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Dr. Ingram’s Retirement Letter
Dr. Hoxworth Retirement Letter
COVID-19 Update – 2-11-2021
We are continually monitoring the Coronavirus (COVID-19) situation daily. To conserve supplies and protect both patients and team members, we are enacting additional practice changes at this time.
- Our Burlington location is currently open on a part time basis. Please call the office to schedule an appointment.
- On other days, our patients that normally see us at this location can be seen in Greensboro if an in- person visit is deemed necessary. We are recommending established patients reschedule any recall visits for a later time.
- We still always have surgeons on call for emergencies.
- All patients will be screens for COVID and temperatures taken before entering our lobby.
- Only patients will be allowed in to the lobby. Family will be asked to wait outside in order to decrease traffic in our office.
- Masks are MANDATORY for everyone entering our office. No exceptions.
We appreciate your understanding and patience during this time.
A Letter to Our Patients Regarding COVID-19 (Coronavirus)
The health and welfare of our patients and team members are paramount. Central Carolina Surgery (CCS) is committed to taking proactive precautions for the wellbeing of our patients. CCS leaders regularly discuss the ongoing outbreak of COVID-19 and stay up-to-date with current COVID-19 resources such as the Centers for Disease Control (CDC) and The North Carolina Department of Health and Human Services (NCDHHS) Task Force. The health of our patients, visitors, and staff is the utmost priority. By taking precautionary measures, it is our goal to maintain the patient’s safety while providing the highest level of
care, which include:
- If you are experiencing fever, cough or shortness of breath, we request you call the office to postpone your appointment.
- All locations are screening all patients and visitors.
- People who screen positive will not be allowed to continue with their clinic visit. People with symptoms will be provided with information about next steps.
- Our Burlington location will only be open on Wednesdays and Thursday mornings.
- Patients are asked to only bring one support person/visitor to their appointments.
- Rescheduling certain long-term follow-up appointments. The decision to reschedule your appointment will be at the discretion of your surgeon. However, exemptions will be made if you are having issues related to your surgery.
- Performing some post-operative and long-term follow-ups by phone call. More information will be made available regarding Telehealth options.
- Enhancing our cleaning practices to include disinfecting waiting and exam rooms and front desk areas, regularly
- Surgeons and Team Members who meet any of the CDC exposure guidelines will be required to follow the CDC guidelines for testing and quarantine.
- Eliminating the entrance of all non-essential vendors to the clinics
- Patients and visitors are asked to follow recommended guidelines to help stop the spread of germs which are posted throughout the clinic.
Elective/Non-Urgent Surgery
Following the guidelines from the U.S. Surgeon General and the American College of Surgeons, Cone Health will no longer permit elective/non-urgent surgery starting on Thursday, March 19. Emergency surgeries for acute infections of the appendix and gallbladder and intestinal obstruction for example will continue. Certain cancer surgeries will also continue.
While your personal health care is very important, rescheduling surgeries will minimize the risk of spreading the coronavirus among patients, visitors and health care providers while allowing the health care system to preserve critical resources and focus on caring for those who need it most.
At this time, we do not know how long these restrictions will last. Please be assured that we will contact you to schedule your surgery as soon as we are allowed to restart elective cases. In the meantime, please communicate with our office if your symptoms are becoming more severe and your surgery needs to be performed urgently. We appreciate the trust that you have placed in CCS for your surgical needs.
Please follow us on our social media for updates.
We recommend these trusted resources for the latest information on COVID-19:
CDC: https://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html
North Carolina COVID-19 Hotline: 866-462-3821 (open 24 hours, seven days a week)
Did you know CCS is the only ERAS® Society Certified Center in the Triad?
ERAS® is short for Enhanced Recovery After Surgery. This worldwide society sets guidelines for the best care for several surgical operations. These guidelines help shorten surgery recovery times by 30% or more and decrease complications.
At Central Carolina Surgery, PA, we have been certified as an ERAS® center. We are the only ERAS® society certified center in the Triad. Our goal at Central Carolina Surgery is to enhance the post-operative course for our patients while minimizing opioid use.
When visiting with your surgeon be sure to ask about our ERAS® protocols and how it will help you in your recovery.
To learn more about ERAS® visit http://erassociety.org/
CCS 20 year History and Accomplishments
On October 1, 1999, Central Carolina Surgery, P.A. was created as an independent general surgery group as a merger between Triad Surgical Specialists and Greensboro Surgical Associates. Our primary goal was to continuously improve the care and experience of our patients. We achieved this goal by consolidating general surgery services and creating efficiencies through collaboration, subspecialization, growth, education and a positive professional culture in the region.
We have been successful in this endeavor. Central Carolina Surgery, P.A. is now recognized as one of the top-performing general surgery groups in the state of North Carolina in terms of safety and outcomes. Our surgeons are broadly trained and experienced in the art and science of surgery. We continue to recruit the best fellowship-trained surgical professionals to our practice. Through our initiatives, we have created subspecialty divisions with robust activity in general surgery, surgical oncology, hepatobiliary surgery, benign and malignant breast disease, bariatric surgery, trauma surgery, endocrine surgery, colorectal surgery, minimally invasive and robotic surgery, a dedicated inpatient acute care surgery service. Our group is also actively engaged in teaching clinical skills to other professionals.
Our practice has reached out and strengthened our corporate and cultural relationship with Cone Health, Randolph Health, and with referring providers. We now provide inpatient and outpatient surgical services in Guilford, Rockingham, Alamance and Randolph Counties. Our physicians serve in diverse leadership positions within Cone Health, aligning our professional and cultural strategy.
Continued growth and excellence in all of our activities is a fundamental part of our strategic plan. Central Carolina Surgery is well-positioned for the future and will be privileged to serve our region for many years.
Mesh Information for Patients – Frequently Asked Questions (FAQs) :
Hernia Mesh FAQs
Q: What is mesh?
A: Mesh is a sheet of material used to reinforce a hernia repair. There are many different kinds. Some stay in the body forever, some are slowly absorbed, and some are made of biologic materials. Your Surgeon will discuss what they believe to be the most appropriate mesh for you.
Q: Why is mesh used?
A: Hernias happen when weak spots become holes in your abdominal wall. When surgeons fix those holes, they use mesh to reinforce their repair. Mesh helps keep hernias from coming back. Hundreds of studies have demonstrated that mesh can be used safely to prevent a hernia from coming back.
- Groin Hernia: 54% less likely with mesh compared with a non-mesh operation1
- Umbilical Hernia: 69% less likely with mesh compared with a non-mesh operation2
- Ventral Hernia: 73% less likely with mesh compared with a non-mesh operation3
Q: What happens if my surgeon does not use mesh?
A: Your surgeon may be able to repair your hernia without mesh. As above, the hernia may be more likely to come back. How likely depends on where and how big the hernia is.
Q: If you repair my hernia with mesh, what is the expected risk/benefit?
A: As shown above, mesh may help prevent the hernia from returning. Risks of using mesh include mesh infection, mesh migration, and excessive mesh shrinkage. These risks are possible but occur at low frequency.
Q: Can mesh become infected? What happens then?
A: With the right mesh in the right patient, the likelihood of mesh becoming infected is very low. If an infection happens, it can require antibiotics and sometimes surgery.
Q: Does mesh cause pain?
A: Some patients have pain after hernia surgery with mesh, but pain can also develop after hernia surgery without mesh. Recent studies found equal numbers of patients with pain, with and without mesh.2,4 Indeed, in most operations the use of mesh results in an improvement in quality of life.
Q: What are the mesh lawsuit commercials about?
A: Some mesh products have been used incorrectly or withdrawn from the market due to complications. Many of these were not used for hernia procedures. Not all meshes are the same. The surgeon will make choices concerning the right mesh based on the current information available.
Q: Will the mesh show up or interfere with imaging tests such as X-rays, MRIs, CT scans?
A: Depending on what mesh is used, it may show up on imaging studies. This can be helpful for your surgeon in the follow up. Mesh will not prevent you from getting X-rays, MRIs, or CT scans.
Resources for Patients:
USA Food and Drug Administration:
Americas Hernia Society: https://americanherniasociety.org/patient-education/
British Hernia Society: http://www.britishherniasociety.org/for-patients/
Other questions you should ask your surgeon about surgical mesh for hernia repair include:
- What is the mesh you will be using made of?
- What is the name of the mesh you will be using?
- In my case, is it possible to repair the hernia without mesh and if so, what is the expected risk/benefit?
- Is there patient information that comes with the mesh product and if so, how can I obtain it?
- What is the risk for hernia recurrence? Pain? Infection? Other complications? Do these risks change depending on the type of mesh that you use?
- How does the operative approach you are recommending (e.g. open repair versus laparoscopic repair) affect how the mesh will be used?
- In the future if I require a repeat operation, what information should I tell my health care providers regarding the mesh that was used and where it was placed?
- What is your rate of hernia recurrence with patients like me? With mesh, without mesh?
Am I a candidate for weight loss surgery?
The Bariatric Surgeons at Central Carolina Surgery are proud to announce the relaunch of the website https://ccsbariatrics.com
New features include easier navigation, procedure option explanations and patient testimonials. Let us help you decide if Bariatric Surgery is right for you to accomplish your personal health goals.
What is Breast Pain?
By Matthew Wakefield, MD
Breast pain, or mastalgia, is very common. It is usually cyclic mastalgia. This is pain and tenderness in both breasts before your menstrual cycle. Breast tissue can also feel swollen or lumpy during that time. Most commonly breast pain occurs in the upper outer portion of your breast towards your underarm. Cyclical breast pain usually resolves after your menstrual cycle.
Cyclical mastalgia is most common in 30s and 40s. It can occur earlier and can occur after menopause. This is especially true if taking hormone replacement therapy when postmenopausal. This type of breast pain is almost never associated with breast cancer.
When should you see a doctor?
Breast pain that needs to be seen by your physician is pain that is not cyclical. This pain does not occur regularly with menstrual cycle. Pain that occurs in a specific spot in the breast also needs to be seen by your doctor. You will need a breast exam and possibly further evaluation.
What is the treatment for breast pain?
Dietary changes:
1. Sometimes eliminating caffeine from your diet may help breast tenderness. This may take up to six months to have relief. Caffeine is in many things we eat and drink so must pay attention.
2. Eliminating chocolate may have same effect as caffeine.
3. Eating a low-fat diet can decrease estrogen levels and reduce breast pain as well as help general health. Limiting meat and dairy products and eating more fish can be helpful.
4. It is helpful to keep a food log to associate certain foods with breast pain also.
Lifestyle changes:
1. Exercise can decrease estrogen levels, help with general fitness and weight and improve breast pain and tenderness.
2. Stop smoking
3. Make sure you have well-fitting, supportive bra
4. Warm compresses when tenderness and pain occur
Nutritional supplements:
1. Evening primrose oil may help reduce breast pain. Recommend taking 3 grams per day for at least six months to see benefits.
2. Dietary flaxseed may reduce breast pain in some studies. (1 muffin with 25 mg)
3. Vitamin E (200-600IU/day) and Vitamin B6 may be helpful also. It is reasonable to try these for several months to see if they help.
Medications:
1. Nonsteroidal over the counter pain medications like ibuprofen are also helpful. Sometimes a topical gel like diclofenac might be helpful also.
2. Tamoxifen is an anti-hormonal medication used for breast cancer treatment and prevention. For severe cases it can be used for breast tenderness but due to side effects and risks it is used sparingly.
3. Other medications like danazol and bromocriptine have been used in past but due to significant side effects they are really not used anymore.