HealthLinks Upstate Jan-April 2023


Making a difference, one family at a time. PruittHealth Hospice and Palliative Care offers a family-focused approach to care that creates an extra layer of support and consideration of alternative treatment options. Our caregivers are dedicated to providing compassionate care and comfort to our patients and their loved ones. PruittHealth delivers hospice and palliative care 24 hours a day, 7 days a week tailored to each patient’s individual needs. Contact us today and learn about the PruittHealth difference. The PruittHealth Organization complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Anderson • 864-226-1219 License # HPC-0102 Greenville • 864-962-6699 License # HPC-0102

These include: • Same-day appointment access • 24/7 access to your care team • Urgent care • Sports and Work Physicals • Discounted lab work • Office visits • EKG • X-rays • Flu shots • Sick visits • Chronic disease management • Virtual visits ASK ABOUT OUR EMPLOYER PARTNERSHIP PROGRAMS SPARTANBURG | CAYCE | GREENVILLE | DRAYTON MILLS | MOUNT PLEASANT 864.252.4808 | WWW.PALMETTOPROACTIVE.COM Direct primary care for you and your family. GET WELL. STAY WELL. LIVE PROACTIVE. Accessible & Affordable Healthcare Starts Here. PALMETTO PROACTIVE HEALTHCARE is a Direct Primary Care (DPC) family medicine practice that reunites the physician and patient in a proactive partnership. We dedicate our efforts to your care while keeping the cost of care affordable and known to our patients. With our PROACTIVE PATIENT PROGRAM (P3), you will have access to the care you need to get well and stay well for only 1of 5 Smart Money Moves $70 PER MONTH. No co-pays. No surprise bills. 1208 Ella Street Anderson, SC 29621 864-965-9150 118 S. Pendleton Street, Suite A Easley, SC 29640 864-306-4599 You can also contact these other physician owned and operated direct primary care clinics in the Upstate. Established 2010 1068 North Church Street Greenville, SC 29601 864-702-2365

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THE TRUSTED CHOICE When my dad suffered a stroke, it was my turn to help him with important decisions, like making the right choice in rehabilitation. I asked the medical professionals that treated him who they trusted for the best care and outcomes. They said Encompass Health, the nation’s largest system of rehabilitation hospitals. There, they created a rehabilitation program specifically designed for his needs using advanced technology and innovative treatments. And he was cared for by a highly trained, experienced staff that showed professionalism and compassion throughout his recovery. Now I know why they are the trusted choice of medical professionals. // ©2021:Encompass Health Corporation:MyTurn

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 5 11 | BIRTHMATTERS BirthMatters reduces teen pregnancy through reproductive health education and empowers expectant young adults to raise healthy families through doulas utilizing the community health worker model. 12 | HELPING MOTHER’S MILK FLOW Research shows that 60% of mothers have to stop nursing before they feel like they are ready. Today, nonprofits and hospitals have lactation coaches, resources, life coaches and mentors who are helping women nurse longer. 14 | EXERCISES FOR PREGNANT MOMS Pregnant women once were discouraged from exercise as gentle as taking a walk because gravity might pull the baby out prematurely. Modern science has debunked those myths, and today’s women are encouraged to maintain active lifestyles right up until the baby arrives. 16 | DOGS OPEN DOORS TO HEALING Eight dogs share the duties of Prisma’s Friends Encouraging Therapeutic Coping and Healing program. Five dogs focus on pediatrics; two dogs help with adults and one “floating” pup goes wherever it is needed. Prisma’s program is the first in South Carolina with a fully in-house facility dog program. 20 | TRUST IN ROBOTICS Beth Cook, M.D., recently completed her 500th robotic gynecological procedure at Summerville Medical Center, a Trident Health Lowcountry hospital. As of early November, almost 5,000 such surgeries have been performed at the hospital, including 3,350 obstetric and gynecological procedures. 22 | MORE OB-GYN’S ARE FEMALE Over the past few decades, an increasing number of OB-GYN physicians are female, and this ratio is growing. Nationally, approximately 60% of practicing OB-GYNs are women, according to a 2020 report by the Association of American Medical Colleges. 24 | ILLNESSES THAT MOVE FROM MOTHER TO BABY Women have a weakened immune system during pregnancy that can leave them more vulnerable to contracting infectious diseases and transferring them to their baby. Knowledge of how to best prevent and treat these maladies can help decrease potential risks to newborns. 26 | A WILD RIDE AND A WORLD-RENOWNED RACE It has been “a wild ride” since Irv Batten became director of The Cooper River Bridge Run three years ago. He joked that he can’t wait until “a normal year,” knowing that pulling together an event that is among the best organized and best conducted 10K races in the world can’t possibly include the normalcy that most people know. 31 | WOMEN IN HEALTH We are lucky to live in a community where women not only are succeeding but leading and thriving in a field that touches everyone. 50 | DNA PATH TO HEALTH The Medical University of South Carolina, in conjunction with Helix, has launched a community research project titled “In Our DNA SC.”The goal of this program is to investigate how genetics impact health and to develop ways of offering personalized health care to patients. 53 | KIDNEYS - THE BODY’S WORKHORSE Kidneys are the body’s workhorse – cleaning out toxins, removing waste and balancing bodily fluids. Because your kidneys process the vast majority of what you put into your body, it is important to be mindful of what you eat and what prescription medications, over the counter medications and supplements you take. 56 | WINTER BLUES In addition to the winter season, with shorter days and less sunlight, a lot of other factors now contribute to seasonal affective disorder. There has been an increase in cases of SAD, a type of depression, since 2020. 58 | PROCRASTINATION RESOLUTION There are science-based techniques to help people overcome procrastination, an emotional regulation problem. 60 | HOPE FATIGUE – IT’S REAL The latest mental health challenge cropping up in therapists’ offices is a deficit of optimism accompanied by a sense of being overwhelmed about important issues beyond a person’s control. A Washington Post reporter coined a name for this issue: hope fatigue. 66 | CHOCOLATE’S CURES It’s been called the food of the gods – and its nutritional and medicinal qualities have been touted from the carvings of the ancient Olmec Indians of Central America all the way to the Harry Potter films. CONTENTS DIRECTORIES OB-GYN/Pediatrician............................................................. 71 BY THE NUMBERS S.C. Kidney Disease and Transplants.................................. 54 Procrastination.................................................................... 59 IN EVERY ISSUE Publisher’s Note....................................................................... 6 About the Cover...................................................................... 7 Living Healthy Area Events...................................................... 8 The Lighter Side of Health Care. ........................................... 30 A Unique Case....................................................................... 62 Faces & Places. ...................................................................... 64 Upstate Area Nonprofits........................................................ 68 There's an App for That......................................................... 70 The Pulse on Upstate Nurses. ................................................ 72 ISSUE 6.1 JAN-APRIL 2023 UPSTATE SPONSORED MEDICAL CONTENT Rustic Jem A Boutique: Shopping Fun for Moms....................... 29 FEATURES

6 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com “Slow Down and Smell the Pluff Mud” “Slowww Downnn!” My parents scolded as 10-year-old Cullen stuffed away six homemade tacos in under three minutes. It was a running joke that the only way to get young Cullen to eat any slower was if he fell asleep. When they told me to eat slowly, I would feign nodding off and my mom and dad would keel over in amusement. Being an only child has its perks, one of which is being absolutely hilarious in your parents’ eyes. Aside from not choking, the lesson my parents were trying to instill was to experience what I was doing, or eating, firsthand. They wanted me to smell and taste the food. They wanted me to give myself room to breathe. “Slow down” meant “have a conversation with us, Cullen.” I think we need to remind our adult selves to slow down every once in a while. While I’m fond of routine, autopilot can dim our experiences, and slowing down can have a defogging effect. Slowing down has helped me through the stress of moving and closing out my first year as sole proprietor of HealthLinks while continuing to grieve the passing of my father. Lately, slowing down has opened my eyes to appreciation. I’ve been able to pause and take in our new home on Wadmalaw Island. I’ve heard the quiet of the country that is so loud its deafening. I’ve traded in Netflix and emails for white herons and mud-popping oysters. But without slowing down, the true enjoyment of experience can be lost. Appreciation of experience is something that has not been lost on me, thanks to slowing down. It seems strange to be speaking of the importance of slowing down when most of us are busy making New Year’s resolutions and meticulously mapping out each step of our successes in 2023. As I set my 2023 goals, I will regularly remind myself to slow down. I invite you to join me. Let’s see what slowing down and smelling the pluff mud can bring us in the new year! Cullen Murray-Kemp, Publisher Cul len Murray Kemp UPSTATE Publisher CULLEN MURRAY-KEMP Managing Editor LISA BRESLIN Assistant Editor MOLLY SHERMAN Copy Editor BRIAN SHERMAN Art Director KIM HALL Webmaster GEORGE CONKLIN Sales Manager MANDY WILLIS Photography Partner CARIN SCATES Writers Media Consultant BRANDON CLARK Distribution Manager Latrale Gunther – Distribution: C&R Marketing Administration & Bookkeeping GINGER SOTTILE Distribution U.S. Post Office, Harris Teeter, Ingles, CVS, Food Lion, Medical Offices TO ADVERTISE IN HEALTHLINKS UPSTATE PLEASE CALL 864-612-7694 MEDICAL MARKETING GROUP HealthLinks Upstate reserves the right to refuse advertisements. Acceptance of advertisements does not imply the service or product is recommended or endorsed by HealthLinks Upstate. 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 • Issue 6.1 JAN-APRIL 2023 JANET E. PERRIGO L.C. LEACH III COLIN MCCANDLESS LAURA HAIGHT LEAH RHYNE ISABEL ALVAREZ ARATA LINDA ESTERSON THERESA STRATFORD LISA BRESLIN MOLLY SHERMAN BILL FARLEY DENISE K. JAMES AMY GESELL LISA WACK RILEY MATHEWS PUBLISHER'S NOTE Scan to discover our other HealthLinks platforms!

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 7 ABOUT THE COVER... This issue of HealthLinks is one of our favorite issues to create. It rolls out during the time of year when you, our readers, are reflecting about 2022, making resolutions to ensure a better 2023 and seeking nuggets of hope that the world is still filled with good people. Reporter Amy Gesell’s story about therapy dogs* and Linda Esterson’s piece about BirthMatters and the Newborn Center of Charleston are a few of the many page turners about blessings to count. Clark Leach writes about the neurological reasons people procrastinate and ways to curb that bad habit. And last but far from least, our Women In Health section celebrates the intelligence, the compassion and the accomplishments of a distinct group of women who are leading the way to better health. The world is indeed still filled with good people and blessings to count. To simple pleasures and good health, Lisa Breslin, Managing Editor *HealthLinks has just learned that Vivi, one of the facility dogs that helped children and families heal and feel better, died. She had been diagnosed in September with lymphoma. Thank you, Vivi. You will not be forgotten. Please consider texting Lovevivi to 41444 to contribute to the Prisma Health Canine F.E.T.C.H. unit in her memory. JAN-APRIL 2023 COMPLIMENTARY JAN-APRIL2023 NAVIGATING PREGNANCY & MOTHERHOOD BYE BYE PROCRASTINATION UP S TAT E SPECIAL WOMEN IN HEALTH ISSUE CHARLESTON | DORCHESTER | BERKELEY ABBEVILLE | ANDERSON | CHEROKEE | GREENVILL | GREENW OD | LAU ENS | PICK NS | OCONEE | UNION | SPARTANBURG F.E.T.C.H. HEALING KIDNEYS: BODY’S WORKHORSE Volume 6, Issue 1 • JANUARY-APRIL 2023 HealthLinks UPSTATE UPSTATE FOR QUALITY HEALTH PROVIDERS AND UNBIASED ANSWERS TO YOUR HEALTH QUESTIONS VISIT UpstatePhysiciansSC

8 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com HEALTHY AREA EVENTS l ving JANUARY 21 Pickens County Meals on Wheels “TNT” 6:30 p.m. McKissick Center • Liberty Pickens County Meals on Wheels has come up with a “dynamite” fundraiser and they hope you will join them for their “Tacos ’n Trivia” night at the McKissick Center. Live music, tacos, trivia and prizes are all yours for the taking with a $20 admission. Along with the taco bar is a cash bar for those of you who enjoy an adult beverage with your trivial pursuits. or call 864-855-3770 JANUARY 28 Hartness Half Marathon and 5K 9 a.m. 500 Hartness Drive Greenville JANUARY 11 Table for Two Maternity Services 11:30 a.m. 101 E. Wood St. Spartanburg Engage with other mothers and a certified lactation specialist in an “open and supportive forum” to discuss the benefits and challenges of breastfeeding. Attendance is free, but you must register because lunch is provided. Call 864-560-2297 to register. JANUARY 21 The Greenville Track Club Run Downtown 5K 8 a.m. Race starts at intersection of Broad and S. Main Greenville Run in the 44th Annual Greenville Track Club Run Downtown, the oldest and most popular 5K in the state. JANUARY 11 Swamp Rabbit Trail Tour 9:30 a.m. 50 S. Richardson St. Greenville Spend two hours biking your way through Greenville's Swamp Rabbit Trail as you're guided through sights such as Falls Park, Cancer Survivors Park and refreshments at the Swamp Rabbit Café. Bicycle, helmet, a bottle of water and a guide provided. Recurrent event: Every Monday and Wednesday at 9:30 a.m. and Fridays at 2:30 p.m. Benefiting the 501(c) (3) charity A Child’s Haven, this race offers a variety of ways to run: a 5K, the half or even by way of a relay team. The course is a combination of off-trail and on-pavement footing and is sure to provide interesting sights along the way. All participants must pre-register.

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 9 FEBRUARY 3 Runaway Friday Wine Lunch Noon M. Judson Booksellers Greenville Sneak out of work for a once-a-month, end-of-the-week afternoon of selfcare. Hosted by M. Judson Booksellers, you’ll enjoy three small plates from Camilla Kitchen, paired with wine from Mission Grape and an education on each of the pairings. You won’t go home empty-handed. You’ll leave with a sweet treat and perhaps a new favorite wine – available for purchase. 864-603-2412 or FEBRUARY 5 Ice Breaker 8K Lakeside Park Piedmont Square One Events and Upstate Ultra host this trail-running 8K at the new, beginner-friendly trail system in Lakeside Park. Full of turns and switchbacks, more experienced runners can test their agility and speed. FEBRUARY 11 Cupid’s Chase Greenville 10 a.m. Conestee Park 840 Mauldin Road Greenville Join us at Conestee Park to celebrate Community Options’ Annual 5K. Helping house and employ people with disabilities since 1989, proceeds from this race will go to support and continue Community Options’ mission. DOWNTOWN INMAN, SC MARKET ON MILL 19 MAR 16 APR 21 MAY FOOD TRUCKS 50+ LOCAL VENDORS INFLATABLES FACE PAINTING BALLOON ART PETTING ZOO 12 PM - 4 PM | SUNDAY SHOP LOCAL MARCH-MAY & SEPT-NOV 3RD SUNDAY ALONG MILL STREET IN INMAN, SC For vendor application please email Presents:

10 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com FEBRUARY 25 Greenville Half Marathon & 5K 7:30 a.m. Peace Center 101 W. Broad St. Greenville Presented by Upstate Mothers of Multiples, a nonprofit organization bringing together parents and guardians of twins, triplets and higher orders of multiple births. Set your pace with 2,000 other regional runners as they race down the Swamp Rabbit Trail. There’s a 5K for those of you who love to run but can't commit to the 13.1-mile course. FEBRUARY 24 Music and Movement in CSP 5:30 p.m. CSP Amphitheater 52 Cleveland St. Greenville Interested in drumming circles and exploring the power of movement and rhythm? 864-255-5010 for more information or contact Laura Coleman Nickles at FEBRUARY 25 Sweetheart Charity Ball Greenville Convention Center 15 Exposition Drive Greenville Support Greenville’s Meals on Wheels with this elegant evening of cocktails, dining and dancing. Participants will enjoy live music, a silent auction and more. Purchase tickets, purchase a table or become a sponsor at: FEBRUARY 18 Evening of Hope Gala Dinner and Auction 6 p.m. Greenville Convention Center 15 Exposition Drive Greenville Enjoy a cocktail hour, a sit-down dinner and the thrill of bidding on auction items as you support Project Hope Foundation in its mission to serve those with autism in the Upstate area. Support Project Hope’s mission to deliver therapy, education, adult services and community engagement to Greenville. APRIL 23 2023 Upstate Heart Walk 1 p.m. Corner of Main Street and Broad Street Downtown Greenville Take a stroll and step up to help defeat heart disease and stroke with 1-mile and 3-mile options. Your contribution supports critical and lifesaving research as well as boosting your own mental and physical health. Visit to register. MARCH 18 2023 Red Cross Heroes Unmasqued Gala 6 p.m. - 10 p.m. Hyatt Regency Greenville The Red Cross invites you to an evening of wine tastings, silent and live auctions for the 30th annual Heroes Unmasqued Gala! For questions or sponsorship opportunities, contact Patti Grossi: MARCH 31 & APRIL 1 Hub City Hog Fest Noon - 9 p.m. Morgan Square The 2023 Hub City Hog Fest, a barbecue contest to benefit Mobile Meals of Spartanburg, will take place on March 31 and April 1. The city of Spartanburg will block off several roads downtown around Morgan Square to accommodate the dozens of teams that will compete in this annual competition. MARCH 4 9th Annual Joy DuBail Relay for Life Comedy Classic 5 p.m. - 10 p.m. Greenville Shrine Club & Event Center Support the American Cancer Society during an enjoyable evening of live music, live comedy, raffles, prizes and a live auction.

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 11 While pregnancy is often a time of joy and anticipation, some women don’t have family members and friends to lean on. They have to navigate pregnancy and motherhood alone. Marqulia Gowens didn’t have much support when she had her two oldest children. With the first, she was young and the father wasn’t in the picture, she explained. And with the second, he was around but could offer minimal assistance. Late in her third pregnancy, Gowens visited a maternity fair and met someone who closed the door on her solo journey. That someone was Amber Pendergraph-Leak, executive director of the nonprofit BirthMatters, which offers support and care to expectant mothers in underserved communities. “At the time, I was good as long as my kids were good,” Gowens recalled. “Amber helped me realize that I was abandoning myself and doing more for others than doing for myself. … You can’t pour anything into your children or anyone else if you’re not putting yourself first. That stuck with me.” Gowens received prenatal, delivery and postnatal care through BirthMatters. Pendergraph-Leak visited her at home on a weekly basis, offering essential tools for self-care. She was also by Gowens’ side during labor, in the doorway during her emergency cesarean section and with her in the recovery room to help her become comfortable with breastfeeding. Just as the organization’s other doulas do for all clients until the baby’s first birthday, Pendergraph-Leak continued visiting Gowens weekly – often with diapers and clothing in hand. The support Gowens received mirrors what’s typical of BirthMatters. The doula services are varied and plentiful, at no cost to the family. “Being community based, one day you might be a massage therapist, the next day you might be a therapist and the next day you might be a grandma, a sister and auntie,” said Pendergraph-Leak, explaining how doulas wear many hats. “Whatever they need, you meet them where they are. … We empower our moms to make informed decisions and help them through the process.” With grant funding and awards from organizations such as the Mary Black Foundation, the Institute for Child Success and the United Way, BirthMatters has helped 60 Spartanburg families annually; the nonprofit plans to expand assistance to 200 families each year and open additional sites throughout the state, according to Pendergraph-Leak. The organization utilizes the community health worker model to bridge communities, health care systems and state health departments as care unfolds. Eligibility requirements for BirthMatters are based on income; mothers must be 25 years old or younger and families must be Medicaid-eligible Pendergraph-Leak estimated that about 85% of the clients are African American, and they come to the organization mostly through word-of-mouth referrals and local OB/GYN practices. Through BirthMatters, Gowens was able to meet with therapists who encouraged journaling, taught her mental exercises and provided parenting tips to help her manage her postpartum depression and avoid triggers from life’s stresses. Gowens credits the staff at BirthMatters for helping change her perspective and “get myself together and focusing more on me.” She went to cosmetology school and now owns her own salon, Quays Majestic Hands, in Spartanburg. “As I continued through the program, I got better,” she said. “I got ahold of my life and got to be a better mother to my children.” Additional Information: FINDING COMMUNITY DURING PREGNANCY By Linda L. Esterson

12 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com By Linda L. Esterson THE BREASTFEEDING JOURNEY

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 13 Lindsay Hall hoped to breastfeed her infant son for six months. She attended classes and did as much reading as possible prior to his delivery during the coronavirus pandemic. But no matter the preparation, Hall faced many unexpected hurdles and had to seek help. Hall is not alone; many women expect breastfeeding to be a smooth, natural, formula-free process and then discover it is anything but smooth. And formula is needed. Though the formula shortage that captured the news and crippled many families has abated, and the Food and Drug Administration continues to bolster supplies with the approval of specialty formulas from overseas, the benefits of breastfeeding continue to be highlighted. According to the Centers for Disease Control, more than 83% of infants are breastfed in the United States and nearly 56% continue to be breastfed at six months of age. Nearly 25% of babies are breastfed exclusively through six months, while 19% receive formula supplementation within the first two days of life. When Hall’s son was about 3½ weeks old, he became fussy during feeding, so she visited the Newborn Center of Charleston, an affiliate of Coastal Pediatric Associates, for guidance. Experts determined the baby had a dairy allergy. A heavy dairy eater, Hall relied on cheese cubes as a healthy snack, and her son’s little gut was inflamed. “They really put me at ease about it and told me it’s very common,” Hall said. “They gave me a plan to keep trying to breastfeed.” This included replacing dairy with dairy-free snacks. The Center’s staff shared the many feeding positions designed to help her baby latch and feed comfortably and successfully. Hall also learned that she had a clogged duct and mastitis that hampered the process, and that her breast pump was not the right size. “Without the support from the Newborn Center, I think I probably would have been lost and given up,” she said. “They provided so much guidance and support, especially in the early days. You’re a sleep-deprived mom, trying to get your baby fed, happy and asleep.” The Center’s ability to help mothers is about working with the needs and the comfort of the baby and the mother, explained Kimberly Kinkade, nurse practitioner and board-certified lactation consultant with the Center. Latching issues are common to many mothers like Hall, particularly if baby is not getting enough milk or the process causes pain for mom. Mothers are taught “the football hold” or upright positioning to help. Techniques such as breast compressions also can promote milk flow. Past surgical histories and anatomy changes can present challenges for moms. Kinkade works with women to help stimulate milk production to override these issues. Stimulating milk production may also include extra pumping and extra feeding as well as herbal supplements, which are recommended in consultation with mom’s obstetrician. The confidence Hall gained because of her partnership with the Center enabled her to continue breastfeeding exclusively for 4½ months; then, with formula supplementation, she breastfed until close to her six-month goal. Her dwindling milk supply impacted her ability to continue. According Kinkade, many moms stop breastfeeding as a result of environmental pressures and stressors, often after returning to work. “I do see a lot of moms who elect to cease their breastfeeding journey at that point, just because it becomes too much of a juggle for them to try to be a mom, be professional and make everybody happy,” she commented. During a “return to work” visit, the Newborn Center staff helps moms develop a feeding plan that’s conducive to their schedule. The Fair Labor Standards Act of 1938 requires employers with 50 or more employees to provide reasonable break time – uncompensated – with a place other than a restroom for women to express breast milk for up to a year after birth. Laura Grant elicited guidance from the Newborn Center for all three of her children, especially with feeding her twin sons born two years ago. With her first baby, she breastfed exclusively for nine months but, with the twins, didn’t supplement until nearly a year. The Newborn Center’s lactation consultant helped thwart issues with a blood blisters and painful latch with her first and with positioning and a feeding schedule for the twins – while she breastfed them simultaneously – as well as support for tracking feedings and pumping after her return to work. “It's mind-blowing to think that I was able to do that,” Grant reflected. “I think every mom that can breastfeed, even if it's a couple of days or a couple of years, it's such a huge triumph. I think it’s amazing that our bodies can do that.” Each breastfeeding journey is unique. “The perfect plan is one that parents can implement and maintain while attaining their goals and having a happy, thriving baby,” Kinkade explained. “This is their personal journey, and it is our job to find that balance for them.”

14 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com There was a time when pregnant women were discouraged from exercise as gentle as taking a walk because gravity might pull the baby out prematurely. Modern science has debunked those myths, and today’s women are encouraged to maintain active lifestyles right up until the baby arrives. Careful exercising can strengthen muscles, better preparing the mother for a healthy delivery. According to Caitlin Guevara, co-owner of Fit4Mom in Charleston, “Three great components of any prenatal fitness program are cardio, strength and core work. Cardiovascular exercise is particularly important during pregnancy to help the mom-to-be to regulate her heart rate, which increases during pregnancy, to manage the higher volume of blood delivering oxygen and nutrients to the baby.” FOUR EXERCISES FOR PREGNANT MOMS By Janet E. Perrigo

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 15 HERE ARE A FEW RECOMMENDED EXERCISES HERE IS A RECOMMENDED CARDIO EXERCISE AT FIT4MOM – THE SQUAT JUMP OR SQUAT TO HEEL RAISE Directions: From standing, bend your knees and sink the hips down and back as you would to sit down in a chair. Forcefully straighten the legs and hips, pushing off the balls of your feet to either a jump or a heel raise. Repeat for 90 seconds, and then move on immediately. As a pregnant mom herself, in 2017, Guevara found her community at Fit4Mom: “They got me through the newborn days, and they have carried me onward. My passion is to help other women find their own strength in motherhood at any prenatal or postpartum stage.” GUEVARA RECOMMENDS THE UPRIGHT ROW AS A STRENGTH-BUILDING EXERCISE Directions: Use a resistance band or dumbbells. Start with arms extended straight, bend and raise the elbow up to just below shoulder height. Exercise 90 seconds and then move on immediately. Dr. Megan Rome, PT, DPT, CLT, of Rome Physical Therapy in Summerville, is a pelvic floor and obstetrics physical therapist. After studying and practicing in Florida for many years, she returned to open her own clinic in the Lowcountry. Dr. Rome agrees that there are few reasons to avoid exercising while pregnant. “If you are not experiencing any medical complications but are experiencing aches and pains, urinary issues or vaginal pressure, I would recommend seeing a pelvic floor physiotherapist so that you can return to exercising quickly and to prevent anything from getting worse,” she said. DR. ROME RECOMMENDS BRIDGE EXERCISES AND CORE HOLDS Directions for bridge: Lift the pelvic floor, engage your lower core, press knees out slightly with your heels firmly into the ground. Lift your hips slowly off the floor and slowly lower. Directions for core holds: On your hands and knees, lift your pelvic floor and pull in your low core as if you are gently hugging your baby with your belly. Hold for 30 seconds. Both Dr. Rome and Guevara agree that your pre-pregnancy level of physical fitness is a determinant in choosing the types of exercises to practice during pregnancy. It is important to exercise in a range that is familiar to your body and with the approval of your doctor. The benefits of being as physically fit as possible before, during and after the birth of your child are numerous and well worth your best efforts.

16 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com “How do you feel about dogs?” Katelyn Leitner, child life specialist, asks a nervous patient at Prisma Health-Upstate. When the little girl says she loves dogs, Leitner nudges the conversation a bit further. “What if I had a dog that worked here and could come help us with what we’re doing today? If I did, would you want to meet her?” A nod. Leitner leaves the room and returns with Kalle, a golden retriever/Lab mix. Then comes Leitner’s favorite moment in the introduction: the patient’s reaction. “It’s the same face every time,” Leitner laughed. “When the dog is brought into the room, the patients always make the face. It’s joyful and surprised and it’s the purest, most genuine thing I see in the course of a day.” In addition to her duties as a child life specialist with Prisma Health-Upstate, Leitner is the facility canine coordinator for Friends Encouraging Therapeutic Coping and Healing – F.E.T.C.H. – a 6-year-old program that is the first of its kind in South Carolina. Eight dogs share the duties of the F.E.T.C.H. program. Five of them focus on pediatrics, while two dogs help with adults and one “floating” pup goes wherever it is needed. Kalle, King, Cookie, Becky and Vivi make up the four-legged pediatric F.E.T.C.H. team. “This program was started with lots of passion behind it,” Leitner said. “We had visiting volunteer therapy dogs, and, every time they visited, things were better for the kids. We thought, ‘Why can’t better be always?’ We decided to work to make it be always.” “We still have our volunteer therapy dogs, and we love our volunteer family,” Leitner added. “But the facility dog model allows us to go beyond some of the limitations associated with volunteer pups.” Each dog has a primary handler and is identified as the dog’s “mom or dad,” plus a secondary handler – “the fun aunt”; there currently are no fun uncles – who also trains with them and serves as backup. F.E.T.C.H.’s handlers are child life specialists, physicians and a psychologist. Though they might be fluffy, the dogs’ presence isn’t “just fluff.” They work hard for their money, errr . . . treats . . . and they have measurable effects. From consolation to education to finance, these dogs illustrate their value daily. Vivi, a doodle specializing in pediatric sedation and radiology, is a good example of how these dogs can help save the hospital, patients and insurance companies money. One of Vivi’s patients requires MRIs on a regular basis. Prior to the dog’s involvement, the child’s stress level required sedation to keep her calm and still for every MRI. Sedation involves IVs, fasting and perhaps an overnight stay. These daunting experiences and expenses are moot when Vivi jumps onto the table, lies on her patient’s feet and “takes the ride” through the MRI machine with her friend. When Vivi is present, the patient “ “ F.E.T.C.H. PROGRAM NUDGES HEALING FORWARD By Amy Gesell When the dog is brought into the room, the patients always make the face. It’s joyful and surprised and it’s the purest, most genuine thing I see in the course of a day.

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 17 is comforted and remains still without the need for medical intervention. The patient can come in, have her “pictures” taken and leave without extraneous measures or costly stays. Another 7-year-old patient previously had a negative experience with the insertion of an IV at a facility through a different health care system. It was a taxing event, resulting in the youngster being physically restrained. Both he and his mother were nervous about the IV requirement for his procedure at Prisma. After finding out that the patient had dogs at home, Leitner recruited Kalle for assistance. The patient and mother – making “the face” – were delighted. The patient loved Kalle, and the IV was administered with one nurse, Kalle, and Leitner present. One poke. No tears. No restraints. One mother sobbing in relief. “This is how it should be,” the mother said, “and that’s not how his first experience was. Now that I know that it [an IV] can be done, it’s a game changer.” F.E.T.C.H. dogs also can do what dogs do best: listen.This was never more apparent than when a young patient was admitted to the hospital because she had attempted to harm herself. Leitner, Kalle and the patient went on a long walk ending in Prisma’s vast playroom, which has lots of soothing, natural light. The trio sat on the floor, with Kalle sandwiched in between. “Can I tell you why I’m here?” the patient asked. Petting Kalle, she matter-of-factly recited her troubles. Her father recently died from cancer; she'd broken up with a boyfriend; she was having these feelings and didn't know what to do with them; she attempted an overdose; and, most upsettingly to her, her little brothers found her unconscious. “I don’t want that to happen again,” she said. “This is a delicate area for a child life specialist,” Leitner said. “We aren’t necessarily psychiatrists or therapists, so we focus on making the patient comfortable – letting them know that they are OK here.”

18 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com But something about the young woman’s factual delivery tugged at Leitner. “Do you have big feelings?” Leitner asked. “You don’t have to tell me, but Kalle is a great listener.” The patient lifted Kalle’s soft, golden ear and whispered her secrets. After some time, she spoke out loud, muffled only by Kalle’s fur. “That was scary,” she said. “But I feel so much better.” “Dogs are so magical and can be a huge bridge for children who are scared, confused or have big feelings,” Leitner noted. “They are exceptionally talented when it comes to helping children in the Psychiatry Department and children on the spectrum. It’s a world our dogs can access that we as adults sometimes can’t,” said Leitner. The F.E.T.C.H. dogs have a larger-than-life presence in the Upstate community. They’re seen throughout Prisma-Upstate hospital systems and offices and make a big splash with their Instagram accounts and their appearances at local events. “We go out and visit elementary schools for health and career fairs, and there is a huge Instagram following,” Leitner said. “We also attend donor-funded events and have developed excellent relationships with dog-related businesses in the Upstate.” One member of the team is the star of two books: “Kalle Gets an EEG” and “Kalle Goes to the Doctor.” Rich photography accompanies Kalle’s tales, which eases fear caused by potentially frightening medical procedures. The dogs are also featured in their own 25-minute documentary, “Unleashed.” DOGS AT-A-GLANCE Working 40 hours a week, the five superstars of pediatric care are: KALLE – a golden Lab mix who works on the general patient unit as well as the Epilepsy Monitoring Unit. KING – a golden retriever whose job is in pediatric supportive care. BECKY – another golden retriever helps with pre-op and surgery, working from around 5 a.m. to 2 p.m. VIVI – a doodle specializing in pediatric sedation and radiology – helping kids get through MRIs, CT scans and other imaging. She also helps prepare kids for sedation. COOKIE – the golden retriever star of the outpatient centers. She’s matched with a variety of procedures and serves specialty offices – all of the “…ologies” – and travels, working in a doctor’s office setting and for nonsedative procedures. Pediatric medicine isn’t always a sunny room and a happy ending. The truth is that not every patient gets better. It’s hard on patients, families and their teams – including the dogs. “On any given day, a dog could be scheduled to see up to 20 kids – anywhere from five minutes to an hour, depending on the need. But sometimes, if the burden of their work is heavy, as it is in a bereavement setting, the dog’s schedules can change,” explained Katelyn Leitner, a child life specialist with Prisma Health-Upstate and the facility canine coordinator for Prisma’s Friends Encouraging Therapeutic Coping and Healing program. “For every five minutes of heavy stress, dogs should engage in 10 minutes of hard play. As humans, we can talk out our stress and about our bad day at work. Dogs can’t,” Leitner added. “They are little sponges that soak up the bad to make our situations better, but the only way for them to drop the weight of their day is to simply be a dog and play with other dogs. Play brings the energy back into their work. It might sound crazy, but we’re very sensitive to our dogs’ needs. We know what’s hard for them, and we don’t hesitate to pull them out for a break. We value the quality of a visit over the quantity.” This model must be working. F.E.T.C.H. has yet to retire any of its dogs. That’s not to say that retirement won’t eventually happen, which is why F.E.T.C.H. looks ahead to building a future. Philanthropy is the key to F.E.T.C.H.’s financial success. Each dog is both “sponsored” and “endowed” by businesses or individuals. Sponsorship covers the initial purchase price, transportation and training of the dogs and handlers, and the dog carries the representation of that sponsor for the life of its service. Endowments pay for care, feeding, grooming and vet bills for the duration of a dog’s service. No patient is ever charged for visits from the F.E.T.C.H. team. Community donations, fundraisers and sales of F.E.T.C.H. calendars also help. Clemson Miracle, Dabo’s Foundation, Stone Academy of Communication Arts, Pops for Pups and The Noble Dog Hotel all have provided F.E.T.C.H. endowments or sponsorships. For more information on how you can support the dogs of F.E.T.C.H. and to watch their documentary, “Unleashed,” visit CARING FOR THE DOGS WHO CARE FOR OTHERS

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 19 FAMILY & LOCALLY OWNED SINCE 1975 Experience the SPORTSCLUB DIFFERENCE SRI.ERNESTHEALTH.COM 160 Harold Fleming Court • Spartanburg, SC 29303 864.594.9823 864.594.9600 Follow Us STROKE CERTIFIED | AMPUTEE CERTIFIED Memory and mood changes, difficulty sleeping, shortness of breath, fatigue, and pain are just some of the issues experienced by many of those recovering from COVID-19. To help patients combat these problems and work toward recovery, we proudly offer a post-COVID rehabilitation program, featuring: • Physical, occupational, and speech therapy evaluations • Personalized plans of care led by rehab specialists • Strategies for managing energy, sleep, nutrition, and overall wellbeing • Transition programs for return to life at home or work • Instruction on at-home exercises and caregiver support To learn more about inpatient or outpatient post-COVID rehabilitation services at Spartanburg Rehabilitation Institute, please contact us today!

20 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com By Janet E. Perrigo Does the thought of a steely, cold metal robot operating on your fragile body feel a bit unsettling? A historic milestone that recently took place at Summerville Medical Center should calm those jitters. Beth Cook, M.D., recently completed her 500th robotic gynecological procedure at Summerville Medical Center, a Trident Health Lowcountry hospital. As of early November, almost 5,000 such surgeries have been performed at the hospital, including 3,350 obstetric and gynecological procedures. Currently, fellowship-trained, board-certified surgeons keep three robotic systems at the hospital booked for gynecological, orthopedic, spinal, pediatric, reflux, weight-loss, breast, vascular, bariatric and general surgeries. The surgical training program for robotics is rigorous and extensive, but the results are well worth it, according to Dr. Cook. Although she performs more hysterectomies than any other procedure, common gynecological robotic surgeries also include pelvic organ prolapses, myomectomies, endometriosis excisions, removal of noncancerous ovarian cysts and excision of adhesions. Working from the robotic console of a 3D high-definition screen, Dr. Cook has enhanced visualization of the operative field. The robotic arm allows for a full 540-degree “wristed” rotation, which gives her extended range of motion. Tiny incisions are made, ports with connected instruments are inserted and then she is ready to perform delicate and precise procedures. The robot acts as an extension of her hands, and, because the video image is true to actual movements, she can operate intuitively with better and faster results. Patients who choose robotic surgeries are pleased because they require a smaller amount of pain medication and recover at a faster rate than traditional surgery offers. Surgeons like Dr. Cook also appreciate the minimal bleeding and impact on surrounding tissue. In gynecological surgeries, the robotic equipment allows for less overdistension of the abdomen, which minimizes discomfort and expedites the surgical recovery protocol. Increased visualization allows skilled surgeons to complete these procedures more quickly. For example, a typical hysterectomy can be finished in 35 to 40 minutes. The surgeon can ARE YOU READY TO TRUST A SURGICAL ROBOT?

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 21 even suture using the robotic arm. However, Dr. Cook points out, “Suitable cases must be chosen wisely. There are still some limitations. Not everyone is an automatic candidate for robotic surgery.” Summerville Medical Center began its robotic surgeries in late 2012, with Dr. Cook helping to lead the way. “It’s truly remarkable what our surgeons and surgical staff have accomplished in the past 10 years since our first minimally invasive robotic surgery,” Jeff Taylor, CEO of Summerville Medical Center, reported. “Our team is dedicated to ensuring that Lowcountry families have easy access to high-quality care, and providing options like robotic surgery ensures they recover and return home to their families quickly.” For Dr. Cook, it’s much more personal: “My goal every day is to change the lives of my patients. My passion is caring for women across generations for every decade and milestone in their lives,” she explained. “I want to help them get back to their favorite hobbies and to enjoying their active lives. It is an honor to care for the women in our community.” THE ROOTS OF ROBOTIC SURGERY The origins of robotic surgery can be traced back about 50 years to the military. In an effort to decrease forward battlefield casualties, the Department of Defense began searching for ways to help field medics stabilize wounded soldiers until they could be evacuated to more thorough medical care. In the 1960s, the idea of telepresence surgery that combined virtual reality and robotic technology was considered to be a possibility. With the bedside assistance of a medic and a “robotic scrub nurse,” the surgeon might be able to operate successfully from a remote location behind the battle lines. On Sept. 7, 2001, the first surgical robot was used to complete a trans-Atlantic surgery between New York City and Strasbourg, France. A 68-year-old woman received a successful, minimally invasive cholecystectomy. However, with the world reeling from the 9/11 attacks, the amazing operation received less attention than it might have otherwise. In 2005, the Food and Drug Administration gave approval for robotic surgery for gynecological purposes. Source:

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

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 23 and reviews online, the distance to her office, and, importantly, the quality of the clinic or office she is in.” “It seems when [male doctors] can’t figure out a medical problem, they presume it must be stress,” Gretchen asserted. “That story gets old. Women understand the multiple roles of a woman and look into a situation further to make sure there is no medical reason for symptoms before going down the stress road.” Gretchen’s assertions are closely linked to the trending term “medical gaslighting,” when a health care provider dismisses a patients’ worries, minimizes their symptoms or makes them feel like their symptoms are imagined. According to Melinda Wenner Moyer’s 2022 New York Times article, “Women are Calling Out ‘Medical Gaslighting,’” “the term ‘gaslighting’ derives from a play called ‘Gaslight’ about a husband’s attempt to drive his wife insane. And many patients, particularly women and people of color, describe the search for accurate diagnosis and treatment as maddening.” “We know that women, and especially women of color, are often diagnosed and treated differently by doctors than men are, even when they have the same health conditions,” explained Karen Lutfey Spencer, a researcher quoted in Moyer’s piece who studies medical decision-making at the University of Colorado, Denver. Some women lean on nurse midwives, who are predominantly female, for their OB-GYN care. “We work with women from an early age through menopause,” said Barbara Davenport, CNM, a certified nurse midwife at Prisma Health in Greenville. Many female patients prefer to work with a female practitioner because they can “identify more with someone who has had similar experiences,” Davenport noted. “When a patient has a health practitioner who she can relate to, it often builds confidence in the relationship.” As a midwife, Davenport strives to “help women understand and trust their bodies.” Throughout Dr. Campbell’s experience, quality care is patients’ top priority: “Most people believe if a doctor provides a high quality of care, they will not care if they are a male or female.” Patients typically consider technical skill, compassion and experience as part of their evaluation, and a male OB-GYN may check the boxes best for them. Many women have a relationship built over the years with their male OB-GYN and the trust they place in him has grown. For women who live in more rural areas of South Carolina, Dr. Campbell explained, the most important consideration may become the availability of physicians, rather than the physician’s characteristics or background. The potentially smaller number of male physicians in these areas may not trouble some women who may not be able to, or may not wish to, travel a great distance for their visits. GENDER PREFERENCE AMONG PATIENTS OF THEIR TREATING OB-GYNS CARE SERVICE FEMALE MALE NO PREFERENCE Who do you prefer for having primary health screening? 72.8% 3.1% 24.1% Who do you prefer for pelvic exams? 92.6% 2.6% 4.9% Who do you prefer for obstetric care of an unborn baby? 68.2% 5.4% 26.4% Who do you prefer for major gynecological surgery? 61.0% 15.9% 23.1% Which gender has more sympathy? 34.6% 19.5% 45.9% Which gender is more trustworthy? 29.5% 15.1% 55.4% Which gender has more respect for their patients? 12.6% 17.4% 70.0% Which gender is more knowledgeable about women's health? 39.0% 8.7% 52.3% Which gender has better bedside manners? 19.2% 11.0% 69.7% Which gender tends to spend more time with their patients? 22.3% 8.5% 69.2% Which gender is a better OB-GYN? 48.7% 4.9% 46.4% Source: National Library of Medicine. Many female patients prefer to work with a female practitioner because they can 'identify more with someone who has had similar experiences.' “ “ Medical Gaslighting Source: