillment in making a meaningful difference.

Following his first year of medical school at Northwestern University, Dr. Michael Granieri became the first student to participate in the urology department’s medical mission trips to Mexico and Central America. He worked with faculty members like Dr. Christopher Gonzalez, who would become his mentor, and several urology residents. The team provided underserved communities in rural Mexico with treatment of genitourinary diseases, seeing as many as 50 patients in a weekend. “It was just a great experience, and it really solidified my interest in urology,” said Granieri, a Urologist at The Conrad/ Pearson Clinic.

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Lance Price

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Leading Pain Management Specialist Advocates for Controlled Use of Medical Cannabis to Ease Patient Suffering By JAMES DOWD

Growing up in Memphis in the 1960s and 1970s, Dr. Autry Parker developed a keen sense of personal discipline and enthusiastically focused on his academic and musical studies, while some of his peers did not. The future anesthesiologist remembered that, although he took note of how some classmates and acquaintances experimented with various substances, his interest was clinical rather than personal.

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Autry Parker

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WEST CANCER CENTER - 1ST IN THE REGION TO OFFER NEW PROSTATE CANCER IMAGING About 1 in every 8 men will be diagnosed with prostate cancer during his lifetime. The American Cancer Society estimates the disease will cause about 34,500 deaths in 2022 across the United States. At West, detection and staging has expanded beyond conventional means with a new, FDA-approved radiopharmaceutical called PSMA for PET/CT scans that offers a much wider indication for all stages of prostate cancer and has fewer payer restrictions. Now available for annual prostate screenings and outside physician referrals.

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PHYSICIAN SPOTLIGHT

Restoring Function and Confidence Conrad/Pearson’s Dr. Michael Granieri finds fulfillment in making a meaningful difference. By LAWRENCE BUSER Following his first year of medical school at Northwestern University, Dr. Michael Granieri became the first student to participate in the urology department’s medical mission trips to Mexico and Central America. He worked with faculty members like Dr. Christopher Gonzalez, who would become his mentor, and several urology residents. The team provided underserved communities in rural Mexico with treatment of genitourinary diseases, seeing as many as 50 patients in a weekend. “It was just a great experience, and it really solidified my interest in urology,” said Granieri, a Urologist at The Conrad/Pearson Clinic. “Ultimately through that experience I gained more exposure to urology and saw the different ways to improve someone’s quality of life and to really make a meaningful difference in one’s life.” His practice focuses on men’s health, including erectile dysfunction, prosthetic surgery, male stress urinary incontinence, male infertility and reproductive surgery, and reconstructive urology. “Those are my niche areas,” Granieri said. “Erectile dysfunction (ED) is probably the most common condition I manage and treat. ED can happen at any age, but it becomes more common as we get older. Once we hit age 50, approximately half of all men have experienced some form of ED.” Age can be a factor in other men’s issues as well, depending on the diagnosis of the particular disease. “Peyronie’s disease occurs usually in patients in their middle age – the 40’s and 50’s and 60’s – but I can see patients younger and older with that as well,” he said. “Male stress urinary incontinence is something I typically see in patients after treatments for prostate cancer, particularly in older populations. Male infertility is more common in younger patients who are trying to conceive during their 20s, 30s and 40s.” A typical week for Granieri is split between the operating room and the clinic. He sees between 100 and 150 patients a week.

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Since some of these issues can be very private and personal, Granieri says it is important to make sure patients feel comfortable discussing their problems and what he can do to help them. For example, there are a number of treatment options for ED to help restore function. “First line therapy is lifestyle modifications - diet and exercise. Then you might look at oral options - pills like Viagra or Cialis. Beyond that there are options like urethral suppositories, a vacuumerection device, penile injections, penile implants and surgical correction.” Another option for ED, currently offered locally at Conrad/Pearson, is low intensity shock-wave therapy. “Shock-wave has been around for several years and among treatments for ED, it’s one of the newest,” said Granieri. “It’s not currently FDA approved, but it does have some promising results for the right patient. It’s a lowintensity shock wave therapy to the erectile tissue designed to improve blood flow to the erectile tissue. Usually you do weekly treatments – 30 minutes to an hour – for six weeks and then you assess the response to it. It’s still an evolving new therapy but with encouraging results. He says the advantages of shock-wave therapy are many. “Overall, it’s relatively low risk and for the right patient it can provide a meaningful response with minimal side effects,” Granieri added. “It can help improve the natural blood flow to the penis. So, for the appropriately selected patient it can be a great option.” He comes from a family of health-care providers, including a father who is a Chicago physician, a mother who is a nurse, and at least six other family members who are physicians, including his wife, Dr. Elizabeth Campbell Granieri, an endocrinologist and a native Memphian. They met at Duke University where she was doing a medicine residency and he was doing a residency in urology. Asked what advice he might have for today’s medical students,

Michael Granieri he says he would encourage them to follow their passions. “Choose a field you’ll be happy in and one that you can provide the best care to your patients,” Dr. Granieri says. “Within medicine there’s so much variety there’s always a good chance to find a field that’s really just right for you. Just work hard and always strive to do the right thing for your patients.” He chose urology as a means to make significant improvements in his patients’ quality of life. It’s a field with a bright future as well.

“We’ll always see ongoing advances in treatments for urologic cancers, particularly in immunotherapy and the genetics of genitourinary malignancies,” Granieri said, “However, I am confident there will be more advancements in treatments of ED and incontinence, so I think the future is bright and we’ll continue to see technologic advances in all areas of urology. “It’s important to keep up with the latest advancements to find the best way to help your patients.”

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Easing the Toll of PTSD for Military Veterans, continued from page 1 considered an established firstline treatment for PTSD at this time because the evidence is not conclusive.” The procedure is typically completed in the pain clinic of a VA facility and may require a referral from psychiatry. Because Florida doesn’t have a VA center for SGB treatment, For the Love of a Veteran refers veterans to Richard Gayle, MD, founder of Lake Nona Medical Arts, specializing in pain management and regenerative medicine. Also, four Stella Centers throughout Florida offer the treatment. Veterans who cannot find a venue or afford the treatment typically “continue to use standard care, which consists of mental health services and pharmacological therapy,” explained Gayle. Financially strapped veterans may receive assistance via For the Love of a Veteran, which covers the medical costs for SGB shots “because the VA is very limited and most insurance won’t cover this life changing procedure,” noted Price. “We also cover travel and lodging cost if needed.” Price, who received SGB treatment in October 2021, said “my flashbacks, night terrors, insomnia … have dramatically decreased. The SGB has given me a quality of life that I’ve not had since 2007.” Post-injection, Price slept “the longest … 15 hours. I woke up refreshed like a cloud had been lifted or I literally was rebooted. If nothing else, the SGB treatment has given me the opportunity to get closer to my friends and family without constantly thinking about the worst-case scenario.” Price hasn’t needed a second SGB shot, which many veterans do. SGB is not perceived as a miracle drug and may not work for all patients, many of whom may need multiple shots to receive continuing benefits. Shay Seaborne, CPTSD, has had five SGB procedures. “I find great relief with each,” he said. “Unfortunately, my trauma is severe and complex, so the relief only lasts a couple of weeks. But each (shot) builds on the last, so I hope this will help me reclaim my nervous system.”

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After years of continuous war, the number of veterans suffering from PTSD has reached an alltime high.

Otherwise, A Living Nightmare

During a recent Fourth of July celebration, a veteran’s mother heard “a big homemade boom go off.” Her son “jumped up and took off running like he had a 100pound backpack,” she said. “I found him in the house crouched down in a corner. He was back in war. I cried seeing my son in that place in his head. I can’t wait to see him with the shot.” After years of continuous war, the number of veterans suffering from PTSD has reached an alltime high. Sgt. First Class Jonathan Zehring, who spent 455 days as part of the American offensive in the Kunar province of eastern Afghanistan, was asked, as part of therapy, to share his worst combat memories on paper. “They wanted me to read it 20 times before I went to bed,” he told 60 Minutes. “And I did it one or two days (then) crinkled the piece of paper and threw it away. I’m like, ‘Why am I doing this? I watched people I know die.’ Like, that’s always gonna bother me.” Zehring saw zero improvement through talk therapy but was an improved man after SGB treatment. A similar situation was going on with Marine Sgt. Henry Coto, who spent months patrolling war-torn Iraqi towns, and selfmedicated post-military with alcohol and marijuana. He told 60 Minutes he’d tried a dozen medications that didn’t help. “I

thought if I kept going the way I was going, there’s only two ways that’s gonna end: dead or in jail.” After Coto received two SGB shots, his brother observed: “Dude, I don’t know what they did, but it’s amazing.” Coto couldn’t stop smiling. Sean Mulvaney, MD, who administers SGB treatment, said: “These people … wrote a blank check to their nation that included their life. As citizens, we need to help them when they come home, when they’re broken.”

More Research Needed

Researchers are toiling to pinpoint changes in the brain associated with PTSD. The newest theory is based on research that shows PTSD isn’t only psychological. Repeated exposure to bomb blasts and the protracted stress of hazardous re-deployments may cause physical changes to the brain, making it hyperactive, according to Michael Alkire, MD, general anesthesiologist at UCI Medical Center in California. He noted that post-treatment, four of five veterans reported relief from depression and suicidal thoughts. “There are very few things in medicine that work that quickly,” he marveled. Price pointed out “more conclusive studies need to be done to prove what this treatment is truly capable of doing.” He encourages veterans to “never stop fighting” for the life-changing treatment just as diligently as they never stopped defending the U.S.

“If one treatment doesn’t work, find another,” he urged. “The answers are out there for everyone to have a successful and fulfilling life. Never give up.”

VA Facilities Treating PTSD with SGB: ARKANSAS: • Central Arkansas Veterans Health Care System CALIFORNIA: • VA Long Beach Health Care System • Northern CA Health Care System GEORGIA: • Atlanta VA HealthCare System HAWAII: • VA Pacific Islands Health Care System INDIANA: • Northern Indiana Health Care System MARYLAND: • Maryland Health Care System MINNESOTA: • VA Minneapolis Health Care VIRGINIA: • VA Richmond Healthcare Center WEST VIRGINIA: • VA Martinsburg Health Care

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Leading Pain Management Specialist Advocates, continued from page 1 “I was never caught up in the whole reefer madness movement. It seemed stupid to me, and of course I saw people who smoked too much and weren’t much good for anything because it adversely affected them,” Parker said. “Science has proven that our brains are still developing during the teenage years and overuse of cannabis can have a detrimental effect on adolescents. That’s why we need to keep it away from kids, but the situation is quite different for adults who may benefit from medical cannabis to help ease suffering.” A former president of the Memphis Medical Society, Autry serves on the board of directors for the Tennessee Pain Society and the Tennessee Society of Interventional Pain. He is a board-certified, fellowship-trained anesthesiologist specializing in the interventional treatment of severe spinal and neuromuscular pain. He earned a bachelor’s degree in Zoology from Howard University, a Master of Public Health and a Doctor of Medicine from Yale University and completed his residency and fellowship at Johns Hopkins Hospital. Today, Parker serves as the director of interventional pain services at the Memphis VA Hospital. He is also an associate professor at the University of Tennessee Center of Health Sciences. As a leading pain management specialist and advocate for controlled usage of medical cannabis, Parker continues to observe and record how the substance affects the human body and how it may be used to benefit patients. And he agrees that strict safeguards must be in place to protect patients and prevent young people from experimenting with recreational usage. “It’s more important than ever before to keep this away from kids because Tetrahydrocannabinol (THC), which is the compound in cannabis that affects a user’s mental state, is more potent than ever. When I was growing up it may have been around 6 percent, but now it may be 30 percent or higher,” Parker said. “From a policy standpoint, we must proceed carefully and protect our young people while providing avenues for pain management. I believe both are doable.” Parker understands his perspective is controversial to many, although according to the National Conference of State Legislatures (NCSL) more than three dozen states – including the Tennessee border states of Alabama, Arkansas, memphismedicalnews

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Mississippi, Missouri and Virginia – regulate cannabis for medical use by patients who qualify for those programs. States such as Arkansas have already opened dispensaries that sell cannabis for medical use, whereas others like Mississippi are still in the stages of safety testing, registration and licensing. “Although more than 30 states have some form of legalized therapy, as a doctor working in a prohibition state, I’m required to walk a very delicate line with regard to educating patients about medical cannabis,” Parker said. “The U.S. doesn’t allow physicians to prescribe it, but in states where it is regulated, they can recommend its usage or indicate that a patient has a qualifying condition that will allow them to buy it.” According to the NCSL, Tennessee is one of 10 states that permit the use of ‘low THC, high cannabidiol (CBD) products for “medical reasons in limited situations or as a legal defense,” along with border states Georgia, Kentucky and North Carolina. And while medical cannabis is not available for patients in Tennessee, Parker said the proximity of the state to those that do offer regulated programs will likely result in an eventual shift in policy. “Someone could legally purchase medical cannabis in Arkansas, but be put in jail for bringing it across the Mississippi River into Tennessee. This is simply untenable and needs to change and we need to move toward the medicalization of cannabis,” Parker said. “That being said, I don’t think it will happen anytime soon. I think there are some – not all, but some – in our electorate who will take pride in Tennessee being the last state to legalize medical cannabis.” Some surveys support Parker’s claim. According to the Marijuana Policy Project (MPP), a national organization dedicated to legalizing cannabis, Tennessee is one of 13 states that do not offer a medical cannabis program, and it is one of 19 states that criminalize possession with imprisonment. The organization cites a 2018 poll conducted by Middle Tennessee State University that reported 81 percent of voters in Tennessee favor legalization of marijuana to some extent, while 44 percent would like to see it made legal for medical use. As Parker sees it, the question is not if, but when Tennessee will legalize cannabis for medical use. He believes that when it does happen, great effort must be made to educate

medical personnel, patients and the public. He argues that physicians should do more than recommend medical cannabis for patients as a pain management therapy and conduct regular follow-up visits to determine if the therapy is effective or not and what, if any side effects it produces. He believes cannabis therapy should be taught in medical schools, as well as in programs training pharmacists and other medical personnel. And he feels strongly that medical cannabis

should never be marketed to young people. “We need to move toward making medical cannabis a viable treatment option, but we must be responsible and thoughtful in the way we do that,” Parker said. “I firmly believe that Tennessee can study the issue and learn from the best practices as well as the mistakes that other states have made and become the model for how medical cannabis should be regulated and made available.”

Although more than 30 states have some form of legalized therapy, as a doctor working in a prohibition state, I’m required to walk a very delicate line with regard to educating patients about medical cannabis. — Autry Parker, Board of Directors, Tennessee Pain Society, Tennessee Society of Interventional Pain

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GrandRounds Wilson Named Chair of the Department of Ophthalmology, Director of Hamilton Eye Institute at UTHSC Matthew W. Wilson, MD, FACS, has been named the Barrett G. Haik Endowed Chair for the Department of Ophthalmology in the College of Medicine at the University of Tennessee Health Science Center and director of the Hamilton Eye Institute. He began his new roles this month. Wilson has served as the acting chair of the UTHSC Department of Ophthalmology since April, 2021, and was the Matthew Wilson vice-chair of Academic Affairs for the department since 2013. As chair, Wilson will oversee all activity to ensure the department’s goals and objectives are met. This includes developing the vision for growth of the department’s clinical and academic aspects. “We are absolutely delighted that Dr. Wilson is the new chair of ophthalmology in the UTHSC College of Medicine,” said Scott Strome, MD, executive dean of the college. “Dr. Wilson is an outstanding clinician and a luminary in the field of ocular melanoma. He is also a distinguished researcher, educator, and mentor. The department has an incredibly bright future with him at the helm.” Wilson has been a professor in the Department of Ophthalmology at UTHSC for 23 years. Recruited in 1999 by his mentor Barrett G Haik, MD, FACS, Dr. Wilson has developed an internationally recognized ocular oncology program at HEI and St. Jude Children’s Research Hospital. He has developed active translational research programs that improve his patients’ clinical care. He also serves as director of the St. Jude Global Retinoblastoma Program, and since 2002 has helped create retinoblastoma centers of excellence in Central America, the Middle East, and Southeast Asia.

“It is a great honor to be chosen to lead the Department of Ophthalmology at UTHSC,” Wilson said. “I am excited to work closely with Dean Strome, senior leadership, and our faculty to continue to grow the Hamilton Eye Institute – a remarkable asset made possible by the vision and generosity of Dr. Barrett G. Haik and Dr. Ralph Hamilton. The Hamilton Eye Institute houses the teaching, clinical, and research missions of ophthalmology under one roof. We have a strong tradition of excellence that we embrace and will continue to strive for. I have no doubt that we will provide outstanding faculty, residents, and fellows.” Wilson obtained his undergraduate degree in biology from Furman University in Greenville, South Carolina. He earned his medical degree from Emory University in Atlanta in 1990 and completed his internal medicine internship, ophthalmology residency, and a fellowship in ophthalmic pathology at Emory University. He also completed fellowships in ocular oncology at Saint Bartholomew’s and Moorefield’s Eye Hospital in London, England, and ophthalmic plastic and reconstructive surgery from Casey Eye Institute in Portland, Oregon. He has authored over 160 peerreviewed publications and 20 book chapters. His service to the ophthalmic community earned him the Lifetime Achievement Award from the American Academy of Ophthalmology in 2018. He was awarded the St. Jude Chair in Pediatric Ophthalmology in 2010 and named chief of Ophthalmology at St. Jude in 2013. Dr. Wilson currently serves on the Board of Trustees for Furman University.

UTHSC Team Receives $2.84 Million to Study Flu Infections Amber M. Smith, PhD, associate professor in the department of Pediatrics at the University of Tennessee Health Science Center (UTHSC), is the lead investigator on a new $2.84 million award from the National Institute of Allergy and Infectious Diseases. The

award will support a team lead by Smith to develop a new computational approach to better understand flu infection. Morgan Craig, PhD, researcher at the Sainte-Justine University Hospital Research Centre and assistant professor of Mathematics and Statistics at the Université de Montréal, is the coprincipal investigator. Klaus Schughart, PhD, visiting professor of Microbiology, Immunology and Biochemistry at UTHSC, is a co-investigator. Influenza infections range from asymptomatic to deadly. How a patient fares depends on a variety of factors, including their geography, genetics, and/or any underlying health conditions. In addition, the virus itself can lead to different infection trajectories, immune responses, and outcomes. In this study, Smith’s team will use a new computational approach to simulate individual flu patients under a variety of different conditions. The team will use these simulations to analyze different patient responses to infection and treatment, to test analytical predictions of infection risk, and to define biomarkers that predict infection severity. “The recent COVID-19 pandemic highlighted that respiratory infections can be different for different people. The same is true for influenza. It also highlighted how little we know about what causes them to be so heterogenous,” Smith said. “Our recent work on modeling COVID-19 suggested that small changes in immune responses would be sufficient, but we know that genetics and the environment someone lives in can also change their baseline level of immunity. With so many factors at play, it’s difficult to understand which ones have a role and whether they are meaningful with respect to outcome. Fortunately, mathematics gives us the ability to tease this apart and evaluate the contribution of potential mechanisms in addition to constructing ‘virtual populations.’” Smith, who is also a core faculty member of the Institute for the Study of Host-Pathogen Systems, has been

using mathematical models to study influenza infection for over 15 years. She is a member of the international Board of Directors for the Society for Mathematical Biology.

Crosstown Back & Pain Institute Welcomes Dr. Leland Berkwits Crosstown Back & Pain Institute, the Mid-South’s only multi-disciplinary pain management clinic, is proud to announce ACGME fellowship-trained spine and pain specialist Leland Berkwits, MD, as the newest addition to the team, with a focus on non-operative spine treatment, pain management, and physical medicine & rehabilitation. Berkwits began his practice as a boardcertified specialist in Physical Medicine & Leland Berkwits Rehabilitation, also known as Physiatry. As a Physiatrist, he is trained to treat injuries and illnesses of nerve, muscle and bone. His focus is on the use of non-surgical minimally invasive techniques to decrease pain and enhancing function without surgery. In his clinical experience practicing Physiatry, Berkwits began to realize that while many patients suffer from musculoskeletal, neurological, and spinal issues causing pain, very few patients had the opportunity to see a non-surgical expert as they entered the medical system. In mid-career, he left his practice to begin an Accreditation Council for Graduate Medical Education (ACGME) accredited interventional spine and pain management fellowship at Orthopedic and Spine Specialists in York, Pennsylvania. He became a passionate advocate for a patient’s access to interventional care before they ever reach the point of needing surgery, and he now has over 15 years’ experience practicing interventional spine and pain medicine. Learn more about Dr. Berkwits and Crosstown Back & Pain online at www. crosstownback.com

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GrandRounds Regional One Health Center for Innovation Announces Partnership with Welwaze The Center for Innovation at Regional One Health focuses on applying disruptive thinking to health care to create new ways to provide care. Its latest enterprise is a partnership with Welwaze and its innovative breast health monitoring system designed to detect early signs of breast disease. “We are really excited to be working with Welwaze on its journey to save lives with its groundbreaking technology,” said Alejandra Alvarez, director for the Center for Innovation at Regional One Health. “Our partnership makes it possible for us to offer the latest medical advances in breast disease detection to our patients at Regional One Health.” According to the Center for Disease Control, breast cancer is the most common cancer among women worldwide. Every minute a woman is diagnosed with breast cancer and every eight minutes a woman dies because of this disease. Alex Ness, founder and CEO for Welwaze, says his company is entirely focused on reducing that number of deaths through early detection of this disease using Celbrea’s ecosystem and raising women’s awareness to maintain a healthy lifestyle and keeping their annual checkups. Celbrea is an FDA cleared singleuse disposable pad that monitors the surface temperature of the breast as a biothermal activity marker for early signs of breast disease. It provides results in just 15 minutes. Early intervention can save lives, so the goal Ness says is to alert women if there is a possibility of breast disease to encourage them to take action early and make an appointment to see their physician. Doctors in oncology and imaging at Regional One Health will use this breakthrough breast health monitoring technology with their patients.

“We want to encourage women to seek medical attention as early as possible so they have the best chance to survive,” said Ness. “Our innovative technology helps women easily learn if there is any sign of breast disease so if the results show breast disease, they know how important it is to make an appointment with their physician.” Ness says the collaboration with the Center for Innovation at Regional One Health is extremely important. “We have the opportunity to work directly with doctors and patients which allows us to gather vital data that will validate the effectiveness of Celbrea and allow us to properly communicate these results to the medical community.” The Innovation Center at Regional One Health seeks to build a health care ecosystem of innovators and entrepreneurs by providing a platform that inspires, aligns, and cultivate new ideas, research and technology. The Center focuses on three areas to help disrupt the health care industry: • Building - Testing the viability, desirability and feasibility of promising ideas through the Innovation Lab. • Partnering - Creating high-performing partnerships with experts in a variety of fields through the Healthcare Ecosystem Collaborative. • Amplifying - Helping companies validate their business model or clinical use case through the Healthcare Startup Incubator. “At the Center for Innovation we focus on empowering health care innovators to drive innovation that will improve patient experiences and outcomes locally, nationally, and globally.” said Alvarez. “One of the most exciting opportunities we have is to provide our patients first-hand access to state-of-the-art technology leading to directly improving the health of our community.” continued on page 8

Two Tennessee Hospitals Earn Electrophysiology Accreditation Methodist University Hospital and Methodist Le Bonheur Germantown Hospital are the only two hospitals in Tennessee, and are among about 30 nationwide, to receive procedural accreditation in electrophysiology from the American College of Cardiology for outstanding expertise in caring for arrhythmia patients. “This accreditation reflects our unwavering commitment to diagnose and treat patients who suffer from cardiac issues,” said Anna Lopez, chief operating officer of Methodist Le Bonheur Germantown Hospital. “Participating in this rigorous evaluation process affirms the priority we place on patient safety and the world-class heart care we provide to patients across the Mid-South and beyond.” Electrophysiology assesses heart patterns, including abnormal heart rhythms, or arrhythmias, which increase a person’s risk for stroke. One in 18 Americans experience heart arrhythmia, with 70 percent of people being between the ages of 65 and 85. Risk factors include advancing age, high blood pressure, obesity, diabetes, chronic kidney disease and smoking. Treatment can include cardiac ablation and implantable devices like pacemakers and cardioverter defibrillators. For more information on the cardiology services available at MLH, please visit MethodistHealth.org

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Market Volatility Comes With The Territory Something I want to acknowledge up front is that investing is stressful. Chirag Chauhan, While the saying goes that money cannot buy you everything, we all AIF®, CFP® know that it is not about what you can buy—it is what money represents. While it may represent something different for each of us, I would think we can all agree that no matter who we are, money represents our future, how much flexibility we have, how many choices we have, and how much freedom we have—flexibility, choice, and freedom to live our lives the way we want. Let’s talk about why volatility exists and how it acts. If you were walking along and this bear jumped into your path, what would you do? Most of us would want to run. I certainly would. But contrary to our natural instincts, wilderness guides say to lay down on the ground and play dead. There’s no way to outrun, outswim, or outclimb a bear, so your best bet is to face it down…by lying on the ground. The same is true of bear markets. By fleeing, you might only make the situation worse. But by facing it down, you’ll be well prepared to make it through. Quick disclaimer: I by no means are advising you to go out and face bears, nor do I advise you on how to deal with a bear. Bears are best avoided! We all know that just stuffing it under our mattress or into a hole in our backyard means it will lose worth over time due to inflation. That’s just the nature of the world we live in. And now, with very few pensions left and longer lifespans, we must fund our own lives for what could be many years to come. The only true way to do that these days is by putting it in the stock market.

Helps protect funds against inflation risk

Grows potential for the future

We invest our money to help protect against inflation, so our money doesn’t lose value, and to potentially grow funds to help us fund our future retirement or other future goal. We also know the market isn’t just going to keep going up all the time, unfortunately. I wish it were! But sell-offs are needed in order for us to make money.

What Is Volatility, Really? Simply put, it’s changing stock prices. Sometimes they can change wildly from day to day, or even in a single day. For example, one company’s stock can start off the day at $5 a share and end the day at $10 a share. Or, worse, it could start the day at $10 a share and end the day at $5 a share. When you’re invested in multiple stocks, which is what mutual funds or exchange-traded funds allow you to do, this can be unnerving when you see your fund losing value throughout a day or week. However, this is one way you and other investors make money, so it’s necessary. For example, let’s say you buy a stock at $1 a share. Over the course of a month, it goes up to $10 a share! But then the next month, it plummets down to $0.50 a share. You’d get nervous, right? But if you’re continually investing, you’d get to buy more shares at $0.50, instead of your original price. Then over the course of several months, the stock goes up to $5 a share. You’ve made money! When it’s happening, volatility can make us all nervous. But it’s important to remember that it’s common and has happened all throughout history. It’s also often unpredictable, meaning trying to buy and sell at specific times to take advantage of price swings is very difficult, if not impossible, to do.

Causes Of Volatility     

How a particular company or group of companies is performing Investor emotions Worldwide events, like wars, disease, or social unrest Economic policies of other countries The economic policy and strategy of the United States government

When we build your portfolio, we prepare for a variety of scenarios on your behalf, but we want to ensure you’re right alongside us every step of the way. We’ll also talk about how we plan for volatility, and how we partner with you to help your plan stay on track to the best of our ability, no matter what the markets are doing. We’ve individually and as a country faced crises before, and in the past, we’ve come out better and stronger for it. Amazing innovations come out of challenging times, and we’re seeing the same in this current crisis. I genuinely believe there is a lot to be hopeful for in the future.

Chirag Chauhan, MBA, AIF®, CFP® is a managing partner of Bluff City Advisory Group in Memphis, Tennessee. For more info, please visit bluffcityadvisory.com.

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GrandRounds In addition to impacting the local health community, Ness says his product will be able to support current challenges women face regarding access to doctors, screening centers or women who simply need to monitor themselves more often because of their breast density or genetic profile. Where mammograms are available, Ness says this new technology will increase women’s compliance when it comes to keeping up their recommended mammography schedule. If the results are positive, it will also provide a wakeup call for women to be more diligent and motivate them to go see their doctor. To be selected as a partner with the Center for Innovation, businesses must complete an in-depth discovery process that allows Regional One Health to learn the potential partner’s needs and ensure their goals align with Regional One Health’s goals. Regional One Health also examines its processes to determine whether the health system has the right processes in place to ensure the ability to successfully handle the scope of the project. A committee then reviews and score the results, evaluating Regional One Health’s capacity to provide the needed services and the viability to execute the project.

Baptist Memorial Announces Executive Promotions at its Memphis-Area Hospitals Brad Parsons has been promoted to vice president/CEO of Baptist Memorial Hospital-Memphis, and Allison Bosse has been promoted to administrator and CEO of Baptist Memorial Hospital for Women and the Spence and Becky Wilson Baptist Children’s Hospital. These promotions went into effect May 1, 2022, and Bosse along with Lindsay Stencel, administrator and CEO of Baptist Memorial HospitalCollierville, will both report to Parsons, who will continue to serve as CEO of Baptist Memphis. “It is with great pleasure that I announce Brad and Allison’s promotions,” said Jason Little, president and CEO of Baptist Memorial Health Care. “They have both excelled as leaders at Baptist. Brad admirably led the staff at Baptist Memphis through a global pandemic, and Allison has implemented an impressive number of new pediatric programs since joining Baptist in 2014. I look forward to their continued success and advancement of quality care for patients and the greater community.” Prior to joining Baptist Memphis as administrator and CEO shortly after the pandemic began in May 2020, Parsons was CEO and administrator of NEA Baptist Memorial Hospital and

NEA Baptist Clinic. He also served as administrator and CEO of Baptist Memorial Hospital-Union City. He started his career with Baptist as an assistant administrator at Baptist Memorial Hospital-Golden Triangle in 2008. Parsons holds a bachelor’s degree in Business Administration from Birmingham Southern College and master’s degrees in hospital administration and business administration from the University of Alabama at Birmingham. Bosse joined Baptist in 2014 and quickly advanced from a graduate assistant in 2014 to associate administrator for Baptist Women’s Hospital in 2019 and pediatric service line administrator in 2021. A former Groner Fellow, Bosse has worked on financial and operational management, budget planning and strategic development. She successfully aided in the deployment of a partnership with Vanderbilt Monroe Carell Children’s Hospital for pediatric specialty service coverage in pulmonology and urology and launched several programs at Baptist Children’s Hospital, including a Certified Diabetes Educator Telemedicine Program and Baptist Children’s Hospital Sleep Lab. Bosse has bachelor’s degrees in marketing and management from King University and a Master of Health Administration from the University of Memphis in 2016.

Bosse will succeed Kevin Hammeran, who has served as CEO and administrator of Baptist Women’s Hospital and Baptist Children’s Hospital since 2016. He will retire on June 3. “I am grateful for Kevin’s leadership of Baptist Women’s Hospital and Baptist Children’s Hospital during the past six years,” said Little. “His wealth of knowledge and commitment to quality has advanced women’s and children’s health care in the Mid-South.” Hammeran joined Baptist from New York Presbyterian where he served as senior vice president and chief operating officer. In that role, he was the chief administrative officer of the Morgan Stanley Children’s Hospital and the Sloane Hospital for Women. Hammeran also served as executive vice president and COO for Miami Children’s Hospital and St. Christopher’s Hospital for Children in Philadelphia. He also held various key leadership roles at The Children’s Hospital in Boston and Geisinger Children’s Hospital Center (now Janet Weis Children’s Hospital at Geisinger) in Danville, Pennsylvania. Baptist Memorial Health Care is one of the country’s largest not-for-profit health care systems and the largest provider of Medicaid in the region. Baptist offers a full continuum of care to communities throughout the Mid-South and consistently ranks among the top integrated health care networks in the

I CHOOSE better clinical trials

I choose Baptist Cancer Center to give my patients access to lifesaving clinical trials and advanced treatment options close to home. Certified by the Commission on Cancer and a member of the exclusive National Cancer Institute Community Oncology Research Program (NCORP), Baptist Cancer Center offers world-class cancer care in Tennessee, Mississippi and Arkansas communities across a vast network of locations. I choose Baptist Cancer Center’s progressive cancer treatment, compassionate care and hope for my patients. For a complete list of clinical trials, please visit baptistcancercenter.com/trials.

baptistcancercenter.com/trials

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GrandRounds nation. The health care system comprises 22 affiliate hospitals in West Tennessee, North and Central Mississippi and East Arkansas; more than 5,400 affiliated physicians; Baptist Medical Group, a multispecialty physician group with more than 800 providers; home, hospice and psychiatric care; minor medical centers and clinics; a network of surgery, rehabilitation and other outpatient centers; and an education system highlighted by Baptist Health Sciences University (formerly Baptist College of Health Sciences). Baptist employs more than 19,000 people, and in fiscal year 2020 contributed more than $352 million in community benefit and uncompensated care to the communities it serves.

Campbell Clinic Launches Three New Locations Campbell Clinic Orthopaedics is opening three new locations this summer, further bolstering its position as a national and international leader in musculoskeletal care as well as the largest orthopaedic practice in West Tennessee and North Mississippi. With current locations in Germantown, Collierville, Midtown Memphis, and Southaven, the practice will soon add the following new locations to its roster: • East Memphis (585 S. Mendenhall, opening June 2022) • Arlington (Airline Road, opening July 2022) • Olive Branch (Goodman Road, opening August 2022) This geographic expansion is an effort to continually provide increased access to care for Campbell Clinic’s valued patients throughout the MidSouth region and beyond. “In order to further our commitment to delivering world-class orthopaedic and musculoskeletal care to those who need it most, we are growing our presence closer to where patients live and work,” says Dr. Frederick Azar, Chief of Staff of Campbell Clinic. “Our desire to provide the highest level of care to our patients means expanding our footprint both locally and regionally.” Daniel Shumate, CEO of Campbell Clinic, agrees. “These three new locations bring us to a total of eight locations – all of which will be crucial to helping us continue to provide superior orthopaedic care in the very communities we serve.” All three new locations, staffed by Campbell Clinic providers, will be open Monday through Friday and will offer walk-in, urgent orthopaedic care, x-ray, casting and physical therapy services for patients needing everything from pediatrics to geriatric care. Founded by the late Willis C. Campbell, M.D. in 1909, Campbell Clinic is world-renowned for its clinical excellence. Campbell Clinic is an industry leader in orthopaedic medicine, surgery, teaching and research. For more information, visit www.campbellclinic.com memphismedicalnews

.com

Dr. Jeffrey Sawyer with Campbell Clinic Named President of the Pediatric Orthopaedic Society of North America The Pediatric Orthopaedic Society of North America (POSNA) recently announced that Dr. Jeffrey Sawyer, a pediatric orthopaedic surgeon at Campbell Clinic, has been named its 39th president of the organization. POSNA is a non-profit organization that strives to advance pediatric orthopaedics via promoting education, research, and quality care. Campbell Clinic has a long tradition of legacy and leadership in POSNA as retired orthopaedic surgeon, Dr. Terry S. Canale, and current orthopaedic surgeon, Dr. James Beaty, both served as presidents of POSNA. Sawyer is a board-certified, fellowship-trained pediatric spine surgeon who has practiced for 21 years. In addition to holding multiple leadership roles at POSNA, he is also a board member of the Pediatric Spine Foundation and a member of the Scoliosis Research Society. He has also been a POSNA Traveling Fellow and won the POSNA Jeffrey Sawyer Special Achievement Award for his work on the Pediatric Orthopaedic Workforce. Dr. Sawyer has authored over 125 peer-reviewed publications, 30 book chapters, 200 national and international presentations, and serves as a reviewer/editor for the Journal of Pediatric Orthopaedics, American Journal of Orthopaedics and Orthopaedic Clinics of North America and serves on the Board of the Pediatric Spine Foundation. He is a national/international expert on pediatric orthopaedic trauma and spinal deformity and earned the ranking of “Top Doctor” by Castle Connolly and Memphis Magazine. His work has appeared in USA Today and Parents magazine. He graduated from the University of Rochester School of Medicine and did his residency at the University of Pennsylvania before doing his Pediatric Orthopaedic Fellowship at the University of Tennessee-Campbell Clinic. In his spare time, he participates in IRONMAN competitions and has completed four Full IRONMAN and 13 Half-Ironman Triathlons. Being in the top 10 percent in his age group worldwide, he is currently ranked as an IRONMAN Bronze All-World Athlete. He receives the greatest satisfaction from spending time with his wife, Julie, and their three active sons Luke, Zac, and Jake. For more information on Dr. Jeffrey Sawyer, visit http://www.campbellclinic.com/physician/jeffrey-sawyer “Dr. Sawyer is more than deserving of this role,” says Dr. Frederick Azar, Chief of Staff for Campbell Clinic. “In this leadership position, he will be able to lend his tremendous talent, energy and creativity to POSNA and advance

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Patient referrals can be made at maysandschnapp.com or call 901-747-0040. MEMPHIS: 55 HUMPHREYS CENTER DRIVE, SUITE 200 SOUTHAVEN: 900 AIRWAYS BLVD., SUITE A6 (LICENSE #P-00151)

Medical Director: Moacir Schnapp, MD Pain Clinic Associates, PLLC, is a licensed pain management clinic. License #PMC0000000690

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GrandRounds their work with excellence, as he has done for our practice and his patients at Campbell Clinic.”

West Cancer Center & Research Institute in Collaboration with Semmes Murphey and St. Francis Hospital is 1st in the MidSouth with New Targeted Therapy for Brain Tumors Andrew Boucher, MD and Madison Michael II, MD, neurosurgeons at Semmes Murphey with Matthew Ballo, MD, radiation oncologist at West Cancer Center are the first in this region to offer GammaTile® Therapy, a novel approach to treating brain tumors. GammaTile Therapy is an FDAcleared, Surgically Targeted Radiation Therapy (STaRT) that is designed to delay tumor regrowth for patients with brain tumors while protecting healthy brain tissue. The first two patients have been treated at St. Francis Hospital to date. Over 200,000 patients are diagnosed with an aggressive brain tumor in the U.S. each year. Aggressive brain tumors tend to be resistant to current treatments and have a high likelihood of recurrence. GammaTile is FDA-cleared for patients with newly diagnosed malignant brain tumors and recurrent brain tumors, including gliomas, glioblastomas, meningiomas, and brain metastases. The postagestamp-sized GammaTile, which is embedded with small radiation sources, is implanted in the last five minutes of brain tumor removal surgery. The radiation immediately begins targeting tumor cells in the area where the tumor is most likely to recur. Over time and after the radiation has been delivered, the tile naturally resorbs. GammaTile Therapy is shown to improve local tumor control, which can extend a patient’s life. According to Matthew Ballo, MD, Director of Radiation Oncology at West Cancer Center, “We are very excited to partner with Semmes-Murphey Neurosurgery Clinic and St. Francis Hospital to offer this exciting new technology. For many patients with recurrent brain cancer, a repeat surgery and a second course of external beam radiation therapy is the only way to slow down the progression of disease. Unfortunately, our hands are often tied by previous surgeries and previous external beam radiation treatments. By delivering the treatment from the inside of the brain, GammaTile lets us avoid the skin, scalp and normal brain but still deliver a high dose of radiation directly to the brain tumor. GammaTile will allow us to treat patients with brain tumors that quite frankly cannot be treated any other way. This is another example of how by working together we can meaningfully improve the lives

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of cancer patients here in Memphis and throughout the Mid-South. The company is headquartered in Tempe, Arizona. For more information, visit https://www.gtmedtech.com

Opening of Ivy Trails at Parkwood, a Program Exclusively for Women Parkwood Behavioral Health System has opened its new, inpatient behavioral health unit, Ivy Trails at Parkwood, a Program Exclusively for Women. The new unit opened on July 14. Ivy Trails is a specialized treatment program designed to help women develop healthy lifestyles, improve coping skills, identify emotional triggers and learn to promote resiliency. Our program and staff are trained to specifically meet the needs and treatment concerns of women. Our goal is to help women manage stress, anxiety and depression, navigate grief and loss, process relationship difficulties, resolve trauma and recover from postpartum depression. According to the Office on Women’s Health, more than one in five women in the United States experienced a mental health condition in the past year, such as depression or anxiety. Alicia Plunkett, CEO, Parkwood Behavioral Health System, says one of her favorite quotes is by Madrianne Arvore: “An illness of the mind is an illness of the body, and vice versa.” In a world where women wear multiple hats, we have to pay attention to our thoughts and our bodies. It is through this process that we heal and become better advocates for women’s health. Our trauma-focused treatment program focuses on brief intervention and solution-focused therapies. Within our exclusive women-only programming, we incorporate concepts of Cognitive Behavioral Therapy, Dialectal Behavior Therapy, and expressive therapies such as mindfulness, art, music, yoga and equine therapy. After completing treatment, women may transition to our Intensive Outpatient Program or Partial Hospitalization Program, offered Monday through Friday. Our goal is to help women thrive by providing new skills and knowledge through therapeutic intervention to face new and existing challenges. Parkwood Behavioral Health System is located on a beautiful 37acre campus in the northwest corner of Desoto County in North Mississippi, just a few miles from the Tennessee state line. At Parkwood, we care for a wide age range of patients from the age of 5 to senior adulthood. Whether you or someone in your family is struggling with mental health issues, depression, thoughts of suicide or selfharm, or substance use disorder, we

offer multiple inpatient and outpatient programs specifically designed to meet your needs. The physicians and staff at Parkwood strive to provide the best outcomes possible and help patients progress toward a more independent, self-fulfilling lifestyle. Learn more at www.parkwoodbhs.com

Baptist to Expand Brain & Spine Center of Excellence with Cedar Gate Technologies Baptist Memorial Health Care’s Brain & Spine Network Center of Excellence is expanding its collaboration with Cedar Gate Technologies (Cedar Gate), a leading value-based care performance management technology company. The Brain & Spine Network Center of Excellence is a collaboration between Baptist and Semmes Murphey Clinic designed to provide a cost-saving and high-quality benefit for employees who suffer from back and neck pain and other neurological conditions. First offered to Baptist’s employees and a select number of businesses, this Center of Excellence has proven to significantly reduce outof-pocket costs by providing proven solutions and leveraging personalized care through assigned nurse navigators who assist in diagnosis, treatment, therapies, interventional pain management and, if required, surgical care and recovery. Initial outcomes for the center show that patients returned to work 14% more quickly than the national average, and 90% of patients reported satisfaction with their care. “We’re excited to offer our comprehensive Brain & Spine Network Center of Excellence to a wider base of employers and patients,” said Kim Hallum-Stewart, system administrator of neurosciences for Baptist Memorial Health Care. “Cedar Gate’s platform allows us to bring our vision to selfinsured employers by providing valuebased payment solutions, streamlined data integration and operational analytics, which serve as a foundation for us to scale and offer excellence in care to employers across our region.” Baptist recently broadened the use of Cedar Gates’s platform from a singular specialized surgical specialty implementation to a multifaceted application to encompass the expanded vision for the Center of Excellence. “Semmes-Murphey has a passion for saving lives, improving quality of life and advancing the field of neurosurgery,” said John Lewis, Semmes Murphey CEO. “Cedar Gates’s platform has given us the tools to integrate business operations, strengthen our partnership with Baptist and offer more employers the opportunity to participate in the

Brain & Spine Network Center of Excellence.” Cedar Gate’s payment technology enables the Brain & Spine Network to manage prospective bundled payment programs with automatic conversion of fee-for-service claims into a single, bundled claim. “Value-based care is becoming increasingly recognized as the future of health care delivery and reimbursement in the U.S.,” said Cedar Gate CEO David Snow. “We are pleased these solutions helped meet Baptist’s needs and allow for continued success.” The Brain & Spine Network Center of Excellence is focused on

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GrandRounds providing high-quality, patient-centered neurological care, emphasizing value for patients and employers. Baptist’s Centers of Excellence measure outcomes and compare results with programs across the country. The Brain & Spine Network clinical team consistently achieves top rankings among its peers. Employers can choose from Baptist’s service offerings to determine what will work best for their employee population. Baptist’s Brain & Spine Network has a robust offering of services and can tailor those services to meet an employer’s specific needs. Cedar Gate enables payers, providers, employers, and service administrators to excel at valuebased care. Our unified technology and services platform enhances and automates data management activities to deliver employer and provider analytics, care management, and payment technology necessary to pursue every payment model and optimize performance in all lines of business. From primary care attribution, to bundled payments, to capitation, our platform is designed to improve clinical, financial, and operational outcomes for all. To learn more, visit www.cedargate. com

OrthoSouth Workers’ Compensation Conference We’d be honored for your attendance at the 2022 OrthoSouth “re-booted” Workers’ Compensation Conference on October 27th. Featuring Dr. Riley Jones as MC, and Jeff Francis, Assistant Administrator, Tennessee Bureau of Workers’ Compensation as keynote speaker in the morning hour. The event will also showcase a panel of experts including physician, physical therapist, attorneys, and nurse case manager for a full 360 discussion of a workers’ compensation case profile.

Date: Thursday, October 27, 2022 Venue: The Great Hall & Conference Center Venue address: 1900 South Germantown Road, Germantown, TN Price range: $35.00 attendees | $500.00 vendors Attendees and vendors please register via the attached link and select your profile. We hope to see you there!

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Welcome Our Newest Providers Thomas Kleisli, MD

Cardiothoracic Surgery

Ashley Fratello, MD Cardiothoracic Surgery

Saint Francis Medical Partners is happy to welcome Ashley Fratello, MD and Thomas Kleisli, MD to our Thoracic and Cardiovascular Surgery Associates team. Ashley Fratello, MD received her Bachelor’s degree in Business Administration and attended medical school at SUNY, Stony Brook University, NY. She completed her Integrated Cardiothoracic Residency in Los Angeles, CA. Thomas Kleisli, MD received his Bachelor of Science degree in Chemistry/Biology and obtained his doctorate at the University of California, Irvine. He completed his residency in General Surgery at Maricopa Medical Center in Phoenix, AZ. Dr. Kleisli has earned fellowships for Congenital Cardiac Surgery, Cardiothoracic Surgery and a Postdoctoral Research fellowship in Vascular Surgery. Conditions Treated Coronary artery disease Valvular disease processes (including aortic, mitral and tricuspid) Congenital heart defects Carotid artery blockages Peripheral arterial blockages Aneurysms of the chest, abdomen and peripherally Lung cancer or other abnormalities Venous disease

Procedures Performed Coronary artery bypass grafting (including without bypass machine) Aortic or mitral valve replacements (including TAVR) Lung resections Leg bypass procedures

6005 Park Ave., Ste. 802 Memphis, TN 38119

To refer a patient, call 901-236-0508. Scan the QR code or visit SFMP.com to learn more about the entire team.

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