General Surgery

Nigel McNeill (General Surgery)

Nigel McNeill (General Surgery)

He’s a 38-year-old father of four with an active lifestyle, a passion for volunteerism, and a job he loves as a firefighter/EMT for Grant County Fire District No. 3 in Quincy.

So when a doctor told Quincy’s Nigel McNeill that an on-the-job injury suffered on May 16 would require surgery and a long recovery, McNeill was devastated.

“I was literally in tears,” he says. “This was our busy season, coming up on July and August. I needed be out there with the guys.”

In an occupation where risks are part of the job, the injury caught him by surprise.

“It wasn’t doing anything exciting,” he says. “I wasn’t saving babies or breaking glass. I was just checking the oil on an engine. When I came back out I felt a slow burning sensation in my abdomen.”

McNeill was taken to the emergency room at the hospital in Quincy where Dr. Fernando Dietsch quickly diagnosed a hernia and referred him to a facility he was familiar with in Wenatchee for further care.

The surgeon in that facility told him he needed surgery to repair his hernia but that laparoscopic surgery, which is less invasive than conventional surgery and typically has a much shorter recovery period, wasn’t the right option, McNeill says.

With surgery scheduled for June 12, recovery expected to take six to eight weeks and fire season rapidly approaching, McNeill was desperate to find a way to get back on the job sooner.

Then a friend at Kittitas Valley Healthcare in Ellensburg suggested he get a second opinion and referred him to Dr. Thomas Penoyar of KVH General Surgery.

Penoyar, who is skilled in laparoscopy, saw him immediately.

“He told me it could be done laparoscopically,” McNeill says. “He said it was pretty much a chip shot. He had a great sense of humor but was professional at the same time.”

A week later, on May 31, Penoyar performed the surgery.

At the hospital, “they took me right back. There was great communication,” McNeill says. “The last thing I remember is being wheeled into OR, then I woke up and they were right there with me.”

McNeill went home from the hospital that same day. On June 18 he was released back to full duty.

It isn’t the first time someone in his family has gotten exceptional care at KVH, McNeill says. Nine or ten years ago his mother experienced possible heart attack symptoms while traveling through Ellensburg and ended up in the KVH emergency department.

“They got her right in and treated her. It turned out to be her gallbladder,” he says. “What she told me about her experience sounds a lot like mine. Whatever you’re doing down there, you’re doing it right.”

And that’s a message he’s sharing.

“We don’t have an operating room here in Quincy. Most people, when they need care they have the mindset to go to Wenatchee,” he says. “It’s maybe 40 minutes to Wenatchee, maybe 15 or 20 minutes more to Ellensburg. For me, those extra minutes are worth it.

“I’m telling everybody I know, you probably should check out KVH for your surgical needs before you go to another facility. The word is out. I’m telling everyone.”

Josh Kirk

Josh Kirk

“I like art. I like science. Dentistry is a perfect blend of the two.”
Dr. Josh Kirk’s childhood was cavity-free. “It was always fun. I loved getting my teeth polished. I still do.” But at 16, Kirk was surprised when a dentist started to numb his mouth without telling him why: he had his first cavities. Kirk left abruptly, and returned to his childhood dentist, who performed the procedure. “He did a fantastic job,” says Kirk, who still has those first fillings.

For Kirk, that childhood experience was also a lesson in the importance of provider/patient communication.
These days, you’ll find 33-year-old Kirk at his own bustling practice, Mountain View Dental Center, where his wife, Amy, also works as office manager. “I couldn’t do it without her,” admits Kirk, who spends roughly ten hours a day in patient care. 
The couple first met in dental school: Kirk was a student, and Amy on staff. “I knew right away I wanted to marry her,” declares Kirk. And so they wed, and soon after moved from Arizona to Texas, where Amy experienced her first snow. “It snowed a lot there, actually,” he recalls. “We got tornadoes, blizzards, extreme flooding. It was incredible! The northwest seems mild by comparison.”
The couple moved to Ellensburg in 2017 with their son James, now three years old and big brother to ten-month old Julianna. The move brought Kirk back to his roots. Born in Kennewick, his parents live in the Tri Cities. “But my mom went to college here, and so did I. So did my siblings. We’re all honorary Ellensburgians,” Kirk grins.
Last year, the extended family was celebrating Thanksgiving together when Kirk noticed a protrusion in his lower abdomen. “I don’t know how it happened,” he jokes, “but I’m sure that the second helping of turkey didn’t help. It didn’t hurt at first, so it’s hard to say when or how it began.” 
Over the next few weeks, the inguinal hernia continued to grow and become painful. After a consult with Dr. Tom Penoyar, Kirk was scheduled for surgery.
“He told me it could be done laparoscopically,” recalls Kirk, who was then given written instructions for the days leading up to his surgery. Kirk was grateful for the details. “It’s all good information to know. I’d hate to schedule surgery, take time off work, and then need to cancel because of something I hadn’t done correctly.” As a dentist, Kirk regularly performs in-clinic surgeries. Now in the role of patient, despite his jovial nature, Kirk was serious about preparing for his own procedure.
When the day for surgery arrived, Kirk answered routine questions while being prepped for surgery. While he describes the staff as professional, “I could tell everybody was in good spirits. I was happy to be there.” Kirk has nothing but praise for everyone involved – from check-in, to pre-op, to the OR where the nurse anesthetist explained his process to Kirk, and the nurse started an IV.
When he woke up after surgery, Kirk felt nauseous, a typical side effect of anesthesia. “They gave me all the time I needed,” says Kirk, “and brought me some gentle foods, including chocolate pudding – my favorite.” A short time later, Kirk was ready to leave. Amy drove him home and got him in the recliner.
Dedicated to his patients, Kirk returned to work the following Monday. It might have been a little too soon. “I only missed two days of work, but that first day back was tough,” he says.
After a visit with Dr. Penoyar two weeks later, Kirk was officially cleared for all activity. And Kirk is nothing if not active.
Already an avid cyclist and runner, Kirk put mountains on his 2019 bucket list. After climbing Mt. St. Helens with his brother-in-law in 2017, this year, the two plan to tackle Adams, Baker, and then Rainier. “That’s the big one,” Kirk says, eyes shining with anticipation.
As a life-long learner who embraces new challenges, no one who knows Kirk doubts he’ll scale any obstacles in his way. Now fully back on his feet, he’s eager to let the community know about the quality of “awesome care” he received.
“What would that say about me, if I’m asking people to come to me as a local provider and yet I’m not willing to receive local care?” Kirk asks. “You have a choice. You can stay local and support your community, people that live down the road from you. So, why not? Give them a chance. They won’t let you down.”

Jerry Grebb

Jerry Grebb

From pizza and steak to homemade brownies, Jerry Grebb has an appetite for the good things in life.

But when eating led to unexplained abdominal pain, Grebb got a taste of something different – Kittitas Valley Healthcare.

A Washington State University grad who grew up in Quincy, Grebb, a CPA, fell in love with Ellensburg when he moved here 40 years ago. When his now 38-year-old daughter was born, Grebb also fell in love with KVH Hospital. This past September reminded him why.

For months, Grebb had experienced periodic pain after eating. The week before Labor Day he saw an internal medicine specialist who, suspecting gallstones, scheduled an ultrasound for the following Tuesday. But the Sunday before Labor Day, Grebb landed in the emergency room at KVH Hospital where a CT scan revealed a hiatal hernia.

The bottom of Grebb’s stomach, including the duodenum and beginning of his small intestines, had worked its way into the opening where the esophagus passes through the diaphragm to the stomach. “The opening was stretched or torn,” he says. “Two thirds of my stomach was up in the hernia above my diaphragm.” It was pressing on his heart and lungs and keeping him from normal eating.

Dr. Timothy O’Brien of KVH General Surgery arrived within minutes, ordered Grebb’s stomach evacuated and told Grebb he’d need surgery. But first Grebb would be hospitalized for treatment of a pancreatic inflammation. “I liked Dr. O’Brien’s style,” Grebb says. “He was very matter-of-fact. He’s a very bright man and so plain spoken. He doesn’t try to dazzle you.”

Two days later when Grebb had the previously scheduled ultrasound O’Brien was on hand. So was Dr. Ken Harris, a trusted friend of Grebb’s who runs a private practice out of the KVH General Surgery clinic. So was the newest partner in the KVH General Surgery clinic Dr. Tom Penoyar who is trained in laparoscopic surgery for hiatal hernias, a cutting edge procedure that is less invasive than conventional surgery and results in shorter hospital stays and quicker recovery. “With laparoscopic, it’s one day in the hospital. With conventional, it’s five,” Grebb says.

On Thursday, with Harris assisting, Penoyar operated on Grebb. Working through five small abdominal incisions, Penoyar pulled Grebb’s stomach down from his chest and into proper position and narrowed the hernia by sewing its two edges together. He then wrapped the upper part of Grebb’s stomach around and behind Grebb’s esophagus, sewing the stomach to itself to create a “collar” that will keep it from sliding up into Grebb’s chest.

Called the Nissen technique, Penoyar performed the procedure an estimated 30 times while training in the Boston area. That may not sound like a lot, he says, but the nationwide average during training is six.

On Friday, Grebb went home. On Saturday, he walked downtown. On Monday, he went to work. Not long after, he was eating pizza without problems and calling his experience a perfect collaboration between the old and new guard at KVH.

“Dr. Penoyar has done more hiatal surgeries than Dr. Harris because of where he trained, at a big hospital in Massachusetts,” Grebb says. “It was wonderful that he was able to perform the procedure here. And I was so impressed by the sageness of Dr. O’Brien and Dr. Harris.

“That’s what the punch line is here,” Grebb says. “We’ve got both – the sage older team and the new surgeon trained with the latest technology. I couldn’t have asked for a better outcome.”