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Greenville Health System (GHS) has been advancing health care for generations. The stories below provide an inside look into GHS and how we’re transforming health care for the benefit of the people and communities we serve.
Greenville Health System (GHS) has been advancing health care for generations. The stories below provide an inside look into GHS and how we’re transforming health care for the benefit of the people and communities we serve.
According to AAA, an estimated 46 million Americans hit the road and traveled 50 miles or more last year at this time, and many will do the same again this year. With that in mind, Safe Kids Upstate has compiled its top six travel tips from the U.S. Department of Transportation and National Highway Traffic Safety Administration to keep you and your family safe on the roads this holiday season:
Holidays offer a wonderful opportunity to visit family and friends. By following a few safety measures, you and your family can travel safely to any destination.
The Surgeon General of the United States, Dr. Vivek H. Murphy, has declared Thanksgiving Day to be National Family History Day. He said, “Healthcare professionals have known for a long time that common diseases – heart disease, cancer and diabetes – and rare diseases – like hemophilia, cystic fibrosis and sickle cell anemia – can run in families. Tracing the illnesses suffered by your parents, grandparents and other blood relatives can help your doctor predict the disorders to which you may be at risk and take action to keep you and your family healthy.”
This is of particular importance for cancer survivors. About 5% to 10% of cancers are caused by genetic mutations that can pass from one generation to the next. This is especially true for breast cancer and colon cancer, but also for ovarian cancer, endometrial cancer and many others. Knowing whether you have a cancer causing mutation is valuable information for other members of your family who might want to know to reduce their cancer risk.
If there is a possibility that a cancer survivor has a mutation that can be passed to the next generation, genetic testing is available to identify the mutation. The people who assist in this process are called genetics counselors. Genetic counselors are professionals with specialized training in medical genetics to help you understand your risks and make decisions about pursuing genetic testing. Genetic counselors discuss implications of genetic testing results on an individual level so that you know as much as possible about what the results could tell you before you receive them.
At a genetics-counseling visit, the genetic counselor meets with the cancer survivor and asks about which relatives had what kind of cancer. This information is put together to create what is called a “pedigree” that helps determine which tests for which genes might be useful. One of the major challenges to a thorough genetic counseling evaluation is a lack of accurate knowledge about the family cancer history. All too often the cancer survivor is unable to provide the needed information about his or her relatives’ diagnoses of cancer.
If the genetics counselor doesn’t know what cancers and health problems exist in a family, he or she is not able to determine the likelihood of them recurring in other relatives and are not able to offer sometimes life-altering preventive measures. According to the U.S. Department of Health and Human Services, a recent survey found that 96 percent of Americans believe that knowing their family history is important. Yet, the same survey found that only one-third of Americans have ever tried to gather and write down their family’s health history.
This brings us to the U.S. Surgeon General’s Family History Initiative. It aims to encourage Americans to know and record their family medical history. The Surgeon General has created a new computerized tool to help make it fun and easy for anyone to create a sophisticated portrait of his or her family’s health. It is called My Family Health Portrait, and it’s available for free online at familyhistory.hhs.gov. This tool helps users organize family history information and save their family history information to their own computer.
During this Thanksgiving holiday, we invite everyone to share their cancer and medical information among family members. It could very well make a difference to you or someone you love. If you would like more information about cancer genetics or to schedule a consultation at the GHS Cancer Institute, call (864) 455-5836 or check out the cancer genetics web page.
Lindsay Metcalf, a genetics counselor with the GHS Cancer Institute, contributed to this blog.
It is autumn here in the Upstate—the leaves are turning, the temperature is dropping, and football dominates the weekend news. But it is also a time for us to reflect on the many blessings that enrich our lives and to give thanks for them. Like our pilgrim forefathers, we all face struggles on a daily basis that push our buttons and heighten our stress level, yet most people here in the Upstate have to admit that their life circumstances are pretty good compared to those in impoverished or war-torn areas of the world. Here at the Fertility Center of the Carolinas we are forever thankful for the privileged role that we play in assisting couples to start and expand their families through our services.
Who would have thought, even 20 years ago, that we could help couples burdened with inheritable conditions like cystic fibrosis, sickle cell disease, or familial cancer genes conceive children that they would assuredly know were not at risk for developing those diseases? Through the technological advancement of preimplantation genetic diagnosis (PGD) we can now provide our patients peace of mind that their children will not have to worry about the specter of looming genetic illnesses. Through its laboratory cousin, preimplantation genetic screening (PGS), we have been able to improve the pregnancy rate of in vitro fertilization to where almost three quarters of couples conceive and carry to term, typically with a single baby. The use of PGS has allowed us to reduce the percentage of IVF pregnancies that are twins while improving the overall chance of success. These miraculous advancements have arisen after years of painstaking research and commitment from physicians and scientists from around the globe, allowing us to refine and apply these techniques locally. For this we are truly thankful.
We also count ourselves lucky for being an integral part of healthcare and health education in our community. The outstanding students and residents who rely on us for their learning continuously challenge us to maintain a handle on the latest advances in our field and are a tremendous source of pride. Like inquisitive children (incredibly smart, insightful children) they want to know why we do things the way we do and force us to stay on top of our game as physician scientists and teachers, lest we misinform the very people who may be caring for us some day. Education is about sharing, and sharing goes both ways when it comes to the relay of information between pupil and mentor. Helping young, fresh minds enthusiastically slog through complex clinical puzzles makes you silently root for their success while affirming that you actually know something, regardless of what your own children say. To the students, residents, and other learners who graced our doorway during the past year we say, “Thanks!”
But the greatest thanks go to the many patients who have entrusted us to help them with a variety of health issues when they might have chosen to go elsewhere. By definition, a healthcare provider needs someone on the receiving end of their provisions, otherwise he or she would just be a lonely individual with a whole lot of education and unfulfilled career aspirations. The reason that we got into medicine was to apply whatever talents we might have toward the promotion of health and well-being in others. Don’t let anyone convince you otherwise. Thankfully, this privileged vocation provides countless causes for celebration on a regular basis here at The Fertility Center of the Carolinas. Whether it’s alleviating pelvic pain, extinguishing fiery hot flashes, or seeing a heart beat on a long-awaited ultrasound exam, we revel in the success of our patients. For sharing that with us, we thank you all.
So we’ll all go back to work after turkey day a little plumper than before, memories of family gatherings fresh in our minds and visions of winter holidays fast approaching. Realize that the folks at The Fertility Center of the Carolinas will be here with the doors open, just as we have been for 363 out of 365 days a year for the past 24 years (fertile time knows no clock). And know that the smiles that you see on the faces of the person at the front desk, the nurse who takes your blood pressure, and the doctor who comes to greet you in the waiting room are there because they are genuinely thankful and happy to see you.
The recent changes to the USA Soccer youth concussion guidelines has put to rest a long debated topic of youth heading in soccer. Preliminary research suggests attempting to head the ball in soccer before proper eye tracking and motor skills have developed increases the risk of face, skull, and spinal injuries with possible cognitive or concussive effects. The changes made will make heading before the age of 10 in any sanctioned event, practice or game, illegal. Youth soccer players between the ages of 11-13 will be allowed to head in practice, but will not be permitted to perform the technique during game play.
Injury reduction is the main purpose of this shift in youth soccer. Improper heading at any age or skill level may increase the risk of injury, while delaying the implementation of this highly skilled maneuver until proper athletic development has occurred is a responsible and safe step for the sport. This will allow for training and emphasis on skills many feel are lacking in USA soccer. The result will be a greater focus put on foot skills and agility for the under 10 teams without having to dedicate practice time to coaching heading technique to children that may not have developed the proper eye tracking or motor skills to perform such a task.
The changes USA Soccer has made in regards to its youth concussion guidelines has brought it up to speed with current research and in line with other youth sports associations. The absence of heading may be the most noticeable change, but the implementation of more unified concussion protocols and return to play criteria along with changes to substitution rules to allow for proper screening of possible head injuries, is a welcomed advance in the sport. Game winning headers in under 10 youth soccer may be a thing of the past, if they ever existed, but the reduction in head injuries will be welcomed by the families of those participating.
The United States Soccer Federation (USSF) has released a guideline for youth soccer that limits the amount of exposures younger players have to “heading” the ball. For those in the groups of U10 and younger, heading of the ball is now prohibited and in age groups up to age U13 the number of exposures in practices will be limited.
From an anatomical standpoint, this is a strong move as the younger athlete does not have the strength or control of the body to properly contact the ball with the head and minimize the forces delivered. Also, this gives time for proper instruction to be done in a controlled environment to educate the player in correct technique for heading the ball. The lessening of limit as the player ages corresponds with the structural development of the player as he or she ages and gains strength in the neck and upper back regions, allowing the body to become able to cope with the forces more readily. This has the possibility of protecting the developing brain from injury at younger ages with repeated head strikes in the earliest exposures to the sport.
The purists of the game may argue that by delaying the teaching of this technique until age 11 may hinder the player’s development and slow the growth of the game within the United States. They also might say this will cause a decline in international standing as U.S. players are “falling behind.” This idea comes from the competitive vein but the theory is that a slightly more mature player could be developed to train properly to prevent a head injury from heading the ball.
The reality of the situation is that head injuries, such as concussions and chronic traumatic encephalopathy (CTE) can not only occur from directly striking the ball but also from head to head contact on a challenge or collision that causes a player to fall and strike the ground head first. Although this is a good first step from the USSF, more education of player, coach and parent as time passes will determine if this guideline is effective when put in practice from theory.
If exercise were a cancer medicine, it would be a billion dollar blockbuster. As it is, exercise is free and it is indeed beneficial against cancer. Two recent medical journal reports have shown that exercise can reduce the risk of breast cancer. The first is a review article in Critical Reviews in Hematology and Oncology in October, which analyzed eight published observational studies of the effect of physical activity on survival for women with localized breast cancer. When all the studies were combined, moderate exercise of more than 120 minutes per week led to a 50% reduction in the risk of recurrence, which corresponded to improvements in overall survival of 4% at five years and 6% at 10 years. This is roughly the same benefit as chemotherapy.
The second is a study published in Breast Cancer Research and Treatment online on October 28, which looked at women who are BRCA mutation carriers and are therefore at high risk for breast cancer. It showed that exercise could lower their risk for breast cancer, even before considering surgery or medications for risk reduction.
In the study, 139 premenopausal women who were carriers of the BRCA mutation were randomized to one of three groups. The “low-dose” group performed a treadmill exercise 150 minutes per week, the “high-dose” group exercised for 300 minutes, and a control group exercised for less than 75 minutes per week. The women provided blood and urine samples and had MRI breast imaging after five menstrual cycles.
The breast MRI scans and the laboratory tests showed lower levels of estrogen for women in the “low dose” exercise group and even lower levels of estrogen for women in the “high dose” group. In other words, more exercise resulted in lower estrogen levels, which corresponded to lower risk of getting breast cancer for these women.
This is good news for all women. Exercise is something over which a woman has control and which is inexpensive. It is also good for mental health, heart health and weight control. The national guidelines from the American Cancer Society recommend 150 minutes of moderate exercise per week and twice weekly resistance exercise. I am impressed with the growing number of medical studies that support these guidelines. The two studies described above are part of the growing body of evidence that exercise lowers the risk of breast cancer recurrence for breast cancer survivors and lowers the risk of getting breast cancer for a woman at risk.
At the GHS Cancer Institute Center for Integrative Oncology and Survivorship (CIOS), exercise is an important part of the prescription for healthy living for cancer survivors. For more than 20 years, the oncology rehabilitation program at the Life Center, now called Moving On, has helped cancer survivors recover from the effects of cancer therapy, increase their physical conditioning, and improve their exercise habits. In the last year, CIOS has strengthened its relationship with the YMCA to help cancer survivors develop and continue their healthy exercise habits at a Y facility close to their home.
If this blog were a television commercial advertising a prescription drug, it might conclude by saying, “Ask your doctor if exercise would be good for you,” So, I will say it. Cancer survivor or person at risk, ask your doctor how you can learn to exercise safely and effectively and how you can develop good exercise habits. For more information about exercise for cancer survivors, call the Center for Integrative Oncology and Survivorship at (864) 455-1346.
Doug McCormick, MSN, APRN-BC, contributed to this blog.
Do you suffer from allergies, but don’t want to get weekly allergy injections? If so, then sublingual immunotherapy (SLIT) may be right for you.
SLIT has been available for over 30 years, most widely available in Europe. Many U.S. allergists and ENT’s doing allergy immunotherapy have been performing SLIT for over 20 years. The U.S. Food and Drug Administration still considers non-commercial forms of SLIT “off label” pending sufficient U.S. long-term research data. However , U.S. research has continued to increase since the 1990s showing SLIT safety and efficacy.
SLIT is a form of allergy immunotherapy that is delivered under the tongue. For patients with multiple environmental allergens to grasses, weeds, molds and trees, this can be an alternative to allergy shots. SLIT can be administered at home once or twice daily depending on the severity of your allergies. Treatment usually lasts three to five years. There are also commercially available prescription drops under the tongue for those with only grass or ragweed allergies.
Total time for SLIT administration at home is just over 3 minutes. After the drops are administered, one holds them under the tongue for 2 minutes before swallowing. Then, you allow time for at home documentation of administration of the drops and any adverse symptoms. The ideal patients are those with asthma, nasal polyps or other comorbid conditions who cannot tolerate injections. Other candidates for this treatment are young children who don’t tolerate injections, patients with prior surgical intervention limiting the use of the arms as injection sites, those who live too far away from doctors’ offices or have jobs and other responsibilities limiting their ability to get to a doctor’s office for weekly injections.
People should seek help from a doctor for their allergies when they have tried over the counter medications and not had relief of symptoms. Also, if their allergy is limiting their quality of life, enjoyment of the outdoors or is causing sleep disruption. People diagnosed with asthma, sinusitis or other sinonasal diseases should schedule regular visits with a doctor.
Can you believe it? They went and did it again! An influential and trusted organization—the American Cancer Society (ACS)—changed its recommendations for breast cancer screening, announcing the changes in the Journal of the American Medical Association. One news outlet called the changes “major,” while another used the term “radical.” So, what’s the deal?
While it’s true that ACS has changed its breast cancer screening recommendations, these changes are hardly radical. So, what changes were made? And why are they such a surprise?
Let’s start with the new recommendations. Here they are:
Now, here is what the new recommendations do not say:
To those who are unsettled by the changes, I understand. But if it seems like we are changing the rules, remember that change in medicine is nothing new.
I see these changes as a tremendous opportunity for patients, doctors, and indeed, organized medicine. It’s a chance for us, as healthcare providers, to put our money where our mouths are when it comes to patient-centered care and use these changes as a springboard to have important conversations about what we want health care to be and what we are willing to do to get it.
The discussion of harms and benefits of screening mammography—or any other intervention—cannot be limited to academic publications that are sent down from above. We need to talk about these changes in doctor’s offices, at cocktail parties and soccer games, because if we want to improve our health, we are going to have to dig in and work on the solutions together.
This week the South Carolina Department of Health and Environmental Control (DHEC) reported four recent deaths from influenza. Unfortunately, these deaths will not be the last for the year.
Many people have the mistaken impression that influenza is a trivial disease. On an average year, the flu strikes about 7 percent of the population. While most cases involve a week or so of misery followed by recovery, a portion of these people are not so lucky.
Each year, 200,000 people are admitted to the hospital for influenza-related complications and, like the recent cases, 30,000-40,000 people die from influenza. Complications of influenza include respiratory failure requiring mechanical ventilation, heart disease, encephalitis, and kidney failure sometimes requiring dialysis. Children with the flu who are given aspirin occasionally develop a life-threatening complication known as Reye’s Syndrome. The most heartbreaking part of this is that it is largely preventable by vaccination.
Immunization is the most effective means of protecting yourself against the flu. Even last year when there was a partial mismatch of the vaccine due to unanticipated mutation of the virus, there was no increase in the number of flu deaths despite the increased number of cases. This implies that the vaccine may have still been partially effective, causing the disease to be less serious.
It is impossible to tell, at this point, how severe the coming flu season will be or how effective this season’s vaccine will be. Very early data indicates a good match between the vaccine and the circulating strains. Now is the time to get your flu shot and avoid becoming one of the heartbreaking statistics that were reported this week.
In addition to getting vaccinated, it is also important to follow three steps to keep yourself and those around you healthy this cold and flu season.
Visit ghs.org/flu for more information about the flu.
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He became the 42nd recipient of the Robert E. Leach Sports Medicine Leadership award for outstanding service in orthopaedics and sports medicine.
Accepting new patients. 103 Omni Drive, Suite B, Seneca SC 29672 Office: 864-886-9250
GHS is helping improve health and wellness in Spartanburg County
Lung cancer is most treatable when detected in its earliest stages.
View beautiful trees, enjoy fun activities and support GHS Hospice of the Foothills at the OMH Foundation 12th Annual Christmas Tree Festival.
Dr. Porter will lead the SC Orthopaedic Association which represents 200 orthopaedic surgeouns throughout the state. Congratulations!