HealthLinks Charleston July/August 2022

COMPLIMENTARY CHARLESTON | DORCHESTER | BERKELEY CHAR L E S TON JULY/AUGUST 2022 KETAMINE ’ S CURING JOURNEY FOOD OVER PHARMACEUTICALS SPECIAL WOMEN IN HEALTH ISSUE RIDING THE WAVES : OCEAN THERAPY

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www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 9

10 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com 16 | YOU ARE WHAT YOU EAT The idea is to use food as preventive medicine, rather than having to rely on pharmaceuticals. 20 | ALL SYSTEMS CLEAR – CONTROLLING PANIC A body overreacts to a stressor, creating a fight-or-flight reaction that doesn’t apply to the day-to-day modern world. 22 | FACIAL SCARRING: HEALING AND HIDING IN PLAIN SIGHT According to the American Society of Plastic Surgeons, in 2020, 15.6 million people in the United States had some form of facial surgery. 27 | SUN WORSHIPERS BEWARE Changes in pigmentation such as age spots, liver spots and freckles, along with wrinkles and other signs of aging on the face, are the result of photoaging, which is caused by exposure to the sun. 30 | SOOTHE THE SKIN WITH THE HEALING POWERS OF PLANTS Check out some of the natural remedies native to areas in South Carolina you can use to soothe your skin ailments this summer. 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. 56 | FROZEN STIFF: A PAINFUL CONDITION WITH AN OMINOUS NAME Doctors don’t know for sure what causes frozen shoulder, but they agree that the nagging problem can take up to a year or more to go away, and there’s a decent chance it eventually will return. 59 | CONCUSSION DETECTION IN THE BLINK OF AN EYE Blink rates became the foundation for Dr. Trevanian Tsai’s research with engineer Mark Semler to develop a way to capture blink rates and translate that data into diagnosis for concussion. 66 | PUTTING YOUR BEST FOOT FORWARD It’s important to consult a podiatrist as soon as possible if you have a foot or ankle issue that is affecting your daily activities. 69 | WHEN YOUR EYES ARE BIGGER THAN YOUR STOMACH While physical inactivity, processed food and the rise of fast food are contributing to health concerns, a general disregard of serving sizes also is a big issue. Issue 11.4 JULY/AUGUST 2022 CHARLESTON FEATURES W MEN I N HEALTH

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 11 73 | A STEP BACK FROM REALITY Although they are a treatment and not a cure, ketamine infusions have been effective in helping people deal with depressed brain functioning. 78 | SURF’S UP FOR OCEAN THERAPY Waves 4 Women is a four-week program that focuses on learning to practice mindfulness, manage uncomfortable emotions, develop a growth mind-set and empower women to do more than they think they can. 82 | CCMS: COMMON SKIN CANCER WARNING SIGNS At Trident Dermatology, health care professionals use the acronym ABCDE to help patients recognize melanoma early and learn how to distinguish it from a common mole. 84 | TECHNOLOGICAL ADVANCES IN HEALTH CARE Whether health care technology is addressing vision deterioration, renal failure, heart disease or a host of other physical ailments, such advancements are significantly improving treatment for patients with these challenges. CONTENTS SPONSORED MEDICAL CONTENT When Change is a Good Thing. .................................................55 Getting Patients Back on Their Feet...........................................65 DIRECTORIES Dermatology....................................... 94 Plastic Surgery..................................... 95 BY THE NUMBERS Facial Scars. ........................................ 24 Photoaging. ........................................ 28 IN EVERY ISSUE Publisher’s Note.................................. 12 About the Cover................................. 13 Living Healthy Area Events................. 14 There's an App for That...................... 77 The Lighter Side of Health Care. ........ 80 Charleston Area Nonprofits................ 86 A Unique Case.................................... 88 Healthy Pet: Happy Pet....................... 90 The Facts on Food & Drink................. 92 The Pulse on Charleston Nurses. ........ 96

12 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Issue 11.4 July/August 2022 Publisher CULLEN MURRAY-KEMP [email protected] Managing Editor THERESA STRATFORD Assistant Editor MOLLY SHERMAN Copy Editor BRIAN SHERMAN Art Director KIM HALL Webmaster GEORGE CONKLIN Internet GENE PHAN Sales Manager MANDY WILLIS [email protected] Writers Media Consultants ANDY BIMONTE [email protected] BRANDON CLARK [email protected] CRYSTAL WILSON-CHAMBERS [email protected] Photographer JENN CADY [email protected] TO ADVERTISE IN HEALTHLINKS, PLEASE CALL 843-732-4110 Distribution Manager CAROL CASSIDY Administration & Bookkeeping GINGER SOTTILE Distribution U.S. Post Office, Harris Teeter, Publix, CVS, Food Lion, Medical Offices 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 L.C. LEACH III ISABEL ALVAREZ ARATA LEAH RHYNE CHRISTINE STEELE JANET E. PERRIGO BILL FARLEY EILEEN CASEY DAVE CLUCAS STACY DOMINGO COLIN MCCANDLESS KATHERINE WATERS ANNE TOOLE LISA BRESLIN DENISE K. JAMES Scan to discover our other HealthLinks platforms! A Tribute to the Wonderful Women in My Life. Welcome to our special Women in Health edition of HealthLinks. With National Women’s Day coming up in August, this feels like a great time to pay our respects to some of the most influential women in our lives. For me, that means my wife – a health care leader in her own right – and my mother. If you’ve read any of my previous Publisher’s Notes, you are probably wellaware of my father’s recent passing. My words highlighted the loss, his impact on my life and the lessons he taught me. Yet I often neglected to mention the grace my mother displayed through her loss. Without forgetting about their nearly 40 years of marriage, she began to build a new life – day by day. She connected with friends, embarked on adventures and even renovated an old family home on the river where she grew up. She welcomed my daily calls and engaged with me on topics ranging from what was wrong with my golf game to deep insights into my father’s personality and professional legacy. She may not know this, but these conversations provided a balance that helped stabilize the anxiety I felt from losing my father. From yelling at the “blind” basketball referees to unwavering support through my scholastic trials to providing consistent motherly guidance and intuition, I can say with absolute certainty that I would not be here today with my mother. Then there’s my female, minority, doctor-of-nurse-practice wife, who has made a career out of saving children’s lives, which, ironically, is only her second most difficult job next to keeping me in line. In all seriousness, Dr. Marissa Kemp has been my crutch since I was 16 years old. She cheers me along when life is great and helps pick up the pieces when things fall apart. Trust me when I say she has pulled me out of some very dark corners. Her professional passion and drive provide the necessary inspiration to force me out of bed every morning. With each breath she makes my world a happier, more fulfilled place. Like our Women in Health rock stars in this issue of HealthLinks, Marissa provides proof that success and prosperity are achievable for women in our society. We all have women who shape our lives for the better. How many times have we been reluctant to go to the doctor, eventually giving in to the insistence of our wives, sisters or mothers, only to find out that if we had waited any longer to see a health care professional, we would have jeopardized our health? Let’s raise a glass to the amazing women who help keep us healthy and happy – and pave the way for continued success for future generations of females. Cheers to good health, Cul len Murray Kemp Cullen Murray-Kemp

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 13 ABOUT THE COVER... I have to say that one of my favorite things about summer in the South is the fresh food. Watermelon, blueberries, tomatoes, peaches – I could spend hours at our local farmers markets admiring all the fresh local produce. That’s why I love this cover. To me, it’s absolutely beautiful. When I think about food in the summer, I think of a colorful garden salad or a refreshing fruit plate. It’s just a way to make these hot, hazy days a little bit brighter. This is a jampacked issue filled with great information, so we hope you are enjoying this magazine while lounging in the hammock or at the beach. It’s our Women in Health issue, and we have interviewed some of the most influential local women in health care. Get to know who they really are through the pages of this magazine. Of course, we would be remiss not to warn you about the dangers of UV rays in a summer issue. Check out our story about correcting dark spots and how you can keep your skin healthy. We also covered how to handle panic attacks and ketamine, a treatment for depression. Since you’ll have your flip-flops on for the next couple of months, you might want read our story on common foot problems. There are so many great features in this issue – too many to list here. You’ll have to read it for yourself. For the wonderful photos of our Women in Health, we want to say a special thank you to Jenn Cady Photography. And we also want to thank Hyatt Place in Mount Pleasant for providing the tremendous backdrop for the WIH head shots. And speaking of fresh food, thank you to Dish & Design Catering, especially Anja Stief, for completing our WIH photo shoot with some delicious bites. Thank you to our graphic designer and our copy editor for making sure this issue not only looks beautiful but also is well-read. And we want to recognize our wonderful writers, all of whom are extremely valuable to us. We appreciate all their hard work. Thank you to our sales staff, especially Mandy Willis, and everyone on the HealthLinks team for their contributions to this issue. And, of course, thank you to our sources. They lend us their expertise and time, both of which are priceless. We hope you enjoy this summer issue of HealthLinks magazine. And, as always … To health and happiness, Theresa Stratford, managing editor JULY/AUGUST 2022 COMPLIMENTARY CHARLESTON | DORCHESTER | BERKELEY CHAR L E S TON JULY/AUGUST 2022 KETAMINE’S CURING JOURNEY FOOD OVER PHARMACEUTICALS SPECIAL WOMEN IN HEALTH ISSUE RIDING THE WAVES: OCEAN THERAPY CHARLESTON PHOTOGRAPHY AND POSING EXPERT VISIT JENNCADY.COM AND SCHEDULE YOUR PHOTOSHOOT TODAY!

14 | 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 SATURDAYS FROM APRIL TO NOVEMBER CHARLESTON FARMERS MARKET 8 a.m. to 2 p.m. 329 Meeting St. • Charleston charlestonfarmersmarket.com SATURDAYS YEAR-ROUND GOOSE CREEK FARMERS & ARTISANS MARKET 9 a.m. to 1 p.m. 519 N. Goose Creek Blvd. • Goose Creek facebook.com/gcfam2021 SATURDAYS FROM APRIL TO DECEMBER MCCLELLANVILLE LAND & SEA MARKET 9 a.m. to 1 p.m. 1369 Pinckney St. • McClellanville facebook.com/mcvllandandseamarket THURSDAYS FROM APRIL TO NOVEMBER MONCKS CORNER FARMERS MARKET 3 p.m. to 6 p.m. 418 E. Main St. • Moncks Corner monckscornersc.gov SUNDAYS FROM APRIL TO OCTOBER MOSQUITO BEACH FARMERS MARKET 3 p.m. to 7 p.m. 1229 Mosquito Beach Road • Folly Beach follybeachfarmersmarket.org TUESDAYS FROM APRIL TO SEPTEMBER MOUNT PLEASANT FARMERS MARKET 3:30 p.m. to 7 p.m. 645 Coleman Blvd. • Mount Pleasant experiencemountpleasant.com

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 15 LOWCOUNTRY THURSDAYS FROM MAY TO OCTOBER NORTH CHARLESTON FARMERS MARKET 3 p.m. to 7 p.m. 5025 Lackawanna Blvd. • North Charleston northcharleston.org SATURDAYS YEAR-ROUND SEA ISLAND FARMERS MARKET 9:30 a.m. to 1:30 p.m. 2024 Academy Road • Johns Island seaislandfarmersmarket.com THURSDAYS FROM APRIL TO JUNE SUMMERS CORNER FARMERS MARKET 5 p.m. to 8 p.m. 1609 Beech Hill Road • Summerville summerscorner.com/farmers-markets/ SATURDAYS FROM APRIL TO NOVEMBER SUMMERVILLE FARMERS MARKET 8 a.m. to 1 p.m. 200 S. Main St. • Summerville summervillesc.gov FRIDAYS FROM MAY TO OCTOBER THE TOWN MARKET ON JAMES ISLAND 6 p.m. to 9 p.m. 1122 Dills Bluff Road • James Island jamesislandsc.us/the-town-market WEDNESDAYS FROM APRIL TO NOVEMBER WEST ASHLEY FARMERS MARKET 3 p.m. to 7 p.m. Ackerman Park • West Ashley charlestonfarmersmarket.com/west-ashley-farmers-market/

IT’S TRUE: YOU ARE WHAT YOU EAT By L. C. Leach III

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 17 “What we eat plays a huge role in how we feel and how our body operates,” said Dr. Cici Carter, physician and owner of FreshMed LLC, in Charleston. “The foods we consume in our diet are the building blocks to everything going on at a microscopic level.” Consider wheat, rye and barley, grains that are among the world’s most important food sources. But the Mayo Clinic reports that about 200,000 people in the United States suffer from an immune reaction to gluten, a type of protein found in these grains. Over time, it creates inflammation that damages the lining of the small intestine, leading to medical complications. The solution, Dr. Carter said, is to opt for other grains such as quinoa, brown rice, tapioca and millet. “The idea is to use food as a preventive medicine, rather than having to rely on pharmaceuticals,” she said. “And on the whole we’re all becoming more aware of how and where we’re getting our food.” While this idea officially originated more than 100 years ago, it has been steadily evolving since the 1940s. For example, the U.S. Department of Agriculture created the original seven food groups in 1943 but opted for the model of the four basic food groups from 1956 to 1992. Then came the food pyramid in 1992, MyPyramid in 2005 and MyPlate in 2011, which is the most current USDA nutritional guide. While the 1956 version of eating healthy simply mentioned fruit and vegetables as a combined dietary staple, the current nutritional standard also offers serving sizes, plus the recommendation to make “half your plate fruits and vegetables.” “The focus is now much more on plant-based items, with fruits and vegetables being equivalent to proteins and grains, with a splash of dairy,” Dr. Carter said. “We’ve learned much more about the nutritional properties of what we eat and related those properties to benefits and possible harmful impacts on our health.” Let’s say you want to opt for a certain style of eating for an entire week, consuming three square meals a day. Dr. Carter recommended the MyPlate option: • BREAKFAST – Two organic eggs over easy in ghee or olive oil over a bed of arugula with half of a smashed avocado with sea salt and lemon juice. • LUNCH – Spring mix salad – no iceberg or romaine lettuce – with organic chicken breast, plus lots of vegetables such as red and yellow peppers, carrots, red onions, tomatoes and broccoli, with two tablespoons of flaxseed sprinkled on top with an oil-based dressing. • DINNER – Baked salmon over a bed of quinoa and roasted Brussels sprouts. And in terms of contributing to a much longer quality of life, Dr. Carter recommended numerous foods that work to fight off chronic diseases: • ORGANIC DAIRY: milks and yogurt – to reduce risk for cancers and allergic responses such as asthma and eczema. • WILD CAUGHT SALMON – Contains omega 3 nutrients, which are considered to be an anti-inflammatory fatty acid. • CRUCIFEROUS VEGETABLES: broccoli, Brussels sprouts, cauliflower – They’re high in fiber and contain sulforaphane to help maintain healthy weight, stabilize blood sugar, reduce chances for diabetes, bind toxins and flush them from the body. • UNSALTED NUTS: ALMONDS, WALNUTS, BRAZIL NUTS – They contain proteins, healthy oils and omega nutrients. • BERRIES: BLUEBERRIES, BLACKBERRIES, RASPBERRIES – They are packed with antioxidants and can reduce the risk of cardiovascular disease and cancers. • FLAXSEEDS: LIGNANS – They contain fiber, protein and omega 3 nutrients to protect against cancer. They often are used as a beneficial garnish in salads and other foods. • GREEN TEA – It contains antioxidant and anti-inflammatory properties, plus a calming amino acid to help with mood and cognition. Healthy eating is something most of us have heard ever since our days of learning the basic nutritional food groups. Now, more than ever before, because of increased medical knowledge and changing habits in work and leisure, a healthy diet may not only be the starting point for what ails you but the thread that can keep you going for a really long time.

18 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Other foods with a high content of fiber, probiotics or antioxidants include oats, green tea, organic yogurt, beans and turmeric. “The goal now is to eat a lot of whole foods versus processed foods,” Dr. Carter said. “We’ve had to evolve this recommendation based on the weight-related conditions we’ve watched develop over the years.” The World Health Organization reported that in 2016, more than 37% of adults in the United States were either overweight or obese – more than triple the 1975 figure. That number now stands at more than 42%, equating to a yearly death toll of about 2.8 million people. With a simple change in eating habits, Dr. Carter said you can not only live longer and feel years younger but, eventually, when you pass the age of 80, you’ll come to view aging as simple chronology. “We’ve learned much more about the nutritional properties of what we eat and related those properties to benefits and possible harmful impacts on our health,” she said. “So while it does take a certain amount of work and active participation to make changes to your eating habits and lifestyle, the outcomes are certainly worth it.” “ “The idea is to use food as a preventive medicine, rather than having to rely on pharmaceuticals. And on the whole we’re all becoming more aware of how and where we’re getting our food.

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20 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com I was 22 the first time I experienced a panic attack. It was September of 2001, several weeks after the attack on the Twin Towers. I lived across the river from Manhattan in Northern New Jersey and lost a friend when the Towers fell. I awoke in the middle of the night gasping for air. I felt like there was a semi-truck parked on my chest. I was sobbing, choking and I didn’t know what was happening. Corrigan Rutherford, a Charleston-based educator and school administrator, understands those feelings all too well. “All of your body systems shift into overdrive,” she said. “You might vomit, your heart races and you don’t know if you’re going to explode or not. You just know, ‘I have to get out of this place or I am going to die.’” ALL SYSTEMS CLEAR – CONTROLLING PANIC By Leah Rhyne

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 21 Panic attacks, or panic disorders, are common these days and are becoming ever more so. “Panic disorders are extremely prevalent nowadays, especially in the population of 18 to 25 years old,” said Steven Krozer, CEO and nurse practitioner at iTrust Wellness Group in Greenville. “Mental health symptoms, which include panic disorders and generalized anxiety disorders, have increased approximately 30% to 40% in the last several years in this population alone.” “I think the world being as connected as it is with social media and a global internet, direct consumers of information by technological needs are exposed to a significant amount of information than that of other generations,” he added. “News, for example, is now global – school shootings, COVID-19 and economic collapse potential. This is what our population is exposed to every day.” In short, we’re all stressed all the time, and it’s difficult to find an escape route. So our bodies overreact. That’s exactly what a panic attack is, in fact. A body overreacts to a stressor, creating a fight-or-flight reaction that doesn’t apply to the day-to-day modern world. Katy Stebbins Yahr, MA, LPC, with Still Point Counseling in Mount Pleasant, explained: “Panic attacks occur when your brain is having an overreaction to the body’s natural physiological response to fear or danger.” Causes can include stimuli in your environment or something as simple as drinking too much caffeine, trigging your body to respond with an increase in physiological activity. “Your brain sends signals to prepare you for what it is incorrectly coding as an emergency,” she continued. “Your sympathetic nervous system triggers the release of adrenaline and cortisol. The blood flows to your major muscles, and your heart rate increases and breathing quickens to prepare you to flee or fight.” So what do you do when you experience a panic attack? Said Yahr: “Most people experience a panic attack for about 10 to 15 minutes, which is how long it takes until the brain has exhausted all of its resources attending to the perceived emergency. Knowing it will subside is empowering for people who experience panic attacks.” She encourages her patients to set a timer so they can track how much time actually passes. It’s also important to know the symptoms and how they differentiate from a physical condition such as a heart attack. Symptoms to look out for include squeezing, fullness or pain in the center of your chest and pain or discomfort in one or both arms, the back, neck, jaw or stomach. “If you’re unsure,” said Yahr, “you should always go to the emergency room to get checked.” Treatments for panic disorders can include antidepressant medication to calm down the nervous system as well as supportive care like cognitive-behavioral therapy. CBT teaches people to recognize physical sensations early so they can use tools such as deep breathing, exercise or mediation to control their symptoms. It’s widely used to treat anxiety, depression, eating disorders and addiction. These are all tools familiar to Rutherford, who uses a mix of them to keep her panic in check. “I try to be more organized in my daily life,” she said. “I work to control the things I can control. I’ve worked with a therapist, and I’ve learned a little bit of anti-anxiety medication can help a lot. It’s enough to slow my brain down.” And as for me, I remain on a journey similar to Rutherford’s. Panic will always be there, on the edge of my world, but, with the tools I’ve put in place through the years, I know I’ll be fine. You will, too. And if you’re worried, don’t forget: It’s always OK to ask for help. INCREASING THE RISK Factors that may increase the risk of developing panic attacks or panic disorder include: • Family history of panic attacks or panic disorder; • Major life stress, such as the death or serious illness of a loved one; • A traumatic event, such as sexual assault or a serious accident; • Major changes in your life, such as a divorce or the addition of a baby; • Smoking or excessive caffeine intake; • History of childhood physical or sexual abuse. Source: Mayo Clinic.

22 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Pretend you are considering facial surgery to change your aesthetics or to correct damage due to injury or treatment of skin cancer. While you will face a number of variables on how you want to look, how much you want done and who to use for the surgery, one constant in the process is that you will have a surgical scar. For the past 32 years, Dr. Marcelo Hochman has been helping patients of all ages and needs not only to get new looks but also to keep their surgical scars hidden and unnoticeable. “We all want to look our best,” said Dr. Hochman, who is the owner of The Facial Surgery Center in Mount Pleasant and also is double-board-certified in facial plastic and head/neck reconstructive surgery. “And a goal in facial surgery is to camouflage the best possible scar.” There are two different types of facial scars. For example, suppose your face has been scarred by disease or injury. Dr. Hochman and his team would guide you through the process of reconstructive surgery. “If a scar is from an injury, then we’re starting with a cut in the skin which is not planned,” Dr. Hochman said. “It may be irregular or bruised, and there may be things about it that impact the way the incision heals.” How quickly a reconstructive scar heals can depend on its size and the amount of surgery. The scar could heal within a week, but, if you require a skin graft, the healing could take several weeks. “But any time the skin is injured or a cut is made into the skin, it heals in the same fashion – by producing a scar,” Dr. Hochman said. FACIAL SCARRING: HEALING AND HIDING IN PLAIN SIGHT By L. C. Leach III

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 23 The same is true for the second type of facial surgery – cosmetic or elective. This involves enhancing the aesthetics of the face and includes deep plane face-lifts, nose surgery, eyelid surgery and skin resurfacing with lasers or physical planing of irregularities. The healing process for any scar is usually six to 12 months, with redness at first, followed by hardness of the treated area, then a softening of the scar and a gradual fading of the redness. “When we surgically create a scar, we have some control in how it heals,” Dr. Hochman said. “But the healing process itself, what the body goes through to weld those tissues back together, is the same regardless of what caused the scar.” The American Society of Plastic Surgeons reported that in 2020, approximately 15.6 million people in the United States had some form of facial surgery. Nose reshaping led all categories, with more than 352,000 procedures. “The technology and our understanding of facial aging’s root causes are ever-improving, and we now have the ability to combine multiple techniques to achieve unprecedented facial rejuvenation results,” he said. “And if we maximize the healing process in a certain way that we control, then you will not look different, only better.”

24 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Since his first facial incision, Dr. Hochman has been repeatedly recognized by peers and patients alike – and not just for his surgical abilities. He has been awarded the Order of the Palmetto, South Carolina’s highest civilian award, by making it possible for poor people in his community to get free medical service. And he also has a special niche practice for children with vascular tumors, with patients seeking his expertise from around the country. He said that since 1990, facial surgery for any reason has increased. “Cosmetic has become more popular and sought-after,” he said. “And reconstructive procedures have risen because of more injuries from dog bites, gunshots and motor vehicle accidents.” So if you are contemplating any kind of facial surgery, either cosmetic or reconstructive, Dr. Hochman and his team will give you all the information you need to decide. “It is only natural to want to look as good as you can regardless of the cause,” he said. “And for me to be able to change someone’s life through reconstructive surgery, migraine treatment or cosmetic surgery is an amazing privilege.” FACIAL SCARS By the Numbers The market for scar treatment in the United States is estimated at $12 BILLION per year.* In the United States, 500,000 PATIENTS are treated each year for burns, many of which leave scars and painful contractures that require major surgery.* Each year in the developed world, an estimated 100 MILLION patients acquire scars dues to facial surgery.* Up to $7.5 BILLION is spent annually on treatment of burns in the United States, and much of this cost is related to treatment of the resulting scar and contracture.* There was a 22% INCREASE of facial procedures from 2000 to 2020, and 2022 is expected to show continued growth in the popularity of plastic surgery.** Source: *National Library of Medicine.** American Society of Plastic Surgeons.

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“Humanry has perfected the process of helping us continuously grow our medical practice.” Dr. Andrew J. McMarlin, DO CAQSM HUMANRY'S 3 STEP REVIEW 72% of patients say their first step in finding a new doctor is checking online reviews. PATIENT'S INVITATION We'll send your patients a personalized text message and email, inviting them to review. CHOOSE REVIEW TYPE We encourage positive reviews to be shared and critical reviews to be sent directly to you. WRITE REVIEW Humanry is the most simple & intuitive platform to post reviews. (1) (2) (3) * Our review technology is one of only two systems that connect directly to Google. To learn more about profitable growth, visit humanry.com or to schedule a consult, call (864) 432-2468.

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 27 SUN WORSHIPERS BEWARE By Isabel Alvarez Arata It’s impossible to hide from the sun, especially when there are multiple benefits to being outdoors, including encouraging movement, boosting mood and reducing stress. Unfortunately, however, sun damage is a concern for many Americans, especially those over 50. Changes in pigmentation such as age spots, liver spots and freckles, along with wrinkles and other signs of aging on the face, are the result of photoaging, which is caused by exposure to the sun. According to Yale Medicine, “Unlike normal, chronological aging, which is dictated by age and genetics, photoaging happens when ultraviolet light from the sun or tanning beds permanently damages the skin’s structure.”

28 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Photoaging starts in the teens to early 20s and can be measured by comparing the skin on the face to an area of the body that is not exposed to the sun. Wrinkles, pigmentation changes, loss of skin elasticity, rough and uneven skin texture and tone and redness and broken capillaries all are signs of photoaging. While everybody is susceptible to this problem, some people are more prone to sun damage, especially those with pale skin, light-colored eyes, blond or red hair and those who burn easily. In addition to genetic factors, geographical location and climate play a significant role in the extent of photoaging that people may develop as they age. One of the best ways to address photoaging is to prevent further damage. UVA radiation damages the skin at all levels, affecting collagen and elastin, while UVB light irradiates the outer layer of the skin, damages DNA and can cause precancerous cells known as actinic keratoses to form. The American Academy of Dermatology recommends daily use of a broad-spectrum sunscreen with a sun protection factor of at least 30 to shield skin from UVA and UVB rays. It also recommends generous applications of sun protection, water-resistant formulas and re-applying sunscreen every two hours or after swimming and sweating. Daily use of sun protection, wearing UV-protective, wide-brimmed hats, staying in the shade and avoiding peak sun hours aid in preventing further photoaging but will not undo damage that already has been done. While most treatments for sun damage are considered cosmetic and therefore not covered by insurance, people who want to look younger can invest in a variety of therapies to reduce common signs of photoaging. Options include fractional skin resurfacing lasers and pulled dye lasers, which can help make the skin appear younger while also healing broken blood vessels and reducing redness. Different lasers are used to address different concerns, but they are, in general, an excellent choice to boost the skin’s elasticity and overall appearance. Another option, intensive pulsed light therapy, is similar to laser therapy, but, instead of focusing just one wavelength of light on the skin, releases light of many different wavelengths. Another popular and somewhat more affordable option are chemical peels, where a chemical substance such as glycolic acid is used to gently remove the top layers of the skin and reveal a more youthful complexion. In addition, many topical medications address pigmentation changes and skin texture. Both overthe-counter products and prescription medications with active ingredients such as retinoids have been shown to even the skin tone and reduce fine lines caused by photoaging. When addressing photoaging, it’s important to discuss concerns and desired outcomes with a trusted dermatologist. Both dermatologists and physician-staffed med spas are equipped to safely address the effects of sun damage with minimally invasive treatments and ongoing prevention. The best time to address the effects of skin aging is usually when patients can stay out of the sun for at least a few weeks at a time because many treatments make the skin extra sensitive to UVA and UVB rays. Treating photoaging can be a slow process, especially since sun exposure is inevitable, but patience, dedication and an innovative skin-care team can make all the difference. PHOTOAGING By the Numbers More than 1 OF 3 AMERICANS report getting sunburned each year. Source: U.S. Department of Health and Human Services. Most people only apply about 20% TO 50% of the amount of sunscreen needed to achieve the amount of SPF on the label. Source: National Center for Biotechnology Information. Most adults need about 1 OUNCE OF SUNSCREEN – enough to fill a shot glass – to fully cover their entire body. Source: American Academy of Dermatology. Tanned skin is damaged skin, yet nearly 1 OF 3 YOUNG white women engage in indoor tanning each year. Source: U.S. Department of Health and Human Services. It has been reported that approximately 80% OF SKIN aging on the face can be attributed to UV exposure. Source: National Center for Biotechnology Information. Wrinkles, pigmentation changes, loss of skin elasticity, rough and uneven skin texture and tone and redness and broken capillaries all are signs of photoaging.

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 29 www.tridentdermatology.net FOR AN APPOINTMENT CALL 843.797.3960 9295 Medical Plaza Dr. Ste A-B, Charleston, SC 29406 At Trident Dermatology®, Our Priority is to Deliver Quality Dermatological Care to Informed Patients in a Comfortable and Convenient setting. • Treatment of a variety of skin conditions, including acne, eczema, psoriasis, rashes, etc. • Diagnosis and treatment of various skin cancers by our fellowship trained Mohs surgeons and our in-house lab. • Various cosmetic services including wrinkle treatment, laser hair removal, peels, lesion removals, vein treatment, etc. SERVICES www.healthlinkspodcast.com

30 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com SOOTHE THE SKIN WITH THE HEALING POWERS OF PLANTS “Jewelweed” of my eye. Jewelweed is a common field treatment that can be used to soothe rashes. If you’re on a hiking trail and making enemies with stinging nettles or poison ivy, crush up some jewelweed to express the sap inside the stem and rub it on the affected site to alleviate itching and burning. As the summer sun begins to heat up in South Carolina and humidity rolls in from the coast, expanses of green plants begin to crawl out of hiding – and so do skin issues of summer’s past. Indigenous people have relied on the innate healing properties of plants for centuries, and many of the essential medicines we associate with modern day drugs have derived from plants. While being grateful for the contemporary remedies of today, it can be beneficial for some treatment and prevention measures to use raw plants and incorporate components of them into our routines. Check out some of the natural remedies that are native to areas of South Carolina – and that you can use to soothe your skin ailments this summer. By Molly Sherman Source: National Library of Medicine.

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 31 Say 'aloe' to aloe vera. Commonly used to alleviate sunburn, the cactus-like plant also is effective in preventing wrinkles, stretch marks and pigmentation and seems to speed healing by improving blood circulation and warding off cell death around a wound. Break open a leaf’s rind to release the gel, rich with enzymes, antioxidants and vitamins A and C, and smear liberally. Nothing seedy about hemp seed oil. Often represented by the relaxation effects of its extraction, CBD, this oil, derived from the seeds of the hemp plant, has a similar soothing effect on the skin. Rich in fatty acids, it helps the skin retain moisture and can hydrate areas irritated by eczema or other inflammatory skin conditions. Its additional anti-inflammatory and antimicrobial properties can improve acne scars and UV damage and strengthen the skin’s natural barrier. Fresh rosemary for fresher skin. While delicious for baking something nourishing and savory, rosemary is also a delicious plant for nourishing the skin. The antioxidant effects of caffeic acid and rosmarinic acid are effective in preventing cutaneous photodamage, which is associated with skin cancer. Rosemary also has been effective in lightening dark spots and acne scars, reducing skin puffiness and wrinkling and has proven to be effective against bacterium causing acne. Rosemary can be added to a carrier oil such as coconut oil or into other moisturizing creams. Put some purslane in your purse. This herb, home to many sidewalk cracks and untouched garden beds, has natural cooling properties capable of soothing skin, relieving inflammation and reducing rashes. Purslane extracts and concoctions of crushed leaves mixed with oil, which is common in Ghana for treating boils, is as effective as an antibacterial and antifungal. A poultice of the plant or a form of the released juice is commonly applied externally to a range of skin ailments, from insect stings to itching skin to skin sores.

32 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com 1200 Hospital Dr., Mt Pleasant, SC 29464 • 843.375.4000 • www.vhcharleston.com What is a Critical Care Hospital? Critical Care hospitals like Vibra Hospital of Charleston, are uniquely designed to effectively care for medically complex patients. Critical Care hospitals have physicians, nurses and staff who specialize in caring for patients who are critically ill and/or have complicated medical needs like respiratory care. Choosing the right post-acute setting for critically ill patients is crucial for achieving the highest outcomes for these complex patients.

MEN WI N HEALTH We are excited to present the first ever HealthLinks Women in Health edition. On the following pages, you’ll find some of the most influential local women in health care. It was an honor speaking to them and learning about each of their unique journeys – including why they entered the health care field, who inspires them and why they love what they do. We are lucky to live in a community where women not only are succeeding but leading and thriving in a field that touches everyone. There are so many wonderful women in health care, and we wish we could highlight them all. We want to thank them for the care and dedication they show their patients and the love they pour into their work each day. The strength they have exhibited, especially in the past two years, is inspiring and admirable. We hope you enjoy reading our first ever HealthLinks Women in Health edition. Top row (left to right): Anna Hawkins, ARCpoint Labs of Charleston; Heather Downs, Lowcountry Power Yoga; Imani Nowell-Ingram, ARCpoint Labs of Charleston; Dorian Nixon, Palmetto Family Home Care; Dr. Jeris Cox, Adore Fertility; Dr. Virginia Gregory, Smile Carolina Dental Group; Dr. Carolyn R. Word, Charleston Allergy + Asthma; Dr. Lindsey S. Steadman, Charleston Allergy + Asthma; Dr. Lori A. Robbins, Palmetto Digestive Disease & Endoscopy Center; Cindy Robbins, The Village at Summerville; Mary Guillaume, The Village at Summerville; Diana Brito, The Village at Summerville; and Jessica Ancrum, Caring Transitions. First row (left to right): Lisa Leland, ARCpoint Labs of Charleston; Keshia Wigfall, Palmetto Primary Care Physicians; Brooke McCoy, The Stretch Zone; Dr. Sarah Kalani Wharton, Cypress Chiropractic & Wellness; Carrie Boan, Emotional Intel Strategies; Dr. Meredith L. Moore, Charleston Allergy + Asthma; Megan Keogh, The Breast Place; and Whitney Huff, The Breast Place. Photo by Jenn Cady.

34 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com MEN WI N HEALTH Being a physician and being a mom each come with their own unique challenges. Dr. Hala Sabry found that out when she was trying to balance her two full-time careers – one as a board-certified emergency medicine doctor and the other as a mother of five with two sets of twins. That led her to create the Physician Moms Group, to offer support and strength to other female doctors who also are moms. In just six short years, the group has grown from 20 friends into the largest online support network for women physician mothers, with more than 120,000 members nationwide. Charleston family practitioner Dr. Kay Durst discovered the group when it was still in its infancy – with just a few hundred members. A third-generation family practitioner and the first woman in her family to become one, Dr. Durst said the support and camaraderie the group offers fills a much-needed void. “I've been out of medical school for a while, but there wasn’t as much uplifting of female physicians then. Unfortunately, these days, women still face challenges when it comes to equal rights and equal pay. In academics, there are still more male physicians in leadership roles. Even though my babies are teenagers now and going off to college, it has been good to get some feedback and support around being a full-time mother and full-time physician.” The group has offered educational seminars on topics such as physician burnout, women and finances, contract negotiation and the business of medicine – running your own medical practice. Dr. Durst said the group has also been a great source of support to the women doctors during the COVID-19 pandemic: “From racial issues to shootings to accidents to COVID, we talk about how it affects us because we are on the front lines. It's been very helpful.” The group is open to any female M.D. or D.O., including researchers, emergency doctors and family practitioners. Smaller unofficial “chapter groups” like the Holy City Physician Moms Group also have popped up to support each other locally. “There are a lot of smart women physicians who are also moms who are putting together education for the greater good,” said Dr. Durst. In addition to offering support in their professions, the group serves as a resource for the women in other ways: sharing referrals for nannies, advice on schools and even gardening, for example. “It's a great group,” said Dr. Durst. “We really get a lot of support from each other.” The group will hold its first in-person gathering since the start of the COVID-19 pandemic this year. The Physician Moms Group Third Annual Conference will be held Aug. 5 through Aug. 7 at the West Beach Conference Center on Kiawah Island. Registration is open now, and the conference still has a few openings for sponsors. Visit meeting.mypmg.com/registration/ to sign up. “It's very exciting, because it's a chance for us to meet with female physicians from all over,” Dr. Durst said. For more information, visit mypmg.com. SUPPORTING EACH OTHER WITH COMPASSION AND STRENGTH By Christine Steele Dr. Hala Sabry, left, with Dr. Kay Durst.

MEN WI N HEALTH www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 35 Keshia Wigfall grew up possessing both a compassionate heart for those who were suffering and a fierce passion to do something someday to help alleviate pain and distress, especially for the elderly. However, her journey into the important but behind-thescenes world of health care management has not been a direct path. During the past 20 years working in a local hospital, she earned her medical billing and coding certification from Southeastern Institute in 2013. In 2018, she accepted a position as an insurance specialist with Palmetto Primary Care Physicians. Most recently, in January of 2022, Wigfall stepped into the position of site supervisor at the PPCP Urgent Care Center in North Charleston. If life wasn’t busy enough before, it certainly is now. “I oversee a team of 30 people, including nurse practitioners, physician assistants, nurses, phlebotomists, certified medical assistants and front desk staff. My responsibilities require providing leadership and communication in accordance with PPCP policies. It is my job to see that we maintain an efficient and well-organized urgent care,” explained Wigfall. “Our team must be ready at all times. We are open seven days a week, so a big part of my job, especially during the pandemic, was making sure that we were always properly staffed while keeping the team members safe so that we could continue to serve the community.” Executive Director of Marketing Vivian Walton concurred: “Keshia leads our team in a fast-paced environment, where we treat walk-in patients with high acuity and often in high volumes. This means having both medical and nonmedical staff members that are prepared for anything.” As is typical of the more than 9,000 urgent care centers in the United States, the very nature of this health care setting is demanding. Each day brings a variety of new patients who have been unable to schedule a necessary appointment with their primary care physician. Treatment might be offered for anything from an earache to a fracture. Those patients requiring more advanced care must be assessed quickly and referred to an acutecare facility. For Wigfall, building healthy relationships among her team members is one of the favorite parts of her job. Admiring their hard work and dedication, she employs a variety of proven communication skills to make sure everyone hears what she is saying and understands thoroughly. Good communication has helped the team develop strong relationships, but, more importantly, it has also helped in providing the best patient care. Wigfall is also known and appreciated for her ability to adapt to constantly changing and challenging daily work situations. “Urgent care is unpredictable, and it’s just like life. You never know what is going to be thrown at you. Adaptability expands our capacity to handle changes no matter what they may be. It is my job to be well-prepared and ready,” she acknowledged matter-of-factly. Wigfall’s passion to help others in distress has found its home at the Palmetto Primary Care Physicians Urgent Care Center. By Janet E. Perrigo Keshia Wigfall PALMETTO PRIMARY CARE PHYSICIANS North Charleston 843-572-7727 palmettoprimarycare.com @palmettoprimarycare Good communication has helped the team develop strong relationships, but, more importantly, it has also helped in providing the best patient care. " " Photo by Jenn Cady.

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