HealthLinks Charleston Jan/Feb 2023

COMPLIMENTARY CHARLESTON | DORCHESTER | BERKELEY JAN/FEB 2023 DOGS OPEN DOORS TO HEALING WHEN MOTHER’S MILK WON’T FLOW WINTER BLUES TO BRIGHT CHAR L E S TON HOPE FATIGUE – IS REAL CHOCOLATE’S CURES SPECIAL WOMEN IN HEALTH ISSUE

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8 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com 14 | DOGS OPEN DOORS TO HEALING Paws4TheKids has sparked breakthroughs in children’s healing for the last two years at the Medical University of South Carolina Shawn Jenkins Children’s Hospital. 19 | BIRTHMATTERS BirthMatters reduces teen pregnancy through reproductive health education and empowers expectant young adults to raise healthy families through doulas utilizing the community health worker model. 20 | HELPING MOTHER’S MILK FLOW Research shows that 60% of mothers have to stop nursing before they feel like they are ready. Today, nonprofits and hospitals have lactation coaches, resources, life coaches and mentors who are helping women nurse longer. 23 | A WILD RIDE AND A WORLD-RENOWNED RACE It has been “a wild ride” since Irv Batten became director of The Cooper River Bridge Run three years ago. He joked that he can’t wait until “a normal year,” knowing that pulling together an event that is among the best organized and best conducted 10K races in the world can’t possibly include the normalcy that most people know. 25 | MORE OB-GYN’S ARE FEMALE Over the past few decades, an increasing number of OB-GYN physicians are female, and this ratio is growing. Nationally, approximately 60% of practicing OB-GYNs are women, according to a 2020 report by the Association of American Medical Colleges. 28 | EXERCISES FOR PREGNANT MOMS Pregnant women once were discouraged from exercise as gentle as taking a walk because gravity might pull the baby out prematurely. Modern science has debunked those myths, and today’s women are encouraged to maintain active lifestyles right up until the baby arrives 33 | WOMEN IN HEALTH We are lucky to live in a community where women not only are succeeding but leading and thriving in a field that touches everyone. 57 | DNA PATH TO HEALTH The Medical University of South Carolina, in conjunction with Helix, has launched a community research project titled “In Our DNA SC.” The goal of this program is to investigate how genetics impact health and to develop ways of offering personalized health care to patients. 62 | ILLNESSES THAT MOVE FROM MOTHER TO BABY Women have a weakened immune system during pregnancy that can leave them more vulnerable to contracting infectious diseases and transferring them to their baby. Knowledge of how to best prevent and treat these maladies can help decrease potential risks to newborns. Issue 12.1 JAN/FEB 2023 CHARLESTON FEATURES

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 9 65 | PROCRASTINATION RESOLUTION There are science-based techniques to help people overcome procrastination, an emotional regulation problem. 72 | TRUST IN ROBOTICS Beth Cook, M.D., recently completed her 500th robotic gynecological procedure at Summerville Medical Center, a Trident Health Lowcountry hospital. As of early November, almost 5,000 such surgeries have been performed at the hospital, including 3,350 obstetric and gynecological procedures. 75 | HOPE FATIGUE – IT’S REAL The latest mental health challenge cropping up in therapists’ offices is a deficit of optimism accompanied by a sense of being overwhelmed about important issues beyond a person’s control. A Washington Post reporter coined a name for this issue: hope fatigue. 78| KIDNEYS - THE BODY’S WORKHORSE Kidneys are the body’s workhorse – cleaning out toxins, removing waste and balancing bodily fluids. Because your kidneys process the vast majority of what you put into your body, it is important to be mindful of what you eat and what prescription medications, over the counter medications and supplements you take. 80 | WINTER BLUES In addition to the winter season, with shorter days and less sunlight, a lot of other factors now contribute to seasonal affective disorder. There has been an increase in cases of SAD, a type of depression, since 2020. 92 | CHOCOLATE’S CURES It’s been called the food of the gods – and its nutritional and medicinal qualities have been touted from the carvings of the ancient Olmec Indians of Central America all the way to the Harry Potter films. CONTENTS DIRECTORIES OB-GYN.............................................. 94 Pediatrician. ........................................ 95 BY THE NUMBERS Procrastination.................................... 66 S. C. Kidney Disease and Transplants...... 79 IN EVERY ISSUE Publisher’s Note.................................. 10 About the Cover................................. 11 Living Healthy Area Events................. 12 CCMS – Viruses................................... 60 There's an App for That...................... 70 The Lighter Side of Health Care. ........ 83 Unique Case........................................ 84 Charleston Area Nonprofits................ 86 Faces & Places. ................................... 88 Healthy Pet: Happy Pet....................... 90 The Pulse on Charleston Nurses. ........ 96

10 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Issue 12.1 JAN/FEB 2023 Publisher CULLEN MURRAY-KEMP [email protected] Managing Editor LISA BRESLIN Assistant Editor MOLLY SHERMAN Copy Editor BRIAN SHERMAN Art Director KIM HALL -- Webmaster GEORGE CONKLIN Sales Manager MANDY WILLIS [email protected] Writers Media Consultants BRANDON CLARK [email protected] Photographer JENN CADY [email protected] Distribution Manager CAROL CASSIDY Administration & Bookkeeping GINGER SOTTILE Distribution U.S. Post Office, Harris Teeter, Publix, CVS, Food Lion, Medical Offices TO ADVERTISE IN HEALTHLINKS, PLEASE CALL 843-732-4110 MEDICAL MARKETING GROUP HealthLinks Charleston reserves the right to refuse advertisements. Acceptance of advertisements does not imply the service or product is recommended or endorsed by HealthLinks Charleston. No part of this publication may be reproduced in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from Medical Marketing Group, LLC. Medical Marketing Group 4 Carriage Lane, Suite 107, Charleston, S.C. 29407 843-732-4110 • [email protected] CHARLESTON PUBLISHER'S NOTE JANET E. PERRIGO L.C. LEACH III COLIN MCCANDLESS LAURA HAIGHT LEAH RHYNE ISABEL ALVAREZ ARATA LINDA ESTERSON THERESA STRATFORD LISA BRESLIN MOLLY SHERMAN BILL FARLEY DENISE K. JAMES AMY GESELL LISA WACK RILEY MATHEWS Scan to discover our other HealthLinks platforms! “Slow Down and Smell the Pluff Mud” “Slowww Downnn!” My parents scolded as 10-year-old Cullen stuffed away six homemade tacos in under three minutes. It was a running joke that the only way to get young Cullen to eat any slower was if he fell asleep. When they told me to eat slowly, I would feign nodding off and my mom and dad would keel over in amusement. Being an only child has its perks, one of which is being absolutely hilarious in your parents’ eyes. Aside from not choking, the lesson my parents were trying to instill was to experience what I was doing, or eating, firsthand. They wanted me to smell and taste the food. They wanted me to give myself room to breathe. “Slow down” meant “have a conversation with us, Cullen.” I think we need to remind our adult selves to slow down every once in a while. While I’m fond of routine, autopilot can dim our experiences, and slowing down can have a defogging effect. Slowing down has helped me through the stress of moving and closing out my first year as sole proprietor of HealthLinks while continuing to grieve the passing of my father. Lately, slowing down has opened my eyes to appreciation. I’ve been able to pause and take in our new home on Wadmalaw Island. I’ve heard the quiet of the country that is so loud its deafening. I’ve traded in Netflix and emails for white herons and mud-popping oysters. But without slowing down, the true enjoyment of experience can be lost. Appreciation of experience is something that has not been lost on me, thanks to slowing down. It seems strange to be speaking of the importance of slowing down when most of us are busy making New Year’s resolutions and meticulously mapping out each step of our successes in 2023. As I set my 2023 goals, I will regularly remind myself to slow down. I invite you to join me. Let’s see what slowing down and smelling the pluff mud can bring us in the new year! Cullen Murray-Kemp, Publisher Cul len Murray Kemp

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 11 ABOUT THE COVER... Welcome to the January/February issue of HealthLinks. We envision you, our dear readers, flipping through the magazine pages as you reflect about the past year, confirm resolutions to ensure a better 2023 and seek nuggets of hope that the world is still filled with good people and blessings to count. Each page of this issue was created to help you see hope and goodness in the world and to help you move toward your better, healthier self. You will discover the nutritional benefits of chocolate and hopefully feel less guilt about taking one more bite during the holiday season. You will learn about the neurological reasons people procrastinate and ways to curb that bad habit. Reporter Amy Gesell’s story about therapy dogs* is one of many page turners that will touch your heart. Last and far from least, our Women In Health section celebrates the intelligence, the compassion and the accomplishments of a distinct group of women who are leading the way to better health. The world is indeed still filled with good people, and I hope that your future blessings are too vast to count. To simple pleasures and good health, Lisa Breslin, Managing Editor JAN/FEB 2023 COMPLIMENTARY CHARLESTON | DORCHESTER | BERKELEY JAN/FEB 2023 DOGS OPEN DOORS TO HEALING WHEN MOTHER’S MILK WON’T FLOW WINTER BLUES TO BRIGHT CHAR L E S TON HOPE FATIGUE – IS REAL CHOCOLATE’S CURES Volume 12, Issue 1 • JANUARY/FEBRUARY 2023 www.CharlestonPhysicians.com SPECIAL WOMEN IN HEALTH ISSUE CHARLESTON PHOTOGRAPHY AND POSING EXPERT VISIT JENNCADY.COM AND SCHEDULE YOUR PHOTOSHOOT TODAY! *Soon after we placed the story about MUSC’s therapy dog program on the page, Healthlinks learned that Bear, a Bernese mountain dog who clocked in 900+ hours comforting and calming patients, died. He had been diagnosed with degenerative myopathy earlier in the year, but he continued to offer loving service. To Bear and his amazing owner, Kyle Kelly, who enabled Bear to brighten the lives of many – thank you.

12 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com HEALTHY AREA EVENTS l ving JANUARY 8 Girlology’s 'Something New About You' Newborn Centers of Charleston 3:30 p.m. 1300 Hospital Drive Mount Pleasant Together with Coastal Pediatrics Associates, Girlology presents “Something New About You,” a program designed to help young women prepare for puberty with greater confidence. Girlology and its top clinicians encourage sharing clear and factual information to girls ages 8 to 11, in a comfortable and safe atmosphere – with an accompanying adult. See girlology.com for more info and to purchase tickets. $50 includes admittance for one adult plus a child. JANUARY 15 White Flag Yoga 12 Step Meeting 4 p.m. The Island Club 1451 Hennessy Street Sullivan’s Island Join instructor Kimberly Thompson as she leads you through an hour-and-a-half of deep-release yoga. “Connecting the cognitive approach of the 12 steps with the somatic approach of healing through movement,” White Flag Yoga welcomes all levels of ability. Though this is a practice open to anyone affected by addiction, you do not need to be a 12 Step member. Bring your own mat and water bottle. A donation is requested. For more information: whiteflagyoga.com JANUARY 14 The 13th Annual PNC Bank Charleston Half Marathon 7:30 start Burke High School 244 President St. Charleston Stretch your legs for 13.1 miles of historic Charleston beauty. The starting pistol fires at 7:30 a.m. in front of Burke High School, and you’ll cross the finish line at Charleston’s Firefly Distillery. Local bands will provide encouragement from stages throughout the course, and the celebration continues with shrimp ’n grits to fill your bellies and drinks to quench your thirst. For more information: capstoneraces.com/charleston-halfmarathon JANUARY 12 CPR Certification Charleston 22 Westedge St., Suite #400 Charleston Become a certified lifesaver! CPR Charleston offers recurring classes, teaching the valuable skill of CPR in a handson environment. You’ll receive the proper training and your certification card on the same day. CPR Charleston also offers pet CPR training, first aid and will come to your place of business for group lessons. For more information: CPRcharleston.org

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 13 JANUARY 28 Bo’s Roast & Chili Cook Off Noon Edisto Hall • James Island County Park FEBRUARY 4 Save the Light Half Marathon and 5K Run/Walk 8 a.m. Folly Beach Pier Lace up your shoes and hit the beach to support the continued preservation of the Morris Island Lighthouse. Whether you run the half or the 5K, the course will take you through the idyllic avenues of Folly Beach, starting at the Tides/Folly Beach Fishing Pier and bringing you back. This USATF-certified race is one not to miss! The marathon is run-only; the 5K is run or walk. For more information: ccprc.com. FEBRUARY 6 Childbirth Education Classes (recurring) 7 p.m. MUSC Shawn Jenkins Children's Hospital Pearl Tourville Women’s Pavilion 7th Floor Auditorium, Room 7010 An in-person experience of “what to expect when you’re expecting.” You, your partner or spouse are welcome to attend MUSC’s childbirth education class. You’ll learn about labor, delivery, postpartum care, pain management and self-care with MUSC’s birthing experts. Classes are recurring each Monday evening. Visit muschealth.org or call 843-792-5300 to register. This year, JI Vikings Bo’s Roast is raising funds for Sara’s Cure, which is dedicated to finding a cure for clear cell sarcoma, and Islands Against Cancer, Inc., another local nonprofit supporting cancer patients and their families throughout their cancer journey. Enjoy oysters, chili, hot dogs, live music and more! For more information: bosroast.com FEBRUARY 11 Cupid’s Chase Charleston 10 a.m. James Island County Park, 871 Riverland Drive Charleston Run or walk the winding trails of Charleston’s James Island County Park to support and celebrate Community Options, an organization dedicated to housing and employment for people with disabilities. Runners, joggers and walkers are all welcome to join. For more information: allittakes.comop.org JANUARY 19 Coffee Cart at Ralph H. Johnson VA Medical Center 8 a.m. to 11 a.m. 109 Bee St. Soldiers’ Angels provides kindness, coffee and snacks for patients and their families as they wait for appointments. Recurring event – twice each month. For more information: soldiersangels.org FEBRUARY 11 8th Annual Building Healthy Communities 5k Run/Walk and Wellness Expo 8 a.m. Hampton Park 30 Mary Murray Drive Charleston The Wellness Expo is centered on raising awareness of and educating the community about the prevention of childhood obesity. Raffles and drawings for prizes will take place throughout the day. This portion of the day is free. For the 5K, registration is $35 and includes a T-shirt and a race swag bag, water, healthy snacks and age-group medals. Proceeds from the registration fees from the 5K will benefit MUSC’s Children’s Hospital Heart Health Program. To register, visit runningsignup.com for registration. For more information: MUSCKids.org/Heart/Health FEBRUARY 25 2023 Lowcountry Heart Walk 8 a.m. registration; 9 a.m. start Brittlebank Park, Charleston Your participation contributes to the American Heart Association’s mission of supporting life-saving science. Boost your own mental health and get your heart pumping! For more information: heart.org.

14 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com DOGS BRING JOY TO CHILDREN’S HOSPITAL By Amy Gesell

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 15 “I said I’m not getting out of bed. I’m not walking your dog either,” the young patient said. “I’ve already walked a dog.” His reluctance to leave his bed was understandable. No child wants to be in the hospital – and certainly not on Thanksgiving. “But have you ever walked a turkey?” a child life specialist asked. The patient brightened as a gentle golden retriever stepped into the room dressed as a Thanksgiving bird; the youngster’s reaction was to get out of bed and walk alongside his new furry and feathered friend. Welcome to MUSC Shawn Jenkins Children’s Hospital, where Paws4TheKids has sparked breakthroughs like this one for the last two years. Three years ago, Carolyn Donohue, former executive director of Nursing, Children’s, Women’s and Mental Health, identified the need for facility dogs in the MUSC SJCH family. “At the time, I’d read various articles about facility dogs. We’re members of the Children’s Hospital Association, and there was a discussion within that network, too,” Donohue said. The work involved in obtaining a facility dog can be daunting, but Donohue forged ahead, writing a grant to the Dunkin’ Joy in Childhood Foundation. Donohue’s vision was a good match for the Foundation, whose mission is to provide joy and comfort for children battling hunger or illness. It awarded the grant and delivered the necessary funding. “Getting the grant was only the beginning,” Donohue said. “The next step was getting the dogs.” Few organizations train facility dogs, and it can take up to five years to receive one once a request is submitted. The Dunkin’ Joy Foundation works closely with Canine Assistants, a nonprofit in Milton, Georgia, that provided the Children’s Hospital’s first two facility dogs: golden retrievers Baskin and Agnes. A dog such as Baskin, who donned the turkey costume, starts work in the morning and begins his journey through a myriad of tasks. He might jump on a bed and ride down to the operating unit with a child to decrease anxiety and be on hand when the patient wakes. He might participate in relationship building exercises with patients and staff. And he may help a child create a “pawsitive” memory of the hospital stay – a paint-stamped paw print mingled with the patient’s handprint on a canvas. Donohue recently shared news about her “semi-retirement” and shift of the leadership reins for the program into the hands of Michelle Jeffcoat, child life specialist and facility dog program coordinator. Jeffcoat and Amy Hauser, administrator for Children’s and Women’s services, share responsibility for the care of Baskin. Jeffcoat is Baskin’s “work mom,” and Hauser is his “home mom.” “Child Life Services is all about communication through emotions and feelings through play – an outlet for the child’s anxiety. It’s fun and messy,” explained Betsy McMillan, manager of Child Life Services. “We are geared toward play to help them forget they are in the hospital. The facility dogs do an excellent job of that.” Registered Dietitian Abbie Hebron, left; Michelle Jeffcoat; and Nurse Practitioner Jess Gardner, right.

16 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com McMillan recounted one child’s chemotherapy experience. “Ten minutes in,” McMillan said, “she would get so anxious, so sick, they would have to stop the treatment and try again another day.” When Agnes was brought in, the child was able to stay calm enough to make it past the first 10 minutes. The second time Agnes came in, she and the patient were lying together on a stretcher as the IV dripped. “Right at the 10-minute mark, Agnes turned around, laid her head on the child’s lap and reached out her paw. It was amazing,” said McMillan. “It was like she was able to pick up on the exact moment the child’s anxiety began. I used to try not to read too much into things like this, but the dog’s intuition was undeniable. She knew when she was needed. A total empath.” Visits, which can be anywhere from a few minutes to an hour, are timed depending upon need. The dogs get lunch breaks and bathroom breaks, just like everyone else. “The only difference between a facility dog’s workday and everyone else’s is the number of snacks they receive,” Jeffcoat joked. It’s not only the children who benefit from the presence of these happy creatures. Sometimes, Jeffcoat calls on Baskin to help with staff support. “In our line of work, especially in pediatric ICU, things can get stressful for staff,” Jeffcoat explained. “Witnessing their interactions affirm the value of these dogs’ presence. Simple statements like that speak so large.” Though she’s in “semi-retirement,” Donohue still has her eyes on the future of the program. “The goal that gets tossed around is 10 working facility dogs,” she said. “Realistically, due to the demand, we’ll probably be able to get four to five more dogs over the next couple of years.” They are also evaluating using facility dogs in the Child and Adolescent Unit of MUSC’s Institute of Psychiatry. “There’s a possibility to expand,” Donohue stated. “We are learning more all the time and the program evolves with it.” “I’m looking forward to the program’s growth,” said Jeffcoat. “As a matter of fact, we have a new dog coming on board.” In mid-November, a golden retriever, Cher, a littermate to Sonny, joined the dog family that assists children in the Cancer and Blood Disorders Unit. Any patient – young or young at heart – can request a visit from a Paws4TheKids staff member. FAST FACTS: Therapy Dogs vs. Full-Time Facility Dogs MUSC has a host of volunteer therapy dogs that visit the hospital on a regular basis. These dogs are owned by private citizens who handle them and schedule visits when time allows. Facility dogs are owned by the hospital system or a program under its umbrella. While facility dogs are pets, they are employees first, and they often have access to areas of the hospital and procedures that privately-owned therapy dogs don’t – including IV placement, blood draws and imaging placement.

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www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 19 While pregnancy is often a time of joy and anticipation, some women don’t have family members and friends to lean on. They have to navigate pregnancy and motherhood alone. Marqulia Gowens didn’t have much support when she had her two oldest children. With the first, she was young and the father wasn’t in the picture, she explained. And with the second, he was around but could offer minimal assistance. Late in her third pregnancy, Gowens visited a maternity fair and met someone who closed the door on her solo journey. That someone was Amber Pendergraph-Leak, executive director of the nonprofit BirthMatters, which offers support and care to expectant mothers in underserved communities. “At the time, I was good as long as my kids were good,” Gowens recalled. “Amber helped me realize that I was abandoning myself and doing more for others than doing for myself. … You can’t pour anything into your children or anyone else if you’re not putting yourself first. That stuck with me.” Gowens received prenatal, delivery and postnatal care through BirthMatters. Pendergraph-Leak visited her at home on a weekly basis, offering essential tools for self-care. She was also by Gowens’ side during labor, in the doorway during her emergency cesarean section and with her in the recovery room to help her become comfortable with breastfeeding. Just as the organization’s other doulas do for all clients until the baby’s first birthday, Pendergraph-Leak continued visiting Gowens weekly – often with diapers and clothing in hand. The support Gowens received mirrors what’s typical of BirthMatters. The doula services are varied and plentiful, at no cost to the family. “Being community based, one day you might be a massage therapist, the next day you might be a therapist and the next day you might be a grandma, a sister and auntie,” said Pendergraph-Leak, explaining how doulas wear many hats. “Whatever they need, you meet them where they are. … We empower our moms to make informed decisions and help them through the process.” With grant funding and awards from organizations such as the Mary Black Foundation, the Institute for Child Success and the United Way, BirthMatters has helped 60 Spartanburg families annually; the nonprofit plans to expand assistance to 200 families each year and open additional sites throughout the state, according to Pendergraph-Leak. The organization utilizes the community health worker model to bridge communities, health care systems and state health departments as care unfolds. Eligibility requirements for BirthMatters are based on income; mothers must be 25 years old or younger and families must be Medicaid-eligible Pendergraph-Leak estimated that about 85% of the clients are African American, and they come to the organization mostly through word-of-mouth referrals and local OB/GYN practices. Through BirthMatters, Gowens was able to meet with therapists who encouraged journaling, taught her mental exercises and provided parenting tips to help her manage her postpartum depression and avoid triggers from life’s stresses. Gowens credits the staff at BirthMatters for helping change her perspective and “get myself together and focusing more on me.” She went to cosmetology school and now owns her own salon, Quays Majestic Hands, in Spartanburg. “As I continued through the program, I got better,” she said. “I got ahold of my life and got to be a better mother to my children.” Additional Information: birthmatters.org. FINDING COMMUNITY DURING PREGNANCY By Linda L. Esterson

20 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com By Linda L. Esterson THE BREASTFEEDING JOURNEY

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 21 Lindsay Hall hoped to breastfeed her infant son for six months. She attended classes and did as much reading as possible prior to his delivery during the coronavirus pandemic. But no matter the preparation, Hall faced many unexpected hurdles and had to seek help. Hall is not alone; many women expect breastfeeding to be a smooth, natural, formula-free process and then discover it is anything but smooth. And formula is needed. Though the formula shortage that captured the news and crippled many families has abated, and the Food and Drug Administration continues to bolster supplies with the approval of specialty formulas from overseas, the benefits of breastfeeding continue to be highlighted. According to the Centers for Disease Control, more than 83% of infants are breastfed in the United States and nearly 56% continue to be breastfed at six months of age. Nearly 25% of babies are breastfed exclusively through six months, while 19% receive formula supplementation within the first two days of life. When Hall’s son was about 3½ weeks old, he became fussy during feeding, so she visited the Newborn Center of Charleston, an affiliate of Coastal Pediatric Associates, for guidance. Experts determined the baby had a dairy allergy. A heavy dairy eater, Hall relied on cheese cubes as a healthy snack, and her son’s little gut was inflamed. “They really put me at ease about it and told me it’s very common,” Hall said. “They gave me a plan to keep trying to breastfeed.” This included replacing dairy with dairy-free snacks. The Center’s staff shared the many feeding positions designed to help her baby latch and feed comfortably and successfully. Hall also learned that she had a clogged duct and mastitis that hampered the process, and that her breast pump was not the right size. “Without the support from the Newborn Center, I think I probably would have been lost and given up,” she said. “They provided so much guidance and support, especially in the early days. You’re a sleep-deprived mom, trying to get your baby fed, happy and asleep.” The Center’s ability to help mothers is about working with the needs and the comfort of the baby and the mother, explained Kimberly Kinkade, nurse practitioner and board-certified lactation consultant with the Center. Latching issues are common to many mothers like Hall, particularly if baby is not getting enough milk or the process causes pain for mom. Mothers are taught “the football hold” or upright positioning to help. Techniques such as breast compressions also can promote milk flow. Past surgical histories and anatomy changes can present challenges for moms. Kinkade works with women to help stimulate milk production to override these issues. Stimulating milk production may also include extra pumping and extra feeding as well as herbal supplements, which are recommended in consultation with mom’s obstetrician. The confidence Hall gained because of her partnership with the Center enabled her to continue breastfeeding exclusively for 4½ months; then, with formula supplementation, she breastfed until close to her six-month goal. Her dwindling milk supply impacted her ability to continue. According Kinkade, many moms stop breastfeeding as a result of environmental pressures and stressors, often after returning to work. “I do see a lot of moms who elect to cease their breastfeeding journey at that point, just because it becomes too much of a juggle for them to try to be a mom, be professional and make everybody happy,” she commented. During a “return to work” visit, the Newborn Center staff helps moms develop a feeding plan that’s conducive to their schedule. The Fair Labor Standards Act of 1938 requires employers with 50 or more employees to provide reasonable break time – uncompensated – with a place other than a restroom for women to express breast milk for up to a year after birth. Laura Grant elicited guidance from the Newborn Center for all three of her children, especially with feeding her twin sons born two years ago. With her first baby, she breastfed exclusively for nine months but, with the twins, didn’t supplement until nearly a year. The Newborn Center’s lactation consultant helped thwart issues with a blood blisters and painful latch with her first and with positioning and a feeding schedule for the twins – while she breastfed them simultaneously – as well as support for tracking feedings and pumping after her return to work. “It's mind-blowing to think that I was able to do that,” Grant reflected. “I think every mom that can breastfeed, even if it's a couple of days or a couple of years, it's such a huge triumph. I think it’s amazing that our bodies can do that.” Each breastfeeding journey is unique. “The perfect plan is one that parents can implement and maintain while attaining their goals and having a happy, thriving baby,” Kinkade explained. “This is their personal journey, and it is our job to find that balance for them.”

22 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 23 It has been “a wild ride” since Irv Batten became director of The Cooper River Bridge Run three years ago. He joked that he can’t wait until “a normal year,” knowing that pulling together a race that is known for being among the best organized in the world can’t possibly include the normalcy that most people know. The COVID-19 pandemic hit soon after Batten took the reins. Runners were invited to participate in a virtual run as solace when the 2020 race had to be postponed. In 2021, Batten, Deputy Race Director Mark Cellars and their small but enthusiastic team organized two Bridge Runs – the one in September 2021 that had been postponed from April of that year and the 2022 version in its traditional April time slot. Dicey weather has sometimes detoured races. For example, in 1986, intense fog delayed the Bridge Run for an hour. Another year, runners paused and found shelter until a lightning-packed storm quickly rolled through the area. “It has been a crazy, crazy time,” Batten said. And he loves every minute of it. Batten’s passion for running started in middle school, and that’s what his life has been all about ever since. He was a high school running star in Florida, and, in 1983, he earned a full scholarship to Charleston Southern University. He has coached runners, been president of the Charleston Running Club and even owned a running store. When he was asked to take the helm of the Bridge Run, the position seemed right up his alley, he said, though he was told that this race was a “different beast” compared to others he had organized. “It can’t be that different,” Batten remembered thinking – until he went to his first CRBR security meeting. “Every law enforcement branch and office you can think of was there,” Batten said. “I also learned about the two-day expo for the race and that is bigger than the Peachtree Road Race expo. It didn’t take long for me to realize that CRBR was much, much more than other races I had organized.” In years prior to the pandemic, the Cooper River Bridge Run lured close to 40,000 participants from all over the world. By December 2022, 9,000 people had signed up for the 2023 race in April – projecting 30,000 for the April event. An incremental climb in the number of participants has Batten and Cellars hopeful that participation will be at the pre-pandemic high again, if not beyond. “The run is so much more than a race. It’s an event,” said North Charleston resident Dan Clapper, who has participated in CRBR 37 consecutive years since 1985, with the exception of 2020, the pandemic year. CRBR remains Clapper’s “favorite run of all runs,” he confirmed. “The camaraderie of the people, all the fun, the buildup of events before the race – it’s above and beyond all races.” Clapper, 69, also loves volunteering for CRBR by passing out race numbers and packets to participants. “You get to see a lot of people you know, including returnees from out of town,” he said. Clapper watches for a visiting participant named Daniel who often wears his 1985 race shirt. “I wore mine one year and we enjoyed taking a photo together,” Clapper said. The Cooper River Bridge Run has a tremendous impact on the local community, the hospitality and tourism industries and other business entities by generating more than $33 million in one weekend. CRBR also supports the Lowcountry through its Charity Connection and grants programs. Ninety-two cents of every dollar spent goes toward the CRBR mission: promoting health and wellness, which improves the quality of life. To learn more: Email [email protected] or call 843-856-1949. A WILD RIDE AND A WORLD-RENOWNED RACE By Lisa Moody Breslin COOPER RIVER BRIDGE RUN OBJECTIVES • Increase interest in cardiovascular exercise in the community. • Raise funds for public education on the importance of exercise. • Generate a spirit of community involvement and volunteerism. • Promote and publicize the Cooper River Bridge Run.

24 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Race director Irv Batten Deputy director Mark Cellars Volunteer coordinator Jennifer Curry Registration coordinator Erin Magera-Hames Elite runner coordinator Michael Banks Special events coordinator Lorrie Warren Elite wheelchair coordinator Kim Aquino Assistant registration coordinator Marcy Krawcheck Transportation Coordinator Carl Beckmann 1978 • The Cooper River Bridge Run was founded by Dr. Marcus Newberry. • 766 finishers ran over the Silas N. Pearman Bridge. 1980 • The racecourse was rerouted over the Grace Memorial Bridge. • The Dewey Wise Trophy was established – for the oldest finisher who runs a time faster than his or her age in minutes. 1981 • The first and only local overall winner, Mark Embler, finishes in 30:54. 1984 • David Branch was the first two-time winner. 1985 • Prize money was awarded for the first time. • The race course was certified. 1986 • The Marcus Newberry Award was established for the first male and female finisher from the Charleston tri-county area. • The race was delayed one hour due to dense fog and an automobile accident. 1992 • Elite runners from Kenya began a long winning streak. 1993 • The first winners of the T-shirt design contest: Caitlin McPhilips and Amy Stewart Reed. 1994 • Oprah ran in the Cooper River Bridge Run. • Julian Smith was hired as race director. 1995 • The race course returned to the Silas N. Pearman Bridge, with over 10,000 finishers. 1997 • The first use of chip timing. • The female course record was set by Elana Myers: 31:19. • Actor Bill Murray fired the cannon to start the race. 1998 • The first two-time female overall winner was Elana Myers. 2000 • The male course record was set by James Koskei: 27:40. 2002 • The Bridge Run Hall of Fame is established. • Genie Wellons became the first wheelchair athlete to compete in the Bridge Run. 2006 • A record number 45,663 registered runners and walkers: 33,742 finishers. • The first time over the new Arthur Ravenel Jr. Bridge. • The debut of the Elite Wheelchair Race. • Runners were required to be seeded according to their finisher times. 2007 • The race capped at 40,000 participants. 2010 • The first timing chips on race bibs. • The second largest race in CRBR history: 38,413 registered/33,413 finishers. 2017 • 40th anniversary celebrated with 40 days of Bridge Run events. 2019 • The CRBR was given The Governor’s Cup award for its impact on tourism and travel. • Irv Batten officially becomes race director. 2020 • A virtual run replaced the regular race due to the COVID-19 pandemic. 2021 • The in-person race resumed on Sept. 25 because the number of COVID cases had dropped. • Hermin Garic set a new course record – 22:58 – in the Elite Wheelchair Race. • The overall champion trophy was named in honor of former Race Director Julian Smith. 2023 • Will mark the 46th anniversary of the Cooper River Bridge Run. HISTORY OF THE COOPER RIVER BRIDGE RUN STAFF

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 25 For many patients, the quality of their OB-GYN care and their preference for a woman tops their list of considerations when they search for their ideal doctor. A female OB-GYN, local patients note, identifies better with their concerns, and they are not as hard to find as they were to five to 10 years ago. Over the past few decades, more and more OB-GYN physicians are female, and this ratio is growing. Nationally, approximately 60% of practicing OB-GYNs are female, according to a 2020 report by the Association of American Medical Colleges. “There has been a steady increase in the number of female OB-GYNs in South Carolina, mirroring these national trends,” noted Dr. Berry Campbell, the immediate past president of the South Carolina OB/GYN Society. Today about half of all medical students are female. But according to the AAMC, 86% of the new physicians who have chosen OB-GYN as a specialty for their training are female. These women will become the OB-GYNs of the next 10, 20 and 30 years and possibly longer if the trend continues. Dr. Campbell sees this same trend close to home where “90% of the recent applicants for OB-GYN residency at the Medical University of South Carolina were female. In their most recent residency class, out of 20 residents, only one was male.” “My No. 1 priority in choosing an OB-GYN is finding a female. When I say that I have a concern, a woman can say that she has had the same concern or maybe has experienced a similar pain,” explained Meghan, a 53-year-old Charleston resident. “I also carefully consider the age of the practitioner, areas of specialty, office location and whether they are in the same health care system as my other providers.” Similarly, Gretchen, a Keowee Key resident in her 70s, said when considering an OB-GYN, her top priority is that the doctor is a woman. She said she will also “check their credentials RISE IN NUMBER OF WOMEN OB-GYNs MATCHES MANY WOMEN’S PRIORITIES By Lisa Wack

26 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com and reviews online, the distance to her office, and, importantly, the quality of the clinic or office she is in.” “It seems when [male doctors] can’t figure out a medical problem, they presume it must be stress,” Gretchen asserted. “That story gets old. Women understand the multiple roles of a woman and look into a situation further to make sure there is no medical reason for symptoms before going down the stress road.” Gretchen’s assertions are closely linked to the trending term “medical gaslighting,” when a health care provider dismisses a patients’ worries, minimizes their symptoms or makes them feel like their symptoms are imagined. According to Melinda Wenner Moyer’s 2022 New York Times article, “Women are Calling Out ‘Medical Gaslighting,’” “the term ‘gaslighting’ derives from a play called ‘Gaslight’ about a husband’s attempt to drive his wife insane. And many patients, particularly women and people of color, describe the search for accurate diagnosis and treatment as maddening.” “We know that women, and especially women of color, are often diagnosed and treated differently by doctors than men are, even when they have the same health conditions,” explained Karen Lutfey Spencer, a researcher quoted in Moyer’s piece who studies medical decision-making at the University of Colorado, Denver. Some women lean on nurse midwives, who are predominantly female, for their OB-GYN care. “We work with women from an early age through menopause,” said Barbara Davenport, CNM, a certified nurse midwife at Prisma Health in Greenville. Many female patients prefer to work with a female practitioner because they can “identify more with someone who has had similar experiences,” Davenport noted. “When a patient has a health practitioner who she can relate to, it often builds confidence in the relationship.” As a midwife, Davenport strives to “help women understand and trust their bodies.” Throughout Dr. Campbell’s experience, quality care is patients’ top priority: “Most people believe if a doctor provides a high quality of care, they will not care if they are a male or female.” Patients typically consider technical skill, compassion and experience as part of their evaluation, and a male OB-GYN may check the boxes best for them. Many women have a relationship built over the years with their male OB-GYN and the trust they place in him has grown. For women who live in more rural areas of South Carolina, Dr. Campbell explained, the most important consideration may become the availability of physicians, rather than the physician’s characteristics or background. The potentially smaller number of male physicians in these areas may not trouble some women who may not be able to, or may not wish to, travel a great distance for their visits. GENDER PREFERENCE AMONG PATIENTS OF THEIR TREATING OB-GYNS CARE SERVICE FEMALE MALE NO PREFERENCE Who do you prefer for having primary health screening? 72.8% 3.1% 24.1% Who do you prefer for pelvic exams? 92.6% 2.6% 4.9% Who do you prefer for obstetric care of an unborn baby? 68.2% 5.4% 26.4% Who do you prefer for major gynecological surgery? 61.0% 15.9% 23.1% Which gender has more sympathy? 34.6% 19.5% 45.9% Which gender is more trustworthy? 29.5% 15.1% 55.4% Which gender has more respect for their patients? 12.6% 17.4% 70.0% Which gender is more knowledgeable about women's health? 39.0% 8.7% 52.3% Which gender has better bedside manners? 19.2% 11.0% 69.7% Which gender tends to spend more time with their patients? 22.3% 8.5% 69.2% Which gender is a better OB-GYN? 48.7% 4.9% 46.4% Source: National Library of Medicine. Many female patients prefer to work with a female practitioner because they can 'identify more with someone who has had similar experiences.' “ “ Medical Gaslighting Source: nytimes.com/2022/03/28/well/live/gaslighting-doctors-patients-health.html

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