HealthLinks Charleston July/August 2023


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1200 Hospital Dr., Mt Pleasant, SC 29464 • 843.375.4000 • 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.

843-494-5004 | DANA BLALOCK, D.D.S. CALL US TO LEARN MORE! 1022 Physicians Dr. #B, Charleston, SC 29414 fax 866-462-0121 for Physician Referrals SNORING KEEPING YOU AWAKE? Nightlase by Fotona treatment is a fast, non-invasive and friendly way of increasing the quality of your sleep by reducing snoring. The procedure is comfortable and you can resume your daily routine immediately aftewards. This “airway enhancement” for patients can be used for snorers and mild sleep apnea patients that prefer to start with this therapy before CPAP or an oral device. Then, it can also be used to improve results of an oral device or CPAP. WE HAVE SOLUTIONS FOR YOU!

8 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com 16 | FRAUGHT WITH FRECKLES Studies have shown that individuals with a multitude of freckles may be more prone to developing skin cancer with excessive sun exposure. 22 | BUILDING TIES GARDEN BY GARDEN Community gardens beautify vacant lots, clean up polluted environments, build stronger ties among people in neighborhoods and produce food for needy families. 24 | THE GREEN HEART PROJECT The Green Heart Project is one of many garden-based learning, or farm-to-school, initiatives. It’s designed to help youngsters grow, eat and celebrate food. 26 | HOLY GUACAMOLE: NATIONAL AVOCADO DAY July 31 is National Avocado Day. If you’re looking to celebrate this healthy fruit by incorporating avocado into your summer meal planning, you might be on the right track 28 | BETTER HEALTH – A LAUGHING MATTER Research suggests that laughter started as a survival tool in animals as a way to communicate that the group was safe from harm. Now doctors know that laughter heals. 33 | QUALITY HEALTH CARE, LIMITED ACCESS There is a sharp increase in funding and programs dedicated to closing the social, economic and environmental gaps in access to quality health care. 36 | TAI CHI: MOVING MEDITATION Dating back to the 16th century, tai chi originated in China. Its physical and mental health benefits range from improving flexibility and balance to decreasing anxiety and depression while promoting a mind/body connection. 40 | THE GREEN-EYED MONSTER Jealousy has been the source of relationship woes, a sign of internal problems from the past and even the central, destroying emotion in the Shakespearean play “Othello.” 44 | TOO MUCH SCREEN TIME Warnings on social media about phone addiction are increasing, and now more doctors, therapists and psychiatrists are treating patients for this addiction. 52 | THE POWER OF ACTIVE LISTENING Active listening builds trust between the speaker and the listener and shows speakers that they are valued – and that their words matter. Issue 12.4 JULY/AUGUST CHARLESTON FEATURES

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 9 56 | WHEN COVID-19 REFUSES TO LEAVE The Centers for Disease Control has discovered through its National Center for Health Statistics that this unpleasant invader is more than happy to hang around in some people longer than expected. 60 | BACK TO SCHOOL WITHOUT A HOME When a family doesn’t have a permanent home, back-toschool traditions and checklists are often daunting at best. 68 | TESTOSTERONE AND SPERM COUNTS DROPPING In the last 40 years, the average, age-adjusted testosterone levels and sperm counts for men have declined consistently. Some studies suggest a greater than 50% drop in sperm counts over the past several decades. 72 | MENTAL HEALTH DEPENDS ON BEING SOCIAL Technology is great, but people still need real, social, in-person interaction. Just talking with someone for five minutes makes a positive difference. 76 | EXERCISE. READ. GET A DOG. Several wise retirees in the area recently offered advice to folks who remain forever curious about how people who live to record-setting ages make it happen 80 | EXERCISE: DOES SEX COUNT? Hundreds of clinical trials have put the “is sex exercise?” question to the test; however, a definitive answer to this question remains elusive. 86 | A SHORTAGE OF EMS PERSONNEL A local EMS shortage could delay response times to the point of putting people in jeopardy. 90 | THE WORKFORCE SHORTAGE IS GETTING WORSE IN THE VETERINARY WORLD Now more than ever, the number of practitioners of veterinary medicine is at an all-time low. If the industry doesn’t show signs of recovery in the next few years, you might end up with a pet that can’t afford to get sick. CONTENTS DIRECTORIES Dermatology .......................................................94 Plastic Surgery......................................................95 IN EVERY ISSUE Publisher’s Note...................................................10 From the Editor....................................................11 Living Healthy Area Events..................................12 CCMS ..................................................................66 There's an App for That.......................................75 The Lighter Side of Health Care. .........................83 Unique Case.........................................................84 Charleston Area Nonprofits.................................88 Faces & Places. ....................................................92 The Pulse on Charleston Nurses..........................96 SPONSORED MEDICAL CONTENT Foot Problems? Help is Close at Hand...............................39 PTS: World-Class Doctors; Personalized Care. ...................43 Focusing on Fitness at the MUSC Wellness Center............49 Practice Born Out of Pain....................................................50 Free Yourself From Allergy Symptoms................................65 BY THE NUMBERS Community Gardens...........................................................23 Laughter..............................................................................30 Screen Time........................................................................46 Socializing and Mental Health. ...........................................74

10 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Issue 12.4 Publisher CULLEN MURRAY-KEMP [email protected] Managing Editor LISA BRESLIN Associate Editor AMY GESELL Copy Editor BRIAN SHERMAN Art Director KIM HALL Webmaster GEORGE CONKLIN Sales Manager MANDY WILLIS [email protected] Writers Media Consultant BRANDON CLARK [email protected] Intern LEXIE SHERMAN 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 LISA BRESLIN AMY CONNOR LINDA ESTERSON BILL FARLEY AMY GESELL DENISE K. JAMES CATHERINE KAUFFMAN L.C. LEACH III KAREN LISZEWSKI COLIN MCCANDLESS JANET PERRIGO MOLLY SHERMAN THERESA STRATFORD LISA WACK Scan to discover our other HealthLinks platforms! The Rise of Artificial Concern and Confusion (Intelligence) It’s the night before press time, and our team of writers, editors and designers have worked tirelessly to hit the deadline. My brain jockeys between the series finale of “Succession” and the deafening sound of the Wadmalaw Island “peeper” frogs. My fingers touch the letter keys, only to be followed by a frustrated pounding of the delete button. Writer's block sets in as I feel the fury of my team build; I’m holding up of yet another edition of HealthLinks. “Damned deadlines,” I yell at nobody but myself. Frustrated by my inability to be creative, I open a window on my browser and type in “Chat GPT.” My curser blinks in the Chat GPT message box, but I pause. “All I would have to do is type in five or six keywords or phrases and artificial intelligence would happily author my July/August publisher’s note for me,” I rationalize. But would that be my publisher’s note? “This is a far cry from ethical,” I admit to myself. I close the browser window and open a Microsoft Word document. “This feels right,” I think. While there’s no doubt that technology can help save lives and connect our world, it also comes at a cost. True human to human interactions are sidelined for social media engagement in the form of “likes” and “shares.” Reliance on cellphones and computers has become a behavioral addiction, as Amy Gesell notes in her article “Cellphones and Screen Time: Break the Streak.” With the emergence of artificial intelligence, we are taking yet another disappearing step into the technological abyss. Will online and print publishers opt for AI-authored articles? Will marketing agencies ever write another press release? What about content writers or paralegals? How are teachers to differentiate between AI papers and students who poured their soul into the work? The future will bring us answers, but, in the interim, please enjoy the new issue of HealthLinks – a publication written, edited and designed by a team of real humans who I am proud to call my friends. Cheers to Good Heath, 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 FROM THE EDITOR... Since I was in elementary school, I have filled many boring moments by looking for patterns. Connecting the dots among the freckles on my arms, I’ve spied Orion’s belt, pyramids, an occasional flower, a smile, a spatula and some other interesting shapes and configurations. Summer months bring new patterns as the freckles burst forth and, with age, brown spots bring new dimension to the palette: “I spy with my little eye an ant on the edge of a mudhole.” Brown spots are perfect mudholes. Thanks to HealthLinks reporter Linda Esterson’s story about the correlation between freckles and skin cancer, I have now added the ABCDEs of Melanoma to my connect-the-dot searches: A – Asymmetry; B – Border; C – Color; D – Diameter; E– Evolving. As a fair-skinned, avid fisher who is fraught with freckles, it is quite likely that I will be the 1 in 5 Americans that the American Academy of Dermatology says will eventually develop skin cancer. I need to be vigilant. We all do. Adding the ABCDEs of Melanoma to my life is only one example of how managing HealthLinks – a publication that offers a 360-degree dive into health – is flipping the script on my routines. “Yes, it’s true. I just accepted a job as managing editor for a health magazine,” I told my siblings as I chowed down on some Cheetos and put an “X” on the calendar to note that I blew off walking with my neighbor. I really do think that the universe and all my guardian angels decided that this job will awaken the healthier me. I know they are right. As I read about the healing power of laughter, National Avocado Day, the joys of community gardens and tai chi, I’m inspired to adopt better habits and explore more health-affirming experiences. I soaked up every piece of advice about aging with joy that the Keowee Key neighbors shared with reporter Lisa Wack for her “Words from Our Wise” article. Bill, Dave, Gerry, Julie, Jim and Gretchen offer more straightforward truths than books, TikToks and scholarly publications reveal. Thank you for picking up this new issue of HealthLinks. As always, we enjoyed connecting with members of the community to learn more so we can share more. To simple pleasures and good health, Lisa Breslin, Managing Editor JULY/AUGUST 2023 CHARLESTON PHOTOGRAPHY AND POSING EXPERT VISIT JENNCADY.COM AND SCHEDULE YOUR PHOTOSHOOT TODAY!

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 JULY 4 Firecracker 4 Miler Laurel Hill County Park 1400 Highway 41, Mount Pleasant 8:30 a.m. Celebrate July Fourth by running down the shaded trails of Laurel Hill County Park at the eighth annual Firecracker 4 Miler. After the race, enjoy music, hot dogs and cold beverages with friends and family. Learn more: Firecracker4MilerCharleston JULY 8 Walk With A Doc Gahagan Park 515 W. Boundary St., Summerville 10 a.m. Walk with a Doc is a free walking program held on the second Saturday of each month for anyone interested in taking steps for a healthier lifestyle. Learn about a current health topic from a health care professional and enjoy a healthy walk and fun conversation. Learn more: summerville-south-carolina/ JULY 29 IOP Beach Run The Windjammer 1008 Ocean Blvd., Isle of Palms 8 a.m. Run the beach at the Isle of Palms Beach Run. 5k and 10k runs are offered, plus a 5k walk and youth fun run. Learn more: special-events-holiday-activities/iop-beach-run JULY 6 Yoga for Kids Bees Ferry West Ashley Library 3035 Sanders Road, Charleston 10 a.m. In this session, kids can move their bodies while exploring shapes and yoga postures, painting pictures using their imagination and practicing affirmations and breath work. Learn more:

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 13 JULY 31-AUGUST 4 The Charleston Museum Summer Camp The Charleston Museum 360 Meeting St., Charleston 9 a.m. Campers ages 6 to 11 are invited to travel back in time to learn about creatures, customs and cultures throughout history. Each camp includes crafts, activities and admission to The Charleston Museum. Learn more: the-charleston-museum-summer-camp-5/ AUGUST 13 First Day Festival Gaillard Center and South Carolina Aquarium 95 Calhoun St. and 100 Aquarium Wharf, Charleston 1 p.m. The First Day Festival celebrates the start of the new school year and provides families with information on resources, free school supplies, free fresh food and free admission to the South Carolina Aquarium. Learn more: First-Day-Festival AUGUST 26 Race for The ARK St. Luke’s Lutheran Church 206 Central Ave., Summerville 7:45 a.m. Join us July 26 - 28, 2023 View Speakers and Agenda at T H E L O W C O U N T R Y M E N T A L H E A L T H C O N F E R E N C E GAILLARD CENTER 95 CALHOUN STREET, CHARLESTON, SC VIRTUAL & IN-PERSON OPTIONS Options! Mental Health H E R O E S Founding Partners In-Person and Virtual Options! GAILLARD PERFORMANCE CENTER 95 CALHOUN STREET, CHARLESTON, SC 26th - 28th - JULY - 2 0 2 3 A special thanks to our Platinum Supporter • World-class talks on trending topics • Up to 15.25 professional contact hours • July 26th Pre-Conference Sessions • Lunch Workshop Session Choices • And so much more!! Mental Health H E R O E S Founding Partners mh d Virtual Options! Mental Health H E R O E S Founding Partners Founding Partners A special th nks to our Platinum orter • Hear from world-renowned experts • 22 unique talks on topics such as depression, anxiety, grief & loss and wellness • Access to great mental health resources (90+ organizations exhibiting) The annual 5k run/walk, 1-mile fun run and Ugly Sweater 5k Dash go through historic Summerville. Proceeds from the event help support caregivers and their loved ones living with Alzheimer’s disease or related dementias. Learn more:

14 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Gadsden Glen Rehab for the Charleston Community Gadsden Glen Center for Health and Rehab was built to restore strength and spirit, providing a healing experience unlike any other in the Southeast. The award-winning Gadsden Glen welcomes the Charleston community for their short-term rehab needs within the Christie Rehab Center. Gadsden Glen is a state-of-the-art environment where healing, rehabilitative care, outstanding physical, occupational, and speech therapy, and successful returnto-home outcomes are emphasized. With the highest patient-to-staff ratio in the area, the Glen offers impeccable, modern amenities, including expansive common and programming spaces, well-equipped rehab and wellness gyms, large, all-private patient rooms, and a variety of culinary and dining options. With costs in-line with the Charleston area, Medicare and insurance coverage allows you to select Gadsden Glen for your short-term post-acute rehabilitation, thus setting you on a successful course of improved health and wellness.

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 15 843.406.6251 - Gadsden Glen is located on James Island, within Bishop Gadsden Episcopal Retirement Community.

16 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com John Baltzegar has spent his entire life outdoors. He mostly enjoyed offshore fishing from “Miss Caroline,” a boat named for his wife of 25 years. His skin, he said, is admittedly on the darker side, and he’s never had to worry about the impact of the sun’s rays. But at Caroline’s insistence, he scheduled a checkup last fall. He hadn’t seen a dermatologist for several years, since before the beginning of the COVID pandemic. Baltzegar, who turns 77 this summer, sold his boat and in September made the twohour trek to see Dr. Manuel Valdebran at the Medical University of South Carolina in Charleston. “I’ve never had any indication I had anything wrong,” said Baltzegar, owner of StoneWorks, a marble and granite fabricator in the Hilton Head area. “Caroline just wanted me to have a head-to-toe checkup.” Dr. Valdebran performed a thorough examination and found a questionable growth on the back of Baltzegar’s shoulder. A biopsy confirmed that the growth was malignant. In early October, a surgeon removed the mole and took a lymph node for examination. Thankfully, the cancer had been confined to the small growth. At his follow-up visit in April, Dr. Valdebran found a pre-cancerous mole on Baltzegar’s temple, which he froze. “My wife’s right – you need checkups,” he said. With his dark complexion, Baltzegar rarely saw any discolorations on his skin. But others with fairer skin, like Caroline, are more prone to sunburn and the dangers of sun exposure. They also may have freckles, which usually appear on the skin of individuals with red hair. There are two types of freckles, or tan spots, according to Dr. Valdebran. Ephelides are small, pigmented spots that are FRAUGHT WITH FRECKLES WHEN TO WORRY ABOUT SKIN SPOTS By Linda L. Esterson

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 17 generally 1 to 2 millimeters in size, light brown in color and more common in people with red hair, who have a genetic predisposition to freckles. They first appear around the age of 2 or 3 and increase during adolescence, Dr. Valdebran explained. They are most often found on the face, arms, neck and chest and become more pigmented during the summer, and they partially disappear with age. Ephelides are associated with a sensitivity to the sun, which activates melanocytes, cells that provide pigment to the skin. Studies have shown that individuals with a multitude of freckles may be more prone to developing melanoma or skin cancer with excessive sun exposure. Lentigines are larger than ephelides, ranging in size from millimeters to centimeters in diameter, and their color can be a darker brown. Also referred to as a sun spot or liver spot, they are more commonly found in people over the age of 50 on chronic sun-exposed skin, mostly on the face, the dorsum or top of the hand or either side of the forearm, Dr. Valdebran added. These spots are generally benign and are confined to the top of the skin. “Freckles themselves are absolutely harmless,” said Dr. Valdebran. “What should be alarming is any new mole that is different from a freckle in people over the age of 40.” A mole is a skin growth that can be flat or raised and is darker in pigment than a freckle. Moles that change in color, size or symmetry over a period of one to three months or appear after the age of 40 should be concerning, said Dr. Valdebran. “Any mole that is rapidly changing should be taken care of immediately because they may represent a melanoma, which is one of the deadliest cancers that we have,” he added.

18 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com A dermatologist will use a dermoscope, a magnifier that enables the physician to view the structure of the pigmented lesion and distinguish the difference between a freckle and a mole. Those that affect the basal or innermost layer of the skin are sometimes determined to be cancerous, and, when they are caught early, there is a nearly 100% cure rate. Dr. Valdebran stressed the importance of seeing a dermatologist as soon as you realize that a growth is changing in size, shape or pigment. “If you know that it is a mole and not a freckle and it is looking irregular, then it should be very concerning and you have to be seen as soon as possible,” he explained. BE MINDFUL OF THE ABCDEs OF MELANOMA A. Asymmetry – half of the spot is unlike the other half. B. Border – the spot has an irregular, scalloped or poorly defined border. C. Color – the spot has varying colors from one area to the next, such as a shade of tan, brown or black or areas that are white, red or blue. D. Diameter - melanomas are usually greater than 6 millimeters but they can be smaller. E. Evolving – a mole or spot on the skin that is different from the rest that is changing in size, shape or color. SKIN SELF-CHECK According to the American Academy of Dermatology, 1 in 5 Americans will develop skin cancer in their lifetime, but, when it is caught early, it is highly treatable. Conducting a regular self-check once a month can help you find areas of concern while they are small. Look for new spots on your skin that are different from others, changing, itching or bleeding. FOLLOW THESE STEPS FOR A SELF-CHECK • Using a full-length mirror, examine your body front and back, then look at the right and left sides with your arms raised. • Bend your elbows and look carefully at your forearms, underarms and palms. • Look at the backs of your legs and feet, the spaces between your toes and the soles of your feet. • Using a hand-held mirror, examine the back of your neck and scalp. Part your hair for a closer look at your scalp. Finally, check your back and buttocks. If you notice a spot that is different from others or that changes, itches or bleeds, make an appointment to see a dermatologist. -American Academy of Dermatology

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 19 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 With over 24 years of serving your seniors in Charleston County, we are a Senior Living community you can count on! We pride ourselves on providing a place that you and your family can call home. OUR LOVE AND ROOTS RUN DEEP! 843.553.6342 2590 Elms Plantation Blvd. North Charleston, SC 29406 Call to schedule a tour and learn about our availability! • • HealthLinks Video • HealthLinks Podcast • HealthLinks Newsletter For inquiries email [email protected] MORE ASSETS = MORE PATIENTS

20 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com 1885 Rifle Range Rd., Mt. Pleasant, SC 29464 843.856.4735 | www. ctor that you choose Lutheran Hospice, faith-based ministry providing ate end-of-life care for patients and ll faiths and beliefs. ospice patients may receive specialized wherever they live—at no cost. aid, V.A. and other insurance program benefits available Lutheran Hospice is a faith-based, non-profit mission to provide our patients with excellent care physically, emotionally and spiritually. We are proud to provide people with life-limiting illnesses daily hope, while ensuring maximum comfort and quality of life. “ ” Non-Profit, Faith-based Senior Solutions Join our Family Live your lifestyle at the community Charlestonians love. Independent Living Apartments & Patio Homes Assisted Living & Memory Care Short-term Rehab • Long-term Care 1885 Rifle Range Rd. • Mt. Pleasant Schedule a tour! 843.856.4713 or 800.940.7435

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22 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com They have been used to beautify vacant lots, clean up polluted environments, build stronger ties among people in neighborhoods and produce food for needy families. But in the 274 years since the first one was established in the United States, community gardens have not only grown to impressive numbers across all 50 states – their original concept of bringing communities together for a common purpose is probably more important now than ever. “We have at least 10 functioning community gardens in Greenville County,” said Aerin Brownlee, program coordinator with Greenville County Recreation. “And besides providing an additional recreation opportunity for our community members, there are so many other benefits that community gardens bring to any neighborhood.” For example, gardening in general has long been recognized as a primary way to relieve stress. Brownlee pointed out that when people work a community garden, they retain a balance between work and wellness in ways that aren’t always apparent in the hustle of everyday life. “Community gardening is something that helps us slow down, clear the head and recharge for all the things we have to do,” she said. “And, even if we don’t realize it at first, it also helps us better our surroundings in ways we are often unaware of.” Many of these ways include: BEAUTIFYING THE LANDSCAPE - Urban neighborhoods often contain vacant lots that have fallen into disuse and neglect, inviting unwanted elements to grow. A community garden in these areas creates a green, living space where birds and beneficial insects congregate. Community gardens also can increase property values. CLEANING UP THE ENVIRONMENT - Plants naturally contribute to cleaner air by adding oxygen to the air and removing air pollution. Plants also absorb rainwater, which means less runoff in streets and less pollutants washed into rivers, streams and lakes. “The increased biodiversity and beauty also benefits the general public as our gardens were placed in spaces where previously only mowed turf was grown,” Brownlee said. BUILDING STRONGER COMMUNITIES - Participating in a community garden allows neighbors to personally connect and get to know each other. This means not only stronger neighborhood bonds but a tendency for criminal elements to stay away. BETTER NUTRITION - Obtaining fresh produce is often a challenge for families living in urban areas. COMMUNITY GARDENS CULTIVATE MANY PURPOSES By L. C. Leach III A young gardener in Greenville gets a lesson and tip on how to care for community garden plants.

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 23 This could mean dispensing with healthy and nutritious eating habits, which many of us take for granted, because the effort and distance to go to get fruit and vegetables costs too much and takes too much time. But it has been proven that the presence of a community garden changes these habits toward healthier lifestyles. “Better nutrition is one of the biggest benefits that working a community garden can provide,” said Jacqueline Williams, program coordinator and master gardener with Columbia Parks & Recreation. “Our official program started in 2011, and now we have three area sites, all owned by the city, that residents can lease.” Williams added that the best part for her happens when participants realize a distinct difference between what they grow and what they buy. “Residents who participate in our community gardens program think the cabbage, tomatoes, eggplant, carrots, lettuce and all the other food from them taste better than the vegetables they get in the store,” she said. “And they also participate for other reasons, such as social interaction and limited space at home for gardens.” Of course, better nutrition can mean far fewer medical problems later on. “Food from one of these gardens can significantly reduce the risk of obesity and obesity-related diseases,” Brownlee said. “And most of the people who work the gardens in Greenville County grow food for personal consumption and enjoy tending their crops with families or friends.” Community gardens made their debut in Colonial America when members of the Moravian Church in North Carolina established them to provide food for the entire community. Later, in the 1890s, Detroit was the first city to start community gardens on vacant lots to hep combat an economic recession. And during World War II, the U.S. Department of Agriculture encouraged Americans to plant what were known as victory gardens. Around one-third of the vegetables produced during this time came from these gardens. Today, the largest community garden in the United States, Shiloh Field, situated on 14.5 acres in Denton, Texas, has produced more than 340,000 pounds of produce in the last 13 years to feed people who otherwise would go hungry. It’s an idea, and a challenge, that Williams said is being explored on a smaller scale in the Columbia area. “The first challenge we have is ‘Who is going to work the gardens exclusively for the benefit of others,’” she said. “And the second challenge is ‘How can we utilize these gardens to benefit our farmers markets and mobile markets and our food banks?’” COMMUNITY GARDENS By the Numbers Most per capita – city • Portland, Oregon – 4.45 community gardens per 1,000 residents. Source: Statista Research - OLDEST – 18TH CENTURY Community of Bethabara, near Winston-Salem, North Carolina. Established by the Moravians in 1759, and still in operation. Note: Eagle Heights, Wisconsin, claims to have the oldest community garden, though it began in the 1950s. Source: Forsyth Community LARGEST – 14.5 ACRES Shiloh Field Community Garden, Denton, Texas. Note: DeKalb County Community Gardens in DeKalb, Illinois, also claims to be the largest in the Unites States, at 15 ACRES. Shiloh is officially recognized as the largest by the American Community Garden Association. Sources: American Community Garden Association; Shiloh Field - Most popular vegetable • tomatoes, easily. They are also the NO. 1 GROWN VEGETABLE in the world at more than 189 MILLION metric tons. Onions are a distant second at 106.59 MILLION metric tons. Source: Statista $6 •The yield amount for EVERY $1 invested in a community garden. Source: Garden Pals - Early morning gardeners and community volunteers work together to fill accessible beds at the Conestee Community Garden in Greenville.

By L. C. Leach III GREEN HEART: HEALTHY EATING, HEALTHY LIFESTYLE Two young student gardeners begin to see the fruits of their labor through the Green Heart Project, a Charleston-based initiative that annually engages 4,000 local students in garden-based learning. Photo courtesy of Jesse Blom.

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 25 The idea began at a Charleston County elementary school as a simple way to make students familiar with how garden vegetables grow. But since that time 14 years ago, this idea, known as the Green Heart Project, has spread to other parts of the Lowcountry and is now viewed as a critical tool to show students the value of developing healthy eating habits at a young age – and as a way to help raise the state's national health ranking. “The Green Heart Project is one of many garden-based learning, or farm-to-school, programs across the state and the nation,” said Executive Director Jesse Blom. “We partner with 18 schools and operate one community-based urban farm. The purpose is to build educational garden-based projects and school programs through growing, eating and celebrating food.” The majority of Green Heart’s partner schools are Title 1 schools, which serve low-income students. These students often live in food deserts, as determined by the U.S. Department of Agriculture. In many cases, food grown at the schools under the direction of Green Heart is sent home with the students to share with their families. “Our one-half-acre urban farm at the Enston Home is nested within an affordable housing community of low-to-moderate income residents,” Blom said. “The Enston Home is located within a food desert, and produce grown at the farm is sold to the community on a ‘pay what you can’ basis to ensure it is affordable.” Plus, Green Heart’s hands-on curriculum serves as an extension to the classroom; students learn how to keep the right bugs in a garden, which compost materials make for a healthy soil and how different foods contribute to a healthy lifestyle. “Our school gardens also help students learn teamwork as they work together to complete a task,” Blom said. “Some of our programs are directly tied to the science curriculum and help students with applications of concepts.” Currently, Green Heart engages 4,000 local students annually in garden-based learning. Their efforts are reinforced with the help of around 1,000 volunteers. “And we also employ 14 high school students in a paid summer internship program,” Blom said. “These gardens help all the students gain a sense of confidence and control over their ability to provide for themselves and encourage healthier individual behaviors.” Blom added that in the long run, he hopes Green Heart’s efforts will help grow a generation of citizens in South Carolina who proactively care for their health and the health of their neighbors. Based on a 2021 health report, South Carolina is only a breath away from hitting rock bottom. In its third consecutive year of researching all 50 U.S. states to determine its annual Community Well-Being Index, digital health company Sharecare and the Boston University School of Public Health placed South Carolina at No. 40 – identical to its placement in 2020 but four notches down from 2019. To move even a few places higher for 2022 and 2023, the state will need improvement in nearly every health category – especially in its dead-last domain of food access. “The state’s food access score is 10 points below the national average and ranked in the bottom six for the domain,” said Dr. Michael Rickles, vice president of research with Sharecare. “Food access is important for mitigating against health risks and chronic conditions like obesity, diabetes, high blood pressure, anxiety and depression, joint pain and fatigue.” For South Carolina’s health to improve in just this one domain, Dr. Rickles recommended community garden projects and ventures such as Green Heart. “It would not only help improve the state’s community rank, which is South Carolina’s second lowest domain, it would most importantly contribute to individual well-being,” he said. The Green Heart Project was founded in 2009 as a small garden at Julian Mitchell Elementary School in downtown Charleston. The original intention was to give students from low-income households access to locally-grown, fresh fruits and vegetables. Now it’s a community-wide mission that is increasingly catching on across the state and the nation. “I’m constantly amazed at the interest, intellect and passion our young people have for environmental conservation, community engagement and physical health,” Blom said. “Their positive attitudes and hunger for learning inspire hope in all of our employees and volunteers to keep doing the work we do.” Our school gardens also help students learn teamwork as they work together to complete a task.

26 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com GOING GREEN: By Colin McCandless THE BENEFITS OF EATING AVOCADOS

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 27 July 31 is National Avocado Day, and, if you’re looking to celebrate this healthy fruit by incorporating avocado into your summer meal planning, you might be on the right track. Wait, did we say fruit? Yes, technically, an avocado is botanically classified as a fruit and not a vegetable, even though its savory qualities may suggest otherwise. It contains a large pit or seed in the middle, making it biologically similar to other fruit such as berries. “But nutritionally, we would classify it as a fat,” explained Laura Nance MA, RDN/LD, CDCES, a wellness dietitian with the Medical University of South Carolina’s Office of Health Promotion. “Most of the avocado – about 70% – is actually fat, with a little bit of carbohydrate and protein.” The good news, as Nance noted, is that avocado is a monounsaturated fat, a heart healthy fat that has been associated with a reduced risk of chronic disease, especially when used in place of saturated fats. A long-term research study published in the Journal of the American Heart Association has shown a link between substituting avocado for saturated fats such as butter or cheese and a decreased risk of cardiovascular disease. As a monounsaturated fat, avocado can lower LDL – the bad kind of cholesterol – and it may be favorable in improving your ratio of good – HDL – to bad cholesterol. Eating avocado as a replacement for saturated animal fats can also reduce the risk for type 2 diabetes. “A lot of heart health benefits with the monounsaturated fats,” asserted Nance, who is also certified in diabetes care and an education specialist. An ancillary benefit of avocado being a significant source of fat is that it makes you feel full, said Nance. “It’s one of those foods that you physically can’t really overdo. Not many people could eat several avocados in a day just because the fat content keeps you more satisfied, takes longer to digest. Fat does {take longer to digest} in general.” She added that avocado is a rich fiber source as well, with a healthy mix of soluble and insoluble fibers, which are good for your heart and gastrointestinal tract. A whole medium avocado actually contains around 10 grams of fiber, according to the Harvard School of Public Health. And lest you think bananas have a monopoly on potassium, eating just half an avocado provides as much potassium as a small banana, said Nance. They also feature vitamin C, vitamin E, vitamin K, B vitamins, folate and magnesium. Though not as robust as fish, avocados are a good plant-based source of the omega-3 essential fatty acids. Avocados have been ascribed the label of a so-called “superfood,” which Nance thinks is not necessarily untrue. She clarified, however, that there are hundreds of foods on the market that have been similarly characterized. “Super foods typically are plant-based foods packed with vitamins and minerals like antioxidants, fiber and potassium – very similar to the profile in avocados,” she said. “That’s why it would be dubbed a superfood if you were going to.” Nance emphasized that the important thing to remember is to get a variety of healthy foods in your diet with different nutritional profiles. For instance, blueberries are rich in antioxidants and olives, nuts and olive oil are other healthy fats conducive to heart health. FITTING AVOCADO INTO YOUR DIETARY REGIMEN So how often should we eat avocado? Nance said half to one avocado a day is “very reasonable as part of a healthy diet.” A medium avocado has about 240 calories, so, if you intend to incorporate it into your meal planning, Nance advised altering your regular daily intake accordingly. Once you’ve made room for it however, she stated that “there is no wrong way to eat an avocado,” although, she qualified, it does help to consider what foods you’re complementing it with. Nance gave her seal of approval to the millennial food trend of avocado toast, particularly if the avocado is paired with whole-grain bread. “You’ve got double the fiber there. It’s a great satisfying breakfast,” she said. Salad aficionados could mix in half an avocado to add even more green to their greens. Even little adjustments like using guacamole in place of queso with chips does your body the favor of swapping a saturated fat with a monounsaturated one. Substituting guacamole for sour cream on Taco Tuesday offers another way to make a small, positive change. “And that is a perfect example of replacing a saturated fat – which sour cream would be because it’s an animal fat – with a monounsaturated fat. It’s a wonderful trade-off,” stated Nance. Additional sources: American Heart Association - eating-two-servings-of-avocados-a-week-linked-to-lower-risk-of-cardiovascular-disease#:~:text=The%20analysis%20found%3A,never%20or%20rarely%20 ate%20avocados. Harvard School of Public Health,,fiber%2C%20and%2011%20milligrams%20sodium.

28 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com “I think laughter is everything. I need it like water, sun and sleep,” said Melissa Sanderson, 50, of Columbia. “I feel elated, stress-relieved, alive … and, if it’s really good, my cheeks are sore.” Chances are, many of your most joyous moments have involved laughter. Whether it’s howling with a group of friends after a bout of hilarity or snickering to yourself when you are amused, there’s something special about the feeling you get after a deep belly laugh that brings tears to your eyes. But did you know that laughter didn’t begin as a reaction to humor? Research suggests that laughter started as a survival tool in animals as a way to communicate that the group was safe from harm. Harrison Brookie agreed that laughter isn’t always about the joke. As founder and executive director of Greenville’s Alchemy Comedy Theater, Brookie has overseen more than 3,000 weekly improv, stand-up and sketch comedy shows at Coffee Underground since 2011. “Laughter is interesting in that it only happens in social animals like gorillas, dogs and humans. It’s the opposite of fear. When you laugh, you are letting others know that it’s safe – you can be yourself here,” he said, adding that it’s also about social connection. “There’s something inherently bonding about the hobby of comedy. Laughter connects us to each other.” And while there is no way to know if someone is actually laughing out loud when texting LOL, it would certainly benefit their health if they were. Certified laughter yoga instructor Linda Gillen has been helping people intentionally chuckle for eight years and said laughter improves your physical, emotional and mental well-being. BETTER HEALTH – By Amy Connor

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 29 “Just 10 to 15 minutes of laughter can provide measurable changes in the body,” she shared. “When you laugh, you breathe in more oxygen for your entire body and brain. It relaxes the muscles, lowers the stress hormone – cortisol – and stimulates your lymph nodes, which improves your immune system.” Gillen’s interest in laughter yoga was sparked after participating in a session at a conference and noticing the benefits. She remembers thinking, “Oh wow. I feel so much better.” Laughter yoga originated in India in 1995 and includes movement and breathing activities to promote intentional laughter. Participants laugh, sing, dance, clap and stomp. Both natural and intentional laughter produce the same positive mental and physical responses. That’s right. Your body can’t tell the difference. “When you laugh, whether it’s spontaneous or intentional, you still get the benefits. You get those endorphins which are like well-being neurotransmitters in your body. They are natural painkillers and stress fighters,” Gillen said. The increased intake of oxygen caused by laughter stimulates your organs and can even improve your cardiovascular A LAUGHING MATTER

30 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com LAUGHTER By the Numbers In 2011, the acronym LOL – laugh out loud – was recognized in the Oxford English Dictionary. Children laugh about 400 TIMES a day. Adults only laugh about 15 TIMES. About 15 MINUTES of laughter a day burns between 10 AND 40 CALORIES. In groups, women tend to LAUGH MORE than men. According to the 2022 Golden Book of World Records, the world record for the longest consistent laughter is 3 HOURS AND 47 MINUTES. health by increasing blood flow to the heart. Laughter also can immediately improve your mood by increasing the endorphins released by your brain. Long-term, it can decrease anxiety and depression and help regulate your body’s emotional response. “Even laughing for 30 seconds can make your body go ‘wow’ because you are releasing tension,” Gillen added. And we all know that laughter can be contagious. Just hearing someone laugh can make you start to chuckle – and your laughter will create more laughter. So what happens if you don’t laugh enough? It can negatively affect your immune system. “Studies have shown that people who don’t laugh have lower levels of oxytocin, a feel-good hormone. This is linked to stress, depression and anxiety, even cardiac stress and schizophrenia because your woes are absorbed into the body rather than being let go,” said Gillen. Indeed, there’s no question that laughter really is good medicine. But maybe laughter’s real superpower is simply that it’s fun. “In my 80 years, what makes me laugh is getting together with family or friends and recalling some of the silly things that happened in our past. To me, laughter is a kind of letting go. I think it is fun to laugh with others. And who doesn’t like fun?” shared Bob Connor of Meridian, Mississippi.

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