Welcome to the GHS blog
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.
Endometriosis is one of the most common and least discussed problems that women encounter. For couples it can lead to almost complete sterility, sometimes without symptoms.
So, what is edometriosis? Endometriosis is the presence of endometrium (the lining of the womb) outside of the uterus, which usually means inside the woman’s lower abdomen (pelvis) on or near her bowel or bladder. It gets there when menstrual blood travels backwards out the fallopian tubes instead of leaving the woman’s body. The cells that make up the endometrium can attach and continue to grow and are responsible for much of the pain that women experience during their period.
While thought to be progressive, in many women endometriosis does not progress and can even be dormant for many years. A teenager with severe menstrual cramps has a 60 to 70% chance of already having endometriosis, and even after starting birth control pills, it can still be there years later causing problems such as unexplained infertility. While only 5 to 10% of normal women have endometriosis, up to 40% of infertile women have the disease. It accounts for $22 billion in healthcare costs in the U. S. alone and affects 176 million women worldwide.
So, how would a woman know she has endometriosis? Significant pain with menstruation (periods) is one suspicious sign. Spotting before the menses starts is another. Pain with intercourse or bowel movements and bowel or bladder symptoms around the time of a woman’s cycle is a reliable sign that endometriosis might be present. Interstitial cystitis and irritable bowel syndrome, much more common in women, are both thought to be primarily due to endometriosis. Infertility, without a cause, (normal sperm counts, open tubes, and ovulatory cycles) gives a woman over 60% chance of having endometriosis.
Endometriosis is a disease with major consequences and one we should all be aware of. In teenagers, birth control pills can stop endometriosis from developing further. In adult women, limiting the number of menstrual cycles is important as well. Suppression with medications is a current therapy, but surgery is the gold standard for both diagnosis and treatment. The good news is that once diagnosed and treated, most women will have relief from their symptoms and have a better chance of getting pregnant.
You can read more about this disease on the Endometriosis Association’s website.
More than 5,000 students are educated each year on a Greenville Health System campus. In fact, if GHS were a traditional college or university, it would be among the largest in South Carolina!
GHS recently launched the GHS Clinical University, a one-of-a-kind academic health center model with primary academic partners Clemson University, Furman University and the University of South Carolina. The goal of this unique partnership is to improve patient care in the region by expanding healthcare research and growing educational opportunities for current and future health professionals.
GHS is currently home to more than 40 academic professional programs and the University of South Carolina School of Medicine Greenville. In addition to future physicians, there are students on our campuses studying in programs as diverse as nursing, pharmacy, therapies, nurse anesthesia, clinical pastoral education, as well as numerous pipeline initiatives. Our programs and educational initiatives span the continuum of undergraduate, graduate and professional-level studies.
Each academic year, GHS hosts Health Career Clubs for local high school students, while area colleges and universities send undergraduate students for simulation and clinical observation experiences. During the summer, high school and undergraduate students explore health care through lectures, workshops, research and community service as part of the Medical Experience Academy (a.k.a. MedEx Academy). The goal of each of these programs is to meet one of our region’s greatest needs — highly-skilled, ready-to-work health professionals prepared to serve our communities.
As health care continues to change, the GHS Clinical University’s innovative partnerships will foster initiatives necessary to address our nation’s growing physician shortage, the demand for improved workforce pipeline programs, and the need to make health care more accessible and affordable.
Interested in learning more about research and educational opportunities at GHS? Visit the GHS Clinical University website.
Cancer cells love sugar, right? This question comes up frequently when cancer survivors start investigating how to alter their diet to better fight cancer. The logic behind the question says that sugar feeds cancer cells and this causes cancer to grow in the human body. The logic continues that avoiding sugar can starve cancer cells, thus helping the body fight cancer. But is it true? Can avoiding sugar really help the body fight cancer? The answer is partly yes, but some explanation is in order.
First of all, our diets contain a number of different kinds of sugar. Fructose is natural sugar from fruits. Lactose is natural sugar from milk. Maltose is natural sugar from grain. Glucose is the simple sugar present in every cell in our bodies. It is necessary for much of energy that keeps our bodies healthy and active. Yes, glucose feeds cancer cells, but it feeds every cell in our body and is necessary for life. Dextrose and sucrose are compound sugars that are made from glucose.
Second, sugars in our diets can be divided into two groups. One group is the naturally occurring sugars, such as the sugars in fresh fruits, honey, maple syrup, molasses and exotic plants like coconut and agave. Foods that contain naturally occurring sugars also contain antioxidants that actually reduce the risk of cancer. The other group is added sugars, such as the sugars in table sugar and white flour. Added sugar includes the 14 grams of sugar in a bowl of sugar sweetened cereal, the 41 grams of sugar in a can of Pepsi or the 91 grams of sugar in a McDonald’s medium triple thick milkshake. Added sugars are found in many packaged, canned and processed foods. Foods with added sugars are often convenient and tasty, but they don’t contain antioxidants. They do, however, contribute to “added sugar overconsumption.”
Added sugars from soft drinks and processed foods like cookies and cakes are harmful to human beings because they cause tooth cavities and obesity, which in turn lead to heart disease and cancer. They also cause inflammation in cells and blood vessels, which lead directly to heart disease and cancer. An editorial in the February 3 issue of JAMA Internal Medicine summed up the situation as “too much sugar does not just make us fat; it can also make us sick.” This is why cancer survivors (and everyone) should avoid added sugars, not because glucose feeds cancer cells.
Added sugars are enough of a health hazard that experts have recommended that women limit their intake to 25 grams per day and men limit their intake to 38 grams per day, which is less than the sugar in one can of Pepsi. For this reason, I call sugared soft drinks “weapons of mass destruction.” I recommend that everyone avoid foods made from sugar and processed flour, that is, added sugars. For me, it means packing fresh grapes (with naturally occurring sugars and antioxidants) in my lunch every day for dessert instead of cookies.
How about you? Do you have any favorite desserts with naturally occurring sugars instead of added sugars? Feel free to share them with our readers in the comments section below.
There are currently more than 600,000 female colorectal cancer survivors in the U.S., and it is estimated that over half of these women are overweight. Despite clear recommendations by medical experts to increase their physical activity, only about one-third of cancer survivors engage in the recommended 30 minutes of moderate intensity physical activity at least five days per week.
With the New Year less than two months old, many of us have made resolutions to exercise more but have already fallen short and become discouraged. What can we do to motivate ourselves to do what we know we should do? I suggest three steps: 1) remind yourself why you want to do it 2) set small, achievable goals, and 3) create an environment for success.
One good reason why colon cancer survivors should exercise is that exercise has an anti-cancer effect. How does exercise actually work to reduce risk of colon cancer or colon cancer recurrence? Losing weight is helpful but only part of the explanation. Apart from weight control, the benefits of exercise include a decrease in insulin and growth factor levels in the blood. This leads to decreased inflammation in the colon and less risk for cell mutations to progress to cancer. Exercise also improves digestion, decreases constipation and reduces stress.
The data are striking. Exercise reduces the risk of colon cancer recurrence even if the person is not losing weight. Colon cancer survivors who exercise regularly, compared to survivors who do not exercise, cut their risk of recurrence of their cancer by 20%. If exercise were a drug, it would be worth billions!
Second, start with small, realistic goals. If one can start by putting on the shoes and walking five minutes a day, that five minutes can become a habit that increases with time. The key is to look at what you can easily do as a start, and then build on that.
Third, create an environment for success. By this I mean, join an exercise facility, mobilize friends and family to join you in exercise, or do something else to make it easy to form good exercise habits.
On the topic of helping you stick with an exercise and diet plan, the GHS Cancer Institute’s Center for Integrative Oncology and Survivorship is participating in a National Cancer Institute study that helps female survivors of colon cancer to improve their diet and exercise. Women eligible for the study will get nutrition counseling over the phone and a membership at an exercise facility at no cost for 12 months. If you are a woman who has had colon cancer, this might be a good fit for you.
For more information about the study, contact Kate Richardson at (864) 455-2860.
Earlier this week, the long-term results of the Canadian National Breast Screening Study were published in the British Medical Journal. This study showed that screening mammography did not decrease the number of Canadian women who died from breast cancer. This might come as a surprise to many of you, but for those of us involved in caring for breast cancer patients, it is not too surprising. In fact, the recent results of the Canadian study confirm earlier publications by the same group about the same study that appeared in various medical journals from 1992-2002.
So, what’s the deal? What is going on with mammograms? Do they help or not?
Well, the answer is fairly complicated, as it involves some pretty sophisticated science and revolves around some misconceptions about what mammography can and cannot do.
First, it is important to point out that the Canadian study is not the only one that has examined the impact of screening mammograms on breast cancer death rates. In fact, this large, high-quality study from Canada actually contradicts a collection of multiple other, similar studies that show that screening mammography DOES reduce the risk of dying from breast cancer in women aged 40-59 (the same age groups included in the Canadian study). But, at the very least, the Canadian study should encourage us to reconsider the value of screening mammograms in women between 40 and 60 and challenge us to more clearly articulate the benefits and harms of participating in screening mammograms.
So, let’s talk about the benefits of mammography. We used to believe, without much doubt, that 1) using screening mammography would lead to detection of smaller cancers and that 2) this would then lead to lower breast cancer death rates. Virtually everyone agrees on the first point—mammograms DO help us diagnose cancers before they get big enough to feel. The second point, however, is not as clear for reasons that the Canadian study highlights.
First, cancers detected by annual screening mammograms tend to be less dangerous and less likely to cause deaths than cancers that cause symptoms. And whether we find and treat such cancers sooner rather than later doesn’t change the fact that they are less aggressive and less likely to cause harm. The ability of a test to find a cancer earlier and make it look like it is saving lives when it isn’t is called “lead-time bias.” And it seems reasonable that some of the perceived benefits of mammograms could actually be the result of lead-time bias.
A second reason mammograms might not be helping as much as we think they are is due to the substantial improvements in our abilities to treat breast cancers once they are diagnosed. Most of these improvements have come in the form of chemotherapy and hormone blocking medicines that have clearly led to more cures of and fewer deaths from breast cancer. Our improved treatments after diagnosis could certainly blunt the beneficial effects of earlier detection.
So, just as the benefits of mammography are being questioned, the risks of harm from mammography are being discussed more openly. More research has been published recently about the increase in stress and resulting decrease in quality of life among women who get routine screening mammograms. Put simply, the idea is that the stress of going to the mammogram appointment and wondering whether it’s “all clear” or “shows a spot” creates a measurable strain on a woman that can have a negative impact on her quality of life. And, since most of the “spots” on the mammogram that are recommended for biopsy do not turn out to be cancer, they are considered, by some investigators, to be “unnecessary.”
This idea of “unnecessary” biopsies even extends to some cases of cancer that are diagnosed based on findings of a screening mammogram. It appears that some cancers, if left alone and not treated, would never grow, spread to other pats of the body or result in death from breast cancer. So, when these cancers ARE found by screening mammography, they are “over-diagnosed,” and subsequently, over-treated. The authors of the Canadian study conclude that about one-fifth of the cancers found in the study participants who had screening mammograms were harmless, and therefore, over-diagnosed.
If any of this is freaking you out, please, don’t let it. We have presumed for some time that over-diagnosis exists. We have also known for some time that most of the biopsies that are done for abnormal mammograms do NOT show cancer. But we have, in the United States, made a choice that when it comes to mammograms, mammographic findings, biopsies and cancers we have set our needle to “SAFE” rather than “SORRY.” The results from the Canadian trial and the recent emphasis on the over-diagnosis of cancer and other harms of screening should not cause us to make drastic changes in our emphasis on safety. We should, instead, openly discuss these issues, both with our individual patients and as a society, so that we can chart a course forward that follows the best scientific evidence and offers us the peace of mind that goes with pursuing our total health.
Exercising isn’t easy. It requires time, dedication, and most importantly, motivation. Having a trained professional or even just a friend by your side can make it easier, right? Well, Olympic athletes are no different than you or me then. For these athletes to be successful and compete at the top of their game, they need trained professionals by their side that can help motivate and guide them through their daily workouts and get them back on their feet after injury. Keith Scruggs is one of those people.
As the director of GHS’ Acceleration Sports Institute (ASI), I have had the privilege of building relationships with the Olympic training centers in Colorado Springs, CO, and Lake Placid, NY. In fact, three years ago, ASI formed a partnership with the USA National Karate Federation and became the official strength coaches for the organization. It was this relationship with the USA National Karate Federation that led me to Lake Placid, NY, in 2012, and introduced me to Keith Scruggs.
At the time, Keith was serving as an assistant head strength coach responsible for training and testing Olympic bobsled, skeleton and luge athletes. He was also assisting head sport physiologist Dr. Brad Weese, an Ashevile native who has designed training programs for some of our nation’s top athletes (Steve Holcomb, Steve Langton, Dallas Robinson, Johnny Quinn and Lolo Jones just to name a few). Keith’s talents were apparent from the start, and I knew immediately that he would be a perfect fit for ASI. So, in June of 2013, I asked Keith to lead the training of all Olympic, professional, college and high school athletes at ASI. Luckily for us, Keith accepted, and some of the athletes he has been training are competing in the Sochi 2014 Winter Olympics!
Since bringing Keith on board at ASI, we have formed a relationship with the USA Para Cycling team and expanded our partnership with USA Bobsled, USA Skelton, USA Luge and USA Track and Field. In fact, ASI is planning to host a combine this summer to find future talent for the USA Bobsled & Skeleton Federation. And in the fall, we plan to host a slider search for USA Luge.
Having a trained professional like Keith Scruggs at ASI is a huge win for our community because it means Olympic-caliber athletes will be coming to Greenville for training. It’s also a huge win for those of you who think you or your child have what it takes to compete in the Olympics.
To train with Keith, or for more information on the events mentioned above, call 454-2749 or email firstname.lastname@example.org.
These days it seems all too common to read about a business or corporation that has been motivated by greed. Often these businesses or corporations take actions that hurt our environment, and subsequently, our health. Last week, we learned that CVS has taken an action that is not motivated by greed; rather, it will likely hurt their bottom line. Their decision to discontinue the sale of cigarettes will contribute to better health for all of us, and they deserve to be recognized for this laudable decision.
As a cardiologist, I know all too well the harmful effects of smoking. Early in my training I learned from studies, such as “Coronary Artery Disease in Combat Casualties in Vietnam,” that smoking accelerates the rate at which plaque (atherosclerosis) develops. You see, the soldiers killed by bullets were found at autopsy to have plaque at their young age of 18 or so. As a result of this study, MREs (Meals Ready to Eat) were no longer packaged with a pack of cigarettes. This was a bold step in the right direction during that time period much like CVS’ decision to stop selling cigarettes is a bold step in the right direction for 2014. As always, though, more can and must be done to prevent the harmful effects of smoking.
Heart disease and stroke are two of the leading causes of death in the United States. In fact, each year about 600,000 people die of heart disease and about every 44 seconds someone in the U.S. has a heart attack. The Department of Health and Human Services launched the Million Hearts initiative in September 2011. The goal of this initiative is to prevent one million heart attacks and strokes by 2017. This can best be accomplished by reducing the number or people needing treatment and emphasizing control of risk factors in those that need treatment. Smoking is among these major risk factors, and smoking cessation will help us achieve this goal.
So, why stop smoking? Smokers can expect to live 10 years less than non-smokers. In our own state, the top three causes of death are well linked to smoking: cancer, heart disease and COPD. Twenty-three percent of the South Carolina population smokes, while the national average is 19 percent. A shocking 11 percent of U.S. women smoke while pregnant. In South Carolina, 16 percent of women smoke during pregnancy. And slightly above the national average, 19 percent of our South Carolina youth smoke. As a result, the Centers for Disease Control and Prevention estimate our state spends $1.09 billion on smoking-caused illnesses. We also have one of the lowest cigarette taxes in the nation. In fact, South Carolina ranks 42nd, which means 41 states have a higher cigarette tax than we do.
CVS’ decision to stop selling cigarettes is monumental, and what makes it even more significant to me is that it was announced during Heart Month. I believe their decision will usher in a new standard for drug stores, in the same way we now enjoy smoke-free air flights and smoke-free hotels. It will also help our state and our country to redirect healthcare dollars saved to fight other illnesses. Most importantly, it will help us save lives.
Lastly, I’d like to wish you a happy Valentine’s Day. And if you smoke, may I suggest you give your valentine the most precious gift of smoking cessation.
Until two years ago, I had never heard of National Donor Day and thus had no idea it was February 14. But on February 13, 2012, I received the call from the Duke Transplant Center saying I was approved to donate a kidney to my young-adult son. That day, while at dialysis and surfing the Internet, my son read about National Donor Day and wrote his own message about it, which later ran as a guest column in The Greenville News.
I was fortunate to be able to be a living donor – a critical option for patients with End Stage Renal Disease. While the waiting list in S.C. for a kidney from a deceased donor can take, on average, three to five years, a live donor transplant can occur whenever there is an approved match – and a willing donor. And while I knew I was a match, the process of getting approved and having the surgery took nine months.
An interesting thing I noticed while going through the process is that people thought it was a big deal for me to give my son a kidney. And it was, but not in any heroic way. Watching him suffer through dialysis for 22 months was much harder than my 48-hour stay in the hospital. Certainly major surgery is nothing one recovers from immediately, but seeing my son look and feel better two days after the transplant than he had in the previous two years was more than enough for me.
While everyone may not have the opportunity or the motivation to be a living donor, anyone has the choice to donate organs or tissue at the time of death. This type of donation leads not only to individuals getting off dialysis but also can give eyesight, help burn victims, save limbs and, ultimately, save lives. On any given day, 112,998 people are waiting for an organ; 18 of those people die every day waiting, and just one organ could save up to eight lives, according to organdonor.gov. For each person that donates tissue and organs, 50 people can benefit. What a legacy!
National Donor Day, celebrated on Valentine’s Day, focuses on five points of life: organs, tissues, marrow, platelets and blood. Based on our family’s experience, I ask you to consider donating any of these and also joining the South Carolina Donor Registry. This can be done through your local DMV or several websites, including www.lifepoint-sc.org and www.donatelifesc.org. This Valentine’s Day, show your love in more than just the traditional way.
What costs our nation over $30 billion per year, results in 1 million hospital visits, claims over 250,000 lives per year and is set to double by 2030 because of an aging population and growing epidemics of obesity and diabetes?
It is congestive heart failure (abbreviated as CHF) which affects approximately 5-6 million Americans. A failing heart results in fluid retention and congestion of the lungs, abdomen and legs. Shortness of breath, swelling and weight gain ensue and restrict mobility. The condition leaves its victims feeling like they are drowning. Occasionally, dizziness, palpitations and loss of consciousness may occur.
Heart attacks, high blood pressure, and heart valve disease account for 97 percent of the causes of CHF. Less frequent, but important, causes are complications from diabetes, alcohol or drug abuse, certain viral infections (called myocarditis), certain medication (especially for cancer), complications from pregnancy, and rare congenital or genetic problems. Occasionally, no cause can be identified.
About half the patients who are diagnosed with CHF may die within 5 years. This prognosis is worse than that for many types of cancer. We, in Greenville, are not immune to this problem. Approximately 750 CHF patients are admitted to Greenville Memorial Hospital every year.
In 2008, a remarkable story of team work and dedication began when a diverse group of professionals — including doctors, nurses, pharmacists, social workers, dietitians, case managers, cardiac rehabilitation, home health, and hospice providers along with support from administration and philanthropy — came together as the ‘CHF Action Team’. A CHF program was launched to provide the best possible care and support to our patients whether they are at home, hospital, clinic or emergency room. A dedicated CHF clinic is one facet of the program in which outpatients are closely monitored, treated, and continually educated and reeducated about diet, lifestyle and treatment.
Thanks to the effort and dedication of the team, GHS has been consistently ranked in the top eight health systems in the nation for low 30-day readmission rates. Nationwide, about 25 percent of patients with CHF who are discharged from a hospital are readmitted within 30 days across the nation.
We are proud of our work, but we also want the community to be aware that CHF is largely preventable with a healthy lifestyle and diet, maintaining ideal body weight, regular aerobic exercise and avoidance of smoking. Everyone should work with their primary care doctors to maintain ideal blood pressure, blood sugar and cholesterol levels.
Prevention is absolutely the most effective way to stem this epidemic. Let’s renew our commitment to this goal this February, which is ‘Heart Month’.
Dev Vaz, MD, is the medical director of GHS’ congestive heart failure clinic and a cardiologist with GHS’ Carolina Cardiology Consultants. For more information about the clinic or CHF, visit http://www.ghs.org/CHFclinic.
Search our database for a physician that fits your life.
Highlights from our milestone year of Advancing Health Care for Generations.
Saturday, April 12, 2014 at TD Convention Center.
Friday, May 2nd at 6:30 p.m in Travelers Rest.
Saturday, April 26, 2014 at Heritage Park.
New center significantly expands options for cancer patients.