HealthLinks Upstate May/June 2022


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

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www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 5 11 | TELEHEALTH ISN’T GOING ANYWHERE. … “The practice went from 2% of telehealth visits to 90% within a week. Now, as COVID wanes, they find that 20% of patients are making the choice to do virtual visits because they like the platform and its convenience.” 16 | EARLY INTERVENTION IS THE KEY WITH BIPOLAR DISORDER Recognizing the signs and symptoms of bipolar disorder early on can help lead to more effective treatment and management of the disease. 24 | AGING GRACEFULLY MEANS LIVING PROACTIVELY It is critical for seniors to adopt a proactive mind-set and schedule regular visits with their primary care physician. 28 | DON’T IGNORE THOSE FLOATERS AND FLASHES Though there’s a chance that floaters and flashes might be no more than an inconvenience, it’s entirely possible that they could be a sign that trouble brewing in your eyes has the potential to cause long-term damage and even blindness. 30 | WHAT TO DO ABOUT BOO BOOS Remedies and treatments for some of the most common injuries. 34 | PAY ATTENTION TO THE SIGNS OF MÉNIÈRE’S DISEASE Patients with suspectedMénière’s disease are encouraged to keep a food diary, but diet is only one part of the puzzle. 36 | WHEN TIME AND REST DON’T CURE YOUR PINCHED NERVE For the tiny minority who have a severe compression of the nerve, surgery is best done sooner than later to minimize the damage and to support healing. 38 | INFLAMMATION: THE GOOD AND THE BAD Inflammation overall is a good thing because it helps the body to fight off infections and heal wounds. It becomes a bad thing when the inflammation gets out of control. 41 | CREATING A SAFE PLACE IN HEALTH CARE FOR LGBTQ PATIENTS Many LGBTQ patients are hesitant to share their gender and sexuality experiences, reducing the proficiency of health care providers to address the whole patient. 44 | SWITCHING TO DIRECT PRIMARY CARE Direct primary care practices don’t accept health insurance. Instead, patients pay the practice directly. 46 | DON'T SUFFER IN SILENCE Even today’s basic digital hearing aids are a vast improvement over the best hearing aids of previous generations. 50 | BREAKING STREET HABITS To avoid re-arrest, former inmates must change almost everything about their lives, and it’s hard. So hard, in fact, that nationwide, approximately 62% of people leaving prison are re-arrested within three years. 54 | SERVICE DOGS HELP IN MORE WAYS THAN ONE Service dogs can help with a range of basic activities like opening doors and picking up objects off the floor, but they also provide companionship and emotional support. CONTENTS DIRECTORIES Primary Care. ......................................................................... 62 BY THE NUMBERS Telehealth............................................................................ 12 Bipolar Disorder.................................................................. 18 Inflammation....................................................................... 39 LGBTQ Health Care............................................................ 42 Direct Primary Care............................................................. 45 Hearing Loss. ...................................................................... 48 IN EVERY ISSUE Publisher’s Note....................................................................... 6 About the Cover...................................................................... 7 Living Healthy Area Events...................................................... 8 The Lighter Side of Health Care. ........................................... 49 There's an App for That......................................................... 52 A Unique Case....................................................................... 56 The Facts on Food & Drink.................................................... 58 Upstate Area Nonprofits........................................................ 60 The Pulse on Upstate Nurses. ................................................ 64 ISSUE 5.3 MAY/JUNE 2022 UPSTATE SPONSORED MEDICAL CONTENT Your Choice For All Things Hearing....................................... 15 Is Vertigo Throwing You Off Balance?.................................... 21 Home First Aid Myths............................................................ 23 Health and Wellness All in One Place.................................... 26 To Temp or Not to Temp........................................................ 33 FEATURES

6 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com In my last publisher’s note, I spoke pretty candidly about the challenges I was facing with mental health. I alluded to the circumstances – my father passing, buying this business, stress around sleep – that pushed me to ask my doctor about adding a prescription medication – SSRI – to my mental health “toolbox.” Two or so months later, I can say that I am happy that I decided to try the medication. Important side note: It takes five or so weeks for most SSRIs to take effect, so don’t worry, as I did, if you don’t feel any reprieve within the first few weeks. In taking the medicine, I was concerned about losing my edge and competitiveness with my business and various activities. The edges have been smoothed but not lost. I still passionately despise losing! With the help of meditation, exercise and a relatively healthy diet, I have found a rhythm in life that was previously absent. My perspective changed a bit, too. Previously I struggled with the “never satisfied” complex – my work – and really, myself, were never enough. My new focus is to offer myself a more gentle, self-appreciative approach. Smile and laugh more, with the clear understanding that not everything is dependent upon this one moment or decision. Another realization I’ve come to understand through the quietening of my anxiety storms is that I must slow down and truly engage with people. Because I was so wrapped up in my self-criticism, my anxiety didn’t allow me to pause, think and engage with life. I’ve found that sometimes I’m even more productive when I move slower and with more purpose. Ultimately, anxiety never gave me a choice. It’s a health challenge without bias. Without warning, it can bound any of us at any moment. We can only be disciplined in our efforts control it. We must equip ourselves with a “mental health toolbox” that allows us to keep moving forward. Fortunately, there are an ever-growing number of mental-health resources that surround us in this community. Be it mental, physical or emotional health, our hope is that HealthLinks can help connect our readers with the best-possible providers and health solutions for them. Cheers to good health, Cul len Murray Kemp Cullen Murray-Kemp UPSTATE Publisher CULLEN MURRAY-KEMP Managing Editor THERESA STRATFORD Assistant Editor MOLLY SHERMAN Copy Editor BRIAN SHERMAN Art Director KIM HALL Webmaster GEORGE CONKLIN Internet GENE PHAN Sales Manager MANDY WILLIS Photography Partner CARIN SCATES Writers Media Consultants BRANDON CLARK CINDY JOHNSON 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 5.3 May/June 2022 LAURA HAIGHT JILL HARPER CINDY LANDRUM STACY DOMINGO BRIAN SHERMAN HOLLY LAPRADE COLIN MCCANDLESS MOLLY SHERMAN ISABEL ALVAREZ ARATA L.C. LEACH III CHRISTINE STEELE JANET PERRIGO KATHERINE WATERS BILL FARLEY DENISE K. JAMES LEAH RHYNE 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... These past couple of years have really brought mental health into the spotlight. Many people who didn’t suffer from anxiety and depression before the pandemic have been feeling their effects lately. That is no secret, but neither is it something to be ashamed of. We decided to highlight bipolar disorder in this issue of HealthLinks Upstate. We spoke to the professionals at iTrust Wellness, who gave us some great information about the effects of bipolar disorder and how to treat it and assured us that anyone suffering from this issue is not alone. We also highlighted primary care. The general and family practices are some of the most important in health care. They see their patients regularly and are usually the first line of defense. We covered stories about primary care as it relates to seniors, telehealth, basic first aid and direct primary care. And, I should mention, telehealth has really taken off in the mental health arena. Please take note of some of our other interesting stories about service dogs, bipolar disorder, LGBTQ health care and another valiant “unique case” story. We want to take the time to thank our team – our editor, graphic designer and wonderful writers – for making this issue a success. We also want to thank our sales team for working hard on distribution and making the magazine accessible to you, our loyal readers. And we couldn’t do any of these stories without our incredible sources. Thank you all for lending us your expertise. We hope you enjoy this issue of HealthLinks. Please send feedback and story ideas to To health and happiness, Theresa Stratford, managing editor MAY/JUNE 2022 COMPLIMENTARY MAY/JUNE 2022 UP S TAT E THE POWER OF YOUR IMMUNE SYSTEM ABBEVILLE | ANDERSON | CHEROKEE | GREENVILLE | GREENWOOD | LAURENS | PICKENS | OCONEE | UNION | SPARTANBURG A FIRST-AID FRESHEN UP LIFE WITH BIPOLAR DISORDER SERVICE LIFE: GIVING PUPS A PURPOSE THE INFLAMMATION EXPLANATION UPSTATE Do you prioritize health for yourself and value the health of your community? HealthLinks has a media consultant position open in the Greenville/Spartanburg area. GREAT CAREER OPPORTUNITIES AT Email us at and tell us why you would make the perfect candidate for HealthLinks.

8 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com HEALTHY AREA EVENTS l ving MAY 14 Born to Run 5K and Kids Fun Run 8 a.m. Bob Jones University The Born to Run 5K fundraiser supports the Piedmont Women’s Center at Bob Jones University. MAY 7 Reedy River Duck Derby 2:30 p.m. Rotary Club of the Reedy River in Greenville Adopt a duck, or several ducks, on the website because it’s time to get back in the water. The Duck Derby will take place at Falls Park on the Reedy River for an over-the-falls, family day of fun. The funds raised go directly to many local charities. MAY 5 Prepared Childbirth – 3rd Trimester & Comfort Measures Noon Via Zoom This class through Prisma Health includes information about the role of the support person, late pregnancy discomforts and warning signs and comfort measures for labor and delivery, including breathing and relaxation. MAY 5 2022 Pharmacy Technician Conference 8 a.m. Spartanburg Medical Center, Heart Center Auditorium This program aims to update pharmacy technicians’ knowledge, tools and skill sets to provide quality care. The conference is presented by Spartanburg Regional Corporate Education and the University of South Carolina College of Pharmacy.

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 9 MAY 16 2022 Assault on Mount Mitchel and Marion 6:30 a.m. Spartanburg Memorial Auditorium The Assault is one of the most intense, premier cycling experiences, drawing a full field of nearly 800 cyclists from across the world each year. A portion of the proceeds generated by The Assault supports other nonprofit organizations, including Finish-Strong cycling team, Partners for Active Living, the Challenge to Conquer Cancer, the Humane Society and the Atlantic Chapter of Multiple Sclerosis. MAY 21 March of Dimes Run for Babies 8 a.m. Duncan Park Drive The March of Dimes Run for Babies also has a shorter race for kids. Proceeds go to March of Dimes, an organization that strives to improve health of mothers and babies through research, programming and funding. MAY 22 Taste of the Upstate 2022 11:30 a.m. Downtown Greenville Taste of the Upstate 2022 features local chefs’ renditions of cuisine from around the world, as well as a silent auction and live jazz performance. Proceeds fight hunger all year round. MAY 24 Meet the Midwives 6 p.m. Via Zoom This event is an opportunity through Prisma Health to meet the Midwives of Greenville Midwifery Care. It is also an opportunity to learn more about midwifery and whether it is the right choice for you. JUNE 6 - 12 BMW Charity Pro-Am Thornblade Club and The Carolina Country Club Amateurs and celebrities are grouped with professionals in a four-day better-ball competition over two courses. The tournament benefits charities including Gibbs Cancer Center & Research Institute, Roper Mountain Science Center, Mobile Meals of Spartanburg, Meyer Center for Special Children and The Cancer Society of Greenville County. JUNE 19 Breast-feeding Class 6 p.m. Prisma Health Tuomey Hospital This breast-feeding class is designed to be an interactive learning session through Prisma Health to teach you what to expect in the first few days of breast-feeding. Please register by your fourth or fifth month of pregnancy.

Meet the Expert KENNETH ORBECK, D.O., FAARM, ABAARM RMI.LIVE | (877) 573-3737 Dr. Orbeck dedicates his practice to helping men and women find relief from hormonal imbalances such as menopause, andropause (the male menopause), adrenal fatigue and thyroid disorders by using a personal functional approach to wellness; combining customized nutrition and fitness regimens with bioidentical hormonal therapy. Dr. Orbeck examines the interaction between each person’s genetic, environmental, and lifestyle factors for an individualized and customized treatment plan for each patient. EMPOWERING YOU TO BE YOUR BEST Dr. Orbeck is motivated by empowering individuals to be their best in health, wellness, and vitality. Dr. Orbeck utilizes the power of metabolic and regenerative science to achieve internal wellness and external beauty one individual at a time. The Carolina's Leader in Integrative-Regenerative Medicine BIO-IDENTICAL HORMONE REPLACEMENT (Individualize & customized hormonal therapy) COMPREHENSIVE AESTHETIC CENTER (Advanced aesthetic care) INTIMATE WELLNESS CENTER (Sexual rejuvenation for men & women) IV NUTRITIONAL THERAPY CENTER (Intravenous application of nutrition & therapy for optimal wellness) Our Centers of Excellence

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 11 A lot of things that became essential during the heart of the COVID pandemic have gone the way of paper files and the $2 gallon of gas. Remember double masking, wearing sterile gloves to the supermarket and washing your groceries in the garage? Telehealth, however, is not only hanging on, but its future, especially as technology expands, is looking good. TELEHEALTH ISN’T GOING ANYWHERE By Laura Haight

12 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com Telehealth is an umbrella term for a number of methodologies, including virtual visits that connect physician and patient through visual and audio technology, phone calls and the sharing of data from wearable or implantable devices. Prior to COVID, fewer than 1% of patient medical visits were done remotely, while at the height of the pandemic, that number rose to 45%, according to Helping to drive adaptation across the board is an increasing acceptance of wearable tech and a focus on increasing development of new medical devices utilizing artificial intelligence and driven by the accessibility of 5G networks. Technology has always been a part of Dr. Darren Sidney’s practice. Dr. Sidney is an electrophysiologist with Charleston Heart Specialists, where implantable tech – pacemakers, defibrillators and wearable heart monitors – have been around for years. Electrophysiologists specialize in treating heart rhythm issues so their patients are used to being monitored remotely. “All the devices we implant have remote capability,” explained Dr. Sidney. “So we can see what their heart rhythm is doing from anywhere in the world.” New wearable devices such as KardiaMobile’s EKG, Apple Watch and Samsung Galaxy Watch 3, now approved as Class II medical devices by the Food and Drug Administration, are helping Dr. Sidney consult with patients without bringing them into the office. “Every day, I get emails from patients sending me strips,” said Dr. Sidney, who is on staff at Trident Medical Center. “More often than not, we’re talking them off the ledge. But sometimes we do find something abnormal, and we’re able to prescribe medication, walk them through some things or triage the situation – like do they have to come into the office or go to the ER.” For his specialty, this immediate access to information is critical. He anticipates some of the implantable tech will fall off as more and more patients become tech savvy and comfortable with wearable tech. But a big part in the equation, he believes, will be whether insurance companies develop codes to make charting and billing for telehealth visits easier and if they ever cover wearables such as FDA-approved smart watches. “That will open the floodgates,” he said. “It will be a game changer.” Communicating health data with your physician is one modality under the telehealth umbrella. Another is visits, which Dr. Sidney’s practice offers but does only a few each month. “My preference for a first-time visit is in person,” he admitted, adding that “by the time they get to me, most patients have seen a primary care doc, a cardiologist and have had some kind of imaging. A lot of times, we know what the plan for these patients is before we even meet them.” That’s not the case for Dr. Steven Newman, a primary care physician with Poinsett Family Practice in Greenville. When COVID hit, “we needed to convert as many patients as we could to a virtual visit,” he said. The practice went from 2% of telehealth visits to 90% within a week. Now, as COVID wanes, Dr. Newman finds 20% of patients are making the choice to do virtual visits because they like “the platform and its convenience.” Dr. Darren Sidney Dr. Steven Newman TELEHEALTH By the Numbers Today, 80% of employers believe telehealth will be a significant part of health care delivery in the future.** 91% of employers will offer telehealth service for mental health.** Prior to the pandemic, patients nationally waited an average of 24 DAYS for a medical appointment and spent less than 18 MINUTES with the physician.** The Health and Human Services Administration found that the highest share of video telehealth visits were used by adults 18 TO 34, those making more than $100,000, those with private insurance and those who were white. They were lowest among those without a high school diploma, older adults, Latinos, Asians and Blacks. (*Source: ASPE - Office of Health Policy) The CDC reports that as COVID took hold, 41% of U.S. adults delayed or avoided in-person medical visits. Telehealth helped resolve the problem with virtual care providers able to see a higher volume of patients, often outside typical office hours. (*Source: Forbes) 58.5% of telehealth users are female.* 28.7% of telehealth users are between 51 AND 70.* 70.5% are white.* *Source: Trilliant Health.** Source: Merritt Hawkins.

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 13 864-574-1195 GROW BUSINESS NOT GERMS. #dontstaydirty HEALTHCARE ENVIRONMENTAL SERVICES OFFICE/BANK CLEANING | INDUSTRIAL CLEANING EDUCATIONAL CLEANING | GOVERNMENT BUILDING CLEANING EVENT CENTER CLEANING | RELIGIOUS BUILDING CLEANING SERVICEMASTER JANATORIAL SERVICES CELEBRATING 12 YEARS SERVING GREENVILLE, SPARTANBURG AND SURROUNDING AREAS. Greenville’s family-owned source for compassionate care utilizing the latest dental technology. DANIEL J KNAUSE, DMD 2131 Woodruff Road, Suite 1100 , Greenville, SC 29607 At the corner of Hwy 14 and Woodruff Road ONE VISIT CROWNS CEREC Single Appointment Permanent Crowns. LASER DENTISTRY As one of fewer than 10 offices in the state with the groundbreaking Solea Laser, we have eliminated the drilling and need for numbing with most fillings. HOLISTIC OPTIONS At Southern Laser Dentistry, we respect the beliefs and needs of our patients who want the most natural and bio-compatible options. DR. K ALIGNERS In office design and manufacture of precision clear aligners at a great value. Brighten your BEAUTIFUL SMILE with FREE WHITENING after completion of Dr. K clear aligners. 864-288-8388 He cautioned that there is a “fairly limited spectrum of conditions amenable to be done virtually.” In that spectrum, he includes mental health and notes that “counseling about depression, anxiety, OCD, PTSD and those types of modalities clearly don’t need a physical exam.” Statistics that show behavioral health is a significant driver in the increase of telehealth visits. The increased accessibility at more medical practices is also helping to bring mental health services to underserved communities where no current practice exists. Where will all this go? Dr. Newman expects to see readily available devices in two to five years that will “measure vitals with much greater accuracy and may even be able to transmit electronically to labs.” A quick finger stick to measure cholesterol, potassium, sodium and blood sugar may all be accessible at home, he believes. But the big unanswered question is: Who’s going to pay for it? Another big question lingers for Dr. Newman who, as a primary care physician, is on the front lines of patient diagnosis. “We have to be very careful about not overutilizing virtual visits even though they are clearly convenient. Convenience is not always without a price. The price is you can’t develop relationships as easily with people with a Zoom meeting or a phone call. There is the element of human touch, of holding someone’s hand when they’re depressed. … You can’t do that over the phone. The patient and the physician have to understand that we cannot lose the humanity that makes the doctor-patient relationship one of the most sacred in the world.”

14 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com FAMILY & LOCALLY OWNED SINCE 1975 Experience the SPORTSCLUB DIFFERENCE FOCUS ON Better Hearing May Is Better Hearing Month Dr. Kathryn Miles Jackson, Au.D., ABAC Owner, Doctor of Audiology $500 OFF Advanced or Premium rechargeable devices with all-inclusive service. Expires 5/31/22. Offer cannot be combined with any other promotional discount. Greenville • 25 Woods Lake Rd, Ste 401 FULLY CONNECT WITH YOUR LOVED ONES! Call today to reserve your appointment! 864.990.0396

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 15 With so many options available for hearing care these days, it can be hard to know who to trust and how to understand what you’re getting from the process. Quality and thoroughness are sometimes compromised when it comes to the kind of service and care needed for people to experience optimal treatment outcomes with a compassionate expert leading the way. And because hearing is such a vital sense in almost every aspect of life, one of the premier places in the Upstate to have your hearing assessed and treated is Upstate Hearing & Balance in Greenville. Less than a year old, UHB is owned and operated by Doctor of Audiology Kathryn Miles Jackson. Her passion for providing professional, evidenced-based care for people with hearing loss, tinnitus and dizziness led her to found the practice in 2021 after working in ear, nose and throat clinics. “In my practice, I provide comprehensive, specialty audiology care in a comfortable, efficient private practice setting,” Dr. Jackson said. “We have a commitment to utilizing best practices – including assessing functional listening in background noise to using real-ear verification measures when programming hearing aids. We don’t cut corners.” UHB services include: • Hearing test - This first step determines if your hearing is at the proper level and serves to craft a treatment plan, if necessary, to renew your ability to hear. • Vertigo assessment and treatment - Positional vertigo is assessed and treated in the office, and the practice plans to grow vestibular – balance – assessment and treatment in the future. • Tinnitus assessment and treatment - Tinnitus often causes buzzing, ringing, whistling or roaring in the ears. An in-depth evaluation of this condition will help to create a specific treatment plan. • Hearing aid programming - Hearing aids are programmed using “real ear verification” measures – otherwise known as “probe microphone” measurements. A slender, soft tube microphone is inserted into the ear canal to measure the acoustic output of the hearing aid at the ear drum. • Aural rehabilitation - Steps include adjustment counseling for new users and their loved ones, along with learning to use visual cues, lip reading and retraining your brain to hear sounds you may not have heard in a long time. • Earwax management - Ear glands sometimes produce more cerumen, or wax, than necessary, to the point of causing pain or ear blockage. UHB removes impacted cerumen. • Custom hearing protection - Custom-molded earplugs offer a higher degree of comfort and sound protection, especially for hunters and shooters, motorcyclists and musicians. Ear impression services are available for those needing musician monitors or custom earbuds. • Cochlear implants - UHB works with local otologists to provide cochlear implant evaluations and mapping services for new and experienced users. No matter your specific need, UHB is committed to creating and delivering a custom-tailored treatment plan for every person. “It’s all about ensuring the best possible listening outcomes,” Dr. Jackson said. “Hearing loss and dizziness affect your ability to connect with your world. Upstate Hearing & Balance addresses those concerns compassionately and efficiently so that people can get back to living their lives to the fullest.” YOUR CHOICE FOR ALL THINGS HEARING For more information, visit By L. C. Leach III SPONSORED MEDICAL CONTENT Dr. Kathryn Jackson of Upstate Hearing & Balance.

16 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com EARLY INTERVENTION IS THE KEY WITH BIPOLAR DISORDER By Colin McCandless COVER STORY

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 17 Bipolar disorder is a mental illness that affects an estimated 7 million Americans annually. Recognizing its signs and symptoms early on can help lead to more effective treatment and management of the disease. Steven Krozer, PMHNP-BC, CEO, and head practitioner with iTrust Wellness Group, a psychiatric treatment facility in Greenville, said bipolar disorder is characterized by a series of highs and lows in mood. When an individual with bipolar is experiencing an elevated mood, the condition can manifest itself in extreme irritability, impulsive spending, insomnia, promiscuous behavior and extreme psychosis. During periods of lows, the disorder can cause depressive episodes in which a person has low energy and feels a lack of motivation. “People who struggle with sleep tend to have more severe symptoms,” noted Krozer. He explained that these mood fluctuations can occur over a period of days, weeks or months and typically in a cycle linked to events such as time change or a change of seasons. The different types of bipolar disorder include bipolar 1, which is more severe and less common, and bipolar 2, which is the most commonly diagnosed and less acute form of the disorder. Krozer emphasized that the most important point concerning treatment for bipolar disorder is that it differs from how depression is treated. Antidepressant medications are used to treat depression, whereas an antidepressant prescribed to treat bipolar could either make the response worse or result in no change at all. Medical treatments for bipolar include mood stabilizers and anti-psychotic medications. It cannot be treated with therapy alone, asserted Krozer. He advised a team-based approach combined with taking the appropriate medications. “The most important thing to consider is balance,” stated Krozer, adding that bipolar disorder affects the brain’s ability to regulate electrical and chemical pathways and creates an imbalance. During episodes of mania when people with bipolar are experiencing elevated moods, their dopamine levels are too high, whereas dopamine levels drop too low amid cycles of depression. Traditional treatments such as mood stabilizers can be used to help regulate the chemical and electrical imbalance bipolar causes, essentially fixing the wiring in a person’s brain. “Early intervention and treatment are key,” Krozer said. “We’re trying to promote getting effective and timely care so we can optimize the function of their brain.”

18 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com Krozer cited the analogy of faulty wiring in a house, which isn’t going to work properly until you correct the problem. “Unless you fix it, it won’t go away,” he said. Krozer recommended that if you suspect a family member or loved one may be bipolar, bring the person to see a mental health specialist such as a doctor specializing in mental illness or a nurse practitioner. He further suggested people taking mental health medication who “feel off” should consider seeing a specialist to determine if they have bipolar disorder. If there has been a misdiagnosis and a person is being treated with antidepressants, the medication can “produce an outcome opposite of the intention or a suboptimal outcome,” he said. “People naturally have highs and lows,” Krozer added. “It’s when it gets to extreme levels that it impacts quality of life and social functioning.” At iTrust Wellness Group, providers are trained to screen for physical, hormonal, electrical and chemical issues. “We believe that mental health is just as important as physical health,” he asserted. The National Alliance on Mental Illness serves as a helpful resource for information on bipolar disorder and offers online screening tools, according to Krozer. He also qualified that bipolar disorder is not necessarily a bad diagnosis, pointing out that an elevated mood can allow a person to accomplish more during these episodes of mania than they typically would. “Some of the most productive people are diagnosed with bipolar disease,” stated Krozer, referencing billionaire entrepreneur Elon Musk as one prominent example. “It’s kind of a superpower in some ways. But it could be detrimental if you don’t get the right treatment.” This is because every time someone with bipolar experiences symptoms, it can inflict damage to the brain over time. However, as long as bipolar disorder is properly managed, an individual with the condition can find balance and function in society. “Early intervention and treatment are key,” Krozer said. “We’re trying to promote getting effective and timely care so we can optimize the function of their brain.” BIPOLAR DISORDER By the Numbers The average age-of-onset for bipolar disorder is 25. On average, bipolar disorder results in a 9.2-YEAR reduction in expected life span. Bipolar disorder affects approximately 2.6% of people living in the United States annually. Bipolar disorder affects 45 MILLION people worldwide. ONE IN 20 American adults experienced a serious mental illness such as schizophrenia, bipolar disorder or major depression in 2020. Sources: CDC, World Health Organization, National Institutes of Mental Health and National Alliance on Mental Illness. Prevalence of bipolar disorder is highest among people in the 18 TO 29 demographic – 4.7% – followed by the 30 TO 44 age range at 3.5%.

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www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 21 If you have not already experienced vertigo, you have a 50% chance of dealing with at least one episode at some time in your life. If you are over the age of 50 and a woman, you face a slightly higher risk. This condition can range from being a brief, annoying health issue to a severe and debilitating problem. The sooner it is treated by a medical professional, the better for the patient. According to CORA PT Simpsonville Clinic Manager Stephanie Stewart, PT, DPT, OCS, “Vertigo can be caused by many different things, such as an inner ear problem created when small calcium particles or ‘crystals’ dislodge from their normal position; Meniere’s disease, which can cause a buildup of fluid and changing pressure in the ear; infection; trauma; and less common problems such as a tumors, medications and migraines. It can be tricky to unravel this type of problem, but it may be diagnosed by a family physician; an emergency room physician; and ear, nose and throat specialist; or a physical therapist. I see many patients who come in for balance problems or dizziness, and they have underlying vertigo that needs to be addressed.” In the past, physical therapy was not considered to be an option for treating vertigo, but that has changed. More family physicians and general practitioners are aware of and comfortable referring their patients to physical therapists who are trained in this area, and patients can also self-refer. The specific physical therapy protocol will be determined by the cause of the vertigo. For example, patients with benign paroxysmal positional vertigo receive head maneuvers to realign the crystals in the inner ear. Other activities such as eye movements, balance training and movement retraining also can decrease the symptoms of vertigo. After doing the head maneuvers, patients may be taught how to do home exercises and movements to continue the adjusting process. Standing on uneven pads to work on balance by challenging their center of gravity and directing eyes to different targets are two other common treatment protocols. Stewart is mindful that every patient is unique in treatment procedure and also in length of time for recovery. “I wish there was a magic number, but every patient is different. It’s not uncommon for me to see patients for one session, treat them and then they are fine. Unfortunately, it’s not always that easy. Some patients need multiple sessions to correct the inner ear problem or to retrain with techniques that decrease their overall symptoms. It all depends on the cause of their vertigo,” she explained. “There is a good chance that physical therapy can help vertigo symptoms go away completely, but, again, that depends on the overall cause. If the patient has symptoms of BPPV where the crystals are not in the correct area, then therapy can often resolve the symptoms. If there is any underlying medical condition or infection, it may take longer for symptoms to resolve or lessen. In this case, patients will often go through therapy until they progress to completing exercises on their own with a home program,” she added. With 20 years of experience in physical therapy – 6½ years with CORA – Stewart has been passionate about physical therapy for most of her life. She was impacted by the role of a physical therapist in a movie she saw while in the seventh grade, and she has never wavered in her calling. Stewart and her family moved to the Upstate of South Carolina in 2021 and “couldn’t be happier making memories here together.” IS VERTIGO THROWING YOU OFF BALANCE? For more information about treating vertigo with physical therapy, call CORA Physical Therapy in Simpsonville at 864-214-0430, or visit By Janet E Perrigo SPONSORED MEDICAL CONTENT

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www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 23 Have you ever been told to apply heat to a sprained ankle? Or to put raw meat on a black eye? Or to put something in the mouth of a seizure victim? Though we are now in the 21st century, many of our first-aid health myths persist to this day, having been handed down for many generations. And no matter the science, the research and the evidence, the following four health myths have been some of the hardest for health professionals to debunk: Starve a cold, feed a fever - You might have heard this saying two different ways – and though well-meaning, both are wrong. Dr. Jeremy Byrd, who specializes in internal medicine and pediatrics with Prisma Health System in Greenville County, said that in both circumstances, you need extra nutrition. “Both symptoms can tend toward dehydration, which is much more concerning than a temperature and may result in hospitalization,” Dr. Byrd said. “So whether you have a fever or a cold, you need all the nutrition and hydration necessary to help fight the illness.” Use butter to treat a burn - Ever touch a hot stove when you were a kid, and have mom and dad rush to treat it with a stick of butter? They were following not only a myth of uncertain origin but one that applied to removing burning tar off the skin of working men. “Butter is genuinely an awful choice to treat a burn,” Dr. Byrd said. “The primary problem with butter is that it is not an antiseptic. A burn, like any other injury, can become infected, so the most important thing is to keep the area clean and prevent infection.” Hydrogen peroxide is good for healing cuts - While hydrogen peroxide is not bad for cuts, Dr. Byrd said it doesn’t serve to heal the wound beyond the psychological form of a placebo. “I know there is something satisfying about the bubbles patients see after applying it to a cut – and even the burn that accompanies it,” he said. “But peroxide actually has minimal action against bacteria. And, with repeated applications, the wound may not heal appropriately and the peroxide can actually kill the tissue.” Instead, Dr. Byrd recommended a much more proven method of handling cuts: use clean water and soap. Tip your head back during a nosebleed - Actually, this can make the condition worse by causing the blood from the nose to run down the back of your throat, irritate your stomach and induce vomiting. And it won’t stop the nosebleed. While there are a couple of medical solutions to consider, Dr. Byrd recommended using your thumb and forefinger to firmly pinch the soft part of your nose shut – while sitting up and tilting your head slightly forward. “This applies to direct pressure to an area where the bleeding is usually coming from,” he said. “Doing this for about five minutes addresses the nosebleed. And the position minimizes the blood being swallowed or entering the airways and causing breathing problems.” If a medical myth has got you wondering, help is as close as a book, a computer or a doctor. “It is always good do your own research and to be very careful in seeking reliable sources,” Dr. Byrd said. “And the best thing is to find a provider you trust and discuss with him or her any information you have heard about any kind of medical treatment, major or minor.” HOME FIRST AID MYTHS: BETTER TO KNOW THAN TO GUESS For more information, visit By L. C. Leach III SPONSORED MEDICAL CONTENT

24 | www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com When we think of aging gracefully, we imagine entering into a season of life when meaning and purpose coalesce with comfort and quietude. Though it is the final chapter, it can be filled with ample opportunities to suck the marrow out of life. Pursuing physical and mental stimulation and taking a more proactive approach to health care are imperative to prolonging and fully enjoying this season. Establishing an ongoing patient-provider conversation is fundamental to living well at any age. According to Dr. Jerome Aya-Ay, primary care physician at Palmetto Proactive Healthcare, “Many Americans live in the reactive phase when it comes to their approach to health care.” While this practice is not beneficial for any patient, he stresses that it is even more critical for seniors to adopt a proactive mind-set and schedule regular visits with their primary care physician. As the body matures, the risk for disease increases, as does the impact of physical and psychological stressors. The following are five aspects of aging of which every senior should be aware and that can be addressed with a primary care provider: 1. Simply put, age is a risk factor for cardiovascular disease, hypertension, high cholesterol and diabetes. Regular appointments allow primary care physicians to conduct screenings and counsel patients on preventive measures. Dr. Aya-Ay recalled a 68-year-old patient who suffered a ministroke. Prior to the stroke, he “thought he was invincible” because he was seemingly in good health. Dr. Aya-Ay was able to guide the patient to a full recovery, and the man has no residual effects. But, he stresses, prevention is preferable to any reactive treatment. “You might look and feel great, but, with age, your risk for heart attack and stroke increases.” 2. Polypharmacy is a growing problem among the elderly population. According to Dr. Aya-Ay, most people start engaging in their health care in their 30s and 40s. From that point on, medications may be prescribed by other physician specialists. Polypharmacy can easily become counterproductive and even detrimental to a person’s health. Having a primary care physician who keeps track of and adjusts medications can help seniors avoid common side effects such as cognitive impairment and imbalance. Additionally, the AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, or the AGS Beers Criteria, contains nearly 100 medications or medication classes that elderly patients should avoid. “As a primary doctor, I quarterback everything,” Dr. Aya-Ay explained. “I look specifically at medications that do not benefit seniors, and I can alter or even eliminate them.” AGING GRACEFULLY MEANS LIVING PROACTIVELY By Jill Harper

www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 25 3. Malnutrition and undernutrition pose unique challenges to an aging body. Elderly people are more prone to osteoporosis and, therefore, need a diet that is rich in calcium and vitamin D. Whether it is not eating enough of the proper nutrients or consuming an excess of unhealthy food, the failure to practice good dietary habits is detrimental to a person’s health. Dr. Aya-Ay pointed out that some families live in food deserts, and, as a primary care provider, he can assess dietary needs and prescribe proper supplements. 4. In addition to proper nutrition, seniors need to engage in regular activity to improve balance and prevent falling. Bones are not a static structure. Appropriately stressing the bones with weight resistance and activities such as water aerobics will improve bone density. Dr. Aya-Ay counsels patients to find structured programs designed for geriatric patients. Additionally, part of the patient-provider conversation includes discussing home conditions such as carpets, rugs, stairs and showers. He also ensures that patients have a trusted and capable person nearby and an established plan if they do fall. 5. Preparation for the final stage of life is one of the most important conversations that seniors should proactively pursue with their physicians. Primary care providers can help patients decide between requesting a full code or do-not-resuscitate. Some providers, like Dr. Aya-Ay, will go so far as to help patients establish a living will and power of attorney and can facilitate conversations with loved ones so that everyone understands a patient’s wishes. Having an ongoing conversation about the unique aspects of aging is crucial to living proactively. Dr. Aya-Ay recommended that elderly patients see their physician every three months or more frequently if there are specific health concerns that need to be addressed. Establishing a working relationship with a primary care provider is one of the most important ways to ensure that the final years are truly the golden years. 355 Berkmans Lane Greenville, SC 29605 864.657.4473 Embrace more in your lifestyle Retirement is about more than just living. It’s about thriving in an environment full of possibilities. You’ll find all that, and more, at Oaks at Chanticleer (formerly The Haven in the Village at Chanticleer). In our personal care community, your loved one will encounter friendly neighbors who greet them with a smile and kindhearted team members who are always on the lookout for ways to brighten their day. They’ll quickly immerse themselves in a lifestyle that feels right from day one and only gets better with each passing day. After you and your family members experience the rich, rewarding nature of life at Oaks at Chanticleer (formerly The Haven in the Village at Chanticleer), you’ll understand why residents say time and time again they wish they’d moved here sooner.