FirstHealth Magazine - Spring 2012 by FirstHealth of the Carolinas

Spring 2012

the magazine from FirstHealth of the Carolinas

The human body shop www.firsthealth.org

Orthopaedics at FirstHealth Richmond Memorial Hospital We help people with bone, joint and muscle problems maximize their quality of life and improve their level of function in a safe and efficient manner. - Local treatment for sports injuries - Pain relief in knees, hips and shoulders - Repair disorders of the knees, hips and shoulders - Both full and partial joint replacements provided - Minimally invasive surgeries - Convenient arthritis care - Many other procedures to restore normal function to damaged joints. For more information, please call (910) 417-4090.

David Casey, M.D.

John R. Moore IV, M.D.

David Strom, M.D.

Kurt Wohlrab, M.D.

Kevin Slater, P.A.-C

Pinehurst Surgical Orthopaedic Surgeons

www.firsthealth.org 856-150-11

CEO Message

A great place to be

David J. Kilarski Chief Executive Officer FirstHealth of the Carolinas

magine yourself taking a new job, in a new and very different community, and then moving halfway across the country to find that you have probably made one of the best decisions of your life. That’s the enviable position in which I found myself last fall when I came to the mid-Carolinas to become the chief executive officer of FirstHealth of the Carolinas. Things could hardly be any better. Oh, don’t get me wrong, especially any old friends or colleagues who might happen upon this message. I was happy where I was. Ohio is a great state, and the Cleveland Clinic for which I had served as president and CEO of two of its fine health system hospitals is one of the premier providers of health care in this country. But my new situation couldn’t be more exciting. It also promises great challenges and a lot of work. Let me explain. First of all, I can’t imagine living in a more congenial location than the Carolina Sandhills and meeting people who are more warm and welcoming than its residents. My wife and I can now safely say that all those stories we had heard about Southern hospitality are true. Everyone we have met has been just as gracious with their hospitality as they have been generous with their time and assistance as we have settled into our new home. I could spend lots of time talking about the amenities of this great place, but it’s time to move on to the heart of the matter and talk about the opportunity that brought me here. Fewer than a dozen men have been fortunate enough to head the unusual organization that is now FirstHealth of the Carolinas, and I was honored to be asked to join their number. From the legendary Dr. Clement Monroe to my immediate predecessor, Charles Frock, each brought unique gifts to the task of introducing world-class medical care to an area that over time grew to expect it. Each was aided by the generosity of a community that has given unreservedly of its time, talent and resources in support of that aim. And each was blessed to serve with a superb group of physicians, nurses and support personnel who shared this vision for big-city medicine with a small-town touch. As it would seem, so am I. Even after several months on the job, I continue to be impressed by the caliber and compassion of FirstHealth’s physicians, staff and volunteers. Every day, I am introduced to yet another example of the tremendous capabilities, technological as well as human, of this great institution. The work of the Foundation of FirstHealth is apparent in all three FirstHealth hospitals as well as in the hospitality of the Clara McLean House and the compassionate care of the FirstHealth Hospice House. The compact, vision and mission of the FirstHealth Physician Group indicate a commitment to care that is uniquely patient-centered, efficient and effective. Every time I visit a nursing unit, I see that care in action. I see challenges, too—national and state as well as local—but there’s nothing like a good challenge to keep things interesting and I am convinced that FirstHealth is wellpositioned for whatever may come its way. I also know that I can count on your help and that, working together, anything is possible for FirstHealth of the Carolinas.

www.firsthealth.org

155 Memorial Drive P.O. Box 3000 Pinehurst, NC 28374 Editor, FirstHealth of the Carolinas . . . . . . . . . . . . . . . . . . Brenda Bouser Managing Editor. . . . . . . . . . . . . . . . . . . . . . . . . . . Jason Schneider Creative Director. . . . . . . . . . . . . . . . . . . . . . . . . . . Jan McLean Production Director. . . . . . . . . . . . . . . . . . . . . . . . . . Traci Marsh

f i r s t h e alt h . o rg

Contributing Writers

Brenda Bouser, Deborah Salomon, Erica Stacy

Contributing Photographers Don McKenzie

Board of Directors FirstHealth of the Carolinas Mr. Julian W. King, Chair Mr. H. Edward Barnes, Vice Chair Robert Bahner Jr., M.D, Mr. Alex Bowness H. David Bruton, M.D. Mr. James H. Bulthuis David M. Cowherd, M.D. John N. Ellis, M.D. Walter S. Fasolak, D.O. Mr. Hew Fulton Mrs. Carolyn D. Helms Mrs. Anna G. Hollers

Mr. David J. Kilarski Ms. Tracy Leinbach Dr. Susan R. Purser Mr. Joel Shriberg Bruce S. Solomon, D.O. William L. Stewart, M.D. Glen D. Subin, M.D. Mr. Robert E. Tweed Mr. David Woronoff

Corporate Officers Chief Executive Officer, FirstHealth of the Carolinas President, Moore Regional Hospital. . . . . . . . . . . . . . . . . . . Mr. David J. Kilarski Chief Financial Officer, FirstHealth of the Carolinas . . . . . Mrs. Lynn S. DeJaco Chief Information Officer, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . Mr. David B. Dillehunt

Departments 1

CEO’s message

FHC news

Support groups

New providers

25 Calendar 26 Letters

Features 3

Rehabilitation in familiar settings

Higher accuracy and fewer risks … with new technology for diagnosing, staging chest diseases

Surgical focus

Chief Medical Officer FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . John F. Krahnert Jr., M.D. Vice President, Human Resources, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . Mr. Daniel F. Biediger Vice President, Finance & Support Services, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . Mr. Jeffrey A. Casey Vice President, Quality, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . . . . . . . . . . . Mrs. Cindy McNeill-McDonald President, FirstHealth Physician Group . . . . . . . . . . . . . . . Daniel R. Barnes, D.O. President, FirstHealth Richmond Memorial Hospital . . . Mr. John J. Jackson President, FirstCarolinaCare Insurance Company. . . . . . . Mr. Kenneth J. Lewis President, Foundation of FirstHealth . . . . . . . . . . . . . . . . . . Mrs. Kathleen Stockham President, FirstHealth Montgomery Memorial Hospital. . . . Mrs. Beth Walker The not-for-profit FirstHealth of the Carolinas is headquartered in Pinehurst, N.C., and is composed of Moore Regional Hospital, Montgomery Memorial Hospital, Richmond Memorial Hospital (a division of Moore Regional Hospital), the Foundation of FirstHealth, FirstCarolinaCare Insurance Company, and Regional Health Services. Comments on FirstHealth of the Carolinas magazine or changes of address should be directed to bbouser@firsthealth.org or to (910) 715-4278.

FirstHealth of the Carolinas is published three times a year by Krames StayWell 407 Norwalk St. Greensboro, NC 27407 (336) 547-8970 President. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . William G. Moore Senior Staff Accountant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kelly Carter © Copyright 2012 by Krames StayWell, an operating company of StayWell/MediMedia USA, and FirstHealth of the Carolinas, Inc. No part of this publication may be reproduced or transmitted in any form or by any means without written permission from Krames StayWell. Articles in this publication are written by professional journalists who strive to present reliable, up-to-date health information. However, personal decisions regarding health, finance, exercise and other matters should be made only after consultation with the reader’s physician or professional adviser. All editorial rights reserved. Opinions expressed herein are not necessarily those of Krames StayWell or FirstHealth of the Carolinas. Models are used for illustrative purposes only.

2 Spring 2012

16 FirstHealth Physician Group 17 VATS lobectomy 18 New pacemakers give patients an MRI option 19 The medical benefits of massage 20 New FirstHealth Hospice & Palliative Care campus opens

Rehabilitation

in familiar settings By Deborah Salomon

If it takes a village to rehabilitate a patient, FirstHealth Moore Regional can provide one. The hospital’s Center for Inpatient Rehabilitation has expanded to include a Rehab Village – a fauxshingled front porch with rocking chairs, grocery store, restaurant booth and a bank. “Providing real-life settings gives our patients a fun and creative environment in which to recover,” says Cindy Sayce, director of Inpatient Rehab and Acute Care Programs at Moore Regional. The expansion, funded by the FirstHealth Moore Regional Hospital Auxiliary, added out-and-about situations to a facility that already included an apartment, kitchen and garden with putting green. The purpose: Helping patients return to the community after a hospital stay. The result: Delightful. Amazingly realistic porterhouse steaks, fruits,

vegetables, cereal boxes and cans line shelves and a refrigeration unit in a Rehab Village grocery store that also features a greeting card rack providing opportunities to reach, read and select. Patients take items to a check-out counter and “pay” and then slide into a booth at the Rehab Café, order from a menu and get a plate of “food.” Afterward, they practice entering a vehicle for the ride home. Home is the actual destination for these patients in as few as 10 days. Returning home can be overwhelming for both patient and caregiver, says Sayce, so practicing everyday activities helps build confidence. On average, Moore Regional’s intensive rehab program gets patients home two days sooner than

The Rehab Village in the Center for Inpatient Rehabilitation at FirstHealth Moore Regional helps patients return to the community after a hospital stay by re-introducing them to such real-life scenarios as a grocery store and a restaurant. The expansion was funded by a donation from the FirstHealth Moore Regional Hospital Auxiliary.

www.firsthealth.org

elsewhere in the state. (See the accompanying “Rehab report card” sidebar.) The Moore Regional program stresses independence, according to Linda DeYoung, administrative director of Rehabilitation Services. In 2010, Sayce made a presentation for the Rehab Village to the Auxiliary, which funds one project annually with proceeds from its Holiday Ball. “It was an outstanding presentation,” says Auxiliary President Julie Martin. “The entrance creates such a pleasant, non-institutional image.” Exactly. “This is the South, where people sit on porches,” Sayce says. The Rehab Village porch requires the patient to navigate a short step, move alongside a railing and then settle into a rocking chair, perhaps for a chat with passers-by. The Auxiliary donated $86,587 for the project, which was designed by Southern Pines architect Robert Anderson.

About 500 patients pass through the inpatient rehab program annually. “They are surprised to see a grocery store in a rehab setting,” says occupational therapist Nicole DuBois. “It makes them think about how they will shop after they go home.” DuBois uses grocery lists to help stroke patients problem-solve. Frustration occurs, but it’s better to start working on it with a professional, in a safe setting, she says. One of DuBois’ patients learned how to walk again while carrying a coffee cup in just a few days. “It’s scary at first, but this boosts a patient’s confidence for things that have to be done every day,” she says.

Rehab makes a difference

Horsewoman Leslie Baldwin suffered a brain bleed and stroke last fall. After a recovery that included 10 days in the Inpatient Rehab unit at FirstHealth Moore Regional Hospital, she now feels well enough to hand-walk her horses.

4 Spring 2012

Leslie Baldwin had fever and a headache before suddenly becoming dizzy and falling. She lay unconscious for seven hours before a friend found her and called paramedics who took her to FirstHealth Moore Regional Hospital. She was diagnosed with a brain bleed resulting in a stroke. “I couldn’t use my right hand or right leg,” the active horsewoman recalls. “I couldn’t write or eat. I had difficulty speaking.” That was November 2011. Baldwin remained in the hospital for a month, the final 10 days in the Inpatient Rehab unit where she received physical, occupational and speech therapy. “Every day, I saw an improvement,” says Baldwin, who is 54. “Leslie was very anxious at first, but overcame that in a week,” says occupational therapist Nicole DuBois. Baldwin used all of the equipment Inpatient Rehab had to offer for her therapy program, but she was especially delighted by the new Rehab Village. “I went ‘shopping’ to work with my brain, to pick out vegetables and remember them,” she says. “I learned to navigate the ‘store’ with a walker.” Because Baldwin lacked strength in her knees and thighs, her first attempt to slide into the Rehab Village “restaurant booth” ended in a plop. The rocking chairs on the “porch” also posed a challenge. Like a horse, Baldwin observed, they don’t stand still. Balance was the issue. “I had to get out of the rocking chair without holding onto anything,” Baldwin says. “That was scary.” Perseverance and the aid of an enthusiastic staff paid off. Now Baldwin feels 90 percent recovered. She hand-walks her horses and drives to pick up sushi. “People thought I would die,” she says. “How well I’m doing I owe to the rehab center. The gals were fabulous. They read your body. They don’t ask you to do anything you can’t do.” Baldwin comes back occasionally to visit her rehab therapists. “I feel good,” she says. “I feel grateful.”

A rehab ”report card“ When it comes to caring for people, FirstHealth of the Carolinas is at the top of the class for inpatient rehabilitation. Our goal is to get our patients home, and our length-of-stay and discharged-to-the-community outcomes make the grade. The facility is fully credentialed by UDSMR, which provides a facility report that allows FirstHealth to compare its performance with other inpatient rehabilitation centers.

Inpatient Rehabilitation Diagnosis October 1, 2010 - September 30, 2011 FirstHealth Center for Rehabilitation

Auxiliary plays “angel” for hospital From its early years, the FirstHealth Moore Regional Hospital Auxiliary has provided an extra touch to projects supporting patients and their families. An early Auxiliary project involved giving cows and chickens to the parents of Depression-era newborns. In 2012, more than 80 years later, the Auxiliary continues to support the community in numerous ways. The 200 supporters of the Moore Regional Hospital Auxiliary provide funding through an annual appeal. Auxiliary projects also get financial support through sales from vending machines located throughout the hospital and proceeds from the hospital’s Gift Shop and book fairs. Although primarily hospital oriented, Auxiliary projects frequently reach beyond Moore Regional’s walls to fund such programs as Kids in Crisis, as well as school gardens, equipment for Mobile Health Services, scholarships for nursing students at Sandhills Community College and home safety monitoring equipment that allows community members to stay in their homes and remain independent. The Auxiliary has also been a major benefactor for recent hospital capital campaigns, making million-dollar pledges to both the In Love and Service and Stepping Stones campaigns. During this decade alone, the Auxiliary has supported an expansion of the hospital’s Child Development Center and, with the 2010 Hospital Ball, raised $86,000 for the hospital’s new Inpatient Rehab Village. The Moore Regional Hospital Auxiliary welcomes new members, men and women, whether affiliated with the hospital or not. For information, call (800) 213-3284.

Multiple Trauma

Brain Injury

Neurologic

Other

Spinal Cord

Amputation

Debility*

14%

Stroke

21%

Orthopedic

45%

*Debility also includes cardiac, pulmonary & medically complex.

Outcomes October 1, 2010 - September 30, 2011 Average Length of Stay (days) Amount of therapy per day, 5 days/week

FirstHealth Center for Rehabilitation

National Average

3 hours

Discharged to community

86%

76%

Discharged to skilled nursing facility

14%

Discharged back to hospital

10%

Total of 547 patients served.

According to our patient satisfaction surveys, 93 percent of our patients rate their experience with the Center for Rehabilitation as excellent and 99 percent would recommend the center to others. If you have questions about this information or would like to review the entire report, please call (800) 213-3284.

www.firsthealth.org

Michael Pritchett, D.O., a board certified pulmonologist, is medical director of the Chest Center of the Carolinas at FirstHealth Moore Regional Hospital.

Higher accuracy and fewer risks Chest Center of the Carolinas

… with new technology for diagnosing and staging chest diseases

The Chest Center of the Carolinas brings together the expertise of multiple specialties in the treatment of diseases of the chest, assisting patients with their treatment plan by minimizing visits and providing the most advanced care possible. The multi-disciplinary Chest Center team includes board certified thoracic surgeons, pulmonologists, medical oncologists, radiation oncologists, gastroenterologists, pathologists and radiologists who are dedicated to the treatment of diseases of the chest. These specialists meet weekly as a group to discuss every Chest Center case and treatment plans for each one of those patients. For more information, call (800) 213-3284 toll-free.

6 Spring 2012

Just two years ago, Brenda Smith would have needed a surgery performed under general anesthesia to determine the cause of the enlarged lymph nodes in her chest. Instead, in June 2010, she became one of the first patients at FirstHealth Moore Regional Hospital to have a minimally invasive Endobronchial Ultrasound (EBUS). Performed by Michael Pritchett, D.O., Smith’s EBUS was done in the hospital’s Outpatient Center and took about 45 minutes while Smith was consciously sedated. A $235,000 gift from the Moore Regional Hospital Foundation in February 2010 allowed the hospital to acquire the state-of-the-art technology that Dr. Pritchett used. Since that time, the Pinehurst Medical Clinic pulmonologist has done more than 150 of the procedures, using EBUS to diagnose and stage diseases of the chest by accessing lymph nodes that previously would have been reached only by surgical means—if at all. “This gets into places that previously were not accessible at all or were risky to get to,” Dr. Pritchett says. “It’s safer, less invasive and more accurate.” Art Edgerton, M.D., a FirstHealth cardiothoracic surgeon, now does EBUS procedures, too. EBUS begins when the physician inserts a small scope into the lungs through the patient’s mouth. After the scope is in place, a special ultrasound probe that is incorporated into the scope sends sound waves through the walls of the airways into the various lymph nodes in the surrounding areas. When an enlarged lymph node is located, the physician takes a tissue sample (or biopsy) with a small ultrasound-guided needle. The procedure allows safe and accurate real-time sampling of lymph nodes that are as small as 5mm as well as those located near major blood vessels.

A “good candidate” for EBUS The day after she had an Endobronchial Ultrasound (EBUS) at FirstHealth Moore Regional Hospital, Brenda Smith was back at her job on the hospital’s s switchboard. Because of a technique called Rapid On-Site cytopathologic Examination (ROSE) and the presence of a pathologist in the room, she had known immediately after the procedure that she didn’t have the cancer that she had feared. By the end of the week, she had a confirmed diagnosis—sarcoidosis, a chronic lung condition. Smith was one of the first patients at Moore Regional to have an EBUS. “Dr. Pritchett told me I would be a good candidate,” she says “It was a very easy procedure, and I had no side effects.” “Dr. Pritchett” is Michael Pritchett, D.O., the Pinehurst Medical Clinic pulmonologist who performed Smith’s EBUS, a procedure offered at no other hospital in FirstHealth’s primary service area. Smith’s EBUS story began after a routine physical found unusually high calcium levels in her body and an X-ray ordered by her primary care physician detected “white spots” on her lungs. After a CT scan revealed enlarged lymph nodes in her chest, Smith was referred to Dr. Pritchett, who told her that an EBUS would help determine if the problem was cancer “or something else.” Smith has nothing but praise for Dr. Pritchett and how he prepared her for what would take place. “Dr. Pritchett is very assuring, and he always tries to explain what’s going on,” Smith says. “Within my experience, I don’t see why anyone who had to go through this procedure would have any hesitation.” Brenda Smith, talked about her EBUS experience at FirstHealth Moore Regional Hospital with Dr. Allen Mask of the WRAL-TV Health Team during an interview that also featured Michael Pritchett, D.O., the board certified pulmonologist who performed the procedure. To view an archived video of the telecast, go to www.firsthealth.org/video.

“We look at all the lymph node stations that we are able to reach,” Dr. Pritchett says. “When we are staging (cancer), we try to biopsy as many lymph node stations as possible. This ensures accurate staging, which in turn determines the patient’s prognosis and treatment options.” Unlike the “gold standard” mediastinoscopy (a procedure for diagnosing and staging lung cancer and other diseases of the chest that involves an incision just above the breastbone), EBUS minimizes complications such as collapsed lung and bleeding and eliminates the risks of general anesthesia. Accuracy rates are high—85 to 95 percent with EBUS alone or nearly 100 percent when used in conjunction with Endoscopic Ultrasound (EUS) to stage lymph node involvement in various cancers.

Electromagnetic Navigational Bronchoscopy Foxfire resident George Galloway had a 13mm spot on his lungs in an area that just a few years ago would have been accessible only with an invasive procedure that required general anesthesia and a large incision between his ribs. Instead, pulmonologist Michael Pritchett, D.O., used Electromagnetic Navigational Bronchoscopy (ENB) to diagnose earlystage cancer. After his diagnosis, Galloway had chemotherapy and radiation treatments. He now has monthly follow-ups with his medical and radiation oncologists, but hasn’t needed additional treatment. “It was still mighty small,” the 87-year-old Galloway says of the cancerous spot. “That’s why it was such a problem to find the thing.” Galloway, a retired AT&T electrical engineer, says he slept throughout his ENB and was “in and out” of the hospital the same day. “I woke up, and I was done,” he says. “I didn’t feel a thing.”

EUS is a similar procedure (done through the esophagus) that is performed at Moore Regional by gastroenterologist Eric Frizzell, M.D., also of Pinehurst Medical Clinic. Dr. Pritchett also uses Electromagnetic Navigational Bronchoscopy (ENB) for improved early diagnosis of lung cancer and other diseases of the chest. A GPS-like tool, ENB uses a threedimensional image created from the patient’s own CT scan to guide a catheter into the distant areas of the lungs. The procedure can be used to reach very small lesions that would otherwise require an invasive procedure for diagnosis. “We want to stay abreast of the most current technologies and utilize them in the care of our patients to get the best and most accurate diagnoses,” Dr. Pritchett says. www.firsthealth.org

S U R G I C A L

F O C U S

The option of

single-incision surgery David Grantham, M.D.

John Fessenden, M.D.

8 Spring 2012

ntil about 30 years ago, gallbladder surgery or open cholecystectomy meant one long cut (5 to 7 inches) in the abdomen, a hospital stay of several days and several more weeks of recovery at home—not to mention a noticeable scar. Then, the surgery of choice for the removal of a diseased gallbladder became a procedure called a laparoscopic cholecystectomy—four small incisions across the abdomen for the insertion of ports through which surgical instruments and a video camera could be placed. Because abdominal muscles weren’t cut to the same degree, the patient experienced less pain, was at less risk for complications such as infection and adhesions, and was usually back at home the same day or the next with much better cosmetic results. A more recent procedure has returned to the single incision—still laparoscopic, but even more cosmetically pleasing since it is tucked into the folds of the belly button. “The actual doing of the operation is the same,” says David Grantham, M.D., a general and bariatric surgeon with FirstHealth Moore Regional Hospital and Pinehurst Surgical. “It’s just the approach that’s different.” According to Dr. Grantham, young women with cosmetic concerns are frequent subjects of single-incision surgeries, but the effectiveness of the procedure for other surgeries has made it an attractive option for a wide range of patients. Dr. Grantham and John Fessenden, M.D., now offer single-incision laparoscopy at Moore Regional for gallbladder and some colon resection procedures. Raymond Washington, M.D., does single-incision colon resections. The incision for these procedures is usually about 4 to 5 cm but is hidden in the belly button, which makes it virtually invisible, especially after a few months of healing. “Three or four months later, you can’t really tell the patient has had anything done,” Dr. Grantham says. Decreased post-operative pain is another positive. “I’ve had a couple of patients who have gone home with just Tylenol for pain control,” says Dr. Grantham. The first widely reported single-incision laparoscopic surgery was done in Philadelphia in 2007 by a professor of surgery at Drexel University. Dr. Grantham performed one of the first single-incision cholecystectomies at Moore Regional about a year later. He did the hospital’s first single-incision laparoscopic colon resection in late 2010 and predicts even greater use of the procedure in the future. “Theoretically, anything you can do laparoscopically, you can do with the single-site approach,“ Dr. Grantham says.

Gastric sleeve

Before and after bariatric surgery

Surgery is only one piece of the bariatric surgery program at FirstHealth Moore Regional Hospital. Behavioral and nutritional counseling, both before and after surgery, are also important features. All prospective bariatric surgery patients are required to attend an information session before surgery. They are also required to be evaluated by a bariatric dietitian and a FirstHealth mental The weight-loss surgery called sleeve gastrectomy (or gastric health provider, as well as undergo tests to detersleeve) used to be offered as the first stage of a two-stage procedure mine that they do not have a medical condition for extremely obese patients for whom the risks of gastric bypass that could delay their surgery. alone were considered too great. The behavioral component of the bariatric program begins long before surgery as candiThat all changed when surgeons began to note that their patients dates are carefully evaluated were losing a large quantity of to determine if they are aptheir excess weight with just propriate for the procedure. the sleeve procedure. Since that The evaluation process time, gastric sleeve has gained ensures that each candidate Raymond acceptance as a primary weightunderstands the procedure Washington, M.D. and possible risks, and that loss surgery. he/she has realistic expectaRaymond Washington, M.D., and David Raymond Washington, M.D., medical director of the Bartions of what will happen Grantham, M.D., of the FirstHealth Bariatric iatric Center at FirstHealth Moore Regional Hospital, believes after surgery. Center, perform sleeve gastrectomy, gastric bypass there will ultimately come a time when sleeve gastrectomy The bariatric patient naviand gastric banding procedures at FirstHealth surpasses gastric bypass as the “gold standard” for weightgator is a registered dietitian Moore Regional Hospital. Free weight-loss surgery loss surgery. who specializes in working sessions are held twice each month in the with bariatric surgery pa“Over the past five years, gastric bypass and Lap-Band Renaissance Room at Pinehurst Surgical, tients, counsels each patient 5 FirstVillage Drive, FirstVillage Campus, Pinehurst. surgeries have gotten most of the attention in the media,” about diet concerns before Dr. Washington says. “But, in the last year, data have shown For more information, call (800) 213-3284 toll-free and after surgery, and works great results comparable or better with sleeve surgery, or go to www.ncweightlosssurgery.org. with patients to create a diet with less concern about nutritional deficits and long-term plan especially for them. complications.” She sees patients at regular intervals after their surgery, and also coordinates A three-year case-controlled study that concluded in 2009 found that minimally invasive sleeve the semi-monthly Bariatric Support Group. gastrectomy compared favorably to minimally invasive Roux-en-Y gastric bypass in terms of surgi-

offers third weight-loss surgery option

The FirstHealth Bariatric Center

cal results, weight loss and resolution of sleep apnea, joint pain, diabetes and high blood pressure. Average operating time was less for the sleeve procedure, and the average hospital stay was shorter. With sleeve gastrectomy, surgery removes a large portion of the stomach, reducing it to about 20 percent of its original size. The open edges are attached to form a banana-shaped sleeve or tube that limits the amount of food the patient can eat and helps the patient feel full sooner. Unlike gastric bypass, sleeve gastrectomy does not involve rerouting the small intestine or bypassing the natural stomach outlet. This less-invasive approach reduces many of the nutritional complications associated with gastric bypass, making it a more appropriate procedure for people who would find it difficult to follow the strict post-surgical follow-up of the more traditional surgery. “Long-term surveillance is important, but it is not as important as with gastric bypass,” Dr. Washington says. There is also less risk of some of the complications of gastric bypass including internal hernias and ulcers. And, because the surgery involves no “foreign bodies,” as with gastric banding surgery, “there is less risk of infection,” says Dr. Washington. Of course, says Dr. Washington, the weight-loss surgery choice always begins with a conversation between patient and surgeon and a lengthy study of the patient’s health and surgical history. “This will help us determine the appropriate procedure,” he says. www.firsthealth.org

S U R G I C A L

F O C U S

Breast reconstruction puts bodies, lives back together Before-and-after photographs offer reassurance, but pictures alone do not illustrate the satisfaction that breast reconstruction has meant for Julia Lawson. Lawson’s breast surgeries began with a mastectomy and ended a year later with surgery to match her healthy breast with the reconstructed one. “It was a real success,” Lawson says of her breast reconstruction experience. “Dr. Stokes is my friend. He put me back together again.” Russell Stokes, M.D., is a board certified plastic surgeon with FirstHealth Moore Regional Hospital and the Plastic and Reconstructive Center at Pinehurst Surgical. He gave Julia Lawson a new breast after her mastectomy for breast cancer.

There are options

Being told you have breast cancer is a blow for any woman. Losing one breast, or sometimes both, multiplies the trauma. The patient may feel like she has no control over what is happening to her, but Dr. Stokes says that is not always the case. There are certainly options for reconstruction—some that can be discussed as early as the first consultation with the general surgeon. “Patients can be seen and given their reconstruction options even before surgery,” Dr. Stokes says. Some reconstruction procedures can even take place during the same surgery as the mastectomy. The patient goes to sleep with two breasts and wakes up with two breasts—although one of them a surgical implant—and great psychological benefit. Amelia Jeyapalan, M.D., a general surgeon with Pinehurst Surgery, talks to 10 Spring 2012

Russell Stokes, M.D.

her patients about reconstruction at the same time that they discuss mastectomy. “My point of view is you have cancer— let’s get rid of it first,” she says. “But we make (concurrent reconstruction) happen as often as we can.” If the general surgeon does not mention reconstruction, concurrent or otherwise, Dr. Jeyapalan advises the patient to ask for a consultation with a plastic surgeon to learn about procedures and results. “As a woman surgeon, I am willing to help a patient reconstruct her breast,” she says. Dr. Stokes also believes that concurrent surgery is an important choice for the patient to have. “I can’t tell you how helpful that is, having both at the same time,” he says. “It also makes the reconstruction easier.”

Options for reconstruction

There are many methods for breast reconstruction, but the most common are tissue breast implants and flap reconstruction. With the implant procedure, the surgeon inserts a temporary tissue expander beneath a pocket under the major muscle of the chest wall. During a process that can take weeks to months, saline solution is injected to expand the overlying tissue. Once the expander has reached an acceptable size, it is removed or replaced with a more permanent implant. Flap reconstruction uses tissue from other parts of the patient’s body, such as the abdomen, buttocks, back or thigh. The procedure can be performed by leaving the donor tissue connected to the original site in order to retain blood supply, or it can be cut off and a new blood supply can be connected. When donor tissue is taken from the back (a procedure call the latissimus dorsi muscle flap), the muscle is moved into the breast site while still attached

to its blood supply under the arm pit. A procedure called TRAM (Transverse Rectus Abdominus Myocutaneous) flap involves taking donor tissue that also includes skin, minor muscles and connective tissue from the abdomen and transplanting it onto the breast site. Some patients find this procedure preferable, because it also results in a “tummy tuck.” Recovery from implant reconstruction is usually faster than with a flap procedure, but both take several weeks. Both procedures may also require follow-up surgery to construct a new areola and nipple, but this is usually a simple procedure that can be done with local anesthesia in the surgeon’s office. The most appropriate candidates for breast reconstruction surgery are women who are under the age of 60, those with small Stage I tumors (less than 2 cm) and those with no incidence of lymph node involvement. Body type, cancer treatment and health status are reconstruction factors. Patients with blood flow issues, diabetes, high blood pressure and high cholesterol are considered high risk. So are those with a body mass index of more than 30. Smokers are never reconstruction candidates, because smoking constricts blood vessels, which can affect healing. According to Dr. Stokes, who has performed 21 concurrent and 40 delayed reconstructions since coming to Pinehurst in 2010, there are several reasons that a woman should consider concurrent reconstruction surgery. “You end up saving time off work and recovery time if you do it immediately,” he says. “The patient will usually spend the same length of time in the hospital, maybe even a day longer. But, remember, you’re saving a whole step here.” Any decision involving the type or even likelihood of reconstruction should follow a lengthy discussion of steps, expectations and possible outcomes between patient (and sometimes partner) and surgeon. Just as reconstruction is an option for some women, it is not for others. “Everybody’s different,” Dr. Stokes says.

Breast Reduction Surgery Information n

Reduced back and neck pain

Decreased skin rashes and irritation

Improved posture

Dramatic improvements in exercising, sports and household chores

Clothing that fits better

Russell B. Stokes, M.D, a board certified plastic and reconstructive surgeon, will discuss breast reduction surgery during an information seminar scheduled for 7 p.m. Tuesday, April 24, at 501 Executive Place, Fayetteville. Space is limited, so call (800) 213-3284 toll-free to register. If the procedure is right for you, it is covered by most insurance plans.

The satisfaction of breast reduction surgery Board certified plastic surgeon Russell Stokes, M.D., has seen how over-developed breasts can impact a woman both physically and psychologically. Clothes don’t fit. Sports are difficult. Pain and skin irritations are common complaints, and posture and self-image suffer. There is a solution to these problems, however. Breast reduction surgery is a procedure that removes excess fat, tissue and skin from the breasts. Also known as reduction mammoplasty, the surgery can be performed at any age but is usually best after the breasts are fully developed. Patients are often women in their 20s and 30s with overly large breasts. Others are women who have experienced breast enlargement with general weight gain. Dr. Stokes calls breast reduction one of “most satisfying” of medical experiences. “The patients are some of the most satisfied patients we see,” he says. Breast reduction surgery can alleviate many of the unpleasant effects of over-developed breasts. These include chronic rash or skin irritation under the breasts and chronic pain, especially in the neck, shoulders and back. “All are very effectively treated by breast reduction,” Dr. Stokes says. According to Dr. Stokes, insurance coverage for reduction surgery can be hard to obtain because of the difficulty patients have in documenting the information insurance companies require for certification. Dr. Stokes’ program—which includes weight-loss verification, physical therapy and expertise in documentation—has a much higher insurance approval rate. “It’s very easy to submit an application with our program,” he says. Dr. Stokes describes the symptoms caused by over-developed breasts as “common problems” that disappear with surgery. “I think a lot of women would benefit from it,” he says.

www.firsthealth.org

S U R G I C A L

F O C U S

“ Gold standard” joint replacement surgery David Casey, M.D.

World-class care … close to home

By Erica Stacy

The body is a complex machine, designed to work hard, play hard, and support innumerable lifestyles and activities. Unfortunately, as with all machines, individual parts sometimes show signs of wear and tear. They can also stop working altoFirstHealth of the Carolinas is a recognized leader gether and need to be repaired or replaced. in joint replacement surgeries. While many procedures are performed at Some of the most commonly damaged body FirstHealth Moore Regional Hospital in Pinehurst, parts are the joints. others are also done at FirstHealth Richmond MeA joint is where two or more bones come tomorial Hospital in Rockingham. The availability of gether as with the knee, hip or shoulder. Joints can orthopedic care at Richmond Memorial is especially be damaged by arthritis or other diseases while helpful to patients who live in Richmond County injury or misuse resulting from certain types of jobs Jason Guevara, M.D. and surrounding communities. (See ad on inside or forms of exercise can also cause problems. front cover.) When joint pain and inflammation limit activities — making even simple “Our patients receive world-class care, close to tasks like walking to the mailbox or getting up a flight of stairs difficult — a home with a uniquely personal touch,” says David physician may suggest joint replacement surgery. Casey, M.D., of Pinehurst Surgical. “Our medical Joint replacement, the so-called “gold standard” response for joint pain, team, from the operating room to the hospital can also help you move more freely. According to the National Institutes of floor to rehab, strives to provide the best possible care so that our patients can resume the activities Health, more than 773,000 Americans have a hip or knee replaced each year. they enjoy without pain as soon as possible. We Shoulders are the third most commonly replaced joint. are committed to patient education, and we tailor “Surgery is never a first option,” says David Casey, M.D., an orthopedic our services to the individual.” surgeon with Pinehurst Surgical Clinic. “We work with patients to try to find Patients who choose FirstHealth have access to a non-operative treatments first. If the pain persists, then surgery may become higher level of care and an expertise that is typically the best choice to improve quality of life and enable them to enjoy physical found only in teaching institutions. activities once again.” “If your car has problems with its brakes, how “Physicians have worked to fine-tune and advance the surgical techniques do you choose a mechanic?” says Jason for joint replacements,” says Jason GueGuevara, M.D., of Pinehurst Hip and vara, M.D., an orthopedic surgeon with Knee. “Do you go to the corner Pinehurst Hip and Knee. “During the last gas station and hope for the best? decade, we have moved to a less-invasive Or do you look for someone who is a brake specialist? Choosing the approach. Cutting less soft tissue, includright hospital for your joint replaceing tendon and muscle, helps us minimize ment is a similar process. Keeping pain and discomfort. But it is important your body in good working order to note that joint replacements are major on FirstHealth’s world-class orthopedic requires an expert mechanic with surgeries, and it takes time, effort and program, or to schedule a consultation appropriate experience. That’s patience to fully recover.” with a board certified surgeon, call (800) what you get when you choose FirstHealth.” 213-3284 or visit www.worldclassortho.org.

For more information

12 Spring 2012

The robotic art of da Vinci GYN surgery By Erica Stacy

Walter Fasolak, D.O.

he theories of artist, inventor and scientist Leonardo da Vinci inspired early versions of technologies that are still being used today. When he was just 12, da Vinci applied his unique understanding of the human body to create the first robot. A replica of a knight, it was designed to mimic the movements of a real person. Today, specially trained surgeons at FirstHealth Moore Regional Hospital employ a modern-day da Vinci to enhance medical care. The da Vinci Si Robotic Surgical System Stephen Szabo, M.D. offers a safe, reliable alternative for certain women experiencing gynecological concerns such as fibroid disease, endometriosis, vaginal prolapse, even cancer. “The da Vinci robot operates as an extension of the surgeon,” says Walter S. Fasolak, D.O., of Southern Pines Women’s Health Center. “It allows us to maneuver more precisely and safely through tiny spaces in the abdomen without making large incisions.” To operate the robot, the surgeon makes several small incisions in the abdomen. Special extensions equipped with precise surgical tools, including cameras, scissors and other instruments, are inserted through these incisions. Images from the camera are uploaded to a console or computer screen and then used by the surgeon as he operates. FirstHealth of the Carolinas recently acquired a da Vinci “The robot magnifies everything,” says Stephen A. Szabo, M.D., of the Pinehurst Surgical Women’s Care Si, a third-generation robotic Center. “It creates a clear, precise picture with a 3D perspective. Because we can visualize the inside of the surgical system with features body, we can more easily identify normal versus abnormal tissue and structures. The robot’s tools move much that include enhanced like a human wrist so we can cut, sew and repair safely and precisely, treating all of the tissue at the site high-definition 3D vision for gently.” superior clinical capability. Because robotic procedures are minimally invasive, patients usually have a shorter recovery—meaning less time away from work—and fewer complications than those who experience traditional open surgeries. Robotic surgery is not appropriate for every woman or every gynecological procedure, however. “Our approach depends on the unique needs of each woman,” says Dr. Fasolak. “Da Vinci is one resource among many treatment options.” Complex robotic technology requires extensive education for the provider and the surgical team. “Each member of the team has a role to play,” says Dr. Szabo. “At FirstHealth of Carolinas, our team is top-notch. The combined expertise and commitment to excellence is a stabilizing force that makes the real difference in patient care.” www.firsthealth.org

The Human

Body Shop

14 Spring 2012

There was a time not too long ago when the idea of a “bionic man” was nothing more than fodder for science fiction television. Today, implantable devices are used — among a host of usages — to replace arthritis-damaged hips, shoulders and knees; regulate heart rhythms and blood flow; open clogged arteries and reinforce bulging vessels; ease chronic pain; treat urinary incontinence; contribute to weight-loss in the morbidly obese; and repair broken bones.

n Aortic Valve Replacements are

In fiscal year 2011 alone, specialists in orthopedics, neurosurgery, cardiac disease, vascular disease, gynecology and surgical weight-loss performed nearly 2,700 surgical procedures involving implants at FirstHealth Moore Regional Hospital. Stents, implantable defibrillators and pacemaker surgeries performed by interventional cardiologists accounted for nearly 2,000 more procedures.

Shoulder replacements are metal and plastic implants that replace the damaged bone and cartilage of the ball-and-socket shoulder joint. The surgery is a treatment option for severe arthritis.

Pacemakers are electronic devices that are implanted under the skin to help regulate the heart beat. Electrophysiologists (cardiologists who specialize in the electrical impulses of the heart) at Moore Regional Hospital now implant MRI-friendly pacemakers (see story on page 18) as well as traditional devices.

Cardiac Stents are small tubes that are used to widen the arteries that supply blood to the heart. The meshwork of stents can be made of metal or fabric, and some are coated with medicines that are continuously released into the artery to help keep it from becoming blocked again.

used to replace failing valves of the aorta with healthy valves – either mechanical or tissue (typically animal tissue). The aorta is the largest artery in the body.

n Arterial Stents are inserted to permanently prop open blocked arteries in people suffering from peripheral arterial disease (PAD). The Radiological Society of North America describes two stent types: bare stents, of the wire mesh variety; and covered stents, which are also referred to as stent grafts.

n Breast Implants are used to correct the size, form and feel of a woman’s breasts after mastectomy (see story on page 10); to correct deformities of the chest wall; and for breast augmentation. There are three general types of breast implant devices, each defined by filler material: saline, silicone and composite.

n Mitral Valve Replacements, either mechanical or tissue, replace diseased mitral valves. In patients with mitral valve prolapse, the replacement correctly controls the direction of blood flow.

Knee Replacements are artificial joints that replace diseased or damaged joint surfaces of the knee. The metal and plastic components are shaped to allow continued motion. Knee replacement surgery, called knee arthroplasty, can be performed as a partial or a total knee procedure.

Spinal cord stimulators use electrical

n Open Reduction Internal Fixation (ORIF) devices are plates or screws used for the surgical repair of broken bones. During 2011, orthopedic surgeons at Moore Regional Hospital used ORIF procedures to repair broken ankles, wrists, arms, hands, fingers, elbows, legs, feet, thighs and shoulders.

n Spinal Bone Graft fills the space between two spinal vertebrae in a procedure called spinal fusion. The bone graft material may be in a preformed shape, or it may be contained within a plastic, carbon fiber or metal cage. The surgeon may use plates, screws or rods to hold the vertebrae and graft in place to promote healing.

n Vaginal Sling is a synthetic or tissue “hammock” that is placed under the urethra (the canal through which urine is discharged from the bladder) to keep it from opening when a woman coughs, sneezes or laughs. Material options include synthetic mesh (polypropylene mesh), the patient’s own tissue or other selective tissue sources.

n Vascular Stents are mesh tubes that are used to expand narrowed blood vessels. A narrowing in a blood vessel is caused by a process called Peripheral Vascular Disease. They can also be used to reinforce a weak vessel that is bulging (aneurysm).

Hip Replacements are artificial joints consisting of a ball component made of plastic, ceramic or metal, and a socket that has an insert or liner made of plastic, ceramic or metal. Hip replacement surgery, called hip arthroplasty, is typically used for people with hip joint damage caused by arthritis or injury.

Adjustable Gastric Bands, also known as Lap Bands, are inflatable silicone devices that are placed around the top portion of the stomach to treat obesity by reducing the amount of food that can be consumed.

current to treat chronic pain with a small electronic system that sends mild electrical impulses to the spinal cord through medical wire leads. At Moore Regional, an anesthesiologist specializing in chronic pain determines if a patient is an appropriate candidate for a spinal cord stimulator and a neurosurgeon implants the device.

www.firsthealth.org

FirstHealth Physician Group Dan Barnes, D.O., spent 10 years as a physician in the U.S. Army before leaving active duty with the rank of major. Now a hospital-based physician at FirstHealth Moore Regional Hospital who moved into health care leadership as medical director of Hospitalist Services, he believes his military service helped prepare him for his new administrative role as president of the FirstHealth Physician Group. “The Army does a great job in leadership skills,” Dr. Barnes says. “It set me up to take on this role and position.” The 110 physicians and mid-level providers who work directly for FirstHealth of the Carolinas comprise the FirstHealth Physician Group. Included are physicians who specialize in hospital medicine, cardiovasDan Barnes, D.O. cular thoracic surgery, neonatology, neurosurgery, infectious diseases, psychiatry, obstetrics and gynecology, family practice medicine and internal medicine as well as the non-physician practitioners (physician assistants and nurse practitioners) who work with them. According to Dr. Barnes, the organization’s purpose is two-fold: excellent patient care and a “rewarding professional home” for those who provide it. “We have a compact focusing on integrity, excellence and quality patient care that describes what sets our doctors apart,” Dr. Barnes says. “It has allowed us to pull together our physicians to determine where we are headed and what we want to be.” Central to the FirstHealth Physician Group philosophy is the delivery of effective, efficient and patient-centered care that ensures a smooth transition from the inpatient (hospital) setting to the outpatient environment. Numerous committees, sub-committees and teams focus on the best ways of accomplishing this inpatient-to-outpatient transition goal. One is the Quality and Professional Effectiveness Committee, which works to assure quality throughout the FirstHealth system. Sub-groups include a team that investigates ways of reducing hospital readmissions; a diabetes work group that is attempting to standardize diabetes education programs throughout the FirstHealth system; and a committee working to assure proper inpatient and outpatient care for congestive heart failure patients. Another group, the Physician Resource Committee, is looking at the physician retention process while working to give providers who are new to the organization “the necessary tools and information to be successful” from the beginning of their FirstHealth experience. Yet another group, the Finance and Operations Council, is evaluating the business side of medical practice to include a provider compensation plan that involves incentives based on quality. Every effort is directed toward attaining the same goal—improved quality of care. “That makes it all worthwhile,” Dr. Barnes says.

16 Spring 2012

Foundation supports physician leadership Physicians are constantly working to build on their skills and knowledge while providing excellent service and leading complex health care teams. However, traditional medical training doesn’t teach the communication, leadership and personal management skills that a demanding health care environment requires. With the support of the community, the Foundation of FirstHealth is developing a Leadership Institute and Center for Physician Renewal, a unique effort to equip FirstHealth physicians for the forefront of health care. Its aim is to give FirstHealth physicians, their families and the organization’s multidisciplinary teams the skills, concepts and support needed to enhance leadership skills, career satisfaction, clinical performance, personal health and resilience. The broad menu of services will include training experiences, tailored coaching, personal assessment and intervention, seminars, retreats, conferences and consulting services that emphasize skill-building in leadership development and professional/personal renewal. The curriculum will include leadership training and coaching; team-building for organizations and departments; physician wellness interventions; and seminars, workshops and retreats that address work-life balance, medical marriage and medical family life. This program is currently being developed. You will hear more about it as it is introduced.

VATS lobectomy A minimally invasive surgery for lung cancer Lung cancer is the leading cause of cancer deaths in the United States in both men and women, claiming more lives each year than colon, prostate, ovarian, lymph and breast cancers combined. Because lung cancer typically doesn’t cause signs and symptoms in its earliest stages, the disease is usually advanced by the time it is diagnosed. Standard treatment options include surgery, chemotherapy and radiation therapy. As with most cancer treatments, the surgical choice depends on the type of cancer and the extent to which the disease has progressed. The standard surgical approach to lung cancer treatment involves cutting through major muscles in the chest wall and spreading the ribs to remove the lobe of the lung involved with the cancer. That incision is referred to as a thoracotomy, and removal of the lobe is called a lobectomy. These are surgical procedures with the potential for complications involving lung function, wound healing or pain control. In certain cases, however, an alternative technique involving Art Edgerton, M.D. video-assisted thoracic surgery (VATS) allows a less-invasive approach to lobectomy, according to Art Edgerton, M.D., a cardiothoracic surgeon at FirstHealth Moore Regional Hospital. Dr. Edgerton describes VATS lobectomy as the latest procedure successfully completed in the “armamentarium” (medical techniques, equipment and medications) available to the cardiothoracic surgeons affiliated with Moore Regional’s Chest Center of the Carolinas. (See a related Chest on VATS lobectomy or other services offered Center story on page 6.) The procedure allows access to the lungs through several smaller incisions by the Chest Center of the Carolinas, call instead of a single large incision and without the physical trauma involved with dividing muscles (800) 213-3284. and spreading the ribs. During a VATS lobectomy, a small video camera called a thoracoscope and surgical instruments are inserted into the patient’s body through the incisions. Images transmitted from the thoracoscope and projected onto a computer monitor guide the surgeon to the surgical area. “Our efforts at the Chest Center are to employ surgical techniques that are oriented toward minimally invasive applications,” Dr. Edgerton says. In addition to limiting the trauma of the surgery, a VATS procedure generally involves a shorter hospital stay, faster recovery and less potential for complications. “Not only does the patient recuperate more easily, but there are fewer complications,” Dr. Edgerton says. Patients needing a variety of diagnostic or treatment procedures of the lung other than lobectomy may be candidates for video-assisted surgery. The best candidates for VATS lobectomy are generally those with earlier stage lung cancers that are confined to a single lobe. Traditional surgery would probably be more appropriate for patients with cancer that has spread beyond a single lobe. “At no time do we want to compromise a patient’s definitive treatment by using a different technique,” Dr. Edgerton says. “Our intent is to offer less-invasive surgical applications when appropriate. We are able to utilize less-invasive techniques with both diagnostic and definitive therapy procedures.”

For more information

www.firsthealth.org

New pacemakers give patients an MRI option

Ker Boyce, M.D.

Lacey Moore, M.D.

18 Spring 2012

Sometimes technologies don’t work together. For years, that has been the case with electronic pacemaker systems, which help regulate the heartbeat, and MRI (magnetic resonance imaging) technology. Pacemaker and MRI manufacturers have typically instructed physicians not to expose patients with pacemakers to MRI scans, because the magnetic field of an MRI machine can disrupt a pacemaker’s electronic system, effectively shutting it down or unintentionally stimulating the heart. Some studies also claim that heat generated in the pacing wires by MRI magnetic and electrical fields could damage cardiac tissue. With the FDA-approved pacing systems now being implanted by electrophysiologists at FirstHealth Moore Regional Hospital, there is now an MRI option. “Until this new device, patients with a pacemaker were unable to undergo an MRI exam,” says Ker Boyce, M.D., an electrophysiologist with Moore Regional and Pinehurst Medical Clinic. “This is an option for those who really need a pacemaker.” Dr. Boyce did the first MRI-friendly pacing system implant at Moore Regional in mid-2011. The procedures are now also being done by electrophysiologists Rodrigo Bolanos, M.D., also of Pinehurst Medical Clinic, and Mark Landers, M.D., of Pinehurst Cardiology Consultants. An electrophysiologist is a cardiologist who specializes in the electrical impulses of the heart. The MRI-friendly pacemakers now being used at Moore Regional have been engineered with multiple safety features including circuits that are immune to strong magnetic fields. Changing health care demographics have had an impact on the increasing need for MRI-friendly pacemakers. According to industry reports, patients over age 65 are the primary users of MRIs and are twice as likely to need an MRI as younger patients. The elderly also dominate the patient population most likely to need a pacemaker. According to Lacey Moore, M.D., a radiologist with Moore Regional and Pinehurst Radiology, MRIfriendly pacing systems give these patients the opportunity for imaging exams that previously were unavailable to them. “Chances are that you are going to need an MRI in your lifetime,” Dr. Moore says. “(This technology) will allow some patients to have scans where otherwise they would not have been able to.” Medtronic’s Revo MRI SureScan is the only pacing system with FDA approval for use in the United States. Even then, not all patients, especially those with certain medical conditions, are appropriate for the technology. That’s a decision for the cardiologist and the patient, says Dr. Boyce. “Still about 50 percent of the patients who require pacemakers will be eligible,” he says. Scans are also limited to specific areas of the body. And, because of all of the steps in the MRI-pacemaker protocol (including clearly identifying the system as MRI-friendly), most procedures are elective. With health care’s increasing reliance on MRI technology as a dependable and efficient diagnostic tool, Dr. Moore expects traditional pacemakers will eventually be phased out in favor of the MRI-friendly systems, especially as numerous manufacturers work to develop their own programs. “Chances are you are going to need an MRI in your lifetime,” he says. “Eventually, it’s going to be standard to have (a pacemaker) of this type.”

The medical benefits of massage By Erica Stacy

Massage.

The word evokes images of pampering and relaxation, but it’s not simply an indulgence or a treat. Massage can be an effective tool for improving health and wellness. Massage therapy dates back 5,000 years. Early healers, including Hippocrates, recognized that rubbing the body with oils, salts and minerals promoted healing, eased pain, and prevented illness and injury. As Western medicine evolved and individuals began to rely on developing medications and technologies, massage moved out of the mainstream, becoming primarily an indulgence for those accustomed to the luxuries in life. The recent emphasis on total health and wellness has revitalized the use of massage for healing, however. “The effects of massage can be profound,” says Jo Ann Richardson, NCLMBT, a licensed massage therapist with FirstHealth’s firstspa at the FirstHealth Center for Health & Fitness-Pinehurst. “It promotes relaxation and restores balance. It encourages the release of hormones that help us feel good and works to decrease pain and promote healing.” At firstspa, massage services are tailored to meet the needs or goals of each individual. “At the first appointment, each client completes a health history,” says firstspa’s Valinda Dees, LMT. “If they have a problem area, we target our services to improve that condition. During the session, we encourage clients to let us know if something makes them uncomfortable. What feels right for one may be painful for someone else. Massage is an intimate, personal experience, and when the client and the therapist work together, the power of touch is amazing.” The manager of firstspa, Kelly Kilgore, calls massage “an investment in good health.” “Just like exercise can strengthen the heart and help reduce obesity, massage can decrease pain and inflammation in the muscles and joints,” she says. “With few exceptions, massage benefits everybody, young or old, all body types, male or female,” she says. “It is not a frivolous luxury.”

Massage and health & wellness Massage therapy may help promote health and wellness in a variety of ways, including increasing flexibility and range of motion; decreasing pain and inflammation, particularly in muscles and joints; improving digestion; calming the nervous system; improving posture and coordination; and reducing blood pressure According to Clare Reinhardt, M.D., the new medical director for the FirstHealth Centers for Health & Fitness, massage should not be considered a replacement for traditional medical care, but it can complement traditional treatment. “The benefits of massage have the potential to create a sense of empowerment, comfort and the reduction of stress, all which are essential to a healthy lifestyle,” she says.

While massage is safe when performed by well-trained, licensed therapists, there are a few medical conditions for which massage or certain types of massage may not be appropriate. Therefore, it is important to discuss massage with your doctor and to keep the therapist informed about your full medical history.

Massage at FirstHealth

Pinehurst (firstspa)

Raeford

Southern Pines

Massage therapy is offered at five of the FirstHealth Centers for Health & Fitness.

Monday through Friday, by appointment only, during regular firstspa business hours. Saturday appointments can also be arranged.

Monday mornings and Tuesday afternoons by appointment only.

Monday through Saturday, by appointment only, during regular business hours.

Pembroke Mondays by appointment only. Call (910) 521-4777.

Call (910) 715-1811.

Call (910) 904-6129.

Richmond

Call (910) 692-6129.

Tuesdays 1 to 7 p.m. and Saturdays 8 a.m. to 5 p.m. by appointment only. Call (910) 410-0123 ext. 221.

www.firsthealth.org

New FirstHealth

By Brenda Bouser

Hospice & Palliative Care campus opens

harlotte Patterson has seen FirstHealth Hospice & Palliative Care through a variety of changes during her more than a dozen years as director. One was the 1996 merger of Sandhills Hospice with FirstHealth of the Carolinas. Last fall, Patterson observed another important milestone in local hospice history—the opening of the new FirstHealth Hospice & Palliative Care campus. “A lot of people have been working on this for a long time,” she says. The three-building FirstHealth Hospice & Palliative Care campus is located on 30-plus acres of wooded, lake-front property on Campground Road in Pinehurst. At one time the site of a local RV camp, the land was a partial gift from former owners James and Michell Kirkpatrick. Central to the new campus is an 11-bed, 16,000-square-foot Hospice House, an acute-care facility for patients needing short-term pain-management and/or symptom control. Ellen Willard, M.D., the medical oncologist and hematologist who serves as Hospice medical director, says the Hospice House fills a much-needed niche in FirstHealth’s “spectrum of care.” “The Hospice House is for patients who need treatment that can’t be provided at home and that

A dream come true

20 Spring 2012

Grief Resource & Counseling Center The FirstHealth Grief Resource & Counseling Center, located in the Administration Building on the campus of FirstHealth Hospice & Palliative Care, offers understanding, support and guidance for people whose lives have been changed by grief. Facilities include a specially designed area for children and a lending library with a variety of resources. The center’s services are available to anyone in the community. Specially trained grief counselors offer individual, family and group counseling to people who have already suffered a loss, as well as those who are dealing with life-altering illness or who are facing the death of a loved one. For more information, call (800) 213-3284.

Generous community giving at work Community giving was especially apparent in the fundraising efforts supporting the construction of the FirstHealth Hospice & Palliative Care campus. The cost of the project totaled about $13 million of which $4.5 million came from the FirstHealth Hospice Foundation. The Stepping Stones Campaign, the largest fundraising initiative in FirstHealth’s more than 80-year history, supported the project as well as the Reid Heart Center and the Clara McLean House at FirstHealth. Although a chapel was not originally part of the Hospice project’s first phase, supporters decided that it should be and raised more than $1 million in a little more than one year—not only for construction but also to support the chapel’s continued operation.

might previously have been provided in a hospital setting,” she says. “These patients need medical treatment and access to skilled personnel as opposed to residential beds for (end-of-life) custodial care.” “I have been hoping for this for so long,” she adds. “This is a need this community has had for years, and there are a lot of people who recognized that need. It supports current services as part of (FirstHealth’s) continuum of care, and it’s been a long time coming.” Charlie McWilliams, chair of the FirstHealth Hospice Foundation Board of Trustees, says the new Hospice House addresses short-term patient and family needs in a home-like setting where their comfort is assured and patient issues are quickly and professionally addressed. “We’re very fortunate to have a situation like that,” he says, “not a hospital, but with all the qualifications and certifications of a hospital if need be. It’s not a place where you want to be, but it’s a place where you can be and know that your loved one will be comfortable.”

A place of reflection Pinehurst resident Charlie McWilliams chaired the fundraising effort for a chapel on the FirstHealth Hospice & Palliative Care campus. He describes the 1,000-square-foot chapel as “a dream for the whole campus.” “It’s primarily designed for people to go and reflect,” McWilliams says. “When you lose a loved one, there are times when you just want to be by yourself and you need a place to do that.” The nondenominational chapel, which can accommodate up to 49 people seated, is used for functions related to services provided by FirstHealth Hospice & Palliative Care: n By patients residing in the house and their families n For small services by families after a death n By clients of the Grief Resource & Counseling Center n For public services for the general community that are sponsored by FirstHealth Hospice & Palliative Care and related to issues of grief and loss The money to build the chapel was raised in a special FirstHealth Hospice Foundation effort that began in late 2010. The goal was $1 million—$500,000 for construction and $500,000 for an endowment that would assure operational costs would always be covered. By December 2011, $1.4 million had been raised.

www.firsthealth.org

Home Care representatives participate in Capitol Hill briefing

FirstHealth launches Patient and Family Advisory Council With the recent launch of its new Patient and Family Advisory Council, FirstHealth of the Carolinas has taken an important step in setting the standard for the extraordinary patient experience. “As health care providers, we have the best of intentions, and we do a really good job,” says Deborah DeLong, administrative director of FirstHealth Hospitalist Services. “But there is room

Connie Christopher, R.N., and Patty Upham, R.N., (second and third from left), of FirstHealth Home Care Services, participated in a recent Capitol Hill legislative briefing and panel discussion on telehealth and its impact on health care.

for improvement, and we want to hear directly from patients and families to learn how we can provide the most extraordinary patient experience every

Two members of the FirstHealth of the Carolinas Home Care Services staff participated in a Washington, D.C., legislative briefing and panel discussion on “How Telehealth and the FITT Act Can Transform Healthcare.” The event was hosted by Sen. Amy Klobucher (D-Minn) and held Dec. 5, 2011, in the Kennedy Caucus Room of the Russell Senate Office Building on Capitol Hill. Sponsors were Philips Telehealth Solutions, the National Association of Home Care & Hospice (NAHC) and its affiliated Home Care Technology Association of America. Panel discussion participants included Patty Upham, R.N., director, FirstHealth Home Care Services; and Connie Christopher, R.N., associate director, FirstHealth Home Care Services. Sen. Klobucher co-sponsored the Fostering Independence through Technology (FITT) Act of 2011, legislation designed to help improve health care by enabling more home health agencies to adopt homemonitoring technologies. FirstHealth Home Care Services has been a leader in the technology since introducing its telehealth service in a pilot program funded by the Foundation of FirstHealth almost a decade ago. Subsequent grants from the Foundation, The Duke Endowment and the Health Resources & Services Administration (HRSA) of the U.S. Department of Health & Human Services have funded additional monitors and staffing that has allowed the service to expand throughout the six-county FirstHealth Home Care coverage area. During the Capitol Hill discussion, Upham called telehealth a “key component” of FirstHealth Home Care’s chronic disease care model, one that allows patients to remain at home while reducing unnecessary hospitalizations and emergency care.

22 Spring 2012

time.” The 30 Patient and Family Advisory Council members include patients, or relatives of patients, who have been hospitalized at Moore Regional, Richmond Memorial or Montgomery Memorial at some point over the last three years. A few physicians and hospital employees are also members. Each member was chosen for his/ her personal health care experience and familiarity with the services provided at FirstHealth. “As health care providers, all too often we talk about what we do to a patient or for a patient, when it should be what we do with the patient,” says Dan Barnes, D.O., president of the FirstHealth Physician Group and an Advisory Council physician member. “By strengthening the partnership among physicians, patients, families and other providers, we will improve the care experience.”

Physicians named to FirstHealth administrative roles

9,911

Two FirstHealth of the Carolinas physicians have assumed enhanced administra-

Number of surgeries performed at Moore Regional Hospital in 2011

tive roles in a reorganization of the health care system’s executive management structure. John F. Krahnert Jr., M.D.,

John F.

has been named FirstHealth’s Krahnert Jr., M.D. chief medical officer, and Dan Barnes, D.O., was named president of the FirstHealth

1,425,860

Number of transport miles traveled by FirstHealth Regional EMS in 2011

369

Physician Group. “Drs. Barnes and Krahnert are both exceptionally qualified to take on their appointed roles,” said FirstHealth CEO David J. Kilarski. “They

First in Quality

Dan Barnes, D.O.

have led distinguished careers and will provide the leadership and experience to advance the organization to continued success.” As FirstHealth’s chief medical officer, Dr. Krahnert will continue to function as a cardio-

Number of patients at Montgomery Memorial Hospital’s Emergency Department receiving free dental care vouchers since 2006

450

Percentage increase in orthopedic surgeries at Richmond Memorial Hospital in 2011

thoracic surgeon in the open-heart program he started at FirstHealth Moore Regional Hospital more than 20 years ago. His expanded administrative role includes oversight of Quality, the Centers for Health & Fitness and Community Health Services. As president of the FirstHealth Physician Group, Dr. Barnes is responsible for the supervision and development of FirstHealth-employed physicians. He also oversees the Dental Care Centers, Home Care Services, Practice Management, Hospice, Behavioral Services and Oncol-

5,705

Number of office visits to FirstHealth Family Care Centers in March 2012

3,627

Number of Cumberland County residents who sought care at Moore Regional Hospital in 2011

ogy in addition to Hospitalist Services. A story on the FirstHealth Physician Group can be found on page 16 of this magazine. www.firsthealth.org

Bariatric Support Group 7 p.m., first Thursday and third Monday of each month, Renaissance Room, Pinehurst Surgical Better Breathers—A support group that teaches individuals with chronic obstructive pulmonary disease (COPD) and their families how to live with lung disease • Montgomery County: noon, second Monday of each month, September through May, Conference Room 1, FirstHealth Montgomery Memorial Hospital. • Moore County: 10 a.m., third Tuesday of each month, except June through August, Conference Center, FirstHealth Moore Regional Hospital. Breast Cancer Support Group 7 p.m., second Monday of the month, except July and August, Conference Center, FirstHealth Moore Regional Hospital. Cancer Support Group 2 p.m., every Tuesday, Sun Room, Cancer Center, FirstHealth Moore Regional Hospital. Unless otherwise noted, support groups meet in the Conference Center of FirstHealth Moore Regional Hospital, corner of Highway 211 and Page Road, Pinehurst. For more information on any of these groups, please call (800) 213-3284.

Cancer Survivors Support Group 11 a.m., second Tuesday of the month, Sun Room, Cancer Center, FirstHealth Moore Regional Hospital. CODA 7 p.m., every Monday, Conference Center, FirstHealth Moore Regional Hospital. Fibromyalgia Support Group 7 p.m., second Tuesday of each month, except December, Outpatient Center Conference Room, FirstHealth Moore Regional Hospital, 238 Page Road, Pinehurst. FirstQuit Support Group—A group for people who have quit or are trying to quit tobacco. • Moore County: Noon, every Thursday, FirstHealth Taylortown Building, 181-C Westgate Drive, West End. • Richmond County: 5 p.m., every Thursday, Conference Dining Room, FirstHealth Richmond Memorial Hospital, 925 S. Long Drive, Rockingham.

24 Spring 2012

Lupus Support Group 4 p.m., third Sunday of each month, except June and July, Conference Center, FirstHealth Moore Regional Hospital. NAMI-MC (National Alliance on Mental Illness-Moore County) 7 p.m., first Monday of each month, Community Classroom, FirstHealth Specialty Centers Building, 35 Memorial Drive, Pinehurst. Post-Deployment Group— For individuals with post-deployment symptoms. 11 a.m., every Monday, FirstHealth Behavioral Services, FirstHealth Specialty Centers Building, 35 Memorial Drive, Pinehurst. Sandhills Ostomy Association 3 p.m., first Sunday of each month, except June through September, Conference Center, FirstHealth, Moore Regional Hospital. Stroke Club 10:30 a.m., second Saturday of each month, Conference Center, FirstHealth Moore Regional Hospital. Susan Sharpe Cancer Support Group (Richmond) 6:30 p.m., fourth Thursday of each month, except June through August, Conference Dining Room, FirstHealth Richmond Memorial Hospital, 925 South Long Drive, Rockingham. Zipper Club—For individuals who have had open-heart surgery. 7 p.m., fourth Tuesday of each month, except December, Conference Center, FirstHealth Moore Regional Hospital.

New Providers Hospitalist Services Margaret F. Campbell, M.D. Board Certified

FirstHealth Hospitalist Service Hospital Affiliation: Moore Regional Hospital Training: M.D., University of North Carolina at Chapel Hill Internship/Residency: Moses Cone Memorial Hospital, Greensboro, N.C.

Family Medicine Valerie D. Taylor, P.A. FirstHealth Family Care CenterRaeford Hospital Affiliation: Outpatient Only Training: P.A., Methodist University, Fayetteville, N.C.

Orthopedics Sherry R. Hall, P.A.-C Pinehurst Hip & Knee Center Hospital Affiliation: Moore Regional Hospital Training: P.A., University of Nebraska Medical Center

OB/GYN Sarah D. Bowen-Pasfield, M.D. Southern Pines Women’s Health Center Hospital Affiliation: Moore Regional Hospital Training: M.D., West Virginia University School of Medicine Internship/Residency: West Virginia University School of Medicine

Pulmonology Sofia Filzer, P.A.-C Pinehurst Medical Clinic Hospital Affiliation: Moore Regional Hospital Training: P.A., East Carolina University, Greenville, N.C.

For a complete listing of FirstHealth of the Carolinas providers, visit the website at www.firsthealth.org/physician. If you prefer a printed copy, call (800) 213-3284.

April Moore Regional Hospital Pregnancy Fair Thursday, April 19 6 to 7:30 p.m. Fair Barn Harness Track Pinehurst An evening for new and expectant parents featuring experts on prenatal care, pediatrics, childbirth, mother-baby care, neonatal services, breastfeeding and more.

Take charge of your health with three simple screenings. FirstHealth Mobile Health Services offers three preventive screenings in the comfort and convenience of its mobile unit. Screenings are conducted using painless, non-invasive ultrasound technology and are available for individuals who are 18 years of age and older. Abdominal Aortic Aneurysm (AAA) Stretching and weakening of the aortic wall can eventually cause the aorta to burst or rupture, leading to life-threatening bleeding. Stroke Screening/Carotid Artery Carotid artery disease is the number one cause of stroke in the United States. Plaque buildup on the artery walls restricts the blood flow to the brain, causing a stroke. Peripheral Vascular Disease (PVD) Plaque buildup in the arteries limits the blood supply to the body’s muscles, organs and tissue, which may lead to the loss of limbs. Upcoming screenings: • Thursday, May 3 9 a.m. to 2 p.m. FirstHealth Center for Health & Fitness-Richmond • Thursday, May 24 9 a.m. to 2 p.m. FirstHealth Center for Health & Fitness-Raeford • Thursday, May 31 9 a.m. to 2:30 p.m. Aberdeen Parks and Recreation For additional screening dates, or to schedule an appointment, call (888) 534-5333.

Breast Reduction Surgery Information Seminar Tuesday, April 24 7 p.m. Advanced Physical Therapy Solutions 501 Executive Place Fayetteville Russell B. Stokes, M.D., board certified plastic and reconstructive surgeon, will discuss the benefits of this surgery. Registration is necessary as space is limited. Blood Drive Wednesday, April 25 10 a.m. to 3 p.m. Conference Center FirstHealth Moore Regional Hospital Corner of Highway 211 & Page Road Pinehurst Annual Women’s Series Monday, April 30 6 p.m. Cafeteria FirstHealth Richmond Memorial Hospital Rockingham

May Kid’s Day Saturday, May 19 9 a.m. to noon Richmond Memorial Hospital Free events, games and health screenings for children. Garden Party Saturday, May 19 Healing Garden Clara McLean House 20 FirstVillage Drive FirstHealth Moore Regional Hospital campus By invitation: $50 per person

June Ninth Annual Blue Jean Ball Saturday, June 2 Fair Barn Harness Track Pinehurst Tickets are $65 per person Cancer Survivors Day Sunday, June 3 2 to 4 p.m. Fair Barn Harness Track Pinehurst Blood Drive Wednesday, June 20 10 a.m. to 3 p.m. Conference Center FirstHealth Moore Regional Hospital Corner of Highway 211 & Page Road Pinehurst Non-Surgical Treatments for Arthritis Pain Wednesday, June 20 5:30 p.m. Monroe Auditorium Conference Center FirstHealth Moore Regional Hospital Corner of Highway 211 & Page Road Pinehurst Join pharmacist Thom Morris, RPh, for an informative presentation and a panel discussion with representatives from the FirstHealth Centers for Rehabilitation, the FirstHealth Centers for Health & Fitness and the FirstHealth Back & Neck Pain Center. Space is limited, so registration is required.

Unless otherwise noted, there is no charge for these programs. For more information or to register, please call (800) 213-3284 or visit our website at www.firsthealth.org/calendar.

www.firsthealth.org

Kindness and care in a time of tragedy It was a parent’s worst nightmare to learn that your child has died. And that’s how we met your team at FirstHealth Montgomery Memorial Hospital that Saturday, Sept. 3, 2011, on Labor Day weekend.

The Williamses encountered numerous helpful and compassionate FirstHealth employees and Montgomery County residents on the day their son, Tyler (pictured in the postage stamp inset), died in a Labor Day 2011 boating accident. Three of them were Emergency Department physician Geoffrey Martin, M.D.; Tony Covington, of hospital Security; and charge nurse Stephanie Kornegay, R.N.

We had gotten the call earlier—just as we had arrived in Chapel Hill for the first football game of the year. We knew once we entered the hospital in Troy that we would have to face the truth. When we got out of the car in the parking lot, we saw a group of people leaving the hospital. A tall, strong-looking man wearing a dark green polo shirt remained in the parking lot far ahead of us. We followed him. He overheard our discussion about the rest rooms and quietly directed us. Then he led us right down the hall to the chapel. His name was Tony Covington (of hospital Security). I still remember (Emergency Department physician) Dr. Geoffrey Martin kneeling in front of me, telling me that my 14-year-old son, Tyler, had died. Dr. Martin said that Tyler never knew what happened – he was killed instantly. He wanted to make sure I knew that so it would comfort me. It still does. We asked to see Tyler and got into the elevator to head to the morgue. Again, that same tall, strong-looking man appeared in the elevator, pushing the buttons with his head bowed. Again, strong yet silent. Before the doors opened, I asked him if he had been waiting for us in the parking lot. And he nodded yes. All of the EMT folks were lined outside the morgue with their heads bowed. I’ll never forget that. Dr. Martin was with us along

26 Spring 2012

with Emergency Department charge nurse Stephanie Kornegay, but this wasn’t about medicine. It was too late for that. We were overwhelmed by the compassion of your team. Thank you for the kindness and care your team demonstrated that day. I’ll never think of doctors in the same way again. Your nurse, Stephanie Kornegay, called her own minister, the Rev. Kelli Sorg, to be with us when she heard that the hospital chaplain was hours away. Looking back, that was the best thing she could have done. The Rev. Sorg answered those piercing questions that we had. She prayed with us. Before we left, Dr. Martin gave me a slip of paper and put it in my hand. He said, “You’re not ready to read this yet; but when you’re ready, please read it.” When I looked briefly at the paper as he folded it, I saw two words —“The Shock.” We left the hospital that day with only two slips of paper: the book title and the number of the charge nurse, Stephanie. Hours later that night, I realized that we didn’t even sign a document while we were there. I just had two small folded pieces of paper. Weeks later, I reviewed the slips of paper. They were actually Post-It notes. One actually said, “The Shack,” not “The Shock,” as I had remembered. Interestingly, I had misconstrued the word based on my own feeling of utter shock. I purchased and read the book, and Dr. Martin was right. It had been comforting. It was exactly what I needed. It was the right prescription. In our son’s eighth-grade autobiography last year, Tyler shared that he had his own “Laws of Life.” In fact, he said, “I understand that some things in my life will never go the way I plan them to. I do know, however, as long as I follow my ‘laws of life’—honesty, compassion and wisdom—I will make myself a better person.” It seems that your team has the same goals. I wanted to ensure that you knew how much our visit with your team touched our lives—even in our darkest of hours. Please share this story with your staff, and please personally thank your team for the job that they do. Consider this a testimonial for your hospital. While we would never wish any family to go through what we have gone through, your staff made a remarkable impression on our lives. They are the epitome of compassion, and they have our deepest gratitude. It’s fitting that I write you this letter on Thanksgiving Day. I would like to donate a stack of the “The Shack” books to be shared with families who experience death due to accidents and violence in memory of my son, Tyler David Williams, if you would allow me that honor. To learn more about Tyler, please read more about him on Facebook at RIP Tyler Williams—We Love You. Ashley B. Williams Greensboro

An “ambassador” for Cardiac Rehab I am proud to say that I feel like your best ambassador based on my stays and experiences at Moore Regional. Therefore, it is my pleasure to tell you that your Cardiac Rehabilitation staff is the best there is because of the dedication that the CR nurses have for their patients. I just completed my second term in Cardiac Rehab because of heart attacks. I came very close to the end of the line and gratefully can say I am happy and lucky to be alive, and I credit not only the doctors and floor nurses, but I especially credit Cardiac Rehab for their expertise. I also had an operation on my heart in 2002 in New York City. Following that, I attended Cardiac Rehab in New Jersey. It did not compare in any way with the care and wonderful attitudes of your staff of Cardiac Rehab nurses at Moore. I had a most successful business in my working years and always had what I believed to be the best employees in my field. Although they were the best, there was always one person who stood out among them as being the very best. I taught that “you are only as good as your people.” Let me say again that your staff is second to none and that Denice Gibson represents a “shining star” in my opinion. I have been in Moore Regional twice in the last two years with heart operations, and the care was superb. What stands out is the special care and attention that Ms. Gibson showed me while I was in the hospital. I would feel absolutely wonderful and optimistic about my continuing recovery after each of her visits. And I looked forward to entering the CR program. She is very well liked by her CT patients and is most qualified and suited for her job. She has an infectious smile the entire time of her work day. Ms. Gibson is a terrific asset for you and the hospital, and she earns my commendations. Lu Navarro Whispering Pines

www.firsthealth.org

Hospital provided treatment with “utmost care” My mother was a patient at Montgomery Memorial Hospital on Aug. 3-7 and Aug. 21-26, 2011. What a wonderful group of people. My mother was treated with the utmost care. I would like to thank all the third-floor staff, especially Janette Deaton, LPN; Vicki McDowell, LPN; Sammy Clelland, LPN; Melisa Britt, R.N.; Jerry Phipps, R.N; and Wanda Stuart, CNA. Special thanks to Dr. Jonathan Brower and Dr. James Lewis. Janet Ondishko Mt. Gilead

“One of the finest facilities in the nation” On Thursday, Oct. 20, 2011, while on a golfing vacation, it was necessary for me to go to your emergency room due to severe chest pains. The service I received by all hospital personnel was outstanding. I was treated promptly and thoroughly and kept informed of the treatment that was being done. All staff was responsive, professional and caring. Again, I would like to thank the staff of FirstHealth Moore Regional Hospital for the outstanding and professional treatment I received. I feel you have one of the finest facilities in the nation, and would not hesitate to use a FirstHealth hospital in the future. John W. Michaels Sunbury, Pa.

For more information on these or any of the services provided by FirstHealth of the Carolinas, please call (800) 213-3284.

28 Spring 2012

Care good enough for a president Friday, Aug. 19, 2011, I attended the Deep-Water Jogging class at the FirstHealth Center for Health & Fitness-Pinehurst. As soon as I entered the pool, I became extremely cold. I could not stop shivering. I told my wife and Kelley Kibler (lifeguard and instructor) that I was cold and was getting out and going to the hot tub. Kelley sent the lifeguard, Chris McLaughlin, to see if he could help. I told him I was fine, just cold. He advised me not to go into the hot tub as it might not be good for the problem. I told him I was going in and if he tried to stop me, I would push him in the big pool. He agreed for me to go in the hot tub, but just for a few minutes and he stayed right with me. I entered the hot tub and was getting warm when, all of a sudden, Kelley appeared along with (support services coordinator) Sandy Ritter, Charlie Pritchard (evening pool manager); Dr. Matthew Reinhardt; and Kay Maria Green (Cardiac Rehab exercise physiologist). I have known Kay Maria since my days in Cardiac Rehab. I love to tease her, because she is one of the very few people shorter than I am. No teasing today; she was strictly business and very professional. She checked my temperature, pulse and had that sphygmomanometer cuff on me in a jiffy. She and Dr. Reinhardt asked lots of questions. Since I had heart trouble, I was advised to go to the Emergency Room. They helped me to my car, which my wife was driving. Upon reaching the Emergency Room, I was taken in immediately to see Dr. Matthew Vreeland. More examination and blood work. Lots of questions about medications. Fever was dropping as was blood pressure. Since I had had cellulitis in the past, Dr. Vreeland decided to give me an IV with antibiotic. My vitals responded to the antibiotic, and I was allowed to leave with a prescription for the antibiotic. President Obama could not have gotten better treatment. I am very thankful to live in Moore County. John M. Barringer Carthage

FirstHealth Bariatric Center Are you ready to change your life and improve your health?

Let us help you begin your journey! FREE Weight-loss Surgery Information Sessions are held on the first Thursday and third Monday of every month (except holidays) at 6 p.m. in the Renaissance Room at Pinehurst Surgical, 5 FirstVillage Drive, FirstVillage Campus, Pinehurst.

Raymond Washington, M.D. Medical Director, FirstHealth Bariatric Center

Arrive 30 minutes prior to the beginning of the program to record weight and calculate body mass index. For more information or directions, please call (800) 213-3284 or visit us at www.ncweightlosssurgery.org

David Grantham, M.D. FirstHealth Bariatric Center

Melissa Herman, R.D., LDN, CDE Patient Navigator

www.ncweightlosssurgery.org 1031-80-11

NON-PROFIT U.S. POSTAGE PAID PERMIT NO. 4 LONG PRAIRIE, MN

155 Memorial Drive P.O. Box 3000 Pinehurst, NC 28374

Because we use a variety of sources for mailing, duplications sometimes occur. Please pass an extra copy along to a friend or neighbor.

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