Colorectal cancer?

Hardly has the panache of breast cancer, eh? While we have become accustomed, nay conditioned, to associate the color pink with breast cancer awareness and activism, most folks probably can’t come up with the color claimed by the colorectal cancer cause. (It’s not as gross as you might think – it’s blue not brown!)

Now, don’t misunderstand me – I am an ardent supporter of raising breast cancer awareness. But March is Colorectal Cancer Awareness Month and some equal time is in order. So, if we move away from the notions of colors for cancers and causes, we could ask ourselves: What should colorectal cancer awareness focus on? What should it all be about? Good question.

I like to think of colorectal cancer awareness as an important part of maintaining total health, something that seamlessly fits with a healthy lifestyle and the desire to live a long, disease-free, high quality life. If you’re reading this blog, it’s a pretty good bet that you’re the sort of person who is interested in effective ways of getting and staying healthy. And you’re also probably interested in the most efficient ways to do that. Well, colorectal cancer provides a model disease when it comes to combining healthy lifestyle choices and medical testing in an effort to maintain (colon) health and prevent (colorectal) cancer.

Let’s start with the fact that colorectal cancer is a very common cause of cancer in the U.S. – it ranks fourth – and many people die from it each year. In fact, more people die of colorectal cancer than any other cancer beside lung cancer. Colorectal cancer IS out there and you – man or woman – ARE at risk for it. So, as educated and motivated health care consumers, get motivated and avoid becoming a victim of this common and deadly disease.

This is where the story gets even better, especially for all you type-A personalities who enjoy a measure of control. It turns out that in the vast majority of cases, colorectal cancer is preventable. We know that people who do the following things have a lower chance of getting colorectal cancer:

1. Exercise regularly
2. Maintain a healthy weight
3. Limit alcohol intake
4. Don’t smoke
5. Eat a diet rich in plant sources – fresh fruits, vegetables and whole grains – and consume fewer red meats, processed meats or those cooked at high temperatures.

Each of these behaviors promotes the body’s ability to ward off cancer and maintain a healthy colon. It’s important to acknowledge, though, that we don’t know that one activity is vastly more important than another and there is no silver bullet that can ABSOLUTELY ward off colorectal cancer. Things like colon cleansing or juicing or coffee enemas have never been shown to help prevent colon cancer.

What does decrease colorectal cancer risk? Well, in addition to the healthy habits listed above, it is very important to ask your doctor to help you do two things:

1. Learn about YOUR personal risk for colorectal cancer, based on YOUR personal and family history.
2. Get a colorectal cancer screening test to look for early, precancerous changes (called adenomatous polyps).

If everyone (that means YOU, if you are up for it) talked to his or her doctor about colorectal cancer risk factors AND got regular screening tests, the vast majority of colorectal cancers would be prevented and the death toll from this disease would plummet. Seems worthwhile to me. Now it’s up to you to decide for yourself. Good luck!

Dr. Brian McKinley

What if your child were deathly allergic to food? Virtually. All. Food.

Then his name might be Joshua and his doctor might be Dr. Jonathan Markowitz, director of the state’s largest pediatric gastroenterology practice at GHS Children’s Hospital.

You can see firsthand the challenges faced by Joshua and his parents, Cara and Brant Koscinski of Charleston, when they and Dr. Markowitz join national talkshow host Anderson Cooper on Friday. (“Anderson” airs locally at 4 p.m. on WLOS.)

In a segment titled “The Boy Who Can Not Eat,” the Koscinski family discusses the disease called Eosinophilic Esophagitis (EoE). The debilitating gastroenterological disease, which is rapidly emerging as a healthcare problem worldwide, can cause severe complications including pain, vomiting, food impactions and scarring in the esophagus.In some particularly sensitive individuals like Joshua, even inhaling small amounts of food through smell could cause a life-threatening whole-body allergic reaction.

The disease requires long-term treatment and has no known cure. There is no FDA-approved treatment. Delays in diagnosis are common, and often patients are misdiagnosed because the main symptoms may mimic gastroesophageal reflux disease (GERD).

Dr. Markowitz, who recently published the first textbook on EoE, is one of the nation’s leading experts on the disease. He, patients and families will gather to watch the show at 4 p.m. Friday at his office at the Children Hospital Outpatient Center.

Food allergies are the main cause in children. Some children do well with elimination of key foods from their diet; others can only eat a few foods or risk risk severe complications.

Said Dr. Markowitz, “I’m grateful that Anderson Cooper took the time to highlight the difficulties that patients and families with eosinophilic esophagitis deal with every day and to help raise awareness of this disease that has become one of the most important chronic gastrointestinal illnesses. I’m so pleased that we have been able to build a program to serve the patients in our region and beyond. I am looking forward to developing an even more robust program with additional services to better meet the needs of these complex patients.”

For more information about this disease or eosinophilic disorders, visit www.apfed.org, the website of the American Partnership for Eosinophilic Disorders (APFED). The non-profit organization is dedicated to patients and their families coping with eosinophilic disorders. APFED strives to expand education, create awareness, and support research while promoting advocacy among its members.

March is National Nutrition Month, and the registered dietitians at GHS’ Life Center have been busy educating members about how to make informed food choices and develop sound eating and physical activity habits. So does this mean we have to exercise hours a day and eat leafy greens for every meal? No, says Jessica Clark, R.D., and Crystal Robinson, R.D. (Thank goodness! While I’m not opposed to sweating a little, I can’t imagine giving up my daily dose of peanut butter at lunch or my cereal at breakfast.)

Clark says it’s easier to incorporate fruits, vegetables and whole grains into your diet than one might think. For example, at breakfast she recommends switching to a whole grain cereal and then adding sliced bananas, peaches or blueberries on top. For lunch, she suggests spreading peanut butter on a piece of whole grain bread and then adding sliced bananas or strawberries on top. If you’re the salad type, try mixing dried cranberries, orange sections or grapes in with your lettuce.

So what about dinner? Clark suggests filling half your plate with fruits and vegetables, about one fourth with lean meat, poultry or fish, and one fourth with grains. To round out your meal, she suggests adding fat-free or low-fat milk, yogurt or cheese. If you’re a casserole lover, she recommends adding vegetables and lower sodium soups to your mix. Pasta lover? Try using whole grain or whole wheat pasta instead. (I’ve tried this and it actually doesn’t taste much different, especially if you serve it with a tomato-based sauce.)

The bottom line? We need to think before we eat and getting our plate in shape in a good place to start. For more tips on eating right, visit Clark’s and Robinson’s favorite websites:

http://www.eatright.org/nutritiontipsheets/
http://www.choosemyplate.gov/food-groups/downloads/MyPlate/DG2010Brochure.pdf
http://www.choosemyplate.gov/healthy-eating-tips/ten-tips.html

One-on-one nutritional counseling is also available at the Life Center. Simply call 455-4231 to learn more.

As part of GHS’ ongoing commitment to improve constantly and to provide comprehensive maternity services to the women of the Upstate, we are now proudly offering midwifery care.

Midwifery care? What does that mean exactly?

Rewind 12 months to a marketing brainstorming meeting about how best to market this new program. To be honest, no one around the table really understood exactly what it was we were offering. We didn’t understand the type of services that would be offered or the difference between a midwife and a certified nurse midwife. One thing we all thought we were right about was that midwives provided obstetrical care only. WRONG! It was all very mystical to us.

So, what is midwifery (pronounced mid-wif-uh-ree)? I posted this question on Facebook last week. Interesting answers ….having a baby at home, natural childbirth, a birthing coach, exercise balls and bathtubs, no drugs or doctor INTERVENTION – letting the woman do the job she was made to do with as little interference as possible, an experienced non-physician delivering a child, and my personal favorite … middle aged wives.

Mystical? Unclear at a minimum.

According to dictionary.com it is a noun, the technique or practice of a midwife. A midwife is a person trained to assist women in childbirth. 2. a person or thing that produces or aids in producing something new or different.

According to MerriamWebster Wordcentral a midwife is a woman who helps other women in childbirth.

Clearer? Hopefully, but knowing what I know now, these definitions don’t tell the whole story, and may make one ask, “is a midwife the the same as a labor coach? A nurse? A doctor? Do you have to receive any kind of training to be called a midwife? Are there different types of midwives?

Great questions and ones the brainstorming team asked. I’ll take these one at a time.

1. Are they the same as a labor coach? They are much more.
2. A nurse? Yes, with specialized training. Certified nurse-midwives (CNMs) are registered nurses who have graduated from an accredited midwifery education program and passed a national certification exam to receive the professional designation of certified nurse-midwife. In South Carolina CNMs must have Master’s Degrees, and are licensed through the South Carolina Board of Nursing. (Note: all of GHS’ midwives are certified nurse-midwives.)
3. A doctor? No, they do not receive training at a four year medical school. However, Certified nurse-midwives are trained and certified to provide primary care for women across their lifespan. Midwives care for women from adolescence through menopause, with a special emphasis on pregnancy, childbirth and gynecologic and reproductive health. They perform comprehensive physical exams, prescribe medications, including contraceptive methods, epidural anesthesia and pain medication during labor if needed. CNMs also provide health and wellness education and counseling.
4. Training required? Yes, to be a certified nurse midwife. See previous answers.
5. Are there different types of midwives? Yes. Click here to read more about the differences between nurse midwives, midwives and doulas. GHS’ practice, Greenville MidWifery Care employs only certified nurse midwives.

Clearer? Demystified? I hope so.

As a GHS employee I’m proud we now have this option for women. This is just another example of living our mission. Anyone interested may access a midwife directly through Greenville Midwifery Care (www.greenvillemidwiferycare.com) or via one of these GHS OB/GYN practices: Greenville Ob Gyn, Piedmont OB/GYN or Premier Women’s Care.

I don’t want to talk about cancer. I want to talk about my grandmother, a white-haired dynamo who didn’t walk so much as bustle, washed and reused tinfoil and once pooh-poohed an elderly gent at the beach in favor of the tanned teen Adonis that she thought would be more suitable for her widowy charms.

Many of us have been fortunate enough to have special grandmothers. But how could your grandma measure up to my Mae Dees? Twenty years after that beach trip, my friends still cackle at the thought of my modest, perpetually polyester-pantsuited Grandma leaning over a hotel rail and convivially pronouncing which men were ogle-worthy. Writing this, I can’t help but laugh. We kids didn’t complain about the six-hour drive to Blenheim knowing she was the destination.

My friends had grandma envy over her; she was that extraordinary.

Grandma was 94 when she was diagnosed with ovarian cancer. She called her new hugely swollen belly the “twins.” The treatment side effects were hard on her, and the cancer didn’t respond to therapy. She stopped treatment and then stopped eating. The end came within a few days, and she didn’t hurt any more.

I thought of Grandma this week when GHS’ Institute for Translational Oncology Research and Lab21 announced a new technology that will give patients real-time feedback and treatment plans tied to their cancer’s specific DNA signature.

This kind of personalized cancer therapy holds the promise of telling physicians which drugs can most aggressively target each patient’s specific cancer. GHS will be one of the first sites in the country to bring this Ion Torrent next-generation gene-sequencing technology into the cancer clinic. Ultimately, we hope it will become an integrated part of the evaluation of all cancer patients at GHS. In essence, every patient who consents to participate in this initiative will have the opportunity to benefit from this leading-edge genomic medicine breakthrough.

Here in Greenville, the technology’s use will require several months of development and validation. Broad patient use is expected next year.

Cancer care has fundamentally changed for the better. More people are surviving – and thriving – than ever before. Our oncologists are excited about the breakthrough – but also recognize that we have far to go. Even if the technology had existed, it might not have worked for Grandma.

But I do wish she had had the chance.

For more information about personalized cancer therapy, visit the GHS newsroom at ghs.org/news.

We’ve just launched our annual employee opinion survey. This is the sixth consecutive year that we’ve reached out to all our staff to tell us what they think about working at GHS. Recently, in my monthly letter to staff (The Riordan Report) that is published in our employee newsletter, I talked about the importance we place on this annual survey.

2012 Employee Opinion Survey

The February Riordan Report is one of my favorites. That’s because I get to talk about our annual employee opinion survey and to encourage all employees and physicians to participate in this important annual event. To me, the survey offers a great example of how we can connect to our values through our mission. The employee opinion survey allows us to measure what we value (e.g., honesty, integrity, trust) and it’s through regular and consistent measurement that we’re able to identify opportunities for improvement and to track our progress.

This year’s survey will take place from March 5th through March 19th. As in the past, all surveys will be completed on-line via the internet. Using an on-line process saves lots of paper and helps tabulate the results more rapidly. We’ll also continue the practice established three years ago of using a unique identification code to log in and take the survey. As always, all survey data is collected and maintained by our external vendor and individual survey results are completely confidential. Using the unique identification codes improves accuracy of departmental and demographic information and helps streamline the survey process. Since we’ve introduced these two features, our participation rate has continued to be strong, turn-around time for results has decreased, and we’ve “gone green” by not wasting paper on a printed survey.

This year we’ll be asking some new questions about how well some of our Commitment to Excellence practices are being implemented throughout the system and we’ve added an open ended question to solicit your feedback about improving communications between different levels of the organization. We’ll also be asking targeted questions to nursing professionals in support of our interest in Magnet recognition. Finally, we’ll continue to include employed and highly aligned physicians in the survey group to ensure that we provide physician leaders with the same type of information that other leaders throughout the system have about their work teams.

Your opinions about working at GHS are worth sharing. In recent years we’ve used the survey results to help guide decisions about many topics ranging from employee benefits to work environment, communications strategies and even leadership development needs to give just a few examples. The cover article of this issue of The View offers an array of examples of how we’ve been integrating employee feedback into plans and actions.

I’ve been talking about the coming survey at this quarter’s Town Hall Meetings and I have encouraged your managers to review initiatives related to your department’s 2011 results with you at staff meetings this month. I plan to circle back and report our 2012 results at the May Town Halls.

I hope you’ll plan to participate in this year’s survey. Your opinions are worth sharing. We want to hear from you.

Michael C. Riordan
President and CEO

Yes it was…it was like a symphony. All the instruments, all the musicians came together in perfect symphonic motion and saved Mr. Johnny Fields’ life. This story is like a symphony, so many pieces to this puzzle, so many parts…and it amazes me that this happens everyday.

Mr. Johnny Fields is a successful attorney from Seneca, SC. He knew early on that he wanted to live in a town where everyone knew his name. His low-country upbringing took him to law school, and he eventually ended up in Seneca, SC. He believes in his community and he believes in the value of a top-notch medical system like GHS.

Mr. Fields first described the events, the people, the technology that saved his life as pieces that came together like a symphony. This symphony had many fluid parts, many underlying themes that many people did not realize.

First, let’s talk about the many people that worked together. There were so many different agencies that worked together that night to help Mr. Fields. Lane Prince of Keowee First Responder Group in Seneca, Rodney Franks of Oconee EMS, Lee Ann Brown of GHS Med Trans, to Joe Henderson, MD at Greenville Hospital System…numerous individuals from different agencies had to coordinate care, dispatch a helicopter close to 60 miles away, land the helicopter in a safe area, and fly him to meet a cardiologist and cath lab team. Each person had to work and keep the patient first while crossing various geographical lines. Mr. Fields was touched by five different agencies in different geographical locations and ultimately, they all worked together to save his life.

Second, let’s talk about timing. Mr. Fields was able to receive the life-saving procedure in the cardiac cath lab at GHS 63 minutes after the 911 call was made. 63 minutes. That is amazing. As Rodney Franks states in the video, it all started with self-recognition. Mr. Fields realized he was having a heart attack and immediately dialed 911. This call triggered an ambulatory run to a rural part of Seneca, SC, driving from his house to a landing zone, flying 60 miles to Greenville, then hurrying into the cath lab at GHS…all in 63 minutes. This regional coordinated care is the epitome of how numerous agencies can work together and keep the patient’s care first.

Third, the idea behind regional care. GHS is reaching out to work with groups like Oconee Medical Center and numerous first responders and agencies to train together and execute the type of care that Mr. Fields received that night. This team effort brought all these agencies together as one to save his life.

Mr. Fields is proud that GHS reaches out to the rural communities like Seneca. He does not shy away from calling Seneca rural and touts the relationship between Oconee Medical Center and GHS. He admits that if it was not the symphonic approach all the members of the first responders used to work as a team and coordinate his transport to GHS, he would not be alive today. He feels so strongly about this metaphor that he made it clear that he wanted the focus of this story to resonate their contribution to his life-saving ordeal.

Mr. Fields is one tough cookie. He survived triple bypass, then a heart attack seven years later. Mr. Fields is ready to tell his story because he is proud of what GHS and all the first responders have done to save his life!

To watch Mr. Fields story, please CLICK HERE!

***Bobby Rettew is an Emmy award winning journalist/storyteller who specializes in documentary storytelling and new media marketing. Bobby is working with Greenville Hospital System to produce these stories and will posting to this blog as a guest during this campaign.