HealthLinks Charleston Nov/Dec 2022

COMPLIMENTARY CHARLESTON | DORCHESTER | BERKELEY NOV/DEC 2022 HIT THE ROAD, SPARE THE BODY BRAIN HEALTH: HOW TO PRESERVE YOUR MEMORY SPECIAL SENIOR HEALTH ISSUE CHAR L E S TON TRAVEL NURSE EXPLOSION SANTA’S LIST FOR PETS

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8 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com 17 | TIPS FOR PROTECTING MEMORY As people live longer, the drive to protect their fading memory rises. A fine-tuned memory is one of the most critical elements to keeping people of any age healthy. 20 | GIVING BETTERS YOUR HEALTH An ever-growing body of research suggests that volunteering also offers individual health benefits that reach beyond the conventionally recognized social and emotional advantages. 24 | HIT THE ROAD BUT SPARE YOUR BODY Long hours crammed into cars, planes and trains can make even the most fit body cranky. By following a few tips and tricks, travelers can curb the chances that crankiness will creep into their neck, hips, back and mood. 30 | GIFTS FOR NAUGHTY AND NICE PETS Santa is making his list and checking it twice to see which family pet has been naughty or nice. Pet experts and enthusiasts offer a list of top dog and cat toys that will make excellent holiday gifts. 62 | HEALTH INSURANCE HELP AND SURPRISES As residents roll through open enrollment, many are surprised to learn how much they can save on their health plans during the coming year. There are “assisters” in most counties ready to help people apply and enroll. 65 | WALKING HEROES HOME Honor Walks pay tribute to organ donors who give life to many others. Doctors, nurses, hospital staff and friends line the halls and cheer for the donors – a gesture that family members find both amazing and heartbreaking. 68 | THE PATH TO ORGAN DONATION Cathy Self was committed to her decision to donate a kidney to her good friend, but that didn’t keep her from frequently asking herself, “Do I really want to do this?” Ultimately, she did, and, through her path to donation, we learn. 72 | STATE HEALTH INDEX The state of South Carolina recently got a report on its overall health for 2021 – and, based on the findings, the state is only a breath away from hitting rock bottom. 74 | BYE BYE PATIENT PORTAL FEARS Though the benefits of patient portals like MyChart are many, challenges crop up, too. Help is only a phone call away. Issue 11.6 NOV/DEC 2022 CHARLESTON FEATURES

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 9 76 | LONELY BUT NOT ALONE It’s possible to feel lonely even when you are not alone. Patients describe loneliness as a feeling of not being “heard” or understood, even if they are surrounded by people. Experts offer help. 80 | TRAVEL NURSE EXPLOSION Many nurses in full-time staff positions in hospitals have been enticed to transition into travel nursing, drawn by higher pay and a flexible schedule that allows for more vacation time and self-care to cope with stress and anxiety. 92 | BON APPETIT As friends and family members roll into your homes this season, the HealthLinks team hopes you will enjoy some of our tasty holiday favorites. To health, happiness and the holidays – cheers! CONTENTS SPONSORED MEDICAL CONTENT When Care is Most Critical..........................................................35 Step Out of the Dark and Understand Insurance Options..........36 All the Pieces for Peace of Mind.................................................39 Skin Cancer: A Preventable Malignancy.....................................40 Accolades and Awards Roll In.....................................................43 Evolving Assisted Living in a Changing Charleston....................45 Replacing Pain, Not the Joint.....................................................47 A Community Caring and Carefree: Franke at Seaside..............49 When New Technology Comes to Assisted Living Communities....50 Lifting Loneliness for People Living with Dementia....................53 Comfort Keepers: Super Senior Care. ........................................54 Helping Seniors and Their Loved Ones Make Tough Decisions......55 Getting a Jump-Start: Long-Term Therapy for Fecal Incontinence. ...57 Be Heard by Your Hearing Care Providers..........................................58 Physical Therapy Before and After Surgery. .......................................59 DIRECTORIES Senior Health Care.............................. 94 BY THE NUMBERS Memory Loss, Disease and Aging. ..... 19 IN EVERY ISSUE Publisher’s Note.................................. 10 About the Cover................................. 11 Living Healthy Area Events................. 12 The Lighter Side of Health Care. ........ 28 There's an App for That...................... 70 CCMS – Value-Based Health Care...... 84 Charleston Area Nonprofits................ 86 A Unique Case.................................... 88 Healthy Pet: Happy Pet....................... 90 The Pulse on Charleston Nurses. ........ 96

10 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Issue 11.6 NOV/DEC 2022 Publisher CULLEN MURRAY-KEMP Publisher@HealthLinksMagazine.com Managing Editor LISA BRESLIN Assistant Editor MOLLY SHERMAN Copy Editor BRIAN SHERMAN Art Director KIM HALL -- Webmaster GEORGE CONKLIN Internet GENE PHAN Sales Manager MANDY WILLIS Mandy@HealthLinksMagazine.com Writers Media Consultants BRANDON CLARK Brandon@HealthLinksmagazine.com CRYSTAL WILSON-CHAMBERS Crystal@HealthLinksMagazine.com Photographer JENN CADY info@jenncady.com 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 • Publisher@HealthLinksMagazine.com CHARLESTON PUBLISHER'S NOTE JANET E. PERRIGO L.C. LEACH III COLIN MCCANDLESS LAURA HAIGHT LEAH RHYNE ISABEL ALVAREZ ARATA STACY DOMINGO THERESA STRATFORD LISA BRESLIN MOLLY SHERMAN BILL FARLEY DENISE K. JAMES AMY GESELL LISA WACK RILEY MATHEWS Scan to discover our other HealthLinks platforms! 2022 has been a strange year. Its peaks and valleys seem to have heightened and deepened, creating an entity not unlike Disney’s Expedition Everest rollercoaster – ask your kids. At the outset of the year, I was ready to take over South Carolina’s health care information and marketing space. Finally, I thought, after nearly a decade of business partnerships, I was cast free to set my own standards, motivate my own team and instantly reach the pinnacle of success. Then life happened. Our big sister/sales manager had a stroke, paper costs increased 100% and we realized our websites and administrators all needed to be HIPAA compliant. The once smooth, silky and serene waters had quickly turned into the lake that never gives up her dead when the skies of November turn gloomy – ask our copy editor. Here come the icebergs, bringing with them a new understanding – the fact that business is hard! Like a puzzle whose pieces have been misplaced – or eaten by your dog – there’s no completion to business. It just meanders continuously, offering short-lived gratification but no true destination. This is why I chose to consciously enjoy the journey. Sometimes it’s nice to realize that the folks who work at HealthLinks love the magazine and believe in our mission. I’ll sit at my desk and listen to the team banter about nothing important and just smile. Heck, I bet if you caught him at just the perfect moment, even our copy editor might even tell you he doesn’t hate HealthLinks. Joking, Brian: You are the best. What a team we have created! My point is that the people around me enthuse my journey. Like any family, we may bicker and fuss, but, at the end of the day, we are here for the team and for the mission, both of which are far grander than any of us as individuals. From our HealthLinks family, I find confidence and security, not just since we are doing a wonderful job disseminating vital health information to our community but because we each have one another’s back when things inevitably go awry. We celebrate victories and commiserate in our defeats. We sometimes walk forward, sometimes backward and often sideways, but we always walk together. As the holiday season rolls around and we all take a collective deep breath, I want to take this opportunity to raise a glass – of wheat grass juice, of course – to this wonderfully flexible, immensely talented and relentlessly resilient HealthLinks team. Thanks for helping me get through this weird, wacky year. In 2023, look for HealthLinks to put an emphasis on providing even better, more thorough health articles, interviews and information and to seeing this content in more places than ever. As always, thanks for reading HealthLinks and cheers to a happy, healthy holiday season. Cullen Murray-Kemp, Publisher Cul len Murray Kemp

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 11 ABOUT THE COVER... Ho ho ho and pass the potatoes. Tis the holiday season, and from our family to yours: Enjoy! This issue is a great one to tuck in your bag when you hit the road or the airport. It is packed with stories that will warm your heart and help your body feel less weary. You’ll discover ways to make travel less taxing. You’ll pick up tips – beyond word puzzles and exercise – for protecting the memory you have. Travel nurses talk about the growing trend to work in places far from home. And the HealthLinks team shares favorite holiday recipes. In this issue, we also shine a light on seniors and the people and resources that help them live their best lives. We hope you will enjoy each journey that these pages have to offer. It was an honor – and lots of fun – to bring this issue of HealthLinks to your homes and to your travel bags. To simple pleasures and good health, Lisa Breslin, Managing Editor NOV/DEC 2022 COMPLIMENTARY CHARLESTON | DORCHESTER | BERKELEY NOV/DEC 2022 HIT THE ROAD, SPARE THE BODY BRAIN HEALTH: HOW TO PRESERVE YOUR MEMORY SPECIAL SENIOR HEALTH ISSUE CHAR L E S TON TRAVEL NURSE EXPLOSION SANTA’S LIST FOR PETS 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 NOVEMBER 19 Holy Smokes Barbecue Festival with Hogs for the Cause Riverfront Park 1001 Everglades Drive North Charleston 11 a.m. Pit masters from across the country will converge on North Charleston’s Riverfront Park to raise awareness of children and families affected by pediatric brain cancer. Sample the wares of nationally renowned barbecue experts while helping to fund this important nonprofit. holysmokeschs.com NOVEMBER 20 Shuck Cancer of Charleston Bowen’s Island Restaurant 3 p.m. An oyster roast for a cause! Shuck Cancer of Charleston benefits the American Cancer Society and Charleston’s Hope Lodge, which provides support for patients and families affected by cancer. cancer.org. Tickets can be purchased at givesmart.com. NOVEMBER 19 Charleston Walk to End Colon Cancer James Island County Park 10:30 a.m. The Colorectal Cancer Alliance is working to end the silence and stigma of colon cancer. Raising awareness and donations, individuals and teams will walk the trails of James Island County Park or participate virtually from their own neighborhood. ccalliance.org/charlestonwalk

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 13 NOVEMBER 29 THRIVE: Sexual Health, Hormones and Body Image Roper St. Francis Healthcare Oncology 2085 Henry Tecklenburg Drive 1st Floor Boardroom Charleston 9:30 a.m. DECEMBER 2- 4 25th Annual Frontiers in Pediatrics Francis Marion Hotel Charleston Organized by MUSC’s Office of Continuing Medical Education, pediatricians will attend three days of presentations to review and discuss the latest in pediatric medicine. medicine.musc.edu/education/cme DECEMBER 3 STAR Therapy Dogs Reading Hour Bees Ferry Library, West Ashley 10:30 a.m. Studies show that reading out loud in a nonjudgmental setting helps develop confidence and reading skills. STAR therapy dogs are the perfect listeners, sitting and listening quietly as participants read aloud. Call 843-805-6892 for more information. A frank discussion on the disruptive consequences that some cancer treatments may have on intimacy, body image and sexual health. Presentations will help you learn how to navigate these issues, manage symptoms and return to a healthy sex life. callcenter.rsfh.com/WLP2/#!/classes/info/AKP004UG DECEMBER 5 Holiday Hoedown Wannamaker County Park North Charleston 6 p.m. An event for people and families with special needs, Mrs. Claus requests your presence at this Western-themed holiday celebration. Put on your cowboy hat and boots and giddyup to Wannamaker County Park’s Hoedown. ccprc.com/calendar NOVEMBER 24 Turkey Day Run Marion Square, Charleston 7 a.m. This popular, historic 5K fundraiser is over 100 years old! Take a 3.1 mile run through the streets of downtown Charleston. Proceeds are divided among charities that include the American Cancer Society, the Alzheimer's Association and the MUSC Children’s Hospital. turkeydayrun.com

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www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 17 MEMORY: THE BATTLE TO KEEP IT Einstein called it deceptive, Spanish artist Salvador Dali dedicated a painting to its persistence and U.S. writer William S. Burroughs once claimed that it kept people trapped within their own pasts. They were all speaking of the human memory, how it affects people’s outlook, perspective and their ability of recall. By L. C. Leach III

18 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com As the U.S. population keeps living longer, the human memory – and how to make it last past the age of 100 or longer – is not just a concern for seniors. It is one of the most critical elements to keeping people of any age mentally sharp and healthy. “Memory is our ability to gather, retain and retrieve information,” said Sara Perry, certified dementia practitioner and executive director of Respite Care Charleston. “While we’re not certain how it works exactly, several different parts of the brain are engaged in the process as we recall, recognize, recollect and re-learn information.” In that process are all kinds of memory that can be triggered or eliminated, gradually or swiftly. BIG, SMALL AND INEXPLICABLE Ask any hundred people who grew up in the 1940s where they were and what they were doing when they heard about the bombing of Pearl Harbor. Chances are that every one of them could remember. But ask any hundred people now what their current car insurance policy covers, and they are likely to respond with more shrugs than answers. Perry pointed out that while things like a personal insurance policy might seem more important for someone to remember, both short- and long-term memory are tied to its significance “and the amount of attention we give it.” “If you forget what you walked into the kitchen for, chances are you were distracted or not that focused on why you went there,” Perry said. “On the other hand, most people can remember exactly where they were and what they were doing when they learned of JFK’s assassination or the terrorist attacks on Sept. 11, 2001. Those were major events that had a tremendous impact on almost everyone alive at the time, so we paid more attention and are more likely to remember them.” And, of course, there is the inexplicable flyby, the memory long forgotten – like a casual comment 50 years ago from a grade-school classmate – that suddenly comes back. “Everyone forgets things, regardless of age,” Perry said. “And while occasional lapses of memory are normal as we grow older, significant memory loss and cognitive decline that impairs day-to-day life are not normal parts of aging and should be discussed with your doctor.” YOUNGER ALL THE TIME Aging itself is becoming a more relative factor in both memory loss and retention. Consider Peggy, a three-year resident of Mount Pleasant Gardens, an Alzheimer’s community that serves 64 residents. Every day, Peggy exercises, listens to music and figures out puzzles – the same things she when she was 20 or 30. “But age has a tendency to change you,” she said. When it does, the battle for memory begins. “Short-term memory in our residents is the first memory to go,” said Denise Kish, executive director of Mount Pleasant Gardens. “Our residents have a mixture of long-term memory and some short-term. And we try to keep the short-term going by doing consistent events each day.” But Kish, Perry and Charleston senior consultant Diane Sancho all pointed out that memory loss and disease are not exclusive to seniors. “Though less common, younger adults can have dementia, too,” Perry said. “Respite Care Charleston has served many people in the community who began showing signs of memory loss in their 40s, several of whom had late-stage dementia or succumbed to the disease in their early 50s.” Sancho, executive director of Alice’s Clubhouse Memory Care Day Center, who has worked with senior-living communities for more than 20 years, said people needing help from early-stage memory loss “are much younger now.” “We have had nurses, artists, contractors, mayors, lawyers, corporals, an anesthesiologist and a university professor who taught six languages, to name just a few,” said Sancho. “Very few have prior brain injuries, and the majority of our newest members are in their late 60s and mid-70s – far younger now than when I started. Wish I knew the answer to why.” REDUCING RISK Because of the innumerable, subtle differences between each individual brain, finding an answer, or perhaps many answers, is nearly as complex as the brain itself. Dr. Mendell Rimer, professor at the Texas A&M University College of Medicine, reported in 2018 that synapses, which serve to connect the brain to the rest of our body – are not only “essential for life” but that memory may also involve the creation of new synapses. “Synapses underlie our memory formation and learning,” Dr. Rimer said. “In dementia, synapse loss or weakening would therefore lead to decreased learning ability, memory loss and memory disorders.” While there is no cure for Alzheimer’s or other forms of dementia, both Sancho and Perry said their members and patients intend to keep every part of their memory in every way possible – regardless of their individual condition or treatment. “Our members at Alice’s Clubhouse are in early-to-mid-stage dementia, and the day center is a place they look forward to joining,” Sancho said. Perry added that while her Respite Care patients walk, play chess, take Spanish lessons, eat the right foods and read books to keep their memory fresh and vibrant, it’s still a gamble. “If I had it all to do over again, I don't know what I’d do differently, because I don't know what caused my dementia,” said Fred, a patient at Respite Care Charleston. “You can still get it even if you do everything right."

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 19 TIPS TO GUARD AGAINST MEMORY LOSS While there is currently no foolproof way to guard against cognitive memory loss, Alzheimer’s and other forms of dementia, there are many simple ways to improve your chances of keeping these illnesses away – and your memory intact. “Food, for instance, is a huge contributor to keeping or losing our memory,” said Nita Leary, an integrative nutrition health coach in Greenville. “The right foods keep our brains as healthy as possible, and I recommend foods that are free of chemical pesticides.” Both Leary and Sara Perry, executive director with Respite Care Charleston, advise a diet rich in fruits and vegetables, lowfat proteins, limited sugar and minimal processed foods. Complementing this diet are eight healthy habits: “I’ve noticed in the past decade that younger people are beginning to become more concerned about what they eat – whereas kids born in the 1990s and before weren’t as aware,” Leary said. Perry added that while there is still no guarantee against memory loss, a healthy lifestyle can greatly reduce the risk. “The risk of dementia increases as we grow older,” she said. “But credible research has consistently pointed to some basic actions we should all take to keep our brain healthy and memory intact.” MEMORY LOSS, DISEASE AND AGING By the Numbers More than 55 MILLION people live with dementia worldwide. There are nearly 10 million new cases every year. – World Health Organization There are more than 54.1 MILLION seniors in the United States. Older adults are projected to outnumber children by 2034 for the first time in U.S. history. – U.S. Census Bureau More than 6 MILLION Americans of all ages suffer from Alzheimer’s.Barring the development of a cure or a medical breakthrough to prevent or slow the disease, this number is projected to grow to 12.7 MILLION by the year 2050 . – Alzheimer’s Association 7 COMMON CAUSES OF MEMORY LOSS • Medications • Minor head trauma or injury • Emotional disorders, such as stress, anxiety or depression • Alcoholism • Vitamin B12 deficiency • Brain tumors or infections • Sleep apnea – Mayo Clinic • Get plenty of sleep; • Don’t smoke; • Drink in moderation; • Stay mentally active; • Socialize and avoid isolation; • Minimize stress; • Exercise regularly as recommended by your doctor, based on your medical situation; • Manage chronic conditions like diabetes, high blood pressure and depression.

20 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com “There is definitely a connection between service and better physical and mental health. I know it is happening, but it is hard to articulate what ‘it’ is,” said Mark Rentfrow, a physical therapist for the past seven years at Alice’s Clubhouse Memory Care Day Center in Mount Pleasant. Results of a study published in BMC Public Health, a peer-reviewed journal that publishes articles on the epidemiology of disease and the understanding of all aspects of public health, demonstrates that “other-oriented” volunteering has significantly stronger effects on mental and physical health, life satisfaction and social well-being when compared to self-oriented volunteering. Other-oriented volunteering has altruistic features and demonstrates concern and care for other’s needs, such as health care or education work, the study reveals. In self-oriented volunteering, the volunteer’s motivation is defined by the desire to develop social networks, acquire skills or evade personal problems. SERVICE SERVES THE BODY People often decide to volunteer to make a difference and improve lives other than their own – and an ever-growing body of research suggests that volunteering offers health benefits that reach beyond the conventionally recognized social and emotional advantages. By Molly Sherman

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 21 These findings suggest that the benefits of volunteering are greater when done for the sake of others and not with the expectation of compensation; however, that does not mean there is no “pay.” “I get a lot of what I like to call psychic income out of working with our participants, particularly a big smile, laughing, cheering,” said Rick Blinn in Respite Care Charleston’s Volunteer Spotlight. “Any kind of indication that they are really enjoying what’s going on gives me a whole lot of enjoyment.” Individuals who volunteer may experience a lower rate of mortality than those who do not, even when considering physical health, according to an analysis of data from the Longitudinal Study of Aging. This correlation demonstrates a connection between wellness and volunteering. “As corny as it sounds, our work is driven by love – plain and simple,” said Sara Perry of Respite Care Charleston. “It's incredibly rewarding work, and life doesn't get much better than that.” Diane Sancho, MSW, executive director of Alice’s Clubhouse, has seen firsthand the positive effects of service among “givers” with dementia. “We have learned that people who were givers in their lives want to keep giving even as their minds fade,” Sancho explained. “When they can give, or when they receive kindness, there are positive effects on their well-being every day.” Sancho recalled a previous mayor who, despite her dementia, continued to advocate for women’s rights – as she had done most of her life – into her mid 80s. The continued advocacy activated her mind. A retired anesthesiologist who was used to putting people at ease continues to put Alice’s Clubhouse members at ease with his words, and a gentleman’s piano playing improves as he plays for others.

22 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com “His music is magic to everyone, and he feels good giving back,” Sancho said. The observations of Sancho and others continue to be reflected in studies of patients experiencing health conditions and hoping to prevent health complications. In a study by the American Society of Pain Management Nurses, individuals suffering from chronic pain experienced a decline in pain intensity, levels of disability and depression when they served as peer volunteers for others in chronic pain. Narrative data notes that a feeling of connection and sense of purpose emerged. As for disease prevention, findings suggest volunteerism may be an effective, non-pharmacological intervention for hypertension, a risk factor for cardiovascular disease, stroke and mortality. A Carnegie Mellon University study confirmed that of 1,654 participants between the ages of 51 and 91, those who had volunteered 200 hours or more in a year were 40% less likely to develop hypertension than nonvolunteers. Extending this observation on volunteering and heart health, an analysis by AmeriCorps using health and volunteering data from the U.S. Census Bureau and the Centers for Disease Control and Prevention confirmed that “states with higher volunteer rates are more likely to have lower rates of mortality and less incidence of heart disease.” In South Carolina, 30.8% of residents volunteer, which is 32nd among the 50 states. The death rate for heart disease in 2020 was 31st. “For some, it’s a way of giving back to an organization that served someone they loved. For others, volunteering is a way of ‘paying it forward,’” Perry said. “Whether the kindness manifests by pulling out a chair for someone or helping them when they walk, the social aspect makes a huge difference with regard to their health and mental status,” Sancho added. “We have learned that people who were givers in their lives want to keep giving even as their minds fade,” Sancho explained. “When they can give, or when they receive kindness, there are positive effects on their well-being every day.”

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24 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com HIT THE ROAD; SPARE YOUR BODY Contributing writers: Lisa Wack, Molly Sherman and Lisa Breslin.

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 25 Long hours crammed into cars, planes and trains can make even the most fit body cranky. Following a few tips and tricks can curb the chances that crankiness will creep into your neck, hips, back and mood.

26 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com TIPS FROM A FREQUENT FLYER Charleston resident Joni Nickoley, 57, is no stranger to long-distance travel. For more that 10 years, her job with a global chemical company has included frequent 10- to 14-hour trips to the Asian Pacific and beyond. • “I stay hydrated and I stretch before, during and after each trip,” Nickoley said. “When I can, I walk up and down the aisle during flights. For hydration, I carry a small hydro flask in my backpack and refill it. I also avoid soda because it causes inflammation.” • “The bags you carry matter, too,” she added. “I used to take a computer bag that hung over one shoulder. It’s better to use a backpack to distribute the weight.” TIPS FROM A DOCTOR Dr. Andrew McMarlin is board-certified in sports medicine and brings 25 years of elite athlete experience to his patients at Winning Health in Mount Pleasant. • “Make the driving part of the trip more of an enjoyable experience rather than an ordeal,” said Dr. McMarlin. “It’s easy to say, ‘Stop every two hours to stretch your back and legs,’ but when you’re on the highway, you just don’t do that unless you have it planned out already.” • “Look at a map before you go and pick some interesting spots: a scenic overlook, the World’s Largest Ball of String,” Dr. McMarlin added. “You may not want to stop to go to the bathroom, but that actually ensures you are stopping and stretching, too.” • “Having said that, you don’t have to go to the bathroom nonstop, which happens if you drink plain water,” McMarlin said. “Hydrate with fluid electrolytes such as coconut water with a little bit of juice and Natural Calm magnesium water.” • And finally, “Make sure to take care of your back. If you are not lucky enough to have one of the newer cars that has amazing lumbar support, your low-to-mid back needs stretching and added support,” he added. TIPS FROM A MOBILE MASSAGE THERAPIST Lakeisha Peay, LMT, the owner of Divine Mobile Massage, has brought relief to residents in the Greenville and Charleston areas for several years. Clients seek relief for neck, shoulder and back pains, especially after long road trips. Peay tends to offer Swedish and deep tissue massages to ease all the crankiness. Clients have also found relief when she uses hot towels or hot stones. Peay sometimes travels eight hours a day to meet her clients. As a result, she practices the following tips that she preaches: • Use a heating pad when you drive or fly. • Allow yourself to stop and get snacks at the gas station; you are stretching and hopefully getting more water to hydrate. • Do stretches that include shoulder rotations and bends to touch your toes. “I can tell the difference if I skip any of these tips,” Peay said. “My body lets me know – trust me.”

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28 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com While I “pondered weak and weary” by the flickering light of … a Bic disposable I was using to light a postprandial cheroot – Relax: I was alone and outdoors – I asked myself when we’d know that the COVID pandemic was over. The answer came back “Nevermore!” An appropriate response in a Lowcountry that honors the poet Poe. And that, of course, is true. Like the seasonal flu, COVID is nothing more or less than a virus. It’s not going to be wiped out, in large part because it’s constantly changing. Newer vaccines will emerge, sometimes actually preventing infection and almost always ameliorating COVID’s symptoms. But there’ll be no raising Old Glory atop Mount Suribachi at Iwo Jima or Churchillian display of the “V for Victory” salute. The best we can hope for is that, like an Atlantic hurricane being downgraded to a tropical storm, COVID will be labeled first an “epidemic” and finally just a seasonal annoyance. And that’s all good. No one asks for your “vaccine passport” anymore and even most doctors’ offices – including my own – no longer require either patients or practitioners to wear masks. Folks doing their grocery shopping with N95s plus plastic shields or wrapping their heads in bandanas or T-shirts or whatever else they could cobble together to fend of the “bug” seem like distant, quaint memories. And the once omnipresent hand sanitizing stations lie idle. Of course, that’s not stopping the conversation about COVID. Not by a long shot. Recently, your faithful disciple of Asclepius attended a cocktail party – a soiree, if you will. There, he was chatting about world affairs with a former State Department envoy when a woman of a certain age broke into our confab demanding to know where she could find free COVID tests. Within our small gathering, the answers were varied. One man offered, “You can get ’em at your pharmacy.” Another demurred, “But those aren’t free. You have to buy them.” A third gentleman suggested, “You can go to a government website and order them. I don’t know how many you can get at one time. Those are definitely free to you, but, somewhere, somebody’s paying for them!” “The American taxpayer!” added a second woman grumpily, as if none of the rest of us shared her taxpaying burden. A kibitzer plunked his Martini down at our table confrontationally: “What the hell do you want COVID tests for now? If you get sick, you’re positive. If you don’t, you’re negative. Or do you just get a kick out of testing yourself?” I could sense that the COVID conversation might be taking a nasty turn, so I begged to be excused and busied myself with the hors d’oeuvres selection. I’ve always believed that it’s counterproductive to overreact to any health threat, no matter how ominous or how many protections against it are recommended. Now, if I could just figure out what to do with that gallon jug of aloe vera and bottle of grain alcohol I stashed two years ago when I thought that all the hand sanitizers would run out, and I’d have to cobble together my own. I’ll never have enough sunburns to use up all that aloe vera. Of course, if a COVID upsurge ever traps me in my humble home again, that fifth of alcohol could come in handy! THE END OF THE PANDEMIC? The Lighter Side of Health Care By Dr. Duke

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30 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Santa is making his list and checking it twice to see which family pet has been naughty or nice. As pets make it to Santa’s list and family members shop for them, they should keep this goal in mind: gifts, especially toys, should be species-appropriate, appeal to the pet’s natural instincts and provide enrichment that safely engages the pet mentally and physically. After consulting local pet experts and enthusiasts, HealthLinks compiled a list of top dog and cat toys GIVE NAUGHTY AND NICE PETS

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 31 that will make excellent holiday gifts. Satisfying their natural desire to hunt is central to cat and dog play. It’s essential to buy species-appropriate gifts for pets because cats and dogs have different needs, drives and behaviors. In addition, toys designed for humans or a particular pet may pose a choking or poisoning hazard when shared with the wrong species. Regardless, supervision is key to ensuring a pet is interacting safely with a new toy. GREAT GIFTS By Isabel Alvarz Arata

32 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com TOYS FOR DOGS Kailey Chisolm from Hollywood Feed in West Ashley recommends Patchwork Pet’s Gingerbread House and Men plush toy for an interactive holiday-themed gift. “The dog has to root around to get the squeaky gingerbread men out of the house,” she said. “The house can also be stuffed with treats and kibble to keep the dog sniffing.” Cathy Bennett of Groovy Goldendoodles and the therapy animal program coordinator at MUSC, is a fan of dog-friendly tennis balls. “Plain and simple, they're easy to carry, rinse and dry quickly from drool, beach sand or mud, and are reasonably priced,” she asserted. Those looking for an interesting take on tennis balls might enjoy The Petstages Grunt 'N Punt Tennis Ball, which keeps dogs engaged by making a grunting sound. Outward Hound’s Orbee-Tuff Soccer Ball Treat-Dispensing Dog Chew Toy is another great way to keep dogs entertained as they push the ball around to get their treats. The toy can be safely used inside and outdoors, in the water or on land. TOYS FOR CATS Kimberly Layman, founder of Kimberly’s Kritter Care in North Charleston, recommended the Cat Catcher by Go Cat. “It’s just a small mouse on a wire with a wand, but every cat I’ve used it with absolutely loves it, “she said. “I especially like to use wands before mealtime so the cat can “hunt” for its food,” she explained. Charleston cat groomer Whitney Bullock loves Zanies Fur Mice by PetEdge. “My three cats still love those tiny, furry mice that they have on the counters at pet stores. They are about 2 inches long, covered in fake fur and are usually displayed inside a big cardboard box that looks like a wedge of cheese. They make great stocking stuffers.” For busy families, South Carolina-based cat expert and behavior consultant Rita Reimers of the Cat Behavior Alliance recommends a USB-charged mouse. “It’s activated by the cat’s touch, has a feather attachment and it’s oblong, so it wobbles, making the feather jerk around like real prey,” she explained.

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34 | 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.

www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com | 35 Critical care is not something you look forward to, but, in Charleston County, it is always near if a life-threatening need comes your way. Vibra Hospital, located in the center of Mount Pleasant, cares for patients with complex medical issues requiring a longer stay in a hospital setting to recover. “Our patients have very complex medical needs and often have been in an intensive care unit suffering from a critical illness,” said Salvatore Aquilina, chief marketing officer with Vibra Hospital. “At Vibra, we will treat the acute illness and existing chronic illnesses to help patients recover.” Hospitalist service, pulmonology medicine, nephrology, infectious disease medicine, surgical coverage and wound care specialists all are on-site. “Our respiratory care team works closely with physicians, nursing staff and our full rehabilitation department to promote healing from complex issues, wean them from ventilators and make their overall recovery as seamless as possible," Aquilina said. “In addition, we are able to provide in-house dialysis for patients with acute kidney injury or chronic kidney failure.” An average stay can be a few weeks at Vibra. During that time, patients receive the necessary medical treatment but also begin rehabilitation if possible. “Rehabilitation becomes a larger part of recovery as the patient progresses,” Aquilina said. “This level of care promotes healing using an interdisciplinary approach to care, maximizes the patient’s potential and is designed to prevent re-admissions to acute-care facilities.” The COVID pandemic of 2020 and 2021 brought new challenges to Vibra, but, because the hospital was set up for critical care, many procedures continued without interruption. The respiratory team, for instance, which now supplies Vibra’s No. 1 medical care service, successfully weaned 82% of its patients off ventilators and intubated 24 others for mechanical ventilation. Everyone wants to get well as quickly as they can, but short recoveries aren’t always possible. “Not every patient can recover in a few days or even a few weeks,” Aquilina said. “Critical care hospitals like Vibra offer a transitional step for patients who require a high level of care for an extended time and transition to lower levels of care to complete their healing journey.” Vibra Hospital can handle other medical needs, including: • Advanced nutrition support; • Radiology, pharmacy and laboratory services. • Medical device, medication and pain management services; • Specialty treatment programs; • Family and caregiver education and support services. Since its founding in 2004, Vibra Healthcare has been helping Americans at 30 hospitals in 13 states. And since the Pandemic, Vibra Hospital employees have gone many necessary extra miles to help patients recover. “Our level of care has evolved with the growing needs of patients,” Aquilina said. “Although we remain focused on caring for the most complex of respiratory patients – those who require ventilator management and weaning – at Vibra, we also care for a wide range of medically complex patients, with a wide variety of needs that are met by a highly-trained and caring clinical staff.” WHEN CARE IS MOST CRITICAL For more information, visit vibrahealthcare.com or call 717-591-5700. By L. C. Leach III SPONSORED MEDICAL CONTENT

36 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Founded in 2005 by Guy Furay, The Insurance Source is so dedicated to streamlining the health insurance buying process that it trademarked the tagline “we make health insurance easier” and built a website that makes shopping for insurance as simple as booking a flight. “Between government bureaucracy and massive insurance companies, said Furay, “most Americans have a hard time understanding their options.” Shopping for health insurance can feel like navigating a dark path in the forest, he explained. People often feel confused – even lost. The goal at The Insurance Source is to shine a bright light that allows clients to see where each path leads. Once they understand the path that is right for them, they can confidently take the next steps. Since the signing of the Affordable Care Act, those who are self-employed, work for companies that don’t offer benefits or are otherwise ineligible for private insurance coverage can shop for health insurance through the government’s dedicated health care website, healthcare.gov. Unfortunately, Furay worries that the website was not designed with the user’s experience in mind. He finds that most of the clients who attempt to use the government’s site end up with more questions than answers. Because health care plans can be complex and must be the right fit for the plan holder, The Insurance Source’s website uses a systematic approach that interfaces with federal programs, considers doctor and hospital preferences and prioritizes clients’ goals and values. One of the most difficult health insurance processes to navigate is Medicare coverage for those over 65. Furay sees it all the time: A client comes in asking about a plan that a friend has been boasting about. On the surface, the plan appears to tick all the boxes. Upon closer inspection, however, the experts at The Insurance Source can determine if what works for one senior will work for another. As a result of extensive marketing done by insurance companies during the annual enrollment period, seniors often become interested in plans that could end up costing them thousands in out-of-pocket and prescription drug costs. Additionally, because some Medicare decisions cannot be undone and impact enrollees’ ability to obtain different coverage down the line, Furay is adamant that those who are new to Medicare speak with one of his representatives. The long-range impact of Medicare decisions can result in unforeseen circumstances. Choosing one type of Medicare product known as a Medicare Advantage plan may have a significant disadvantage. If someone develops health problems and wants to buy the most robust supplement available to minimize costs, they may be unable to do so. They may not qualify for that Cadillac coverage when they need it most because of a previous decision, Furay explained. “Nobody plans on getting sick,” he said, “but we help our clients prepare for the what-ifs of cancer, stroke, heart attacks and other unforeseen illnesses by leading them to the best plan for themselves and their families. One size doesn’t fit all. We’re here to help each person choose the plan that fits them.” SPONSORED MEDICAL CONTENT STEP OUT OF THE DARK AND UNDERSTAND INSURANCE OPTIONS By Isabel Alvarez Arata We help our clients prepare for the what-ifs of cancer, stroke, heart attacks and other unforeseen illnesses by leading them to the best plan for themselves and their families. “ “ To learn more about The Insurance Source, visit insure-u.com or call 864-467-8731.

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