Dear Fellow Residents,
Summer is here and that means thousands of tourists visiting the Grand Strand; unfortunately, some of those tourists will be patients at Grand Strand Regional Medical Center. The good news is that these patients from outside of the region can rest assured that they are receiving excellent medical care from a talented and dedicated group of hospital staff and physicians.
In each issue of Your Life magazine, we share information about both clinical accomplishments, such as our cancer accreditation, as well as accomplishments of our staff members, including recipients of the Dr. Frist Humanitarian Award. It is the combination of advanced clinical services and dedicated staff that makes Grand Strand Regional this area’s healthcare leader.
This issue of Your Life focuses on several topics that are becoming more prevalent in adults— shingles and hepatitis C. The goal of our magazine is to not only highlight hospital services and physicians, but also to educate residents on prevention and healthy living. Both shingles and hepatitis C should be discussed with your primary care physician.
We welcome Robert Messier Jr., MD, to our award-winning cardiac surgery program. Dr. Messier has extensive experience in all areas of cardiovascular care.
Working with Brian McIntyre, MD, and the staff at Grand Strand Heart & Vascular Specialists, he will deliver quality care to our cardiac surgery patients.
This is my last community letter as I will retire this summer after 18 years. I have been fortunate to work with wonderful physicians, hospital staff and volunteers and to meet many patients and their families. It is very satisfying to have been a part of Grand Strand Regional as we have worked together for a common goal—to bring a higher quality of healthcare and a wider scope of services to this community.
Thank you and I wish you good health.
Chief Executive Officer
Matters of the heart
“I remember walking into that operating room, looking over the anesthesia tent and down into the chest and seeing the human heart beating,” recalls Robert Messier Jr, MD, PhD, a cardiothoracic surgeon, of his introduction to heart surgery during residency. “There was nothing else for me from that point on.”
His fascination with the heart led him to focus on it during his 11 years of training following medical school. He has expertise in minimally invasive (MI) valve repair and replacement, coronary artery bypass and laser revascularization, as well as surgical procedures for thoracic aneurysm and atrial fibrillation.
Dr. Messier joined the staff of Grand Strand Regional Medical Center in January, after having practiced in Lynchburg, Va. He was impressed with the strong relationship between hospital Chief Executive Officer Doug White and physicians.
For the surgeon, this has been a Southern homecoming of sorts: After completing medical school at Georgetown University in 1988, he followed up with a cardiothoracic surgery residency and fellowship at Emory University in Atlanta, where his Grand Strand Regional partner, heart surgeon Brian McIntyre, MD, also completed his fellowship.
Polishing a top-ranked program
The growth of Grand Strand Regional’s heart program and the area’s increasing retirement population keep the two-person cardiothoracic practice busy, making it the perfect opportunity “to expand and fortify our services,” says Dr. Messier of the hospital’s top-ranked cardiac surgery program. “The list of illnesses, disease processes and procedures we handle is in constant evolution.”
In particular, Dr. Messier sees MI valve replacement procedures continuing to grow. “The heart relies on proper opening and closing of valves, and these valves frequently require repair as you reach 80 or 85 years of age.” MI surgery offers less trauma (traditional surgical incisions for valve repair, for example, typically involve a large incision; compare that to an incision of just a few inches with MI techniques) and a speedier recovery for patients, and allows physicians to restore more natural function to the heart. Dr. Messier says the hospital is Matters of the heart refocusing efforts on getting women the necessary heart care they need earlier on. “The natural tendency is to think women are protected from heart disease, and that’s true until menopause; then there is a rapid catch-up that makes them as vulnerable to heart problems as men.”
Dr. Messier is also part of Grand Strand Regional’s surgical performance committee and physician manager of the Society of Thoracic Surgeons database.
But first and foremost are the people he treats. “We have a most grateful group of patients, and ultimately that’s what keeps me going,” he says.
Are you aware of the health dangers?
Heads-up, baby boomers: Hepatitis C diagnoses are on the rise, and the majority of people who are diagnosed are in your age group.
According to the Centers for Disease Control and Preven - tion (CDC), about 3 million American adults are infected with the hepatitis C virus and about 75 percent are baby boomers (those born between 1945 and 1965). Three out of 4 infected people are unaware they carry the virus, meaning they are not getting the necessary medical care. Untreated, hepatitis C can eventually lead to liver failure and liver cancer.
“The big change is that the CDC now recommends all baby boomers get an antibody screening test due to their increased risk,” says James N. Powers, MD, an infectious disease specialist with Strand Infectious Disease. Many were infected before the dangers of hepatitis C were fully known.
With no telltale signs that you are infected, screening is essential, Dr. Powers says. And it can save lives. According to the CDC, baby boomers account for 73 percent of deaths related to the virus.
What is hepatitis C?
Hepatitis C is a bloodborne disorder, says Dr. Powers, who has treated more than 1,500 patients with hepatitis C. When the virus enters the body, it attacks the liver, triggering inflammation. It is mostly spread through intravenous (IV) drug use and sharing needles, but prior to 1992—when a test was developed to screen the nation’s blood supply—the main culprit was tainted blood transfusions. In some cases, hepatitis C may be traced back to sexual transmission.
When symptoms appear, usually it is a sign that the disease has progressed. “Most early symptoms are typical of any virus— fatigue, gastrointestinal upset, weakness and lymph node swelling,” Dr. Powers says. “It is not until the later stages, or 10 to 20 years out, that abdominal swelling, weight gain, easy bleeding or bruising and confusion [stemming from the liver’s inability to filter out ammonia] may appear.”
It is important to know your risk factors. Using IV drugs or inhaled cocaine, having had a blood transfusion prior to 1992, having tattoos or body piercings or having a partner who has hepatitis C increase your risk, Dr. Powers says. To help prevent the virus:
- Abstain from drug use. Needle exchange programs have been successful at reducing the number of dirty needles shared among those who continue to use drugs.
- Think twice about a tattoo. If you do get one, go to a reputable tattoo parlor and make sure the staff uses clean needles from sterile packages. The same rules apply to body piercings.
- Never have unprotected sex if you have multiple partners or don’t know your partner’s health status.
Treating the virus
“There is no vaccination for hepatitis C,” Dr. Powers says. Instead, the focus is on treatment, and there is no one medication that can be used. Patients typically receive injectable interferons, along with pills such as ribavirin and protease inhibitors during the first 12 weeks of treatment, with a reduction in medication as the 48-week treatment course goes on, he says. Not all patients will be cured of hepatitis C, and success depends, in part, on how far the virus has progressed. Those with severe liver scarring or failure may need a liver transplant.
Dr. Powers notes that new treatments are expected to hit the market in the next couple of years, including new classes of direct-acting viral inhibitors. “These oral medications will drastically reduce the length of treatment, replace the use of interferons and increase the cure rate,” he says. “Currently, we are able to cure up to 50 percent of patients, but with these new medications we have the potential to cure up to 80 percent—some strains even 100 percent.” The new medications are also expected to be more tolerable to people who may not have been candidates for treatment with the traditional medications, such as those with extensive or even mild psychiatric conditions (such as depression) and kidney failure. They are also expected to offer better outcomes for patients who have already received traditional treatment.
“Hepatitis C is unique because we can actually cure it,” Dr. Powers says. “There are very few viruses in the world that we can cure, so we really encourage treatment.”
Other common types of hepatitis:
- Hepatitis A: a highly contagious infection, often resulting from contact with contaminated food or water, or an infected person; recovery often occurs without any treatment. A vaccine is available
- Hepatitis B: a serious infection of the liver that is passed through bodily fluids; treatment options include oral antivirals and liver transplant. A vaccine is available.
To most adults, chickenpox is a long-forgotten childhood illness. “But what most people do not know is that the varicella zoster virus remains dormant in nerve cells for many years and can reactivate when a person’s immune system is compromised,” says Jason D. Harrah, MD, a family practice physician. “The risk of reactivating the virus increases with age; having other diseases such as cancer, HIV or uncontrolled diabetes; taking immunosuppressive medications such as steroids or drugs given after organ transplantation; and stress.”
This reactivation of the chickenpox virus results in a painful skin disease called shingles. Although anyone who has had chickenpox can get shingles, including children, it is more common in people ages 50 and older and is seen more often in women than men. According to the National Institutes of Health, 50 percent of all Americans will have had shingles by the time they are 80 years old.
Signs and symptoms
Shingles causes a painful, localized, blistery rash. The rash commonly occurs as a single strip on the right or left side of the chest, trunk or back, following a nerve path along the ribs. Less commonly, it can appear on one side of the face. For some people, a burning, tingling or intense pain precedes the rash. People usually suffer only one occurrence.
Antiviral drugs can reduce the severity of the infection if taken within three days of developing the rash. Anti-inflammatory drugs may be prescribed to reduce swelling, and prescription pain relievers can alleviate nerve pain.
“The earlier a person is treated the less likely he or she is to suffer postherpetic neuralgia, the most common complication,” Dr. Harrah says. “Postherpetic pain can be severe and persist for months or years after the rash has cleared.” Caused by nerve damage, postherpetic neuralgia produces chronic intense burning or stabbing pain that can interfere with daily life. For someone with postherpetic neuralgia, even the wind against his or her skin can cause pain.
Is shingles contagious?
A person cannot “catch” shingles from someone else. However, anyone who has not had chickenpox as a child may develop chickenpox by coming into contact with someone who has shingles. The disease is spread by direct contact with fluid from the rash blisters, not through sneezing, coughing or casual contact.
Dr. Harrah urges all patients ages 60 and older to discuss with their primary care physicians whether they are candidates for the shingles vaccine. The vaccine is effective in preventing shingles or, if a person develops the disease, it shortens the length of time of the outbreak and postherpetic pain. The vaccine costs approximately $200 and may be covered by insurance but not by Medicare. Even if the vaccine is not covered, it can keep you safe from the long-lasting effects shingles can have on your quality of life
In March 2013, Grand Strand Regional Medical Center implemented SurgiTrak—a way of sending surgery updates to a patient’s family members and friends, wherever they are. These updates are sent via text message or email to a mobile device such as a smart phone, tablet, computer or laptop with an Internet connection. SurgiTrak sends updates as a patient moves through pre-op to surgery to recovery. Updates are not patient specific; they do not include name, type of surgery or other details.
Patients interested in enrolling in SurgiTrak can provide an email address during hospital preregistration. Brochures with more information are available in surgical offices and through registration at the hospital. SurgiTrak is not available for patients admitted for emergency surgery.
Grand Strand Regional Medical Center is working with Walgreens to provide an optional in-house bedside medication delivery service for discharged patients that is convenient, personal and can help improve patient health outcomes.
“If interested, a patient can have discharge prescriptions filled by Walgreens before he or she leaves the hospital, with a pharmacy technician delivering medication to the bedside within an hour. Once the prescriptions are delivered, patients can be connected to a Walgreens pharmacist if they have questions,” says Megan James, Walgreens pharmacy tech.
“Most patients are discharged with prescriptions, and this service is convenient,” says Liz McKniff, RN, case management director. “We know that patients are going home with their prescriptions and an understanding of their medication therapy.”
Currently, the service is available on three nursing units and will eventually be offered hospital-wide.
Grand Strand Regional Medical Center recently honored recipients of the Dr. Frist Humanitarian Award, the highest honor an individual can earn from Grand Strand Regional and HCA.The award recognizes individuals who best exhibit the spirit of caring and concern in the hospital and community.
Phyllis Fregeolle received the Employee Award. Phyllis joined the hospital in 2011 and is an ambassador in food and nutrition services. She delivers meals to patients and interacts with them daily, checking on their meal requests and their satisfaction. She was honored for her strong work ethic and kindness toward patients and co-workers. Phyllis often keeps in touch with patients without families after they are discharged from the hospital. She truly cares about people and goes the extra mile.
John Molnar, MD, received the Physician Award. Dr. Molnar is medical director of the emergency department and current chairman of the hospital board of trustees. He is frequently seen on television, addressing health and medical issues affecting our community. Dr. Molnar is a resource for staff and physicians and always takes the time to help when a patient or visitor has a concern. Dr. Molnar also volunteers at the field hospital at the annual Myrtle Beach marathon. Whether he is staffing, volunteering or attending a board meeting, Dr. Molnar brings an attitude of focus and caring leadership.
Laura Eagan received the Volunteer Award for her 17 years and more than 18,000 hours of service to the hospital. Whether answering questions, discharging patients, directing visitors or coordinating information desk volunteers, Laura has a smile for everyone. She also coordinates the Auxiliary’s scholarship program. Laura and her husband, Jim Eagan, volunteer for many hospital community events, including the annual health fair, prostate screenings and flu shot clinics.
Richard Osman, MD, has been elected chief of staff at Grand Strand Regional Medical Center.
Dr. Osman is board certified in otolaryngology and joined the hospital medical staff in 1999. Randy Goodroe, MD, cardiologist, was elected vice chief of staff, and Lewis Dickinson, MD, trauma surgeon, will serve as treasurer. Chief of surgery is Antonio Pepe, MD, trauma surgeon, and chief of medicine is William O’Connor, MD, family practitioner
The Commission on Cancer of the American College of Surgeons has granted Three-Year Accreditation with Commendation to the Cancer Program at Grand Strand Regional Medical Center.
The hospital demonstrated a Commendation level of compliance with one or more standards that represent the full scope of the cancer program.
Medical oncologist Vijay Paudel, MD, chairs the Grand Strand Regional cancer committee.
The program includes comprehensive care with medical, surgical and radiation oncology treatments; a multispecialty approach to coordinate treatment; information about ongoing clinical trials; access to education and support; a cancer registry; and lifelong patient follow-up.
Welcome new physicians
James N. Powers, MD
Board Certified: infectious disease
Internship/Residency: Wake Forest University, Winston-Salem, N.C.
Fellowship: Wake Forest University, Winston-Salem, N.C.
Strand Infectious Disease