Beaufort Memorial Hospital Living Well- Winter 2013

1. BournetoBourneto QuitQuit toAfter 17 years of puffing, MATT DAMON embraced a new smoke-free identity LEARN TO STAY HEALTHY WITH DIABETES page 56 Keep Senior Moments to a Minimum DIETARY SUPPLEMENTS: DO YOU REALLY NEED THEM? BMH Offers Advanced Technique for Prostate Cancer Surgery WINTER 2013

2. The spa-like atmosphere, cotton gowns and soft Mammo- Pads make your visit comfortable and less stressful. Onsite radiologists review images while you wait so that you can leave knowing your results. Board-certified surgeons are onsite to provide same-day consultations, enabling you to go from screening to diagnosis in one place, in one visit, for your added convenience. Breast Care Coordinators are available to guide your care, offering information and support every step of the way. Why do more women choose the Beaufort Memorial Womens Imaging Center? Beaufort Memorials Womens Imaging Center was designed to address womens breast health issues, from screening to diagnosis on your time schedule, and in the comfort of a relaxing, serene environment. OUR SERVICES INCLUDE SCreenIng MaMMograMS ________________________________________ DIagnoStIC MaMMograMS________________________________________ BreaSt ultraSounD________________________________________ StereotaCtIC BreaSt BIopSy________________________________________ Dexa Bone SCanS________________________________________ ultraSounD BreaSt BIopSy SaMe-Day reSultS Spa-lIke SettIng CoorDInateD Care Take a sTep fOr YOUr healTh TOdaY. Call 843-522-5015 TO sChedUle YOUr annUal mammOgram. Beaufort Medical Plaza, 989 riBaut road, Suite 110 Beaufort, Sc 29902 BlufftoN Medical SerViceS, 11 arleY WaY, Suite 102 BlufftoN, Sc 29910

3. CONTENTS COVERPHOTOBYARMANDOGALLO 52 DEPARTMENTS 2 Opening Thoughts Working together, we can help ourselves and our community to live well. 46 Virtual Health Supportive apps, one supersmart heart chart and the worlds most clever piece of cutlery. 54 Out of the White Coat A window into the lives of our doctors ... out of the white coat. 56 Healthy Insights Diabetes Educator Kathy Phillips helps patients manage their disease. FEATURES 3 Advanced Care for Prostate Cancer Learn about the advantages of a robot-assisted prostatectomy through a Q&A with BMH urologist Michael Staley, MD. 4 Staying Sharp Here are seven tips to improve your brain health. 6 Body Boosters? Dietary supplements may not be all theyre cracked up to be. 10 Got Excuses? Skipping your screenings may be putting your health in danger. Stop with the excuses and put on that gown. 14 Managing Your Health with a DIY Tool Kit Apps and gizmos that can help control diabetes and heart disease. 18 Is It the Stress Talking? From heartburn to breakouts, heres how anxiety may be playing fast and loose with your health. 20 The Wonderful World of Greens Green vegetables can strengthen bones, sharpen your vision, even prevent birth defects. Eat up. 25 Knee-to-Know Basics This joint keeps you jumpingand walking, climbing and moving. Lets see how it operates. 34 Run for Your Life With a cancer diagnosis, exercising may be the last thing on your agenda. Heres why to reconsider. 38 14 Good-for-You Gifts These holiday presents will make everyone on your gift list feel better inside and out. 42 Special Delivery And you thought choosing your babys name was tough. Here are three other important birth decisions. 49 A Ball Is Born BMH celebrates 25 years of the Valentine Ball. ON THE COVER After 17 years of a daily pack-and-a-half habit, it was love that persuaded one of Hollywoods true nice guys to put down the cigarettes. For inspiration, advice and a boy-meets-girl romance, see how Matt Damon quit smokingand how you can tackle it yourself. 28 SPECIAL Getting the Best of Breast Cancer A cancer survivor tells her story. WINTER 2013 1

4. A s you read through this edition of Living Well I challenge you to think about what it really means to live well, and to ask yourself if there is more that you could and should be doing. Then decide what it will take to get you where you need to be. Our mission in offering this community magazine is to provide useful information that helps you and your family to take positive steps to improve and enjoy your health. That is why youll frequently notice local options for, say, quitting smoking, managing an existing chronic disease or becoming more physically t. Many of these services are offered right here at Beaufort Memorial. So, whats stopping you? WHAT IS THE FUTURE OF HEALTHCARE? The only thing certain about healthcare these days is change, and we still dont fully know or understand what that change will look like here or across the nation. That doesnt mean there arent things we can do now to fulll our mission to provide superior healthcare services and to improve the health of the community. And boy, have we been busy! This fall we opened a new internal medicine ofce on Ladys Island in Beaufort and added a board-certied internist, Dr. Robert Vyge (read more on page 55); recruited a new, board-certied urologist who has performed hundreds of robot- assisted minimally invasive prostate surgeries (read more on page 3); and, opened a comprehensive Joint Replacement Center with our leading orthopedic surgeons (read about one on page 54), rehab specialists and many others, working together to make it the top choice for orthopedic care in the region. Weve also recruited several new OB/GYNs who soon will be opening a practice in Beaufort, and were beginning work to expand and renovate our Intensive Care Unit (ICU), an effort that is being funded in part by community donations to the BMH Foundation. We know we cant rest on our laurels and ignore opportunities to recruit the best and the brightest physicians, develop needed services for the community, and stay on the cutting edge of medicine. And, we know we cant do these things alone. HOW CAN YOU HELP? As the only not-for-prot hospital in the region, we reinvest our revenues in our services, equipment and facilities. By supporting the BMH Foundation, you can do the same. The Foundation has begun selling tickets to the 25th annual Valentine Ball to benet the ICU expansion. By attending or making a donation, you will be working right beside us to fulll our mission and help the entire community live well. Rick Toomey President & CEO Working Together, We Can Help Ourselves and Our Community to Live Well OPENING THOUGHTS BEAUFORT MEMORIAL HOSPITAL President & CEO Richard K. Toomey, DHA, FACHE The BMH Board of Trustees Gerald Jerry Schulze, Chair Terry Murray, Vice Chair David Tedder, Secretary/Treasurer Andrea Allen, MS, LMSW Kathleen Cooper David House Terry Murray Faith Polkey, MD James Simmons, MD Patricia Thompson, MD Ex-officio members J. Chadwick Tober, MD, Chief of Staff Bill Nettles, Chairman, BMH Foundation Bill McBride, Beaufort County Council representative BMH Editorial Courtney McDermott, Director, Marketing & Communications PRODUCTION Editorial Editor-in-Chief: Sally Kilbridge Editors: Erin Feeney, Matt Morgan, Ellen Olson, Tom Weede Copy Editor: C.J. Hutchinson Design Chief Art Director: Pamela Norman Art Directors: Andrea Heser, Rod Karmenzind, Kay Morrow Production Senior Production Manager: Laura Marlowe Special Projects Coordinator: Jenny Babich Imaging Specialist: Dane Nordine Production Technology Specialists: Julie Chan, Sonia Fitzgerald Circulation VP/Business Intelligence Group: Patrick Kehoe Postal Affairs & Logistics Director: Joseph Abeyta CLIENT SERVICES Chief Client Officer: Beth Tomkiw VP/Client Services & Strategy: Paul Peterson Account Managers: Carey Ballard, Lauren Keeton, Gerry Kubek, Kirsten Markson, Barbara Mohr, Ryan Smeets ADMINISTRATION Vim & Vigor Founder: J. Barry Johnson Chairman Emeritus: Preston V. McMurry Jr. Chief Executive Officer: Matthew J. Petersen Chief Operating Officer: Fred Petrovsky Executive VP/Sales: Chad Rose, 888-626-8779 VP/Content: Jeff Ficker Creative Director: Marc Oxborrow Beaufort Memorial Hospital 955 Ribaut Road Beaufort, SC 29902 843-522-5200 843-522-5585 Doctor Referral Service Living Well, a subtitle of Vim & Vigor,TM Winter 2013, Volume 29, Number 4, is published quarterly by McMurry/TMG, LLC, 1010 E. Missouri Ave., Phoenix, AZ 85014, 602-395-5850. Vim & VigorTM is published for the purpose of dis- seminating health-related information for the well-being of the general public and its subscribers. The information contained in Vim & VigorTM is not intended for the purpose of diagnosing or prescribing. Please consult your physician before undertaking any form of medical treatment and/or adopting any exercise program or dietary guidelines. Vim & VigorTM does not accept adver- tising promoting the consumption of alcohol or tobacco. Copyright 2013 by McMurry/TMG, LLC. All rights reserved. Subscriptions in U.S.: $4 for one year (4 issues). Single copies: $2.95. For subscriptions and address changes, write: Circulation Manager, Vim & Vigor,TM 1010 E. Missouri Ave., Phoenix, AZ 85014. 2 WINTER 2013

5. Q Is surgery a better alternative than watchful waiting for treating prostate cancer? A Closely monitoring a patients condition can be appro- priate in some cases. But surgery has been shown to offer the best long-term results. Depending on the type of cancer and your overall health and preferences, your doctor may recommend other options, including radiation or cryotherapy. Q Does surgery offer any other benefits? A Yes. A radical prostatectomy, which involves the removal of the prostate gland and some surrounding tis- sue, will allow your doctor to more precisely determine the stage of the cancer based on a pathological specimen. The success of the surgery also can be determined just a few weeks after the procedure with a simple blood test. Q What are the advantages of a da Vinci Si robot- assisted prostatectomy? A Because the procedure can be performed through several small incisions in the abdomen, there is significantly less blood loss and postoperative pain. Patients are dis- charged from the hospital just one day after surgery and will need a catheter for one week. In comparison, open surgery involves a two- to three-day hospital stay and two to three weeks with a catheter. Q Why do you need to use a robot to perform the laparoscopic surgery? A Robotic technology, like the da Vinci Si, provides high-definition visualization in three dimensions and magnification. Its instrumentation is more functional than traditional laparoscopy instruments. Thus the robot can allow us to use laparoscopy in cases that would be very difficult to perform laparoscopically without it. Q Should I have an annual PSA test? A Yes! Although the U.S. Preventive Services Task Force decided last year not to recommend regular prostate- specific antigen screenings, most urologists disagree with the decision. Prostate cancer is the second leading cause of cancer deaths in men. The PSA test is a simple, inexpensive blood test that can alert us to a potential problem. Men between the ages of 55 and 69 should have the screening every year. BMH urologist Michael Staley, MD, discusses the advantages of a da Vinci Si robot-assisted prostatectomy. The minimally invasive surgery offers a faster, easier recovery with less pain AdvAnced cAre for ProstAte cAncer Meet Dr. Staley A board-certified urologist, Michael Staley, MD, joined Coastal Carolina Urology Group this summer after practicing for 13 years in Asheville, N.C. Staley grew up in Columbia, S.C., and earned an MBA at Georgia State University before starting med school at the Medical University of South Carolina in Charleston. After graduating in 1994, he interned at Medical Center Hospital in Burlington, Vt., and returned to MUSC for his surgery and urology residencies. He had the distinction of serving as chief resident in his final year. During his years practicing medicine in Asheville, Staley treated a significant number of patients who had kidney stones and various urologic cancers. He is the only BMH urologist trained to perform robot-assisted prostatectomies. The married father of two and his family have been vacationing on Fripp Island for years. Weve always had the desire to move back to the Lowcountry, Staley says. Working at Beaufort Memorial Hospital has afforded us that opportunity. CALL Schedule a Visit Michael Staley, MD, sees patients at Coastal Carolina Urology Group in Beaufort and at Beaufort Memorial Bluffton Medical Services in Westbury Park, Bluffton. To make an appointment, call 843-524-7607. To learn more about Beaufort Memorials minimally invasive surgery program, visit www.bmhsc.org. 3WINTER 2013

6. I t happens to all of us. You walk into a room and forget what you went in there to do. You mis- place your cellphone and have to call yourself to nd it. You run into an old friend and draw a blank on her name. Frustrating as those little lapses are, theyre not uncommon, especially as we age. Like our bodies, our brains undergo physiological changes, and these can slow down our mental processes. But its not a lost cause. Theres plenty you can do to stay sharp and delay the effects of aging. The same things you do to reduce your risk of heart disease and stroke also help reduce your risk of dementia, says Beaufort Memorial Hospital neurologist Paul Mazzeo, MD. A good diet, regular exercise and keeping stress in check have been shown to be benecial in reducing the risk of developing Alzheimers, the most common form of dementia. Researchers have found its possible to prevent or delay the symptoms of Alzheimers and other dementia through a combination of healthful habits. 1. GET MOVING Studies have shown physical exercise reduces the risk of developing dementia by 50 percent. It doesnt have to be intense exercise, Mazzeo says. People who walk a few times a week get almost as much benet as those who exercise daily. If youve been inactive awhile, its best to start small and build up over time. Any activity that gets your heart rate up is goodgardening, house clean- ing, climbing stairs. Aim for at least 30 minutes of exercise a day ve days a week. Losing your memory is not an inevitable part of agingyour lifestyle has a huge impact on the health of your brain. Here are 7 ways to stay sharp Staying Sharp CALL Dont Forget. Call Today The Memory Center sees patients by appointment only at Beaufort Memorial Bluffton Medical Services in Westbury Park and at Coastal Neurology in Port Royal. To make an appointment, call 843-707-8833. 4 WINTER 2013

7. 2. HAVE SOME FOOD FOR THOUGHT Mom was right. Vegetables are good for you. Ditto for fruit. If you eat fruits and veggies across the color spectrum, youll get the protective antioxidants and vitamins your brain needs to function at its best. I suggest following the Mediterranean diet, Mazzeo says. Its rich in sh, nuts, whole grains, olive oil and fresh produce. Choose sh with omega-3 fatssalmon, tuna, trout, mackerel or sardines. Avoid fast food, rened carbohydrates high in sugar, full-fat dairy products, red meat and processed foods. 3. PLAY GAMES Working your brain is as important as working your body. Activities involving multiple tasks and requiring organization or communication offer the greatest benet. Im a big proponent of activities that promote lit- eracy, Mazzeo says. People who continue learning new things throughout life tend to have the lowest rate of memory decline and dementia. Learn how to play an instrument, study a foreign language or take up a new hobby. Crossword puz- zles, card games or strategy games like Scrabble and Sudoku build your capacity to retain information. 4. GET YOUR ZZZS Most adults need eight hours of sleep to function at maximum capacity. If you cut it short, your produc- tivity and creativity suffer. Good-qualitysleepisveryimportant,Mazzeosays. Its how our brains organize the events of the day. 5. CHILL OUT Stress doesnt just make your hair go gray. It takes a toll on whats inside your head, too. It shrinks key memory areas of the brain, hampers nerve cell growth and increases your risk of dementia. Find what helps you relax, whether its a walk in the park, playing with your dog or a long, hot bath. Deep abdominal breathing is another good way to calm your nerves. Multitasking becomes more difcult with age, reports Mazzeo, so try to decrease the number of things you need to keep track of at one time. 6. MIX AND MINGLE As we age, we often become more isolated. Fight the urge to sit in front of the TV alone, and get out and mingle. Dont Wait to Get Help Forgetting your anniversary isnt cause for panic. But when memory loss becomes so severe it disrupts your life, you may be experiencing the warning signs of dementia. People tend to come in too late, says neurologist Paul Mazzeo, MD. They think their memory loss is due to their age and accept it as normal. Its important to intervene early, when remedies are most effective. Antioxidants and certain vitamins, for instance, work best before the onset of symptoms. Phosphatidylserine, a prescription drug marketed as Vayacog, also has been shown to help with mild memory impairment. Dietary intervention and exercise will help even when youve started to experience some decline, Mazzeo says. But rather than take a pill, its better to get the vitamins and antioxidants in the foods you eat. If your forgetfulness is starting to worry you, its time to visit Beaufort Memorials Memory Center. Because other medical conditions can cause symptoms of dementia, the first step of your evaluation will be a comprehensive neurological examination. If dementia is diagnosed, your treatment plan could include dietary changes, activities, exercise and rehabilitative therapies. Dr. Paul Mazzeo is the medical director of the Beaufort Memorial Memory Center at Bluffton Medical Services. Maintaining good social contact with people helps our brains thrive, says Mazzeo. Reconnect with old friends or make new ones. Join a club, volunteer, visit your local senior center or take a group class. The choice is yours; just stay connected. 7. BREAK BAD HABITS Two of the most preventable risk factors for Alzheimers dementia are smoking and heavy drinking. Studies have shown a combination of these two bad behaviors speeds up onset of the disease by six to seven years. 5WINTER 2013

8. More Americans are turning to dietary supplements and herbals to make up for poor eating habits. But while supplements can play an important role in your health, they also can pose risks Body Bo 6 WINTER 2013

9. According to the National Institutes of Health, the majority of adults in the United States take at least one dietary supplement daily or on occasion to keep them in the pink. Its easier to take a pill than to get the recommended three to five servings of fruits and vegetables every day, says Beaufort Memorial internist Philip Cusumano, MD. But people need to know what theyre putting in their bodies. Just because something is natural doesnt mean its safe. St. Johns wort, for instance, may help with mild depression, but it interacts with a wide range of medi cations, from antihistamines to birth control pills. Its not fruit juice, Cusumano says. Its a real drug. While they may have the same chemical properties as drugs, herbs and dietary supplements arent evaluated or reviewed by the U.S. Food and Drug Administration for safety and effectiveness. Very few supplements have stood up to scientific scru tiny, says BMH internist Randy Dalbow, MD. Youre better off eating a healthier diet and taking the medicines that are prescribed to you. The U.S. Department of Health and Human Services agrees. According to its Dietary Guidelines for Americans, the best way to promote health and reduce risk for chronic diseasesisthroughdietandphysicalactivity.Supplements should not be used as a substitute for a healthful diet. Still, most doctors agree some dietary supplements may be beneficial for managing certain health conditions. VITAMIN D AND CALCIUM Take vitamin D. It helps the body absorb calcium, a min eral needed for strong bones. The body produces vitamin D when the skin is directly exposed to the sun. But not everyone gets enough rays, and very few foods naturally contain D. Were finding a fair amount of vitamin D deficiency in our patients, Dalbow says. Its prudent for them to take 600 to 1,000 units daily, especially in the wintertime. When dosing is based on bloodlevel testing results, dif ferent dosages might be prescribed, he adds, though such testing is not routine. Along with D, an extra dose of calcium often is recom mended for bone health. But too much calcium can cause kidney stones, Cusumano warns. And it can start calcifying arteries. Studies suggest there is an increased risk of heart attack, stroke and other cardiovascular disease from taking calcium supplements. MULTIVITAMINS AND FISH OIL Then theres the multivitamintaken by more than half of adults in the U.S. Many people look at it as nutritional insurance to cover dietary shortfalls. > gOTO Get the Facts on Supplements Want the skinny on dietary supplements? Visit the National Center for Complementary and Alternative Medicine at www.nccam.nih.gov. Part of the National Institutes of Health, it has the latest research on everything from antioxidants to zinc. osters?Theyve become the goto cure for all that ails you. Got the blues? Try a little St. Johns wort. Knees giving you trouble? Take a dose of glucosamine and chondroitin. Coming down with a cold? Pop some echinacea. Youre better off eating a healthier diet and taking the medicines that are prescribed to you. photobythinkstock 7WINTER 2013

10. I take a multivitamin every day because I know I dont eat a perfectly balanced diet, Dalbow says. But its not something I strongly recommend to my patients because theres not a lot of scientic evidence backing it up. In fact, an Iowa study found older women who took a daily vitamin supplement had a slightly increased risk of dying of cardiovascular disease and cancer. Based on that research, I dont recommend multivitamins for women, Cusumano says. I do recommend them for men. Fish oil comes in third behind multivitamins and calcium on the list of most popular supplements. The American Heart Association recommends it for people with high levels of tri- glycerides in their blood. But not all doctors are convinced of its benets. It may make your cholesterol numbers look better, Dalbow says, but it has not been proven to reduce heart attacks or strokes. TOO MUCH OF A GOOD THING While the jury may be out on the benets of dietary supplements, scientists have long known they can be harmful if taken in large quantities. Some people think if 500 milligrams of a vitamin is good, then 2,000 milligrams is even better, says Cusumano. Thats a misconception. Because some ingredients found in dietary supplements are added to foods like breakfast cereals and beverages, you may be getting more of these ingredients than you think. If youre trying to improve your health, look at the cul- tures in the world where people live the longest, Cusumano says, summing up. They dont take any supplements at all. With their healthier lifestyles, they dont need them. Drs. Philip Cusumano and Randy Dalbow are board-certied internists with Beaufort Memorial Ladys Island Internal Medicine. They can be reached at 843-522-7240. With the dizzying array of vitamins, herbs and botanical supplements on the market, how do you know whats best for you? Before you head to the health food store, consider this: ADVICE. Dont rely on your friends, TV shows or an article in your favorite magazine for medical advice. Do talk to your doctor or pharmacist before you begin taking any dietary supplements. Your healthcare provider can help determine which supplements, if any, might be valuable for you. LABELS. Read labels carefully. Dietary supplements contain a variety of ingredients, including vitamins, minerals, amino acids, herbs and other botanicals. MEDICATIONS. Dont take supplements in place of, or in combination with, prescribed medications without your doctors approval. Some dietary supplements may interact with prescription medications or pose serious risks if you have medical problems. SURGERY. Talk with your healthcare provider about the supplements you take if you are going to have any type of surgical procedure. Supplements like garlic, ginseng and ginkgo can affect platelet function and cause bleeding. PROMISES. Be suspicious of a product claiming to be a miracle cure or scientific breakthrough. If a real cure for a serious disease were discovered, it would be prescribed by healthcare professionals. TIPS FOR TAKING SUPPLEMENTS While dietary supplements can under some circumstances be beneficial, Drs. Randy Dalbow (left) and Philip Cusumano agree that they are no substitute for a healthful diet. 8 WINTER 2013

11. want better health care? start asking more questions. to your doctor. to your pharmacist. to your nurse. what are the test results? what about side effects? dont fully understand your prescriptions? dont leave confused. because the most important question is the one you should have asked. go to www.ahrq.gov/questionsaretheanswer or call 1-800-931-AHRQ (2477) for the 10 questions every patient should ask. questions are the answer. open up and say anything

12. Well let you in on a little secret. No one loves to get a health screening. Are there people who dont fear nee- dles? Sure. But no one actually enjoys having a blood test. In fact, I know of no woman who looks forward to a Pap test or her regular mammogram. And if I had a nickel for every person who is eager for their next colonoscopy, Im pretty sure I wouldnt have a single nickel. But even if there are a hundred things youd rather dothings that are far more fun than getting poked and proddedthere are few things you can do that are better for your health than getting your regular screenings. But you have your excuseser, reasonsfor skipping them. Right? Well, hear this. I DONT HAVE TIME. IT WILL HURT. IM NERVOUS. BY STEPHANIE R . CONNER IM TOO BUSY. PHOTOGRAPHYBYTHINKSTOCK If youre skipping your screenings, you may be putting your health in danger GotExcuses ? WINTER 201310

13. IM SCARED. I FEEL FINE. SCREENINGS ARE UNCOMFORTABLE AND PAINFUL. I MIGHT HEAR BAD NEWS. EXCUSE I DONT HAVE TIME Yes, youre busy. Between getting the kids to school, caring for older parents and working, its easy to overlook your own health. Plus, what happens if the imaging center or the lab runs behind schedule? Take a deep breath and remember why youre having these screenings in the rst place: to potentially give you more time with the people you love. If the tests reveal a problem, youll be glad it was found early, when treatment is easierand yes, less time-consuming. If youre a multitasker, take heart. A blood test takes care of many of your important screenings, including blood sugar and cholesterol, with just one draw. Plus, for men, the prostate-specic antigen (PSA) measurement, a screening for prostate cancer, is a blood test that can be done at the same time, too. EXCUSE I FEEL FINE, SO ITS OK TO SKIP THE DOCTOR Wellness is not the absence of illness, says Steven Lamm, MD, a spokesman for Drive for Five, a mens health awareness campaign. People feel well and assume they are well. The truth, he says, is that a lot of conditions take years to develop. You dont wake up at 48 with heart disease, he adds. The earliest signs of heart problems stealthily appear much sooner. People who get regular screenings starting in their 20s are at an advantage. If you learn that your blood sugar or cholesterol levels are in a potentially dangerous range, you can take steps early to bring those numbers down. Not to mention that when people adopt healthy habits at a younger age, theyre likely to stick with them. > EXCUSE I FEEL FINE, SO ITS OK TO SKIPITS OK TO SKIP THE DOCTOR Wellness is not the absence of illness, says Steven Lamm, MD, a spokesman for Drive for Five, a mens health awareness campaign. People feel well and assume they are well. The truth, he says, is that a lot of conditions take years to develop. You dont wake up at 48 with heart disease, he adds. The earliest signs of heart problems stealthily appear much sooner. People who get regular screenings starting in their 20s are at an advantage. If you learn that your blood sugar or cholesterol levels are in a potentially dangerous range, you can take steps early to bring those numbers down. Not to mention that when people adopt healthy habits at a younger age, theyre likely to stick with them. > ITS OK TO SKIP THE DOCTOR. WINTER 2013 11

14. Waiting for symptoms of disease to develop is a dangerous risk. In some cases, it might be too late to do anything about it. EXCUSE SCREENINGS ARE PAINFUL AND UNCOMFORTABLE Only about two-thirds of people who should be tested (thats adults age 50 and older) are getting their colon cancer screenings, says Andrew Spiegel, CEO of the Colon Cancer Alliance. There are well-documented barriers; the most prevalent one we hear about is the prep, he explains. Preparing for a colonoscopy involves purging the bowel, which calls for drinking large doses of a liquid laxative and eating a limited diet in the days leading up to the test. Spiegel says that the volume of solution patients think they have to consume is often exaggerated and that advances are helping to reduce the amount of laxative needed. Additionally, people can request prescription pills that allow for lower-volume liquid prep. Another common challenge to colon cancer screening is the test itself. Although the gold standard for colon cancer screening is a colonoscopy, there are other options, Spiegel notes. We say that the best test you can get is the one youll actually do, he says. Thats because some tests, such as stool tests, might be less effective, but they are still better than no screening at all. Ultimately, the numbers are the most compel- ling argument for screening, Spiegel says. One out of 20 people will get colon cancer if they dont screen, he explains. Thats a lot of people. Thats 5 percent of the population. For women, the perception of pain might lead them to avoid mammograms. In fact, only half of women whose insurance covers annual mammograms get the screening, according to a 2010 study, and researchers speculated that fear of discomfort was one possible factor. And its no wonder when you consider the description of a mammogramhaving your WINTER 201312 call Dont Delay. Make Your Appointment Today The American Cancer Society recommends that men and women at average risk for colorectal cancer have their first colonoscopy at age 50. To make an appointment with a gastroenterologist at Beaufort Memorials Center for Digestive Diseases, call 843-522-7890. Colon Checkup While it may not be the most pleasant screening, a colonoscopy is the best way to discover a problem with your colon. Youre looking directly inside the entire large intestine, says BMH gastroenterologist Kevin Kearney, MD, and if a polyp or tumor is found, it can often be removed on the spot. There are several other ways to check for polyps. They include: Flexible sigmoidoscopy. Similar to a colonoscopy, but only the lower part of the colon can be viewed. While no sedation is required, you will need to have a barium enema and an X-ray to view the part of the colon not seen with the scope. Virtual colonoscopy. Images of the large intestine are taken using a CT scan. No sedation is required, but youll still need to have a bowel prep. In addition, air will be pumped through a tube inserted through your rectum to expand the colon. With either of these procedures, smaller polyps may not be seen. And if polyps or other suspicious areas are detected, youll need to have a traditional colonoscopy.

15. breasts compressed between two plates. But a group of researchers at Wake Forest University found that mammogram pain is mildsimilar to the discomfort caused by a pair of tight-fitting shoes or a mild headache. And we all know how often we women choose to wear tight-fighting shoescertainly more than once a year! So, just remember: A mammogram could save your life. ExcusE I mIght hear bad news The overwhelming likelihood is that its not going to be bad news, Lamm says. But if something is wrong, the sooner its diagnosed, the better. Its clear that whether you hear about the bad news or not, if you have something bad, its going to rear its ugly head, he adds. Whether you see the doctor or not wont change that fact. And heres the bottom line: Screenings iden- tify diseases in their earliest stages, which is when they are most treatable. Women whose breast cancer is detected early have a 98 percent chance of survival five years later, compared with 23 percent for women whose disease is found late. When polyps (precancerous growths) are discovered during a colonoscopy, they can be removed before they develop into cancer. Should colorectal cancer be found during an early screening, patients have a 90 percent chance of survival five years later. Only four out of 10 colorectal cancers are detected early, and once they spread to nearby and distant organs, the survival rate drops to 70 and 12 percent, respectively. no more excuses Sure, there are plenty of reasons to skip seeing the doctor. But the truth is, there are few things you can do for your health that offer a greater return on your time investment. And who knows, maybe with a new appreciation for the benefits of tests, youll start to look forward to these regular screenings. (Hey, theres nothing wrong with a little positive thinking!) Lets do this thing! Your Recommended Screenings Now that youre on board with getting your screenings, lets talk specifics. Below is a list of general recommendations for adults. If you have increased risk due to family history or other factors, your doctor will likely recommend a different screening schedule for you. Blood pressure. At least every two years, starting at age 20. Cholesterol. Every five years, starting at age 20. Blood glucose (sugar). Every three years, starting at age 45. Colonoscopy. Every 10 years, starting at age 50. (Other screening tests are available and have varying frequency recommendations.) Mammograms (for women). Annually, starting at age 40. Starting in their 20s, women also should have a clinical breast exam as part of their regular well-woman exam, at least every three years. Pap test (for women). Every three years, or every five years when combined with the human papillomavirus test. Prostate cancer screening (for men). Starting at age 50, men should have a con- versation with their doctors about prostate cancer screening. Sources: American Heart Association, American Cancer Society im taking controL of my heaLth! Winter 2013 13

16. Diabetes and heart disease have a lot in commonincluding your ability to control them. Weve packed these pages with apps and gizmos that can help MANAGING YOUR HEALTH WITH A BY ALLISON THOMAS Tool Kit YOUR HEALTH WITH A Tool Kit YOUR HEALTH WITH A Tool Kit YOUR HEALTH WITH A D I Y PHOTOGRAPHYBYTHINKSTOCK WINTER 201314

17. Evil Sisters? Why are heart disease and diabetes so similar? It could be because theyre an extension of the same disease, says Aruni Bhatnagar, PhD, a professor, researcher and fellow of the American Heart Association. Bhatnagar and other researchers are studying both diseases as one continuum known as cardiometabolic disease, and the connection between the conditions is already being addressed in caring for patients. Clinicians are now being asked to assume that if you have diabetes, you already have heart disease, so thats how serious it is, Bhatnagar says. O ften, were on the hunt for a two-for-one deal. But heres one package wed rather avoid: diabetes and heart disease. The two conditions typically come as a set because of shared risks, such as being overweight or obese, a sedentary lifestyle, smoking, and high blood pressure and high cholesterol levels. But the upside is this: With those shared risks come shared ways to reduce or eliminate them. Well show you some of the best strategies for reducing your chance for developing complications from diabetes and heart disease, and give you the tools to make it all easier to manage. GOALGOALGOAL Lose a fewLose a fewLose a few poundspoundspounds GOALGOALGOAL Embrace aEmbrace aEmbrace a smart dietsmart dietsmart diet WINTER 2013 15 Of all the risk factors for both diabetes and heart disease, weight may play the biggest role. For type 2 diabetes, the central cause is a chronic calorie surplus. We eat too much and dont expend enough, and its causing the epi- demic, says Janet Bond Brill, PhD, RD, a dietitian and the author of Prevent a Second Heart Attack: 8 Foods, 8 Weeks to Reverse Heart Disease. But the research shows that losing even a small amount just 10 percent of your body weightcan help reverse the damage. Heres the catch: The key to keeping those benets is committing to the notion that weight loss is an ongoing battle, says Marc-Andre Cornier, MD, a spokesman for the American Heart Association and a clinical researcher and endocrinologist. Blood pressure, lipids, diabetesthey can all improve with minor weight loss, Cornier says. But obviously its got to be sustained weight loss, and thats the biggest issue. TOOL: Withings Smart Body Analyzer ($150). It might look like an ordinary bathroom scale, but this wizard will help you stay on top of your weight while also analyzing your body composi- tion, checking your heart rate, and automatically logging and tracking your data over time. Finding the right eating plan to manage diabetes and heart disease can be frustrating, because while experts easily agree on recommendations like plenty of vegetables, they part ways on other guidelines. Should you go low-fat? Should you aim for low-carb? The choice may not be as difcult as you think. If you look at the American Diabetes Associations diet recommendations, the number-one consideration is actually a diet that helps you lose weight, whether its low-fat or low-carb, Cornier says. At the end of the day, its the weight loss that trumps the nutrients effects. As long as you take in less calories, thats going to make the big difference. TOOL: DASH Diet app ($1.99). Originally designed to help lower blood pressure levels, the DASH (Dietary Approaches to Stop Hypertension) eating plan is a favorite among health experts for its rock-solid nutritional prin- ciples and simplicity. This app gives you more than 100 DASH-approved recipes that help you stick with the plan.

18. FOR: SEE YOUR: Regular health checkups and basic diabetes and heart disease care, including glucose, cholesterol and blood pressure monitoring Primary care physician Specialized treatment for cardiovascular disease, the No. 1 cause of death in patients with diabetes Cardiologist Specialized help with diabetes complications or managing advanced disease Endocrinologist An annual eye exam to detect and prevent diabetic eye disease Ophthalmologist/Optometrist Problems with kidney function that can lead to kidney disease and dialysis Nephrologist Diabetic nerve pain and advanced treatment Neurologist Problems related to neuropathy or general foot physicals to keep feet healthy Podiatrist Depression and anxiety related to diabetes and heart disease Psychologist/Psychiatrist A Team Approach It takes a team to manage serious conditions like diabetes and heart disease. Here are some of the key members you should consider adding to your roster. GOALGOALGOAL ManageManageManage your glucoseyour glucoseyour glucose levellevellevel GOALGOALGOAL Keep yourKeep yourKeep your bloodbloodblood pressurepressurepressure downdowndown WINTER 201316 and less than 180 mg/dl after eating. TOOL: Telcare Wireless Glucose Meter (less than $100 for a yearlong contract; covered under many insurance plans). This device resembles a smartphone and uses built-in wireless connec- tivity to upload your test readings immediately throughout the day so you or your physician can access them by a smartphone or a computer. While diet and exercise go a long way toward management of blood pressure many people also need medication. The reality is, most of our patients need two or three drugs to treat their blood pressure, so youre likely going to need multiple different kinds of medication to get good control, Cornier says. Most guidelines recommend specic types of blood pressure medications like ACE inhibitors or ARBs as rst-line treatment. These drugs work to prevent blood vessels from narrowing, keeping them relaxed so that blood ows freely. The goal for healthy blood pressure is less than 120/80 mm Hg. As people with diabetes know, a high blood sugar level isnt the only problem they need to watch out for. Hypoglycemia is another. You dont want your blood sugar to dip very low. If your blood glucose goes too low, youll get an allergic response, your heart rate would go up and you would have an increase in cardiac output, so we have to be particularly vigilant, says Aruni Bhatnagar, PhD, a cardiovascular researcher and a fellow of the American Heart Association. He points to studies that show intensive control of blood sugar can decrease the microvascular complications associated with diabetes, such as kidney and eye disease and neuropathy (diabetic foot disease). Generally, according to the American Diabetes Association, adults with diabetes should strive for daily fasting glucose levels of 70 to 130 mg/dl

19. PHOTOGRAPHYBYTHINKSTOCK Exercise has an insulin-like effect, so your blood sugar can drop dramatically, Brill says. Those who are insulin-dependent need to work with a health professional to prevent situations where their blood sugar drops too low. TOOL: Nike+ FuelBand ($149). This activity bracelet lets you easily track how active you are throughout the day and engage in friendly com- petition with your friends. Ive given these to several people, and its actually very useful, Bhatnagar says. You set your targets and if you dont have enough steps or activity, you can do extra things to meet the goal. GOALGOALGOAL Lower yourLower yourLower your cholesterolcholesterolcholesterol levellevellevel GOALGOALGOAL Make tnessMake tnessMake tness a prioritya prioritya priority WINTER 2013 17 TOOL: Withings Blood Pressure Monitor ($130). You should have your blood pressure level checked at regular physician visits, but this device can keep track of it daily at home or on the go. Just plug it into your smartphone or computer and strap on the cuff. From here you can record and track your readings over time, and even email data to your doctor. Reducing blood cholesterol levels is an important goal for many people, but it is especially so for those with diabeteseven if their results arent that high, Cornier says. Theres pretty good evidence that lowering cholesterol with a statin medication in individu- als with diabetes who have normal cholesterol is still potentially benecial. Thats why the guidelines recommend an LDL of less than 100 if not less than 70, he says. TOOL: MediSafe Virtual Pillbox app (free). This app helps you remember to take your pills, and it means business. In fact, if you dont con- rm that youve taken your meds, the app can be set to notify a relative or a caregiver as needed. A combination of aerobic exercise and strength training for at least 30 minutes per day, ve days or more each week, is recommended as part of any diabetes management plan. But those on insulin should seek expert guidance in developing their workout regimen. Dealing with DepressionPatients diagnosed with a chronic diseaselike diabetes have a higher rate of depression.In return, patients with depression are moreprone to chronic diseases. Its reciprocal, says Beaufort MemorialHospital internist Robert Vyge, MD. Themore depressed you become, the worse thecondition gets because youre less interestedin taking care of yourself. Its important to recognize and treatdepression as early as possible to prevent thedebilitating complications that can arise if youdont properly manage diabetes. Symptomsinclude a feeling of sadness, diminished plea-sure, agitation, fatigue, insomnia and a loss ofinterest in daily activities. Everyone is going to have an occasionalbad day, Vyge says, but its the persistence ofthese symptoms that indicate depression.Vyge encourages those in need to seek help,whether through psychological counseling orsupport groups. QUIZ Understand Your Future Risk Determine your potential risk for having diabetes by taking the DiabetesAware quiz. Go to www.bmhsc.org/livingwell and click HealthAware Risk Assessment.

20. 45MILLION Americans have chronic headaches, many caused by vascular changes and muscle tension related to stress, the National Headache Foundation reports. Men and women with type-Apersonalitieshave double the risk of stroke than less-stressed people, according to a study in the Journal of Neurology, Neurosurgery & Psychiatry. Crave sugar and fat when youre stressed? While stress can shut down your short-term appetite, over the long term, your bodys stress hormone, cortisol, increases appetite and your motivation to eat. The American Psychological Association says that 25%of Americans surveyed reported eating as a way to manage stress. H eartburn. Acne. Headaches. Insomnia. You know the signs of stress. And the American Psychological Association has a few to add to the list: high blood pressure, anxiety, depression and obesity. Heres the frustrating part: Though you probably know whats causing your stress, you may not be able to eliminate the sources of itafter all, you cant just up and quit your job, leave your spouse and ignore your kids. But heres what you can do: You can recognize that prolonged exposure to stress wreaks havoc on your health. You can understand its effects. And you can create a plan to cope. Here are a few things to know about the impact of stress on your body, from head to toe. Stress IS IT THE WHAT ANXIETY COULD BE DOING TO YOUAND WHAT YOU CAN DO ABOUT IT | BY BART BUTLER PHOTOGRAPHYBYTHINKSTOCK TALKING? WINTER 201318

21. The Womens Health Study found that women with high stress at work had nearly double the risk of a heart attack than women with lower job-related stress. Chronic stress can suppress body systems that arent needed for immediate survival. For example, the digestive system may not work normally, possibly contributing to irritable bowel syndrome or heartburn. For people with arthritis, stress may worsen the pain. Some research shows that rheumatoid arthritis is more prevalent in people who experienced a stressful life event in the previous six months (job loss, divorce) than in the general population. Source: 2012 annual American Psychological Association survey 64% believe managing stress is very important. But only 37% say they manage it well. 20%of Americans report suffering from extreme stress. 70%experience symptoms like irritability or fatigue, or feel overwhelmed. In studies, stress is associated with delayed conception in otherwise healthy women. And psychological factors, including stress, can lead to erectile dysfunction in men. WINTER 2013 19 QUIZ Test Your Stress Smarts Stress is serious stuff. The more you know, the better equipped you are to fight back. Take the American Psychological Associations Stress Smarts Quiz at www.apa.org by entering stress smarts in the search field. Then, make a plan for reining in your stress! Getting a Handle on Stress Think of stress as a dam that will overflow if not given out lets. Over millions of years, our body has developed a natural stress response known as fight or flight. Stress actually changes our bodys physiology, says Clark Trask, MD, BMH family medicine specialist. How we deal with stress has a direct effect on our health. Some healthy ways to cope with stress include: Sleep. Make a concerted effort to rest your brain and body. Eight hours a day is ideal. Exercise. Move your body to increase levels of circulating endorphins, dopamine and serotoninall helpful in com bating stress. Mindfulness. Try to focus on one task at a time. Other techniques like deep breathing, meditation and prayer can help calm and relax the mind. Try any one of them to replace the stress response with the relax ation response. There will always be external stressors beyond our control, Trask says. But managing our perception of the stressors and our reaction to them is an empowering first step towards coping with stress.

22. G The Wonderful World of By Colleen RinGeR photographybythinkstock

23. reens Gobble up these6good-for-you veggies 21WINTER 2013

24. What if you could ll your plate to overflowingeven go back for secondsand be healthier? Well, you can! Grab the nearest green vegetable and start noshing. Vegetables in general are good for you, no matter what color they are, says Bethany Thayer, a registered dietitian and a spokeswoman for the Academy of Nutrition and Dietetics. But green vegetables in particular are good sources of vitamins A, C and K as well as potassium. That means that when it comes to your greens, theres no such thing as too much. These six superstars can do everything from reduce your risk of cancer to boost your bone health. And, to misquote Lucy Ricardos immortal Vitameatavegamin commercial, Theyre so tasty, too! KaleWhy its good for you: Kale is the king of superfoods. One serving will give you all the vitamin A and K you need for the day, Thayer says. In fact, one serving of raw kale gives you 525 percent of your daily dose of vitamin K, which is great for bone health. Its also a good source of calcium, folate and potassium. What it tastes like: Expect it to be deep, earthy and slightly bitter, although the smaller leaves can be milder. How to eat it: Remove ribs and use it in place of your usual go-to leafy green (such as romaine or spinach). Put it in salads, on burgers or in an omelet. Feeling adventur- ous? Roast the leaves to make kale chips. Why theyre good for you: The long maligned martyr of the produce aisle, Brussels sprouts offer all the benets a good cruciferous veggie should: antioxidants, vitamin C, folate and more. They will last up to one week when stored in the refrigerator. What they taste like: Think of them as mini cabbages. They have a negative connotation, but theyre really, really good, Thayer says. Howtoeatthem:Ifyouthinkyouknow Brussels sprouts, think again: Drizzle them with olive oil and rice vinegar, then sprinkle with Parmesan cheese. Roast in the oven at 400 degrees for 30 minutes. Youll discover a whole new delicious side of these small green globes. Brussels Sprouts 1 2 WINTER 201322

25. 3 WINTER 2013 23 Why its good for you: Swiss chard gives you a lot of bang for your calorie buck just 15 calories in two cups. Plus, it provides a boost of ber, magnesium and vitamins A and K. Like all greens, it is a heart-healthy addition to your diet. What it tastes like: Do you like beets? Then youll like Swiss chard. Darker greens like Swiss chard do have a stronger taste prole than iceberg or romaine, Thayer says. Its a good a- vor, just different. How to eat it: After sauteing it, add apples or dried cherries for a sweet and sour mixture, Thayer suggests. And, as with other leafy greens, you can add it to salads or sandwiches, or even mix it into a smoothie or a soup. Swiss Chard Join Us at the Chefs Table Gourmet vegetable fare is the latest foodie obsession. Eric Sayers, BMHs executive chef extraordinaire, will demo to- die-for veggie dishes in his hospital kitchen in early January. For details, call 843-522-5433. Reservations for the free event are limited to 12. event What About Iceberg Lettuce? this crispy-crunchy salad staple has a bad rap. It has more to offer than most people give it credit for, says Roxanne Davis-Cote, BMH clinical nutrition manager. true, youll get more nutrients from darker leafy greens, but iceberg still is no slouch. Its very low in calories because its mostly water, so it can help keep you hydrated. Plus, it offers some vitamin A, C and K, and its mild taste suits a variety of palates. If the stronger flavors of darker greens turn you off, try using iceberg as your salad base and slowly incorporating assorted greens. vegetables have a wide range of flavors and uses, Davis-Cote says. experiment with different vegetables to see which flavors work best together.

26. AsparagusWhy its good for you: Is your diet high in sodium? The potassium in asparagus can counteract sodiums negative effect on your blood pressure. Hoping to get pregnant? Asparaguss folic acid can prevent birth defects. What it tastes like: Fresh asparagus has a mellow avor, but it really is a taste all its own, Thayer says. How to eat it: Serve steamed, sauted, roasted or grilled as a side dish. I like to steam them partway and serve them cold with dips, Thayer says. To keep asparagus fresh for as long as possible, store standing up in the fridge in a small dish of water. 4 6 5 WINTER 201324 CollardsWhy theyre good for you: A staple in Southern cooking, collards offer similar vitamins and nutrients as kale, making them good for your bones (calcium) and your skin and eyes (vitamin A). What they taste like: Think about biting into a strong cabbage leaf. How to eat them: Trim the ribs and use the wide, sturdy leaves in place of tortillas or bread for a healthy wrap. If the taste is too biting for you, cook them to mellow the avor. Add smoked turkey for a healthier take on the traditional Southern collards- and-ham combo. BroccoliWhy its good for you: A cousin to cabbage, broccoli is a cruciferous vegetable that is packed with vitamin C, calcium, ber and phytochemicals, which may reduce the risk of cancer. What it tastes like: You may pick up on a hint of cabbage, but its fairly mild and there are many ways to prepare it. How to eat it: Raw is best since cooking damages some of its cancer-ghting com- pounds. Not a fan of raw broccoli? Toss it into stir-fries and omelets, or top your pizza or baked potato with it.

27. BY ELLEN OLSON Knee- B A S I C S BY ELLEN OLSONBY ELLEN OLSON WINTER 2013 25 Your overall mobility hinges on this joint. Heres how to keep it well oiled We run. We jump. We climb stairs. Sometimes we (well, some of us) compete in marathons or climb mountains. Throughout our lives, our knees take a beating. So its no wonder that a good bit of pain is associated with this important joint. But just how important is it? to-Know COMPASSPHOTOGRAPHYBYGETTYIMAGES;BLUEPRINTPHOTOGRAPHYBYTHINKSTOCK

28. Coupe recommends following the RICE steps to ease the pain: rest, ice, compression, elevation. People are often tempted to put heat on pain, but that could actually make it worse. Ice will reduce the swelling and numb the pain, Coupe says. And most importantly, rest! Get off your feet for a bit. Arthritis. Most common in older people, arthritis of the knee is a result of damaged cartilage. The cartilage is there to protect the kneelike a cushiony layer of insula- tion, DiNubile says. When its healthy, the bone can slide across the cushion like ice on ice. But when that cartilage becomes damaged, problems ensuenamely, arthritis. In the early stages, arthritis is treated with nonsur- gical methods, like lifestyle changes, medication and supportive devices. If the arthritis progresses, your doctor may recommend a bit of excavating through arthroscopic surgery or a partial or total knee replacement. Ligament tears. If youre a sports fan, youve probably heard the term torn ACL. Its a common injury in athletes, especially among women. ACL stands for anterior cru- ciate ligament, and actions like twisting your knee with the foot planted, getting hit on the knee and stopping suddenly when running can tear it. The ACL is the best-known ligament, but it isnt alone in being at risk. Your knee is made up of four ligaments, all of which can be torn. Depending on the sever- ity of the tear, surgery may be needed. What Lies Beneath Understanding the construction of the knee can be tricky. Most of us are only aware of the visible kneecap, but theres much more to this joint, says Nicholas DiNubile, MD, an orthopedic surgeon and the author of FrameWork for the Knee: A 6-Step Plan for Preventing Injury and Ending Pain. The main structural elements are bones, tendons and ligaments. Think of those like the walls, floor and roof of your house, he says. Heres how its laid out: The knee joins the thighbone (femur) to the shinbone (tibia). The smaller bone (fibula) that runs alongside the tibia and the kneecap (patella) round out the bone structure of the knee. Tendons con- nect the knee bones to the leg muscles that move the joint, and ligaments join the knee bones and provide stability to the knee. All these elements work together to help you twist, turn, run and jump. CraCks in the Foundation Even the best feats of engineering are sus- ceptible to a few structural weaknesses, and the knee is no exception. The three main structural weaknesses that eventually may call for repair: Overuseandinflammatoryinjuries.These are the types of problems we see in runners, gardeners and other people who simply use their knees a lot, Coupe says. Overuse can result in tendinitis or swollen ligaments, which is painful, but not overly detrimental. The knee is a hinge joint that essentially allows us to move. Without it, we would be immobile, says Kevin J. Coupe, MD, an orthopedic surgeon in sports medicine and a fellow of the American Academy of Orthopaedic Surgeons. Makes you want to sit down for a minute, doesnt it? Heres how to prevent or treat knee pain and injury, and keep this marvel of design healthy and hinged for years to come. Winter 201326

29. FIXER-UPPERS Much like your house, your body will hold up a bit better if you perform basic upkeep. Its always better to prevent injury than treat it, DiNubile says. He offers these tips: 1 Keep a healthy weight. Have you ever loaded your car with heavy objects or multiple people and noticed that the ride wasnt quite as smooth? The same holds true for your knees. When you are overweight, youre putting an extra burden on the knees cartilage, which can cause it to wear down more quickly. 2 Perform a balanced, regular exercise routine. If you only work out the rst week of January, youre not doing yourselfor your kneesany favors. The knees are meant to be moved, DiNubile says. Plus, strong leg muscles help take the strain off of the knee. 3 Experiencing knee pain? Get it checked. By ignoring it, youre almost asking for it to worsen. If you notice persistent pain, dont brush it offtalk to your doctor. With all the treatment options available today, theres no reason why you should have to suffer, DiNubile says. WINTER 2013 27 Build a Better Knee O ne of the best ways to avoid an injury is to strengthen the muscles around the knee. The quadriceps and hamstrings are the two major muscles supporting the knee, says Diane Haigler, supervisor of BMH Comprehensive Outpatient Rehabilitation Services, but it is also important to strengthen the muscles of the joints above and below the kneethe hip and the ankle. The mini squat benefits leg muscles, posture, alignment and core: Lean against a wall with hips, shoulders and head touching the wall. Keep feet shoulder-width apart and about 6 inches from the wall. Tighten your abdominal muscles. Slide down until you cannot see your feet. Hold three to five seconds and return to starting position. Repeat for one to three sets of 10. Call When You Need Rehab After an injury, physical therapy can help speed you back to normal. To schedule an appointment with Beaufort Memorials Outpatient Rehabilitation Services, call 843-522-5630.

30. When Matt Damon went smoke-free, his motivation came from the heart. See how you can discover your inner quitter and breathe free Bourne to WINTER 201328

31. By Teresa Caldwell Board

32. 30 WINTER 2013 Quitting: a Team Sport No question, cigarettes are poison. But even when you know how deadly they are, it takes practical strategies and support to turn the desire to quit into a smoke- free life. Cigarettes are exquisitely designed nicotine-delivery devices that were developed and marketed to addict people to them, says Tim McAfee, MD, MPH, director of the Ofce on Smoking and Health for the Centers for Disease Control and Prevention (CDC). The majority of smokers are both physically and psy- chologically addicted to cigarettes, McAfee says. So the best chance of success comes through a combination of medication and counseling to address both physical cravings and psychological urges to smoke. Smoking cessation counseling can prepare you with a personalized strategy. You can talk to your doctor, attend a hospital support group, or get online or phone support. To help with physical cravings, nicotine replacement is available in patches, gum, lozenges, inhalers or nasal sprays. Prescription medication to ease withdrawal symptoms can be used instead of or in addition to nicotine replacement. Positive Clues Rather than calling the insomnia, irritability and anxiety that can strike as nicotine dependence wanes withdrawal symptoms, think of them as recovery Blame It on Love Aug. 5, 2004, was a life-changing day for Damonthe day he became a nonsmoker and put 17 years of pack-and- a-half days behind him. Rewind a year or so: This story begins, as many good stories do, with a boy-meets-girl epiphany. When Damon met his wife, Luciana Barroso, in Miami in 2003, there was a halo of light around her, and I absolutely knew that moment had changed my life before I even spoke to her, he told Macleans in a 2011 interview. The desire to have children with Barroso became part of his motivation to quit smoking. I remember my brother gave up [smoking] before he had kids, Damon told The Observer in April 2013. He said, Im going to give myself six months or a year to clear out my system. I remember thinking, Yeah, Ill do that, too. Damons motivation was sound: In addition to the better-known health risks of smoking, men who smoke cigarettes have a lower sperm count and increased abnor- malities in sperm shape and function, according to the American Society for Reproductive Medicine. In a July 2004 interview with the Washington Post, just a month before he quit, Damon was already reecting on the toxins in cigarettes. He had switched to a more natural brand, he said. Its amazing. You know, its about 350 additives your average cigarette has, from arsenic, from cyanide to ammonia. Theres a down-to-earth charm about Matt Damon. Maybe its his earnest gaze when he talks about clean water or the ash of dimples as he blazes forth with that dazzling grin. He just comes off as a likable guy. Whether playing things bald and bionic in Elysium, bad to the bone in the Bourne trilogy or scrappy and brilliant in his breakout role in Good Will Hunting, the actor himself seems like someone youd enjoy hanging out with over a beer. But not a cigarette. Those days are behind him.

33. Acetonefound in nail polish remover Acetic Acidhair dye ingredient Ammoniacommon household cleaner Arsenicused in rat poison Benzenefound in rubber cement Butaneused in lighter fluid Cadmiumactive component in battery acid Carbon monoxidereleased in car exhaust fumes Formaldehydemain ingredient in embalming fluid Hexaminefound in barbecue lighter fluid Leadused in batteries Naphthalenemothball ingredient Methanolmain component in rocket fuel Nicotineused as insecticide Tarroad-paving material Tolueneused to manufacture paint Up in Smoke: Whats Really in a Burning Cigarette? A lit cigarette produces more than 4,000 chemicals. Many are poison- ous, and at least 50 are known to cause cancer. Here are some of the chemicals in cigarette smoke, and where else youll find them: Source: American Lung Association Winter 2013 31

34. Source: smokefree.gov Winter 201332 Get Help Breaking the Habit Patty Griswold knew all too well the health risks associated with smoking. But it wasnt until her mother died of lung cancer that the 65-year-old registered nurse found the motivation to break the habit. A few weeks before my mother passed away, she asked me to quit smoking, Griswold recalls. I promised her I would. Realizing she would need help kicking her four-decade addiction, Griswold signed up for the Freedom from Smoking program offered by Beaufort Memorial Hospitals LifeFit Wellness Services. As part of the eight-class program, participants examine their own patterns of smoking, learn how to handle triggers and urges, and receive training on stress management techniques that can help them get through the quitting process and life after cigarettes. Griswold hasnt smoked a cigarette since taking the class three years ago. This spring, she received a clean bill of health from her cardiologist. Call Freedom from Smoking LifeFit Wellness Services offers the American Lung Associations Freedom from Smoking program throughout the year. Cost for the courseconsidered the gold standard in smoking cessation programs is $30. For more information on the next scheduled session, call 843-522-5570.

35. For a successful START to your new smoke-free life, the CDC suggests: Anticipate and plan for the challenges youll face. Remove cigarettes from your home, car and work. Talk to your doctor about getting help to quit. S T A R Set a quit date. T Tell family, friends and colleagues youre quitting. symptoms, suggests Mary Ella Douglas, facilitator for the Freedom From Smoking online program (ffsonline. org) for the American Lung Association. The most intense symptoms start to resolve in an average of 10 days to two weeks, Douglas says. We want people to understand that theyre recovering from an addiction, so these signs are very positive because they mean great changes are taking place physically. Quitting smoking is about the best thing anyone can do to protect their health. Claim a New Identity The majority of smokers want to quit, McAfee says, and many have already tried before. If you dont try, your chances of success are zero. The most important thing is to keep on trying. He compares trying to quit smoking to learning to ride a bicycle. You have to learn to be an ex-smoker, McAfee says. Just like falling off a bike teaches you how to stay on, so-called failed attempts to quit teach you how to set yourself up for success the next time. When asked by The Observer earlier this year how his life had changed since Good Will Hunting made him famous 15 years ago, Damon came up with one big difference: He doesnt smoke anymore. Its an incredible personal accomplishment, McAfee agrees. People should pat themselves on the back if theyre former smokers. In transforming from eager aspiring actor to satised family man, his priorities and identity changed. Ben [Afeck] and I started [smoking] when we were in high school, Damon said. Wed see the great actorsBrando, James Dean, Mickey Rourke, who we loved back then smoking, and we just thought it was cool. A healthy lifestyle became a priority for Damon as he got older, got married and became a father. (He and Barroso now have four daughters.) When asked in 2011 how turning 40 had felt, Damon said, Actually, it felt really good. I felt lucky to have the family that I have and the wife that I have, and the job that I have, and I just kind of found myself wanting health and more of the same. Finding Your Motivation One of the most important ingredients to success is getting motivated and staying motivated, McAfee says. Protecting family members from secondhand smoke can motivate people to quit. Secondhand smoke is full of carcinogens, Douglas says. Quitting smoking is not only good for the individual but for everyone around them. Another source of motivation can be the money you save by not buying cigarettes. You can put the money toward a weekly massage, add it to your college or retire- ment savings, or donate it to a cause you care about. In fact, while saving your own life you could contribute to saving another persons. Damon became passionate about public health issues while traveling in Africa. I cofounded water.org, which focuses on water and sanitation. I was in Ethiopia, and I watched children taking lthy water out of a hand- dug well and putting it in bottles to take to school. The water was so dirty, it looked like chocolate milk, he told Parade magazine in 2009. Parents in these impov- erished areas lose children every year to diseases that could be completely prevented if they had access to clean water. Just $25 will give someone clean water for life, Damon said. In many states, thats the cost of about three packs of cigarettes. In the 2011 movie We Bought a Zoo, Damons character is giving his son advice on talking to a girl. He tells him, Sometimes all you need is 20 seconds of insane courage. And I promise you, something great will come of it. To quit smoking, all you have to do is get through the next 20 seconds without a cigarette. Then do it again. 33WINTER 2013

36. for Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Your WINTER 201334 BY STEPHANIE PATERIK PHOTOGRAPHYBYTHINKSTOCK

37. WINTER 2013 35 W hen 34-year- old Monika Carlson got the news that an inoperable tumor was growing in her brain, she asked her doctor an unusual question. Can I run a marathon? She had successfully run 18 marathons, including two that year, even as her cancer grew, and she was training for another. He looked at me like I was crazy, she says with a laugh. Carlson had surgery and wasnt allowed to run for 30 days. Six months later, 11 days after a potent dose of chemotherapy, she crossed the nish line at the LA Marathon in a Wonder Woman costume and T-shirt that read Powered by Chemo. A friend ran beside her in a Supergirl costume with the message Impossible Things Happen Every Day. Studies show exercise is safe for most cancer patients. It also ghts fatigue, nausea, depression and possibly the disease itself. The best news of all is that time and time again, studies have shown exercise is safe, and its feasible during treatment, says Colleen Doyle, director of nutrition and physical activity at the American Cancer Society. And after treatment, it helps reduce the risk of recurrence and increase survival rates for some of the most common cancer types. Even better news is that you dont have to be Wonder Woman or run marathons. Just 150 minutes of moderate exerciseor 75 minutes of vigorous activityand two days of strength training per week will do. If you or someone you love has cancer, consider these ve powerful reasons to get moving. > It may be the last thing on your mind after a cancer diagnosis, but exercise can ease treatment side effects, boost strength and even help ght the disease itself

38. Working Out Safely If you have cancer, chances are your health has risen to the top of your priority list. In some ways, its the perfect time to start a workout regimen. But first, consider these five precautions, says Colleen Doyle, director of nutrition and physical activity at the American Cancer Society. 1. Dont push it. If you werent active in the past, start slowly. And if you were very active, scale back. Even marathon runner Monika Carlson, who is battling a brain tumor, takes a walk break every mile. 2. Listen to your body. Listen to how youre feeling, Doyle says. If there are days you dont feel like going even for a walk down the block, dont beat yourself up over it. 3. Prevent injuries. Some treatments cause numbness in the hands and feet, or alter your sense of balance. Holding the rails of a treadmill or using a stationary bike might be safer than running on uneven streets. 4. Avoid risks. Some people going through treatment become severely anemic, Doyle says, referring to low red blood cell count. We encourage them to delay any activity. Also, people with compromised immune systems should wear masks outdoors, and those with catheters should avoid pools and lakes. Radiation patients should stay away from chlorine, and those with ports should avoid upper-arm strength training. 5. Talk to your doctor. No one knows your health status better than your oncologist. Be sure to discuss any exercise plan before you begin. WINTER 201336 Carlson when she learned her headaches werent the result of work stress or a neck injury, as doctors initially thought. They were signs that cancer had grown like a tangled weed in her brainstem. Carlson is a passionate marketing professional, runner and board member of the Girls on the Run charity in San Diego. After her diagnosis in September 2012, life became a funnel cloud of surgery, radiation and chemotherapy. Carlson took her dog for long walks after surgery, and when she felt well enough a month later, she started running again. It makes me feel that Im taking charge. Running was part of my routine, and being able to get back to that routine helps me feel more normal, she adds. I ran marathons every year, my friends are all runners, and being able to maintain that helped me feel like myself. Exercise is a powerful way to gain control over your body, self- image and daily routine, says Nancy S. Brennan, a survivor and the author of Active Against Cancer: A Guide to Improving Your Cancer Recovery with Exercise. The cross- country skier took 20-minute walks and swims during treatment for ovarian cancer in 2007. All my best memories from treatment are when I was exercising, taking a walk or a short swim. It felt like the most normal thing I did compared to putting chemicals in my chest and [experiencing] the ridiculous side effects, says Brennan, who has been in good health since treatment. Having your identity taken away as a healthy person is rugged, and for a few minutes you can feel like a healthy person again. once sent patients to bed to preserve their strength, but now they are urg- ing people to throw off the covers and work out. We used to tell them to do it on a wing and a prayer hoping it would make a difference, Doyle says. Now we have the studies to show the evidence on this. Your type of cancer, treatment and level of activity before diagnosis will determine what you can do, so talk with your oncologist about a safe plan. It might range from stretching in bed and walking around the block to practicing yoga and competing in a race. Show em Whos Boss Cancer has a way of taking over your life. Thats what happened to Fight That Bad Boy The No. 1 goal for anyone with cancer is to beat it. In the battle for your life, exercise is your ally. First, physical activity keeps off unnecessary weight, builds muscle, improves bone density, boosts cardio health and acts as an anti-inamma- tory. This creates the ideal environment for cells to ght disease. Second, mounting research suggests that exercise helps ght breast, prostate, colorectal and ovarian cancers. Some studies have found that people who exercise are more likely to complete treatment and survive and less likely to see their cancer return, Doyle says. This marks a major shift in con- ventional cancer wisdom. Doctors

39. PHOTOGRAPHYCOURTESYOFMONIKACARLSON WINTER 2013 37 Beat the Blahs Fatigue is a major problem for people going through radiation and chemotherapy. The solution is counterintuitive but true. This is surprising, but weve seen activity can help with fatigue, Doyle says. It can give you a sense of more energy. Staying active was Carlsons secret weapon against radiation fatigue. She says it gave her the energy to keep up her daily activities. Some people feel ne, some sleep for 18 hours a day, some people end up going on disability, Carlson says of radiation effects. I started walking three times a week, and never got tired enough to miss work. Her experience isnt unique. A study of breast cancer patients found that women who stayed active during treatment not only had more energy to ght the disease, but they also had more energy one and two years later, Brennan says. The author experienced the bounce back effect rsthand. I bounced back after chemo pretty fast. I personally think a daily menu of light exercise has a lot to do with helping the body heal, she says. A little bit goes a long way. Tame Your Tummy Another unpleasant side effect of treatment is nausea, and managing it will help keep your strengthand spiritsup. Exercise can help with this, too. Brennan suffered a queasy stomach after every round of chemotherapy. The only thing that helped was taking a walk. That alone can be an enor- mous benet for people in treatment, she adds. While researching her book, she found that exercise also aids in digestion and helps you make better choices about what to eat. That adds up to a more settled stomach. Seize the Day Carlson is the most positive person with an incurable brain tumor you will meet. Her hope is to keep the tumor from growing so that she can live as long as possiblemarry her anc, enjoy friends and family, and yes, run another marathon or 20. I kind of feel like its a choice you have to make, she explains. You can choose to think about the what ifs, or you can focus on today. Focusing on today is what has helped me. I feel mostly ne. Im more t than the average person. Im not in a hospital bed yet. Why worry about that happening? Thanks to endorphinsthose brain chemicals that trigger pleasant feelingsexercise is a natural mood booster and stress reliever. When youre ghting for your health, you need both. Youre ruining today by worrying about tomorrow. I feel like Im living the reverse of that, Carlson says. I think continuing to run has been a huge help emotionally for me as Ive gone through all of this. Monika Carlson (right) and her glam-runner.com partner Taramae Baize finishing the LA Marathon. Get Going Sticking to a workout routine is challeng- ing when youre healthy, let alone when youre battling cancer. The hard part is getting started, says LifeFit Wellness Center exercise physiolo- gist Hollie Fersner. No matter how much you dont want to do it, you just need to get moving. Start with a goal. Researchers recommend 150 minutes of moderate exercise or 75 minutes of vigorous exercise a week. (Thats 30 or 15 minutes a day, five days a week, respectively.) Go slowly. Its best to ease into it, Fersner says. If all you can manage is 10 minutes of walking, thats at least something. After youve done it a few times, youll start to feel better. Then you can slowly increase the amount of time you exercise. Work out with a buddy. If you make a plan to meet someone at the gym, youre less likely to skip your exercise session. Group classes are great, too. Incorporate resistance training. Resistance exercises are effective twice a week, particularly for people with prostate cancer. call Free Breast Cancer Patient Package This three-month BMH LifeFit membership includes health and fitness assessments, a personalized exercise prescription, frequent follow-up visits with a wellness specialist and a one-hour session with a registered dietitian. Call 843-522-5635 for more information.

40. 2FOR THE SOIL- CHALLENGED GARDENER A battery-powered garden? Believe it. No water- ing, no fertilizer needed to grow mini tomatoes, chili peppers or fresh herbsperfect additions to a pals meal plan. All she needs is this starter kit and two AA batteries. $79, clickandgrow.com A fruitcake- free gift guide that wraps up healthy living in a pretty package BY AMANDA KIPPERT T hey say the best gifts come from the heart, which is half true. The best gifts are also kind to the heart, not to mention the lungs, the brainyou get the idea. This holiday season, instead of giving cat-embroidered sweaters to your giftees, why not look for presents that encourage health and wellness? That doesnt have to be mean bricks of green tea and gym memberships (in fact, the latter might send a not-so-kind message). Instead, take a look at these creative, health-related gift nds for every person on your list. Gifts GOOD-FOR-YOU 1 FOR THE RUNNER WHO NEEDS MOTIVATION Athletic geeks (wait, is that even possible?) will love Sportiiiis, a little gadget that clips to their sunglasses and, using color LED lights and voice prompts, keeps them on track. It relays heart rate, speed and cadence goals so they can keep their eyes on the prize. $149.99, 4iiii.com WINTER 201338

41. 7FOR YOUR YOGA BUDDY Every yogi loves a fresh, pretty mat on which to practice her downward dog. Aspen Yoga Mats lets you personalize mats by color (pink equals nurturing while plum stimulates and inspires) with an emblem to match (Laughing Buddha, Lotus Blossom, etc.). Made from PVC foam, the mats are thick, spongy and latex- free. $49.95, aspenyogamats.com 4 FOR THE FIERCE FOODIE Instead of a bacon-of-the-month club, challenge a serious foodie to morph veggies into beads, and turn chocolate into spaghetti-like strands with a molecular gastronomy kit. Hell learn about science while cooking up cutting-edge dishes that will wow his next dinner party. The kit includes tools, ingredients and a DVD to help him become the Bill Nye of the kitchen. $60, uncommongoods.com 6FOR A DEAR GRANDPA A study by psychologists at the University of Miami found that people who are grateful specically those who write down what theyre grateful forare more optimistic and feel better about their lives. This translates to exercising more and being overall healthier than those who focus on lifes aggravations. A Year of Gratitude, a set of 52 thank-you cards, is perfect for the grandpa whos just received his fourth macaroni- decorated pencil cup. $30, uncommongoods.com WINTER 2013 39 3 FOR YOUR ALWAYS DIETING LUNCHMATE For anyone whos had it with fad diets, this book has one lengthy, but alluring, title: UnDiet: The Shiny, Happy, Vibrant, Gluten-Free, Plant-Based Way to Look Better, Feel Better, and Live Better Each and Every Day! Written by Meghan Telpner, a certied nutritionist who was diagnosed with Crohns disease at 28, the book nixes the word diet in favor of healthy, positive nutritional advice. $22.95, amazon.com 5FOR THE FIT FRIEND IN FARGO When winters chill hits its peak and that athlete in your life still wants to get out for a jog, he or she will appreciate these gloves specially made for runners. The Pulse Lite Glove is lightweight, breathable, wicks away sweat and comes in some very hot colors. $20, brooksrunning.com

42. WINTER 201340 9FOR THE HUNGRY TEEN Send a yummy gift to a young friends mailbox every month with a subscription to Healthy Surprise, a snack delivery service. Each shipment is stuffed with full-sized, gluten-free, vegan snack options, from Kale Krunch to O.N.E. Coconut Water to Cocomojoe Joebars. $33$99 a month, depending on box size, healthysurprise.com 11FOR YOUR TYPE-A BOSS Know someone who has a little aggression to burn off? Why not give her the gift of virtually training with professional boxer Jaime Clampitt? The Empower Boxing Boot Camp package comes with weighted gloves, toning ball, jump rope and DVD. $40, various retailers 8FOR A SHARP GRANDMOTHER Keeping your mind sharp through challenges, such as games, has been shown to increase the brains vitality and even grow new brain cells, helping to lower the risk of Alzheimers disease. Battle your grand- parents in a game of Array, a cross between dominoes and rummy that involves lining up colorful cards more skillfully than your opponent. $15, uncommongoods.com 10FOR YOUR OLDER NEIGHBORS Encourage the older folks on your gift list to keep moving by preloading an iPod Shufe with their favorite music, so walking becomes entertainment. Regular exercise helps improve strength, exibility, balance and coordination, reducing the risk of falls. $49, apple.com

43. WINTER 2013 41 13FOR THE SELF- IMPROVING RUNNER Released this year, Runners World Running on Air: The Revolutionary Way to Run Better by Breathing Smarter, was written by Budd Coates, a four-time qualier for the U.S. Marathon Olympic Trials. $16.99, amazon.com 14FOR EVERYONE Instead of adding to a stockpile of gifts, consider giving the present of helping others. Choose a hospital in your giftees area and donate in their name. Then, let them know that they are part of helping improve the health and well-being of the entire community. 12FOR YOUR INSOMNIAC SPOUSE Who couldnt use a better nights sleep? A 2012 study found that people who slept six or fewer hours a night were four times more likely to suffer a stroke than those who got more shut-eye. Help your loved one sleep soundly with the Sleep Therapy Mask from Sharper Image that lets you control how much light to block out to get the best sleep possible. $39.99, sharperimage.com call Special LifeFit Holiday Promotion Buy a package of eight sessions with a personal trainer for $195 and get a second package for half price. Each session is 30 minutes. Call BMH LifeFit Wellness Center at 843-522-5635 for details. The Greatest Gift of All Instead of buying more stuff this year, consider giving more hope. a gift to the Beaufort Memorial Hospital Foundation in the name of a friend or a relative isnt just generous; it feels gratify- ingly personal. a contribution supporting our hospital represents a special opportunity to make your gift go further, says alice Moss, executive director of the BMH Foundation. I can think of no more profound way to honor the spirit of the holidays, our meaningful relationships and the good- ness within us all than a gift of health and wellness. You can personalize your gift in various ways: Honor a friends loved one who has passed away by giving a gift in his or her name. Donate in the name of a hospital caregiver to thank him or her for treating you or your family member. Include a message the BMH Foundation can con- vey on your behalf when notifying the recipient of your gift.

44. While those are details worth considering, dont let them overshadow one of the most important decisions youll need to make about having a baby: the birth plan. In 2014, you have more choices than ever. Women need to be the masters of their birthing experience, says Carol Sakala, PhD, director of programs for Childbirth Connection, an organization that promotes safe and satis- fying maternity care. You need to read vora- ciously, talk to people, and gure out your goals and how to achieve them. > B Y D O N N A S H R Y E R Why is it that discovering youre pregnant makes every decision you struggle with over the next nine months seem as if your life depended on it? Do we want to nd out the gender? Should the name be traditional or unique? What color should we paint the nursery? Cloth or disposable? DELIVERY SPECIAL While those are details worth considering, dont let them overshadow one of the most important decisions youll need to make about having a baby: the birth plan. In 2014, you have more choices than ever. Women need to be the masters of their Wlife depended on it? Do we want to nd out the gender? life depended on it? Do we want to nd out the gender? Should the name be traditional or unique? What color should we paint the nursery? Cloth or disposable? DELIVERYDELIVERY SPECIAL WINTER 2013 43 These important decisions can help you create a personalized birth plan to make the most of this unforgettable day

45. Where to Deliver First, youll want to choose the hospital where you will deliver your baby. This decision is a major factor in your birth experience and recovery. Choose an obstetrician who delivers at the hospital of your choice. Or, if you already have an obstetrician, nd out with what hospital he or she is afliated. Remember that each hospitals services and approach to birth are unique. For example, a woman with a high-risk pregnancy may require a hospital with a neonatal intensive care unit in case the baby needs specialized care. For another woman, a comfortable recovery room that offers a place for her hus- band to sleep may be a priority. And for another, the ability to have a doula in attendance is important. The hospital you choose will be more than just the place you head when going into labor. Youre likely to attend childbirth-preparation, newborn-care and breastfeeding classes there as well. To be sure youre making the right choice, take a tour to learn about policies, view the birthing rooms and get a sense for how things will go when you walk through the door, overnight bag in hand. WINTER 201344 Whos on Your Team The nonprot healthcare research group The Cochrane Collaboration found in a review of more than 13,000 births that women with early and continuous labor support were more likely to have a slightly shorter labor, less likely to use pain medication and generally reported a positive childbirth experience. Its evidence that choosing your support team is an important decision and should be one of your top priorities. In addition to your spouse or partner, this team usually includes an obstetrician but also might include a doula, a midwife, a friend or a relative. Doulas provide emotional and physical support throughout labor and delivery but no cl

Health & Medicine

Beaufort Memorial Hospital Living Well- Winter 2013