Medical Guide 2020 by Greenwood Commonwealth

THE FUTURE OF WOMEN’S HEALTH IS HERE. From equipment that can get a clearer look inside your body, to a robotic system that can give better surgical results, Greenwood Leflore Hospital is committed to providing our community with the latest technology for both diagnosis and treatment. Some of the most recent additions include the GeniusTM 3D mammography, which detects 20-65% more invasive breast cancer compared to 2D mammography alone. This means a greater potential for an earlier diagnosis and treatment options, as well as up to a 40% reduction in repeat scans. And from a comfort standpoint, the GeniusTM offers the fastest scan time, limiting the time of compression to less than four seconds. And when it comes to clear images, Greenwood Leflore Hospital offers both 3D and 4D ultrasounds, letting moms-to-be see their baby’s features. Then there’s the da Vinci robot for advanced minimallyinvasive surgery. Currently the only one of its kind in north central Mississippi, the da Vinci can reduce pain following surgery, reduce recovery time, and offer greater surgical precision. Also on the diagnosis and treatment front, The Cancer Center at GLH was recently awarded a grant to optimize outcomes for breast cancer patients. The grant will enable The Cancer Center to address early screening and intervention along with assistance for those with economic barriers including transportation to treatment. The mission is to help patients navigate through their care plans and provide extensive physician support while they are getting state-of-the-art treatment. The Cancer Center is also one of only twelve locations in the U.S. that offers Breast Microseed Treatment®, which is the precise placement of radioactive seeds around a lumpectomy site, allowing patients to quickly get back to their normal routines. So when you’re looking for the future of healthcare, it’s probably much closer than you think.

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Robot assistants

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Across the room, Dr. John F. Lucas III is completing the procedure. How is this so? It is all thanks to the da Vinci Surgical System, a robotic tool

used by surgeons at the hospital. The system works this way: Multiple thin mechanical arms perform the tasks that a surgeon, who is sitting and looking through a digitally advanced screen, instructs the system to do. The surgeon can see the inside of the patient with the help of one arm, which holds a camera that is equipped to magnify the subject 10 times, allowing for more accurate and precise procedures. With the advanced camera, the robotic system allows the surgeon to see the inner workings of a patient in three dimensions. This includes the added advantage of gauging depth perception. It also allows the surgeon a wider range of motion

that is not traditionally found in other mechanical health instruments. Dr. Kimberly N. Sanford, an obstetrician-gynecologist who has worked at the hospital since 2016, is working to integrate robotics into the routine operations there. Sanford Sanford said robotics can help reduce hospital stay as well as surgical problems, including pain, wound infection and blood loss. “My patient last week had a hysterectomy, and the drop in her blood count was naught. That is incredible in surgeries

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for uterine fibroids that are known to be very bloody,” Sanford said. “The patients are able to return to work much quicker with no time away from the ability to make a living even after major surgery. As you can see, the benefits are multiple.” Dr. Roger Blake, a new general surgeon at the hospital, agrees that these robotics create a wide range of opportunities. “It opens up the ability for us as surgeons to Blake do things we can’t do any other way,” he said. Blake and Sanford said the main ability of the robot is to achieve the best minimally invasive surgery. “It’s so much better for the patient,” Blake said. “It’s better cosmetically; there are smaller amounts of pain, quicker recov-

ery. It’s a better deal.” “Robotics are the trend towards minimally invasive surgery that is now a new residency and fellowship pathway for gynecologists, general surgeons and urologists,” said Sanford. “It is imperative that the hospital move in this direction to attract young talented surgeons that have perfected their surgeries using robotics. Young general surgeons and urologists are performing up to 80% of their surgeries using this new (system).” So far, the robotics have mostly been used for gynecological and urological surgeries at the hospital. Sanford and Blake both say these new operation methods are becoming more popular for hospital staff. Blake said that before surgeons can perform an operation with the robot, they must go through a specified course for the machine. However, “it’s not like you’re learning something completely different,” Blake said.

“We build on things we have learned before.” “Many older surgeons are taking their years of experience and pairing it with this new technology and synergistically advancing these areas of surgery, gynecology, general surgery and urology, specifically,” Sanford said. Even as these kinds of operations become more common, Sanford realizes that there can be some false impressions. “The biggest misconception is that this technology is expensive and the robot will be somehow autonomous from the surgeon and start working on its own,” Sanford said. “The robotic arms have never and will never work independently of the surgeon. The new laparoscopic technology and 10x magnification not only work to produce a better surgery for the patient, but it can prolong the surgeon’s career due to less wear and tear on the surgeons.” n

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Finding cancer early

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identified, The Cancer Center has started a breast cancer program as a way to spread education about the importance of screenings, provide transportation to those in need and provide guidance to the uninsured or underinsured. The ultimate goal of the program is to optimize the outcomes of breast cancer patients. “What we want to do is impact the age that women first get that mammogram No. 1, and ultimately impact survival in this community and in this region,” said Givens. A $728,770 grant from the Bristol Myers Squibb Foundation enabled The Cancer Center to implement the outreach program recently. The program uses a coordinated care navigation model, which includes a nurse and support staff to help navigate patients through their care plans, physician support and transportation. It also allows the doctors and staff at The Cancer Center to get input from actual breast cancer survivors, who will share what actually worked for them. “The time of intervention is crucial in terms of the outcomes,” said Wilson Gaillard, director of The Cancer Center. “If we can make folks realize that and have them enter into the program at an early stage through early diagnostics, the probability of you coming out on the other end, so to speak, with very little change in your daily activities is 95%plus. That’s where we hope to get, and it can be done.” In the Greenwood and Leflore County area, a late-stage diagnosis is common. “The stage that ladies present is at a much more advanced stage than any other area,” said Givens. “The Delta is a hot box for diagnosis of late-stage disease, whether it’s breast cancer, hypertension, diabetes or anything. So in the health care arena, patients present much more advanced stages.” Breast cancer death rates in some states, including Mississippi, are as much as 60% higher for vulnerable population mem-

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bers who suffer from poverty and a lack of health insurance. Risk factors and access to screening and treatment, which are influenced by socioeconomic factors and proximity to medical services, also play a role in the disparities in outcomes. Gaillard said anyone can join the breast cancer program. For example, if someone were to wake up one morning and find a lump in his or her breast, whether insured or not, and is not sure about what to do next, “you can actually call our cancer center,” Gaillard said. “We have a navigation program, which basically is a clinical care manage-

ment program. We have an RN (registered nurse) who is there to take your call.” The nurse may make a referral to a practitioner at The Cancer Center, a primary care provider or an outpatient clinic. If the patient needs access to care, transportation will be provided. “We have a van service that can get them there once they enter into our navigation program,” said Gaillard. From there on, the patient is assisted with transportation to and from appointments and helped with keeping track of appointment times.

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Givens said the center’s breast cancer program is unique. “What we’re looking at is not only community awareness but then also just walking you through an annual screening that hopefully is negative,” he said. “But for anyone who comes through the program, we’re going to send out reminders so that every woman knows to get a mammogram if she’s at risk. ... We will track them every year, remind them to get the mammogram or follow up if there’s anything that needs to be evaluated. We’re going to walk them through start to finish — basically from diagnosis, or even the evaluation of an abnormal mammogram to diagnosis, to treatment to continuing to follow up after their care. So basically from the beginning to the end of their lives, which we hope is a long time.” If a patient does have breast cancer, the center’s program helps that patient navigate through the different interventions. Givens said The Cancer Center has state-of-the-art equipment and treatment, which is often only available in large cities. The center’s linear accelerator offers daily CT image guidance for accuracy and reduces treatment time. The center reports that it delivers nearly 5,000 external beam radiation treatments annually using this form of treatment. The center is also one of only 12 locations in the United States offering Breast Microseed Treatment. Besides The Cancer Center at Greenwood Leflore Hospital, Givens said the nearest Breast Microseed Treatment can be found in Lexington, Kentucky. The treatment, which takes about 45 minutes, involves inserting “seeds,” each about the size of a grain of rice, into the area needing treatment. The “seeds” deliver the prescribed radiation dose safely over time. “You’ve got everything from surgery to Microseed implant, and we can manage that for you all the way through,” said Gail-

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lard. For those receiving chemotherapy, changes in appearance may occur, such as thinning of hair. The Cancer Center will soon offer a store in its front lobby featuring head wraps, caps and wigs for purchase and some items for free. “It will give patients the opportunity to see what’s out there and evaluate what best fits their personality,” said Gaillard. For early detection, Greenwood Leflore Hospital now offers 3D mammography. Three-dimensional mammography, or breast tomosynthesis, provides more accurate images and detects more invasive breast cancers than two-dimensional scans. “Mainly what we have done in the past was 2D mammography, where you get two images on each breast — a straight view and a kind of oblique side view,” said Alma Jones, mammography supervisor at Greenwood Leflore Hospital. “The 3D is giving a more detailed look at the breast.” The 3D mammogram reduces false positives and callbacks by up to 40% and is the only mammogram with superior accuracy for women with dense breast tissue. “So the 3D is going to help see through that dense breast tissue a whole lot better than what your 2D machine did, and we

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have seen a decrease in patients having to come back for additional imaging,” said Jones. With a 2D exam for patients who have dense breast tissue, “their tissue could get superimposed, and it could mimic a mass or some abnormality there, which would therefore make them have to come back for a second trip for some additional imaging and maybe an ultrasound,” said Jones. During the 3D exam, an X-ray arm sweeps in a slight arc over the breast, taking multiple images. A computer then converts the images into a stack of thin layers, allowing the radiologist to review the breast tissue a layer at a time. “You feel like you see the entire breast now with the 3D, because you are getting so many different angles,” said Jones. The hospital uses the Genius 3D Mammography machine, developed by Hologic, with advanced breast tomosynthesis technology. According to Hologic, Genius 3D exams are clinically proven to significantly increase the detection of breast cancers. Compared to the conventional 2D mammograms, 3D exams improve the detection of invasive breast cancers by 20% to 65%. Jones said the 3D mammogram helps detect breast cancer at an earlier stage. “And when you detect breast cancer at an earlier stage, you have a lot more options as far as treatment-wise,” she said. While Greenwood Leflore Hospital offers the latest technology in prevention and care, the breast cancer program aims to make that technology available to all, Gaillard said. “Unfortunately in the world of health care, we focus on making services available as opposed to making them accessible. Through the breast program, what we’re trying to do is make things more accessible than just make it available.” The program, he said, is about “identifying and eliminating barriers to health care, hoping to have a major impact on outcomes.” n

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‘Silent thief of sight’

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ome eye doctors have given the optic nerve disease glaucoma an ominous nickname — “the silent thief of sight.”

“All of us have a nerve that comes out of our eyeball that goes back to the brain and tells the brain the vision you’re having,” said Dr. Lee Coleman of the Coleman Eye Center.

Glaucoma occurs when that nerve is affected by high pressure in the eye. “Everybody has a normal pressure in the eye, and you can feel kind of what a normal pressure is in your own eye. It’s just like the pressure in a basketball or tire,” the Greenwood opthalmologist said. “The pressure inside your eye is regulated to a very close degree to keep that normalcy, but glaucoma is just the abnormal elevation of the pressure.” Sometimes injuries cause the illness, but it does not necessarily need that kind of impact. “Just like high blood pressure, it just happens on its own,” Coleman said. Unfortunately, there are no clear signs or indications that the disease has started. “There are no real symptoms. There is no pain, no vision

change … until it gets to a really bad point,” he said. “So you’ve got to check it before it gets to a really bad point.” Coleman said the only real prevention is “discovery.” “The only glaucoma we can’t cure and help is the glaucoma that is out there walking around with people that don’t know they have it,” he said. “Tons of people have glaucoma, and we’ll catch it on a routine exam. So, routine screenings are the best way to find it.” The disease is pretty common, Coleman said. Many doctors see it in the elderly and those with diabetes or other chronic illnesses as well as in African American and Hispanic patients, but it can show up in any demographic. “We have a lot of glaucoma in this area because of our diabetes,” Coleman said. “It is the

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most common thing I see here during the day.” Fortunately, he said, treatment has changed a lot over the years and has become much easier on the patient. There are four approaches to treating glaucoma, depending on its severity: eye drops, injectable medicine, traditional surgery and laser surgery. Either type of surgery helps repair the “basic plumbing of the eye,” Coleman said. During the standard procedure, the physician numbs the eye and then cleans with a probe the area where the optic fluids drain. “It is almost like cleaning out the pipes of the (eye’s) drainage system,” Coleman said. The surgery takes about five minutes and does not require anesthesia. With the laser procedure, the physician uses a powerful light to signal the optic cells to adjust their fluid levels. “It’s the same cells that the eye drops are influencing, but in-

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Greenwood Commonwealth

aêK=iÉÉ=`çäÉã~å=ïçêâë=ïáíÜ=~=`ä~êìë=RMMI=~=ã~ÅÜáåÉ=íÜ~í=Éñ~ãJ áåÉë=íÜÉ=çéíáÅ=åÉêîÉ=íç=ÇÉíÉÅí=~åó=É~êäó=ëáÖåë=çÑ=Öä~ìÅçã~K stead of chemicals delivering the message that there needs to be a lower pressure, the laser light can treat that same cell and give it the same chemical signal,” he said. The procedure takes two to three minutes. Neither surgery requires a lengthy recovery. Most patients

can return to work after a day of recovery. Coleman said the biggest misconception about glaucoma is that it invariably leads to blindness. “You’ll hear, ‘I have glaucoma. I’m going to go blind.’” But it’s not a “blindness sentence,” he said. “It’s very easy to treat.” n

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Distance visits

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Generally, visits with a doctor are considered telemedicine, and telehealth would include those plus all kinds of non-clinical services, such as remotely monitoring patients for weight and blood pressure. Perkins Even before the onset of the COVID-19 pandemic earlier this year, Perkins said, North Sunflower was conducting telehealth services via a grant from one its partners, University of Mississippi Medical Center. “Our diabetic patients had tablets they took home with them. Every day, they had instructional videos that told them about their disease,” she said. Patients used the information to set their own goals and also to upload data about their health so they and medical professionals could track their progress. North Sunflower also offered telemedical connections with doctors elsewhere. Patients

jbaf`^i=drfab=OMOMJOMON could come to the hospital’s clinic, and once there, they could visit by computer with an off-site specialist. But now patients can arrange for telehealth and telemedical visits themselves by calling for appointments because federal limits and regulations were relaxed in response to the coronavirus pandemic. Perkins said with the onset of COVID-19, visits to the Ruleville clinic dropped by 50%. Protective measures such as Mississippi’s lockdown limited many types of on-site medical services. People were urged to stay at home to prevent the spread of the disease and reduce the possibility that hospitals might be overwhelmed by trying to care for an influx of COVID19 positive patients. But people still needed to see doctors. The Coronavirus Aid, Relief and Economic Security Act included provisions that allowed the federal Centers for Medicare and Medicaid Services to loosen restrictions on how providers charged for telehealth services.

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In Mississippi, parity laws require that telemedicine reimbursement rates must be equal to in-person visits, the Mississippi Telehealth Association reports. “It has really changed how we are doing things,” Perkins said, describing the ability to conduct telemedicine as a “whole new world for us.” Stepping into that world was complicated. New spreadsheets had to be created for recordkeeping and billing. Also, technology had to be researched and installed. North Sunflower chose a type of software offered by Zoom, the online meeting platform. Perkins said the software provides patient privacy, which North Sunflower wanted to ensure. The clinic even tried unsuccessfully to hack into the software. “We wanted to make sure it was HIPAA compliant,” Perkins explained, although Health Insurance Portability and Accountability Act rules protecting the privacy of patients and medical records had been relaxed to

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the point where providers and patients are allowed to use FaceTime for visits under some circumstances. At South Sunflower County Hospital in Indianola, concerns for patient privacy plus cost efficiency led its providers to choose the ÇçñóKãÉ platform for its clinic’s telehealth visits, according to Dr. Katherine Patterson. açñóKãÉ doesn’t have a mobile app, but it still can be accessed by browsers on a computer, tablet or phone. “We wanted something we could go forward with, that we could continue using,” she said, reflecting on the prospects for telehealth services after the pandemic subsides. “Telemedicine is here now. It’s not going anywhere.” But how it is implemented could change. It’s not clear how federal regulations may be revised over time. “We don’t know what it is going to look like on the other side of the pandemic,” Patterson explained. Patterson has practiced family medicine and women’s health in Indianola for 13 years. She cares for pregnant women, babies, children, teenagers and adults — men as well as women. When the pandemic erupted in March, her practice spiraled downward. “My practice went from 30 to 45 patients a day to minimal patients a day. ... This was kind of devastating,” she said. Telemedicine became a solution for patients and providers. It provides screenings of all

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sorts, including COVID-19 test eligibility, available through technology. That begins with a call to the clinic. “A simple phone call can change the world,” she observed. If someone needs a COVID-19 test and it turns out to be positive, he or she is triaged according to severity. Those who are sent home are monitored by telemedicine. “We continue to follow our positive patients until it is over,” Patterson said. The clinic has 60 employees, including seven doctors and five nurse practitioners. Patterson makes hospital rounds and conducts appointments from the clinic daily. “We want to make sure we focus on the patient and their best care,” she said. “It’s gratifying when everything goes well and the patient does well.” For telehealth services to be accessible, patients not only must have equipment, such as a computer or smartphone, but also must have access to the internet. “One of the biggest problems in the Delta is the broadband and then the technology,” Patterson said. Broadband access is expected to improve with a series of state grants to rural electric power associations for running fiber optic cable in their electrical service areas. Beattie reflected on the ease and productivity of his telemedical visit with the Birmingham physician and remarked that good internet service is even more essential than he

realized. “I can understand why it is more important to have this broadband. ... There are so many practical uses,” he said. The day before his appointment, he and someone from the doctor’s office had participated in a “run-through” to make sure they could efficiently connect online. He then answered a long set of questions about his health to provide the physician with information before the examination. During the actual exam, the doctor — a neurologist with a specialty in movement disorders — spoke with him about his medications and had him perform specific tasks, such as finger tapping. “This is when you take your middle finger

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and your thumb and see how fast you can tap them together on each hand,” Beattie said. He needs the exam twice a year, so he and his wife, who is available to answer questions from the doctor about her observations of Beattie’s condition, are likely to be meeting with the doctor online in another six months. Perkins, the North Sunflower manager, advocates for the continuation of all telehealth services, saying it not only improves health care but provides a better financial value. “It’s all good,” she said. “We are not rewarding for high volume and low quality. We are rewarding people for better quality health care.” n

NOW MORE THAN EVER,

ACCESS TO QUALITY HEALTHCARE MATTERS. NEW TOSHIBA CT (one of two)

If anything, this year has shown us that unexpected events can turn life as we know it upside down. Simple things we expected to remain the same are no longer as they were, giving us the opportunity to take a long, hard look at what is important to us and what we can depend on.

NEW GENIUS 3D MAMMOGRAPHY

The technology at GLH keeps pace with that of much larger metropolitan medical centers, so we are equipped to give area residents cutting-edge care in a local setting.

One thing that’s easy to take for granted is a local hospital that is equipped with the latest technology and a team of medical professionals and staff who are committed to offering this area the best possible healthcare. From a wide range of specialists to the equipment needed to diagnose and treat, Greenwood Leflore Hospital excels.

NEW INFINITY LINEAR ACCELERATOR

Our equipment consists of machines that detect critical issues as well as those—such as our linear accelerator— that treat cancer patients. Our highlytrained group of physicians, nurses, nurse practitioners, technologists, and other staff members are here to give you the right care at the right time.

SPECIALTIES AT GLH INCLUDE: Anesthesiology • Cardiac Rehab • Cardiology • Cardiopulmonary • Critical Care Diabetes Education • Diagnostic Radiology • Emergency Medicine Ear, Nose & Throat • Family Practice • Gastroenterology • General Surgery Hospitalist • Inpatient Rehab • Internal Medicine • Interventional Radiology Medical Oncology • Nephrology • Neurology • Neurosurgery • OB/Gynecology Orthopedics • Outpatient Infusion • Outpatient Rehab • Pain Management Pathology • Pediatrics • Podiatry • Pulmonology • Radiation Oncology Sleep Medicine • Stroke Center / Level II • Urology • Vascular Surgery • Wound Care

Leflore Rehabilitation Center

New Leadership. New Technology. New Direction. Greenwood Leflore Hospital 2020.

Gold Seal for Hospital and Labs

NOW MORE THAN EVER,

ACCESS TO QUALITY HEALTHCARE MATTERS. NEW TOSHIBA CT (one of two)

NEW GENIUS 3D MAMMOGRAPHY

The technology at GLH keeps pace with that of much larger metropolitan medical centers, so we are equipped to give area residents cutting-edge care in a local setting.

NEW INFINITY LINEAR ACCELERATOR

Leflore Rehabilitation Center

New Leadership. New Technology. New Direction. Greenwood Leflore Hospital 2020.

Gold Seal for Hospital and Labs

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Greenwood Commonwealth

Isolation isn’t healthy

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Both Cole and McCray say there’s been an increase in anxiety and depression among their clients. Cole said that there’s been a 15% increase in after-hours phone calls to Life Help since the onset of the COVID-19 pandemic. McCray said he’s noticed increased anxiety among his patients since they “are dealing with a lot of uncertainty and worry. Worry about not just themselves but ones who they love who may be at high risk. And then I’ve noticed definitely an increase in depression. People are just feeling isolated, alone. I think people are feeling frustrated and just kind of like wanting and wishing to get back to their old routines but unable to do so.” In fact, feelings of anxiety have skyrocketed across the country. Google search results for anxiety symptoms spiked from midMarch to early May, according to a study published in the Journal of the American Medical Association in August.

jbaf`^i=drfab=OMOMJOMON Cole and McCray said there are two ways to mitigate the feelings of loneliness from social isolation — keeping in touch with friends and family, and making a schedule and sticking with it. “We are being active to distance physically, but that doesn’t mean we have to disconnect socially,” Cole said. If it’s not possible to see friends or family in person — even with social distancing — then stay in touch through texts and phone calls, Cole said. McCray said that with the help of today’s technology, people can have more intimate connections through video call apps such as Zoom and FaceTime. Those who know someone dealing with social isolation, particularly if that person suffers from anxiety and depression, should reach out regularly to say hello and see how that person is doing, advise both Cole and McCray. Following a daily schedule also can help keep a sound mind

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amid social isolation. Not doing anything can add to feelings of loneliness while also producing “feelings of worthlessness, of being unproductive,” McCray said. “Keeping to a routine and making sure your eating and sleeping habits aren’t getting out of whack” are important considerations for keeping a sound mind and body, Cole said. Additionally, “just try to engage in something meaningful,” she said. As people across the world are reckoning with social isolation, McCray said it’s important to keep in mind the critical role mental health plays to a person’s well-being. “We need to be intentional to prioritize during times like this. It’s something that’s easy to put on the back burner” and not address, he said. A decline in mental health, however, can be just as debilitating as being infected by a virus, McCray said. “It’s just as important.” n

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Greenwood Commonwealth

Baby monitor

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An ultrasound, which uses

high-frequency sound waves to produce an image, “actually shows us the insides of the baby, and that’s how we evaluate the baby and measure the baby and look for anomalies,” explained Ashley Ragland, an ultrasound technologist with Greenwood Leflore Hospital. Ultrasounds come in three forms: two-dimensional (length and breadth); three-dimensional (2D plus depth); and four-dimensional (3D plus time). A standard 2D ultrasound is used for diagnostic tests on the baby, Ragland said. Both 3D and 4D ultrasounds are mostly de-

signed for providing the baby’s parents with real-time images of what their developing child looks like. What’s unique with 4D, however, is that “instead of looking through the baby and evaluating the baby, you’re actually seeing the skin and the features,” Ragland said. A 4D ultrasound can create a “live video” while it is conducted. “You can see the baby yawning, smiling, sucking its thumb, sticking its tongue out. It’s like actually watching a video,” Ragland said. A 3D ultrasound produces still

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pictures of a baby but no moving images. “4D is what we prefer because the images are much better, and as the baby moves, you can compensate to create better images,” Ragland said. That being said, a 4D ultrasound produces no additional medical information for the mother’s physician. “There are no diagnostics to it; there are no measurements; there’s no fetal weight; there’s nothing. It is just for fun — see your baby, let’s see what they look like.” For about two years, Greenwood Leflore Hospital has offered 4D ultrasounds for pregnant women who are keen to see their babies’ exterior features. A 2D ultrasound requires a doctor’s order, but a pregnant woman can order a 4D ultrasound herself. The best time frame within a pregnancy to get a 4D ultrasound is between 27 weeks and 32 weeks — enough time for the baby to develop fat underneath the skin to show features but not too late in the pregnancy, when the baby begins to position itself to get ready for birth. To prepare for a 4D ultra-

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It’s like actually watching a video. ’’ Ashley Ragland

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sound, women must drink plenty of water seven days before the appointment, Ragland said. “Drinking the water will increase the quality and the clarity of the amniotic fluid (fluid floating around the baby), which is like our window,” Ragland said. “We use the fluid for the sound waves to travel through for us to see the baby. The fluid is the most important thing because you need enough fluid for us to get clear, good pictures.” In addition, Ragland said, women should eat and drink

something right before a 4D ultrasound appointment in order to ensure the baby will be active. “Every baby scans differently, and that’s all related to how the fetus is aligned. If the baby is lying face down, looking at mama’s spine, it’s obviously very difficult for us to see,” she said. The location of the placenta, the amount of amniotic fluid and the gestational age all factor into the quality of the image that the ultrasound can render. To schedule a 4D ultrasound, call Greenwood Leflore Hospital’s Radiology Department at 459-7155. Appointments last about an hour and cost $125. Payment is due in advance. “If the baby is cooperating, then we’ll spend the whole hour,” Ragland said. “If the baby is not cooperating, we try to stimulate the baby. We get the mama to roll side to side, let her walk around — I mean, we exhaust all means. And if the baby just will not cooperate, we can just tell them we can reschedule.” Each mom who finishes a 4D ultrasound appointment receives printed pictures of her baby as well as a DVD with the pictures. n

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“Everything in the body is linked together. Everything works together as one big unit,” said Dr. Adam Hodges, a partner dentist at Family Dental Associates. “If you are having any type of dental infection, whether it be in the gums or from the teeth, that can affect the rest of your body.” If not treated, a serious oral infection can cause a host of other ailments — not only in the mouth but also throughout the body. Periodontal disease, or gum disease, has even been linked with negatively impacting cardiovascular health. Gum disease, said Hodges, is a low-grade chronic infection “that your body is fighting when it could be working on something else that you might have going on.” “It kind of affects the whole mouth, although it can be localized around one or two teeth,” he said. Gum disease begins with gingivitis, a mild form of the disease. Gingivitis is a “buildup of bacteria from plaque in your mouth that settles in the gingiva, or the gums, and builds up over time,” said Hodges. “For certain people, it’s genetics. They are more prone to it.” As the disease goes untreated, it can turn into periodontitis, a severe infection that can damage gums and destroy the jawbone.

^í=c~ãáäó=aÉåí~ä=^ëëçÅá~íÉë=~êÉ=pí~ÅÉó=táääçìÖÜÄóI=äÉÑíI=ÇÉåí~ä=~ëëáëJ í~åíI=~åÇ=aêK=^Ç~ã=eçÇÖÉëK=eçÇÖÉë=ë~áÇ=íÜÉ=ÄÉëí=ï~ó=íç=éêÉîÉåí Öìã=ÇáëÉ~ëÉI=~å=áåÑÉÅíáçå=íÜ~í=Å~å=Å~ìëÉ=çíÜÉê=éêçÄäÉãë=íÜêçìÖÜçìí íÜÉ=ÄçÇóI=áë=íç=îáëáí=íÜÉ=ÇÉåíáëí=Ñçê=~=ÅÜÉÅâìé=~åÇ=ÅäÉ~åáåÖ=ÉîÉêó=ëáñ ãçåíÜë=çê=~í=äÉ~ëí=çåÅÉ=~=óÉ~êK “Gingivitis is the inflamma- ease and patients who have a tion of the tissue around your stroke.” Gum disease “inflames the teeth,” said Terry Sheppard, a dental hygienist at Stuckey blood vessels that flow through Family Dentistry. “If you don’t the rest of the body, which in get your gums healthy, if you turn raises your blood pressure,” don’t get your gingivitis under said Casi Raby, who is also a control, it can lead to periodontal dental hygienist at Stuckey disease, which is also a disease Family Dentistry. According to the American that is in the bone around your Dental Association, researchers teeth.” Inflammation of the gums have found that periodontitis — caused by bacteria in the mouth the advanced form of periodontal is what leads to other diseases in disease — is linked with health problems such as cardiovascular the body. “Your mouth is the gateway disease, stroke and bacterial to your body, so that bacteria pneumonia. The association also will travel throughout your said that pregnant women with body, and it leads to the nar- periodontitis may be at an “inrowing of important arteries,” creased risk of delivering said Sheppard. “That can cause preterm and/or low-birth-weight heart disease. A lot of the bac- infants.” “Everything is connected,” teria that is found in gingivitis or periodontal disease is found said Hodges. “So you’ve got this in patients who have heart dis- bacteria, this infection in your pqlov=_v=orqefb=ol_fplk=

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gums, and that can leak into the capillaries and blood vessels in your gums and spread throughout the body and wreak havoc.” Hodges said the disease typically has to progress over a period of months or years before turning into periodontitis. “It would have to be pretty chronic,” he said. “So it’d have to be there for a while, and that’s why it’s important to see a dentist at least once a year to check for that.” Catching gum disease early can prevent damage to the gums, costly procedures and other possible health conditions. “People don’t realize that their mouth can affect their whole body,” said Sheppard. “We have patients coming in all the time, and we’ll educate them about

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those things. ... They just didn’t know that their mouth is compromising their whole body.” Although anyone can get gum disease, there are some patients who are at a higher risk of developing the ailment because of underlying illnesses. Some of those include diabetes, heart disease and cancer. Those who use an inhaler, which dries out the mouth, and smokers are also at a higher risk of getting gum disease. “If you have any other underlying disease or health condition, you could be more at risk of getting gingivitis,” said Sheppard. “If you have infection in your gums, your body can’t fight it as well because it’s already fighting other diseases in your body.”

Greenwood Commonwealth

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Greenwood Commonwealth

Many times, there are no signs of gum disease in the beginning stages. “You can have perfect teeth, no cavities and still have gum disease,” said Hodges. “We see that frequently.” Usually there’s no pain associated with gum disease unless it is “very aggressive or very acute,” he said. The first sign a person with gum disease might notice is bleeding gums. “If you brush or floss and your gums are bleeding or if you spit in the sink and there’s blood, there’s gingivitis,” said Sheppard. Raby added that those with the disease may have gums that appear red and puffy. “You want them to be a pink or light pink color and shape around the teeth naturally,” she said. “But if they start inflaming and become real red, that’s always another sign, too.” A sign of advanced-stage gum disease is loosening teeth. At that point, an appointment with

jbaf`^i=drfab=OMOMJOMON a dentist must be made immediately. Treatment depends on the severity of the gum disease. Late-stage treatments are often much pricier than preventive care and routine teeth cleanings. “If a patient comes past the point of gingivitis, and they’ve gone into periodontitis, you have to do a deeper cleaning on them,” said Sheppard. “It might be that they have to spend more money on their cleaning than just a regular six-month cleaning, and they have to come back more than one time for a dental checkup and cleaning.” If there is a lot of tartar built up, a patient may have to be anesthetized for the cleaning. For severe cases, a patient may be referred to a periodontist. Those with cases of gingivitis can make a full recovery. “If you just have gingivitis, you can get that tissue back healthy,” said Sheppard. “But if it gets to the bone, you can’t get that bone back.” But there is some good news.

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“You can maintain it where you don’t lose any more bone,” she said, and patients can regain their dental health. To prevent gum disease, Hodges recommended seeing a dentist at least once a year, although every six months is preferable. Patients who regularly visit a dentist and get a routine cleaning every six months are rarely diagnosed with gum disease. “They pretty much stay healthy,” said Sheppard. “Now when you get new patients who come in and haven’t had their teeth cleaned in five-plus years, they will have gingivitis.” Keeping good oral hygiene is also important, such as flossing at least once a day, brushing twice a day for roughly two minutes each time and using a mouth rinse at least once a day. “It happens more than people realize, and it can happen to anybody if they are not properly caring for their mouth,” said Hodges. “A little bit of prevention goes a long way.” n

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Greenwood Commonwealth

THANK YOU ALL

FOR ALL YOU DO. Showing gratitude is always important, but it’s especially vital during these times when our staff is going above and beyond trying to keep everyone safe, while giving the best care possible. It’s hard. There are longer-than-usual hours in emotionally draining situations, and yet, that’s what our doctors, nurses, therapists, technicians, support staff, and administration are doing exceptionally well every day. It’s in situations such as dealing with the COVID-19 pandemic that we recognize how fortunate we are to have a highly trained and compassionate medical staff right here, ready to help see us through both the expected and the unexpected. And the behind-the-scenes folks are just as critical to the operation of the hospital, keeping surfaces sanitized, patients fed, insurance filed, and all the pieces that are easily taken for granted. So let’s rally around and show them we know how lucky we are.