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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.
Future Events Already Ruined
Feeling Everything’s Really Awful
Failure Expected And Received
As caregivers, we fear that our loved one will fall, get a bad result, be discouraged, not be able to do something, or that we don’t provide good enough care. Notice that all these fears focus on the future. Since there’s pain and troubles enough in the present, thinking about the future makes the present harder.
CHOOSE instead to be in the present. Notice I said CHOOSE. That’s easier said than done, isn’t it? Fear will inevitably arise. It’s unclear if we have the power to stop fear from coming. Fear affects us physically. Many people notice their heart rate and breathing increase or their temperature rise. Others notice tension in their shoulders and neck or experience nausea, fidgeting and sweaty palms.
Many of the fears of caregiving are related to unknowns. If you work with a hospice, home health, hospital or other agency, ask to speak to your social worker about your questions and fears.
Or find the help line for the illness you’re dealing with. For example, National Parkinson Foundation (800-4PD-INFO), American Cancer Society (800-227-2345), Alzheimer’s Association (800-272-3900), National Alliance on the Mentally Ill (800-788-5131) and the American Diabetes Association (800-342-2383). Googling the name of the illness will lead you to websites that can help you find helpline numbers and other resources. Avoid websites sponsored by groups trying to sell something, instead preferring groups that do research or support caregivers. Ask a friend to help you find answers.
Caregiver support groups also help us face our fears. If your loved one has a terminal or chronic illness, join us on Oct. 6 at 3 p.m. at the Cottingham Hospice House. If your loved one has dementia, a support group meets Nov. 16 at 11:30 a.m. at GHS Oconee Memorial Hospital. You can find other specific support groups by visiting the website of that illness.
Despite these and other good efforts, you may notice some fears don’t go away. If fear is preventing you from living for today, try this exercise to get you more into the present. First notice what fear does to your body, thoughts, feelings, hopes and caregiving. Then CHOOSE to be in the present. Take a deep breath and move your focus from the worries to something in the now such as the following:
Fully enjoy the beauty of a flower or an autumn leaf, the emotions a favorite song creates, the smile that a person you love can bring to your face or the texture your loved one’s hair or skin. Pick up something you love and lose yourself in noticing how it feels and what its beauty is. After focusing on this small immediate thing, see if your fear (and what it does to your body) has decreased.
Instead of Forgetting Everything About Reality (FEAR), take care of the present questions and needs. Leave the future for another day; you have enough energy to handle the present.
Lung cancer is the leading cause of death in the United States, and cigarette smoking is responsible for 87 percent of lung cancer deaths. It’s important to know that lung cancer doesn’t have to be a death sentence. In fact, lung cancer screening is already proving to be helpful in reducing lung cancer deaths.
The National Lung Screening Trial sponsored by the National Cancer Institute found a 20 percent reduction in lung cancer deaths in high risk* individuals who had a CT scan instead of a chest X-ray. It’s important to note that the reason the CT scan worked in this study is because it was performed not once but annually for three consecutive years. Additionally, this study showed that a person’s risk of dying from other causes decreased by seven percent because other issues were discovered during the screening process.
An additional study of more than 3,300 participants examined the conversations that occurred between the patient and clinician during the screenings. For example, if the clinician asked the patient about smoking but did nothing else, there was no difference in the quit rate. However, if the clinician asked about smoking and provided smoking cessation medications and counseling, the odds of quitting increased by 40 percent. This finding confirms that screening and counseling alone are not enough. We, as clinicians, need to do more to help our patients quit smoking for good.
GHS is committed to helping reduce the number of lung cancer deaths in our community through our lung cancer screening program. The program, which combines annual low dose CT scans with a certified QuitSmart smoking cessation program, has already been recognized as a Screening Center of Excellence by the Lung Cancer Alliance.
Screening Centers of Excellence are committed to providing clear information based on current evidence on who is a candidate for lung cancer screening, and to complying with comprehensive standards based on best practices developed by professional bodies such as the American College of Radiology (ACR), the National Comprehensive Cancer Network (NCCN) and the International Early Lung Cancer Action Program (I-ELCAP) for controlling screening quality, radiation dose and diagnostic procedures within an experienced, multi-disciplinary clinical setting.
As clinicians, we know that low dose CT screening is the only proven method to detect lung cancer at an early and treatable stage. We also know that quitting smoking isn’t easy, which is why we have staff dedicated to help you.
To learn more about the lung cancer screening program, visit our website or call 455-1346.
*High risk can vary in definition but is generally considered to be a person between the ages of 55 and 77 who smoked 20-30 pack years and is currently smoking or quit within the last 15 years.
I have been a family medicine physician in Laurens County for more than 27 years. As a family medicine physician, I am responsible for providing comprehensive health care for individuals and families of all ages across the life span.
Over the years, I have seen health care change. Costs have risen, yes, but so have the number of innovations and life-saving approaches. The industry’s focus is also changing from one focused on volume (or number of services performed) to one focused on value. By value I mean delivering high quality care at an affordable price – something consumers are demanding, and rightly so.
What excites me most about the new healthcare environment, though, is our continued focus on the patient. Doctors, nurses, hospitals and the like are all working together to enhance the patient experience. This means everything from more convenient hours and shorter wait times to use of new technologies and a greater emphasis on prevention and wellness.
Like most family medicine physicians, I take an interest in my patients. I want to know how they’re doing, what challenges they’re facing and what I can do to help. This is the role of a “medical home,” and I believe it’s my most important role both now and in the future.
In short, a medical home is a place where a team of medical professionals can provide you with personalized care, follow your health status over time, and spot potential problems before they become life-threatening. Whether you’re 5 or 95, it’s important to have a medical home. It’s even more important to have a medical home that has been recognized by the National Committee for Quality Assurance as a Patient-Centered Medical Home.
“Patient-centered” is the healthcare industry’s way of saying that you are the most important person when it comes to your health care, and your healthcare team is focused on providing you with the best care possible.
As part of Greenville Health System, I am proud to represent one of 37 practices that have achieved Patient-Centered Medical Home recognition and are committed to:
Patient-Centered Medical Home recognition is good news for you and our community because it means the healthcare team is communicating with one another and working together to ensure patients receive the right care, at the right time and the right place.
It also reflects our team’s ongoing commitment to quality. We are constantly assessing where we are and where we should be in terms of delivering high quality care. For example, all of our physician practices are committed to ongoing quality improvement projects that focus on improving outcomes for conditions like high blood pressure and diabetes. However, to be successful, we also need patients to engage in their care and take the necessary steps to improve their health.
At the end of the day what we want most is for our patients to be happy and healthy. We recognize that enhancing the patient experience is critical to our ability to achieve this goal, and we will continue to ask our patients how we can do better.
For more information on our Patient-Centered Medical Home recognition, including a list of practices who have received this recognition, visit ghs.org/pcmh.
We hear a lot about distracted driving and are told not to text while driving, but what about while walking? Safe Kids Worldwide, headquartered in Washington D.C., recently published an article about distracted walking. One of the main points they make in the article is that the incidence of injuries to pedestrians rises during the fall months, so now is the perfect time to discuss pedestrian safety with children, teenagers and adults. Below is the full article.
Cell phones are a great way to keep in touch with teens who are on the go. New research from Safe Kids Worldwide, however, examines how cell phones and other handheld gadgets are causing teens to be more easily distracted, which is leading to greater risk on the roads.
“Teens on the Move,” a report made possible with support from FedEx®, explored the walking habits of 1,040 teens ages 13 to 19. The research found that an astonishing 40 percent of teens surveyed said they had been hit or nearly hit while walking. The teens admitted to three unsafe habits that could be putting them at risk:
Every hour of every day, a teen pedestrian is killed or injured in the U.S. after being hit by a car, bike or motorcycle. Safe Kids developed the study to better understand why teens have the highest pedestrian death rates among children 19 and under. The death rate for teens ages 13 to 19 is nearly three times that of 5 to 12-year-olds. In 2012, 490 children age 19 and under died after being hit by a car while walking. Of those, 284 were teens ages 13 to 19.
The research expands on findings from a 2013 Safe Kids report that observed middle school and high school students crossing the street. That study revealed one in five high schoolers and one in eight middle schoolers cross while distracted by technology.
Safe Kids Worldwide and FedEx recommend the following tips to all of us safe while walking:
Safe Kids also encourages teens and parents to participate in The Moment of Silence Campaign, which asks for this simple commitment: put down your device and pay attention when crossing the street. Safe Kids launched the campaign in memory of Christina Morris-Ward, a 15-year-old who was killed when crossing the street while distracted. She was wearing head phones and carrying a cell phone.
To learn more about teen pedestrian safety and the Moment of Silence Campaign, visit safekids.org.
The 2015-2016 school year has begun, and children across the Upstate are riding the bus, carpooling and some are even driving as well. We remind parents to slow down in school zones; have students be safe while waiting for the bus; and look left, right, and then left again before crossing the street at an intersection – all extremely important safety practices. We tend to focus a lot on the elementary-age child during this time of year.
Because our middle school and high school students are veterans, we don’t focus on them – but we should. We regularly entrust our teens with the responsibility of driving their younger siblings to school before they embark for their own educational destination. We may think it’s enough to talk to our teens about the dangers of drunk driving and the importance of wearing seat belts, but there is another traffic safety issue we must make our children aware of, and that is distracted driving.
Distracted driving comes in many forms. It can include electronic distractions, like navigation systems and cell phones, or more conventional distractions, like interacting with passengers and eating. Texting is the most dangerous of all distractions because it involves manual, visual and cognitive distraction simultaneously. Sending or reading a text takes your eyes off the road for 4.6 seconds. At 55 mph, that’s like driving the length of an entire football field blindfolded.
At Safe Kids Upstate, our goal is to reduce preventable injuries among kids age 19 and under. The largest contributor to these preventable injuries are car crashes. According to the National Highway Traffic Safety Administration, more teens (ages 13-19) die in car crashes than from any other cause of death, about 2,500 per year.
In their 2014 “Teens In Cars” report, Safe Kids Worldwide found that teens dying in cars made up more than 25 percent of the number of children who die from preventable injuries each year. Data shows that in half of these fatalities the teen was not wearing a seat belt, and the number of fatalities was almost equally split between the teen driver and teen passenger.
We know that when a teen is driving with just one other teen as a passenger their chances of being involved in a crash increases by 48 percent. Add additional teen passengers and the likelihood of them being involved in car crash increases by 300 percent.
So, what can we do to prepare our teens for the road? Be a good role model; wear your seat belt every time you get in the car, even for short trips. Studies show that parent involvement increased teen seat belt use by 50 percent. (Meanwhile, nearly 60 percent of teens reported seeing their parents talk on the phone while driving, while 28 percent have seen their parents text while driving.) Also, take a stand by making your car a no-cell phone zone. Even a passenger using the phone can be a distraction.
And lastly, always remember this phrase: buckle up – phones down. This will help everyone arrive safely.
We’ve seen some big news recently about the treatment of breast cancer and it has sparked a national discussion among cancer specialists, patient advocates and cancer survivors. The controversy is about the treatment of a form of breast cancer called “ductal carcinoma in situ.” The acronym is DCIS. It accounts for about 25 percent of all breast cancer diagnoses. DCIS has been considered to be a very early stage of breast cancer. It is called stage 0 to separate it from the more advanced and more dangerous “invasive ductal carcinoma,” ranging from stages 1-4.
On August 20, 2015, a study in JAMA Oncology was reported online. It described an observational study of more than 100,000 women with DCIS in a large national cancer database called Surveillance, Epidemiology and End Results (SEER). Virtually all of the women in the study had lumpectomy or mastectomy and some had double mastectomy. Many received radiation therapy and endocrine therapy like tamoxifen. The study estimated the 10-year breast cancer-specific mortality rate after a diagnosis of DCIS to be 1.1 percent and the rate at 20 years to be 3.3 percent. It turns out that this low risk of dying from breast cancer for women is about the same as the risk of dying from breast cancer for women in an American Cancer Society database, who were not diagnosed with DCIS. In other words, women diagnosed with DCIS, that is, stage 0 breast cancer, have a very low risk of death due to breast cancer that is no higher than the general female population.
The conclusion of many experts is that DCIS is not very dangerous at all and the vast majority of women diagnosed with breast DCIS do not need lumpectomy and radiation therapy, mastectomy or double mastectomy. The further conclusion is that most women with DCIS receive more treatment than they need and the standard of care for treatment of DCIS should change. In a recent New York Times article, some prominent breast cancer experts said that the best way to treat DCIS is to do nothing at all. Other experts said that DCIS should still be considered as a precursor to invasive breast cancer and be treated with lumpectomy or mastectomy. It is rare for oncology experts to be so divided.
What should we make of this controversy? What does this mean to women newly diagnosed with DCIS? I have a few observations. First, all DCIS is not the same. The study indicated that DCIS has a definitely higher risk of invasive cancer and death in certain subsets of women, including women less than age 40, African American women and women with known genetic mutations. The experts agree that these groups should be treated with the current standards. However, it is important to know the specifics of the DCIS before making treatment decisions.
Second, the vast majority of DCIS is truly much less dangerous than invasive breast cancer. The difference is so great that some experts have suggested changing the name of DCIS to something without the word cancer. I offer the following analogies. If invasive breast cancer is a watermelon, DCIS is a plum. If invasive breast cancer is a dandelion, DCIS is a seed that has not sprouted and hopefully never sprouts. If invasive breast cancer is social media, DCIS is snail mail.
Third, a woman newly diagnosed with DCIS benefits from a thorough evaluation by multiple cancer specialists. In the Breast Cancer Multidisciplinary Clinic (MDC) at the GHS Cancer Institute, a woman with a new diagnosis of breast cancer is evaluated in the same visit by the surgical oncologist, the radiation oncologist and the medical oncologist. At this lengthy visit, the breast radiologist and breast pathologist review the specific features of that breast cancer. This systematic and thorough MDC approach has been recognized as a national best practice for breast cancer care.
When a woman is diagnosed with breast cancer, a first impulse might be to “get this off of me now.” I would advise taking a few weeks to think about it, to get a thorough evaluation in a multidisciplinary, real time clinic, and/or to consider getting a second opinion. You are worth the extra effort.
For more information about breast cancer and the GHS Cancer Institute Breast Cancer Multidisciplinary Clinic (MDC), contact the GHS Breast Health Center at (864) 455-1392 .
Breast Nurse Navigator Jo Maria Weathers and Genetic Counselor LeDare Finley contributed to this blog post.
When I received my September issue of Consumer Reports and saw the article about “healthiest snack bars,” I was curious about the criteria Consumer Reports would use to decide that one snack is better than another. To me, it brings up the question of what one wants from a snack and what one should want from a snack. Readers of the Survive and Thrive blog are well aware of our advocacy of a plant-based diet with five servings of fruits and vegetables per day, limited added sugars, whole grain foods and limited red and processed meats. Our readers are also well aware of the need for calorie control and the link between excess weight and cancer. To add to the discussion, I will say that the Center for Integrative Oncology and Survivorship (CIOS) is paying more and more attention to how we avoid bad eating habits, create good habits and maintain good habits. So, what do we really want from a snack? What would make a snack healthy?
The question is important because we are bombarded with advertisements for more food than we need or should eat. The Consumer Reports article points out that 90 percent of pharmacies and gas stations have candy, sugary drinks and salty snacks at the checkout. Clearly candy bars and full-calorie sodas are not healthy. I like to refer to them as “weapons of mass destruction” for what they do to our bodies through excess calories, excess inflammation and immune suppression.
So, if a snack should not contain added sugar, what should it contain? That may depend on your reason for eating a snack. If it is before exercise, you should include a healthy carbohydrate like fruit (natural sugar) or whole grains (without added sugar) paired with a plant-based protein such as peanut butter. If it is simply to hold you over until the next meal, try a non-starchy vegetable that you can eat a larger volume of with fewer calories and pair it with a protein. For instance, carrots and hummus make a great snack. If you are eating just for a sweet taste, try a convenient fruit such as grapes or dried fruit to satisfy your sweet tooth.
I propose that the best purpose of a snack is to satisfy one’s appetite until the next meal. This may not be everyone’s definition, but it is a good one. In this regard, protein and fats are better at satisfying hunger than carbohydrates like breads, foods with added sugar, and candy. One of my favorite snacks is a serving (enough to fill the palm of your hand) of almonds. It has some fat and some protein, but it is tasty and more likely to tide me over to the next meal versus a chocolate chip cookie.
The Consumer Reports article lists berry and nut bars as well as chocolate bars, while rating some as top picks on the basis of less added sugar and protein coming naturally from the fruits or nuts. The snack bars listed as bottom rated tend to have processed protein or fiber in the form of soy-protein isolate or chicory root (this is an added fiber). I will not name names, but I will suggest that you pay attention to grams of added sugar. Bars with less than 10 grams of sugar each are a better choice than bars with 15-20 grams of added sugar each. Remember that the recommended limit for added sugars in our diet is 25 grams per day, which is equal to about six teaspoons of sugar.
In summary, I suggest that you treat a snack as something healthy to get you through to a healthy meal later on. For this, I recommend fruits and nuts. Snack bars are appealing, but they may have more added sugar, more calories or more trans fats than meet the eye. As an alternative to commercial snack bars, I recommend something like this recipe that was given to me by my sister-in-law, Evie O’Kale.
Here’s a yummy treat that will fuel you with wholesome and real food ingredients. It combines healthy fats, carbs and protein to provide an energy boost any time of day!
– 3/4 (loosely filled) cup of medjool dates, pitted
– 1/2 cup of raw almonds
– 1/2 cup raw walnuts
– 2 tablespoons unsweetened shredded coconut
– 2 tablespoons dried goji berries
– 1 tablespoon chia seeds
– 1 tablespoon of almond or cashew butter
– 1 tablespoon raw cacao nibs
– 1/4 teaspoon ground cinnamon
Makes approximately 15 servings (~1 inch balls).
If desired, you may use unsweetened carob powder, hemp seeds or the shredded coconut as a coating.
Place the nuts into a food processor; blend until finely crushed. Then add the dates, pulsing processor until mixture begins to stick together, scraping down sides as needed. Add the rest of the ingredients to the processor, pulsing until well incorporated.
Roll the mixture into small bite-size balls, about an inch in diameter. If you like, roll balls in a small bowl with the coating of your choice. Place them in the freezer on a parchment lined sheet for an hour or two to set; then store in the fridge.
These will keep about a week in the fridge in a glass covered container. Enjoy!
Registered dietitian Jessica Menig contributed to this blog.
Big news! Pepsi Co. recently announced that it will stop using aspartame in Diet Pepsi. The new soda cans will say “Now Aspartame Free” on the label. The reason given is not health or safety issues but rather consumer demand. That is, Pepsi is dropping aspartame after more than 20 years because its customers are uncomfortable with aspartame. Interestingly, Diet Coke and Diet Dr. Pepper use aspartame as their sweeter and will continue to do so, although Diet Coke does have a formula that uses Splenda.
A Gallup poll published in July indicated just how uncomfortable Americans are with artificial sweeteners in diet soft drinks. When asked what foods they include or avoid in their diets, 62 percent said that they avoid diet soda, compared to 61 percent for regular soda, 50 percent for sugar, 47 percent for fat and 39 percent for salt. I am surprised that more Americans avoid diet soda than regular soda. So, are artificial sweeteners that bad? Is aspartame, in particular, that bad?
Health risks for aspartame have been studied extensively. Neither animal studies nor human studies have demonstrated any cancer or other health risk. The Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA) have both pronounced aspartame safe as a general sweetener for food. There is a good discussion of this on the American Cancer Society website. As a physician who practices integrative medicine, I add evidence-based concerns about our mind and body health to conventional medicine. I find no evidence that aspartame is bad. Therefore, I use artificial sweeteners occasionally to help me avoid added sugars. The label “now aspartame free” does not impress me.
Similarly, I have found no evidence that other artificial sweeteners, such as Splenda (sucralose), Sweet ‘N Low (saccharin) and Truvia (stevia), are health risks. In fact, a previous Survive and Thrive blog explains that saccharin is definitely not harmful and may have an anti-cancer effect. (Read that blog post here.) On the other hand, added sugar in soft drinks is a huge health risk. This has also been discussed in prior Survive and Thrive blogs. It is fine to avoid diet soda because we don’t need extra artificial chemicals in our bodies, but it is much more important to avoid sodas containing added sugar. Note that a 20 ounce Pepsi contains 69 grams of added sugar compared to the recommended 25-35 grams of added sugar per day. We definitely don’t want the calories, the inflammation, the diabetes, the heart disease or the cancer. Let not the mouse distract us from the elephant.
At the Center for Integrative Oncology and Survivorship (CIOS), we pay a lot of attention to nutrition and diet. If you would like to learn more about healthy food and drink choices for cancer survivors, call (864) 455-1346. We can provide information about classes and activities or schedule an appointment with our integrative oncology nutritionist. You can also find us online at ghs.org/cios.
Going back to school is such an exciting time, but after a summer of fun it can sometimes be hard to get back on a schedule.
Parents have to readjust to the daily activity of packing school lunches. As a parent, you want to make sure that your children are eating not only a healthy lunch but a safe one as well.
Food safety and good health start at home.
Always make sure to wash your hands prior to prepping or packing any food. Ensure that fruits and vegetables are safe by washing and drying them thoroughly before packing them. Always keep raw foods away from cooked or ready to eat foods to prevent cross-contamination. If you are cooking food, make sure it is cooked to the proper internal temperature. For example, chicken should be cooked to 165 degrees fahrenheit.
To ensure that foods stay at the right temperature by lunch time, buy an insulated lunch box.
When packing food, use baggies and containers that can seal completely. To keep cold foods cold you can use ice packs or even frozen water bottles for dual purpose. For hot items, like spaghetti or soup it is helpful to use a thermos to maintain temperature. It’s also a good idea to use as many non-perishable items as possible so that temperature control isn’t an issue.
A great way to make healthy packed lunches fun is to involve the kids in the process.
They are a lot more likely to eat what you give them if they have a say in what they are given. Let them help you clean and cut up fruits and vegetables and put them in containers for the week and then day to day they can pick an option. You can also keep a bin of healthy non-perishable snacks they can pick from day to day. General recommendations would be: fruit leather, seed and nut packs, unsweetened applesauce, multigrain crackers, granola bars, veggie straws, and banana or apple chips.
Getting creative with main meals everyday can get tough, especially with picky eaters as well as food restrictions.
A lot of schools now do not allow certain foods like peanut butter or nuts due to prevalent food allergies. A good alternative to the classic peanut butter sandwich could be hummus and pita bread or chips. You could also offer a homemade fruit smoothie in a thermos for a yummy treat to break up the sandwich monotony. Homemade soups are a healthier option for cold winter months and will stay warm in a thermos. If you do offer your children deli meat sandwiches, keep condiments on the side and use an ice pack in the lunch box. Sometimes sandwiches will get squished from the pack, so try using whole wheat pita pockets for deli meat sandwiches that hold up better than bread.
The bottom line is to use lunch packing as a learning opportunity with your kids. It can help them learn not only about making daily healthy choices but also food safety!
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