The winter issue of Living Well magazine is here. Learn how to live each day a bit healthier—and happier—with our tips and advice.

1. WellWellLiving
PLUS Sofia Vergara
survived thyroid cancer
and became a TV star
ways to feel healthier
each and every day66
Loving
Life
NO MORE BELLY BUBBLES:
HERNIAS CAN BE FIXED
Enjoying Life After
Shoulder Pain
TIPS FOR A HAPPY, HEALTHY
HOLIDAY SEASON
LivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLivingLiving
BEAUFORTMEMORIAL.ORGWINTER 2016
MEET TWO LOWCOUNTRY-LOVING ONCOLOGISTS…OUT OF THE WHITE COAT See page 6.

2. ROBOTIC SURGERY
BMHDAVINCI.COM
Gynecological SurgeryGeneral Surgery
Patricia Thompson, MD Glenn Werner, MDDeanna Mansker, MD Stephen Sisco, MD Christopher Benson, MD Gregory Miller, MD
The da Vinci robot puts surgeons in the driver’s seat, allowing
them to steer a robotic arm that moves with greater range
and precision than the human wrist. This dexterity enables
minimally invasive procedures that reduce scarring and
speed recovery. And in our area, no one has more experience
putting the robot to work than Beaufort Memorial’s leading
team of da Vinci trained physicians.
Our drivers know how to
handle a tight corner.

3. FEATURES
WINTER 2016 1
INEVERYISSUE
2 Opening Thoughts
3 Introductions
4 Collected Wisdom
6 Out of the White Coat
8 Ask the Expert
32 The Quick List
33 This Just In
38 The Truth About
Depression
40 How To: Share a Diagnosis
42 Quiz: Freak Out
or Chill Out?
44 At a Glance:
Inside a Stroke
46 In the Market: Kale
48 Health by the Numbers:
Medication Mishaps
54 Foundation-Building
Hit the treadmill or the weights?
PAGE 34
9
Long Live Us
We’re living longer
than ever. How about
living better, too?
10
A Strong Voice
TV star and can-
cer survivor Sofia
Vergara is one of
many Americans
who deal with a
thyroid condition.
14
Making the Best
of Every Day
Simple strategies
for eating better, exercis-
ing more and coping with
chronic diseases.
22
When Cancer
Hits Home
A cancer diag-
nosis has a major impact
on the whole family, and
everybody needs support.
28
Take a Look
Inside
You know the
abbreviations, from CT to
MRI. But what do these
scans actually do?
49
Back in the
Groove
From shots to
surgery, there are many
options for patients suffer-
ing from shoulder pain.
8Ask the Expert
Certified registered
nurse practitioner Maggie
Bisceglia answers questions
about the treatment of
urinary incontinence, or
loss of bladder control.
Contents
WINTER 2016
COVER PHOTO BY MARK DAVIS/GETTY IMAGES | RUNNER BY SVETIKD/GETTY IMAGES |
KALE SALAD BY JENNIFER BOGGS/AMY PALIWODA/GLOW IMAGES | DUMBBELL BY FSTOP/GLOW IMAGES
Take it easy: You
can improve your
health in small,
manageable steps.
PAGE 14
THE BIG
STORY
52
Banished
Bubble
Hernias are
uncomfortable, unsightly—
and fixable with minimally
invasive robot-assisted
surgery.

4. OPENING THOUGHTS
GREETINGSFROMTHENEW
PRESIDENTANDCEO
I’d like to take this opportunity to introduce
myself to you and to provide you with exciting
information about your community hospital.
My name is Russell Baxley, and I am the new
president and chief executive officer for Beaufort
Memorial Hospital.
It has been just about 60 days since I assumed my
new post, and I am so impressed with the employees,
providers and community members who support—and
are supported by—this great organization.
Community hospitals play a critical role in the health and well-being of the
patients they serve, and my goal is to support the people who deliver care to you.
By ensuring you have access to the resources you need to live well, we will con-
tinue to fulfill our mission to provide superior healthcare services to our patients
and to improve the health of our community.
How will we do it? By focusing on quality, safety, stability and good steward-
ship of an organization that has served this community for nearly 75 years.
Whether offering new services, recruiting much-needed specialists, or expanding
and improving our facilities, the incredible leaders, board members and staff of
Beaufort Memorial are committed to you and your good health.
As evidence of our constant focus on becoming a highly reliable organization
through patient safety and quality outcomes, we recently were awarded three
“Zero Harm” awards by the South Carolina Hospital Association. The awards are
given to organizations that create and sustain dependable, safe and high-quality
care over a long period of time.
Our hospital was recognized for reporting zero central line-associated blood
stream infections (CLABSI) for 42 months; zero surgical site infections for colon
surgery patients for 42 months; and zero surgical site infections for abdominal
hysterectomy patients for 24 months. You can learn more about this and other
quality and safety topics by visiting beaufortmemorial.org.
You can also learn about the rebirth of our Collins Birthing Center, which will
be transformed through a 19-month renovation and expansion to enhance our
longstanding tradition of caring for Lowcountry newborns and their families.
I look forward to meeting you and sharing great news about your community
hospital and the people who stand ready to care for you. In the meantime, thank
you for welcoming my wife, Stephanie, and me to the Lowcountry.
With best regards,
Russell Baxley, MHA
President and CEO
Living Well, a subtitle of Vim & Vigor™, Winter 2016, Volume 32,
Number 4, is published quarterly by MANIFEST LLC, 4110 N.
Scottsdale Road, Suite 315, Scottsdale, AZ 85251, 602-395-5850.
Vim & Vigor™ is published for the purpose of disseminating health-
related information for the well-being of the general public and
its subscribers. The information contained in Vim & Vigor™ is not
intended for the purpose of diagnosing or prescribing. Please consult
your physician before undertaking any form of medical treatment and/
or adopting any exercise program or dietary guidelines. Vim & Vigor™
does not accept advertising promoting the consumption of alcohol
or tobacco. Copyright © 2016 by MANIFEST LLC. All rights reserved.
Subscriptions in U.S.: $4 for one year (4 issues). Single copies: $2.95.
For subscriptions, write: Circulation Manager, Vim & Vigor™, 4110 N.
Scottsdale Road, Suite 315, Scottsdale, AZ 85251.
BEAUFORT MEMORIAL HOSPITAL
PRESIDENT & CEO
Russell Baxley, MHA
BMH BOARD OF TRUSTEES
Terry Murray, Chair
William “Bill” Himmelsbach, Vice Chair
David Tedder, Secretary/Treasurer
Andrea Allen, MS, LMSW
Kathleen Cooper
Mark Dean, MD
David House
Faith Polkey, MD
James Simmons, MD
EX-OFFICIO MEMBERS
Norman Bettle, MD, Chief of Staff
Hugh Gouldthorpe, Foundation Chairman
Bill McBride, Beaufort County Council Representative
BMH EDITORIAL
Courtney McDermott, Director, Marketing & Communications
Sallie Stone, Editor and Marketing & Communications Content
Manager
Paul Nurnberg, Photographer
PRODUCTION
EDITORIAL
ASSOCIATE CREATIVE DIRECTOR: Matt Morgan
EDITOR-IN-CHIEF: Meredith Heagney
COPY DIRECTOR: C.J. Hutchinson
DESIGN
ASSOCIATE CREATIVE DIRECTOR: Chris McLaughlin
ART DIRECTORS: Cameron Anhalt, Molly Meisenzahl
PRODUCTION
SENIOR PRODUCTION MANAGER: Laura Marlowe
DIRECTOR OF PREMEDIA: Dane Nordine
PRODUCTION TECHNOLOGY SPECIALISTS: Julie Chan,
Sonia Fitzgerald
CIRCULATION
SENIOR DIRECTOR, LOGISTICS: Tracey Lenz
POSTAL AFFAIRS & LOGISTICS MANAGER: Janet Bracco
CLIENT SERVICES
SENIOR ACCOUNT DIRECTORS: Dawn Barnes, Mark Kats
ACCOUNT MANAGERS: Connie McCollom, Katie Murphy,
Marisa Mucci
ADMINISTRATION
CHIEF EXECUTIVE OFFICER: Jason Benedict
SVP, BUSINESS DEVELOPMENT – HEALTHCARE:
Gregg Radzely, 212-574-4380
CHIEF CONTENT OFFICER: Beth Tomkiw
Beaufort Memorial Hospital
955 Ribaut Road
Beaufort, SC 29902
843-522-5200
843-522-5585 – Doctor Referral Service
For address changes or to be removed from the mailing list,
please visit mcmurrytmg.com/circulation.
WINTER 20162

5. Brandon McElroy, MD
Board-eligible internist Brandon
McElroy, MD, has joined Philip
Cusumano, MD, and Robert
Vyge, MD, at Beaufort Memorial
Lady’s Island Internal Medicine. A
summa cum laude graduate of the
University of Tennessee, McElroy
earned his Doctor of Medicine
degree from the university’s Health
Science Center in 2013. During his
four years in medical school, he volunteered at a free clinic
for uninsured adult patients and mentored fellow medical
students. He completed his medical residency this spring at
the Medical University of South Carolina.
INTRODUCING…The newest members of the BMH team
INTRODUCTIONS
Melanie Mooney, MD
Beaufort Memorial Bluffton
Primary Care has added Melanie
Mooney, MD, to its medical staff.
A board-certified family medicine
specialist with 12 years’ experience,
Mooney worked most recently
for a family medicine practice in
Columbia, Kentucky. She started
her career in 2004 at a primary
care practice owned by Westlake
Regional Hospital in Columbia. She later accepted a position
with KentuckyOne Primary Care of Hodgenville. A graduate
of the University of Louisville School of Medicine, Mooney
completed her internship and residency at the school’s
Glasgow/Barren County Family Medicine. During her training,
she worked on the medical staff of Rivendell Behavioral Health
Services and in the emergency department at T.J. Samson
Community Hospital.
Brad Kelly, DO
To meet the growing demand for
healthcare services in Hampton
County, Beaufort Memorial has
added another board-certified
family medicine specialist to the
staff at its Harrison Peeples Health
Care Center. Brad Kelly, DO, com-
pleted his residency at St. Elizabeth
Healthcare in Edgewood, Kentucky,
where he served as house physician
for a 500-bed hospital and led the Code Blue team. Prior to
graduating from the University of Pikeville Kentucky College
of Osteopathic Medicine, Kelly worked as a nursing care tech-
nician for three years at the University of Kentucky Chandler
Medical Center.
William Schreffler,
NP-C
After earning a master’s degree
and certification as a nurse prac-
titioner, William Schreffler has
returned to Beaufort Memorial
Hospital, where he served for
five years as a perioperative nurse.
In his new role as an advanced
practice provider, he will be work-
ing with orthopaedic surgeon Kevin
Jones, MD, at Beaufort Memorial Orthopaedic Specialists. A
graduate of East Carolina University with a bachelor’s degree
in nursing, Schreffler brings 10 years of operating room
experience to the job. He worked for three years as a periop-
erative nurse at Pitt County Memorial Hospital in Greenville,
North Carolina, before joining the staff at BMH. He left
the hospital in 2014 to pursue nurse practitioner studies at
Frontier Nursing University in Kentucky.
WINTER 2016 3

6. PHOTOSBYTHINKSTOCK
HEALTHYHOLIDAYSKeep the happy in your holidays with these helpful tips
on how to enjoy a stress-free, healthful season
Fitting in
FITNESSWith all the Christmas parties, gift shopping
and holiday baking to do, you may find it dif-
ficult to fit in your usual workout at the gym.
But that doesn’t mean you can’t meet your
exercise goals.
Any moderate- or vigorous-intensity activ-
ity performed for at least 10 minutes counts
toward the recommended 150 minutes of
aerobic activity a week. Here are a few options
to keep you moving:
3Brisk walking
3Biking slowly
3Canoeing
3Dancing
3Gardening
3Water aerobics
3Playing kickball with the kids
If you can’t spare 30 minutes for a walk, jog
for 15 minutes instead. In general, 15 minutes
of vigorous aerobic exercise provides the same
benefits as 30 minutes of moderate activity.
COLLECTED WISDOM
WEBSITE
Calorie Counter
The number of calories you burn
during exercise depends on
your weight, the type of activ-
ity and how long you do it. You’ll
find a Calorie Burner Calculator
at beaufortmemorial.org.
Click the “Health Resources”
tab, then “Health Library” and
“Wellness Tools.”
STUFFED BABY PUMPKINS
Looking for a holiday meal that’s festive and healthy? Try this delicious recipe
from Beaufort Memorial Executive Chef Michael Ramey.
INGREDIENTS
6 teaspoons canola oil, divided
1 butternut squash, peeled, seeded
and diced into ½-inch pieces
4 ounces andouille sausage, diced into
¼-inch pieces
½ cup chopped yellow onion
½ cup peeled pear, diced into ¼-inch
pieces
2 teaspoons brown sugar
¼ cup dry sherry
1 cup cooked wild rice/long grain blend
¼ cup dried cranberries
1 teaspoon fresh thyme
1 teaspoon dry sage
1 teaspoon salt
½ cup 99% fat-free chicken stock
4 sugar or pie pumpkins hollowed,
tops removed and reserved
Preheat oven to 350 degrees. Heat 2 teaspoons of oil in a large sauté pan over
moderately high heat and add the squash, stirring occasionally for two to three
minutes to brown evenly. Turn the heat to medium and cook squash another three
to four minutes until just tender. Add the andouille and onion and cook until the
onion just begins to color. Add the pear and cook for three minutes, then add the
sugar and sherry and cook for two minutes. Remove from the heat.
Season inside of each pumpkin with salt and pepper to taste. In a large bowl,
combine the rice, cranberries, thyme, sage, salt and stock. Stir in the sausage
mixture and divide evenly among the pumpkins, lightly packing. Cover with the
reserved tops. Rub each of the pumpkins with 1 teaspoon of oil. Place in a shallow
baking dish and cover with foil. Bake, covered, for 20 minutes. Remove foil and
bake for an additional 10 minutes.
Chef’s Note: Omit the andouille and replace the chicken stock with vegetable
stock for a tasty holiday vegan entrée.
WINTER 20164

7. KEEP IT SIMPLE and
STRESS-FREE
You don’t need to be Martha Stewart to create holiday
traditions your family will remember. Rather than trying
to check off everything on your to-do list and driving
yourself crazy in the process, focus on a few simple
things that will make the season special.
Maybe this year you don’t send out holiday cards.
Instead, spend an evening baking cookies with the kids.
Skip the store-bought knick-knacks and use natural
decorations, like branches, berries and acorns from
your backyard, to give your house a warm, welcoming
feel. A naturally scented cinnamon candle will add to
the ambiance.
Sit by a crackling fire. Warm up with hot cocoa. Take a
moonlight walk with your sweetie. The idea is to reduce
your stress and enjoy the holidays. If you start to feel
overwhelmed, take a breather. Spend 15 minutes doing
something that clears your mind and relaxes you, like
reading a book or listening to soothing music.
It’s not just about keeping your sanity. Stress can
weaken your immune system, making you more suscepti-
ble to a host of ailments, from insomnia to heart disease.
Holiday
Health Tips
The holidays are no fun if you’re laid
up in bed with a cold or flu. Here are
six things you can do to stay healthy
this winter:
1Wash your hands often or
use an alcohol-based sanitizer.
The germs on your hands are the
single biggest threat to your health.
2If you’re traveling in an airplane,
bus or train, use disinfecting
wipes to clean the armrests, tray
table, air vent and seat-belt buckle.
3Stay hydrated to ensure your
mucous membranes are moist
so they can better keep bugs out of
your system.
4A holiday cookie or two is OK,
but avoid overindulging in
high-fat, salty or sugary foods.
5Drink in moderation. Alternate
between alcoholic and nonalco-
holic drinks, such as sparkling water
with lime.
6Get your zzzs. A study found
people who snoozed at least eight
hours nightly were about three times
less likely to catch a cold than those
who slept less than seven hours.
BYTHE
NUMBERS
344Calories in a cup
of eggnog
50–60
Percentage an influenza
vaccination will reduce
your risk of getting the flu
5–20Percentage of the U.S.
population that will get
the flu, on average,
each year
90Number of minutes you
need to walk to burn
off those calories
1Average weight gain, in
pounds, of adults over
the holidays, according to
several studies; common
wisdom has often placed
the figure much higher
Sources: beaufortmemorial.org,
CalorieKing, CDC, Public Library
of Science, WebMD
WINTER 2016 5

8. OUT OF THE WHITE COAT
search for the Caribbean beach villa was
featured in a 2007 episode of HGTV’s
House Hunters International.
“I try to get out there four or five
times a year,” Chahin says. “It’s a great
place for scuba diving. You can put on
your gear, walk into the water and swim
right to the reefs.”
When it’s too cold in the Lowcountry
to swim, Chahin is happy just sitting
with friends on his cruiser, “Knot on
Call,” enjoying the ambience of the
Historic District from Beaufort’s down-
town marina.
Boating isn’t the only recreational
activity from his adolescence Chahin
has revisited. He’s also taken up motor-
cycle riding again. Most of the time, he
stays close to home, riding his Harley-
Davidson Road King to Charleston
or Savannah.
On occasion, he makes a vacation
out of it.
“I’ve done some pretty cool rides
with friends,” he says. “One of my favor-
ite trips was riding from Vegas to Death
Valley in California.”
CALL
Majd Chahin, MD, is a
board-certified specialist
in medical oncology and
hematology at Beaufort
Memorial Medical Oncology
in the Keyserling Cancer
Center. He can be reached
at 843-521-9879.
Medical oncologist Majd
Chahin takes advantage of the
Lowcountry weather by riding
his motorcycle and boating.
Majd Chahin, MD
Growing up on the Syrian
coast, Majd Chahin, MD,
has always had an affinity
for the water.
“It’s in my blood,” says the Beaufort
Memorial medical oncologist. “As a
kid, going to the beach was part of my
everyday life.”
As soon as he completed his medical
oncology training at Emory University,
Chahin returned to his aquatic roots, set-
tling in Beaufort to open the community’s
first full-time medical oncology practice.
“I wanted to live in a small town,
close to the water with weather similar
to where I grew up,” he says.
Beaufort filled the bill. Living on the
river on Coosaw Island has allowed him
to enjoy the pleasures of his youth—
and pass on his love of the water to
his three children, now grown and off
at school.
“When they were young, my kids
loved playing on the sandbars,” Chahin
recalls. “They used to cover them-
selves with mud. That was their life in
the summer.”
Chahin’s vacation home is also on
the water—in Curacao’s Blue Bay. His
ONCOLOGISTS,
OFF-DUTYCoastal lifestyle draws
Beaufort Memorial oncologists
to the Lowcountry
WINTER 20166

9. Radiation oncologist Jonathan
Briggs is a longtime competitive
swimmer who loves Beaufort’s
pools and beaches.
Jonathan Briggs, MD
Despite living for years near
the Jersey Shore, Jonathan
Briggs, MD, couldn’t pass up
the opportunity to try a different kind
of coastal lifestyle. So after accepting
a position with Beaufort Memorial
Keyserling Cancer Center this past
spring, the radiation oncologist moved
his expectant wife, Michele, and three
children to the Lowcountry.
“I knew my kids would enjoy living on
the coast and all the water activities we
can do here,” Briggs says. “We started
going to the beach this summer and
have really loved it.”
As the father of a growing family,
Briggs, 50, sees additional appeal
in Beaufort.
“With four kids, I’m never going to
retire,” he quips. “I thought it would be
nice to live in a place where at least on
the weekends I can pretend I’m retired.”
Briggs also is enjoying swimming again
after injuring his knee two years ago.
With the Beaufort YMCA just a half-mile
from his cancer center office, he can
break away at lunchtime three or four
times a week and get in 100 laps at the
fitness center’s pool.
“It’s helping me get back into shape,”
Briggs says. “After I injured my knee,
I was eating all kinds of comfort food
and gained 30 pounds.”
To swim eight laps in the 25-yard pool
takes him three minutes. In a typical
one-hour session, Briggs will complete
four or five eight-lap sets before taking
a break. Then he’ll start over, trying to
improve his time as he goes.
“It’s a sport that’s about power, but
also technique,” he says. “I coach myself
because there’s always something you
can do to get better.”
A competitive swimmer at Lafayette
College in Pennsylvania, Briggs special-
ized in the backstroke and distance
events. In later years he went on to
compete in the U.S. Masters Swimming
program. Next year, he hopes to partici-
pate in the 11th Annual Beaufort River
Swim, a 3-mile open-water race along
the downtown shoreline.
“When I’m submerged in the water, I
have no other distractions,” Briggs says.
“It’s very soothing.” n
CALL
Jonathan Briggs, MD,
is a board-certified
radiation oncologist
with Beaufort Memorial
Keyserling Cancer Center.
He can be reached at
843-522-7800.
WINTER 2016 7

10. ASK THE EXPERT
AFIXFORLEAKYPIPESLoss of bladder control plagues millions of women,
especially as they get older. But you don’t have to suffer
in silence. New treatments can put a stop to the embarrassing
problem of stress urinary incontinence, says BMH certified
registered nurse practitioner Maggie Bisceglia.
Q
What is stress urinary
incontinence?
SUI is an involuntary leakage
of urine that occurs when a physical
activity or movement, like coughing,
sneezing, laughing, running or lifting
something heavy, puts pressure on
your bladder.
Q
What causes it?
Anything that weakens your pel-
vic floor muscles—the muscles
that support your bladder—can cause
stress incontinence. Childbirth, meno-
pause, obesity or physical changes asso-
ciated with aging are common culprits.
Q
Can SUI be treated?
Yes. You can strengthen
your pelvic floor muscles by
performing Kegel exercises. Your doctor
may recommend supervised pelvic floor
therapy with a specially trained physical
therapist to ensure you do the exercises
correctly. How well it works will depend
on whether you perform them regularly.
One of the latest advancements in
bladder control treatment is a prescrip-
tion medical device that does the Kegels
for you, only much more strongly than
you could do them yourself. Sold under
the name Apex or Intone, the device
strengthens the pelvic floor muscle
using intravaginal electrical stimulation.
The treatment requires that you use the
device five to 10 minutes a day, six days
a week for 14 weeks, then twice a week
for maintenance. Many women prefer
this option because it can be done in
the privacy of their home.
For women with a prolapsed bladder,
another treatment option is a vaginal
pessary, a mechanical device that helps
support your bladder base to prevent
urine leakage during activity.
Q
Is stress incontinence
a normal part of the
aging process?
No, it is not normal, although a lot of
women accept it as such. They manage
the urinary leakage by using incontinence
pads, which can be effective, though
wearing pads all the time can cause other
problems, including a skin rash or yeast
infection. (If you use the pads and are
embarrassed to purchase them at your
local grocery store or pharmacy, be
aware that they can be ordered online.)
When their incontinence is severe, some
women will get to the point that they’re
afraid to leave the house. n
CALL
Make an
Appointment
Maggie Bisceglia is a certified
registered nurse practitio-
ner with Beaufort Memorial
Obstetrics & Gynecology
Specialists. She can be reached
at 843-522-7820.
Maggie Bisceglia,
CRNP, offers
treatment and
advice for people
facing bladder-
control issues.
PHOTOBYTHINKSTOCK
WINTER 20168

11. In America, the average life expectancy
is 78.8 and going up. In fact, we’ve gained
a couple of years in the past two decades—
the life expectancy in 1996 was 76.1.
The seven leading causes of death are:
heart disease, cancer, chronic lower
respiratory diseases, accidents, stroke,
Alzheimer’s disease and diabetes.
A healthy diet, not smoking, staying
active, managing stress and taking basic
safety precautions can lower our risk
of premature death.
The bad news? More than one-third
(34.9 percent) of U.S. adults are obese,
a major risk factor for disease.
The good news? Fewer people are
smoking. Just less than 17 percent of U.S.
adults smoke; in 1965, it was 42 percent.
And while 39.6 percent of men and
women in the U.S. will have cancer in their
lifetimes, the overall cancer death rate has
declined since the early 1990s.
As the average life span increases, we have more opportunities
than ever to improve our health. So what are we waiting for? You have the
power to improve
your health and
prevent or manage
disease, maximiz-
ing the years you
have—both in
length and quality.
Read on to find
out how.
Sources: Centers for Disease Control and Prevention; National Cancer Institute
PHOTOBYALTRENDO/GLOWIMAGES
You don’t have
to meditate on
a mountaintop
to live your
best life.
Issue
The
Health
Day-to-Day
LONG LIVE US
WINTER 2016 9

12. Being diagnosed with cancer was no laughing
matter for Sofia Vergara, but it gave the comedic
actress a powerful new platform
BY KEVIN JOY
VOVOVIOIOCICI ECEC
STRONG
A

13. A
double threat of acting
chops and stunning looks
have made Sofia Vergara
a leading lady in Hollywood.
Try not to be charmed by her
charisma; it’s impossible.
The Colombian-born actress
and model can be serious,
however: One of her public roles
involves speaking out about a
disease whose aftereffects she
manages every day.
In 2000, Vergara—almost a decade before
landing her laugh-out-loud role as spitfire
Gloria Delgado-Pritchett on the ABC sitcom
Modern Family—was given a serious, real-life
diagnosis: thyroid cancer.
The butterfly-shaped gland at the base of
her neck would have to be removed.
Vergara, now 44, couldn’t believe the
news. “I was in shock,” she recalled to
The New York Times. “I was 28 and I wasn’t
smoking. I wasn’t doing many things that
are unhealthy.”
Such a scenario isn’t unusual.
R. Michael Tuttle, MD, a medical
adviser for the Thyroid Cancer Survivors’
Association, says little is known about
what causes cancer (and other disorders)
of the thyroid, a vital endocrine gland. Its
job is to secrete hormones necessary for
regulating temperature, heart rate, mood
and metabolism, among other things.
It is, as Tuttle explains, “your body’s
speedometer.”
Fortunately, for the 20 million Americans
believed to have some form of thyroid
disease, most issues are highly treatable
with medication and, where cancer is
concerned, surgery.
Consider the vivacious Emmy-nominated
bombshell as proof.
“If you know what to do and find the
right care,” Vergara told Parade magazine,
“you can live a normal life.”
PHOTOBYALLENBEREZOVSKY/GETTYIMAGES
WINTER 2016 11

14. Sofia Vergara married
husband Joe Manganiello,
of Magic Mike fame, in 2015.
A SOMETIMES-SILENT
CANCER
Like Vergara, many people in the early
stages of thyroid cancer have no symp-
toms. In fact, Tuttle says, the cancer
is often detected unexpectedly when
testing for other health conditions.
Those with more advanced cases
may experience clearer signs of poten-
tial trouble: hoarseness, difficulty
swallowing or the emergence of nod-
ules (solid or fluid-filled lumps that,
although common, are cancerous less
than 10 percent of the time).
In either scenario, a doctor will
feel around your neck for abnormali-
ties before deciding whether to order
diagnostic tests such as blood work or
an ultrasound.
That’s how an otherwise healthy
Vergara was first diagnosed. She took
her son to an endocrinologist, con-
cerned about a family history of dia-
betes. The doctor checked her son and
then examined Vergara, too; he found
a lump in her neck.
“It’s not like colon cancer or breast
cancer, where there are certain screen-
ings,” says Tuttle, who has treated more
than 2,000 patients with thyroid cancer.
The most common and often slow-
growing forms are known as papillary
and follicular thyroid cancer; combined,
they account for about 90 percent
of cases. Other variations, including
medullary and anaplastic, are much
rarer but typically more aggressive and
tougher to treat.
Total or partial surgical removal of
the thyroid is usually quick. Most folks,
Tuttle says, are back to work within a
few days. Some, including Vergara, have
to ingest radioactive iodine via tablets
to fully eradicate the cancer. Others
with more aggressive tumors may
need chemotherapy.
LIFE WITHOUT A THYROID
The complete loss of one’s thy-
roid, meanwhile, leaves a person
hypothyroid—in other words, unable to
make enough thyroid hormone for the
body to work properly. That requires a
lifetime of daily medicine to simulate
the absent function.
“We give the body the same hor-
mone that the thyroid was producing,”
says Antonio Bianco, MD, president
of the American Thyroid Association.
“The body, in fact, does not know
the difference.”
Finding the proper dosage may
require some tweaks, though. Vergara,
for one, says she “religiously” sees
her doctor and has her thyroid levels
checked every three to six months.
This explains why, when she became
a paid spokeswoman for a thyroid medi-
cation in 2013, Vergara stressed the
2 She has enjoyed a four-year streak of
being the highest-earning TV actress; in
2015, she shared the honor with The Big
Bang Theory’s Kaley Cuoco. Each made
$28.5 million.
3 She used to watch Spanish-dubbed
episodes of the sitcom Married… with
Children, which starred her future
Modern Family “husband” Jay Pritchett
(Ed O’Neill).
4 She relies on custom couture to offer
extra support for her voluptuous frame
and says she might one day seek breast-
reduction surgery.
5 She loves to read. Vergara plows through
several books each month, often reading
for hours at a time.
6 She’s good friends with another famous
Colombian: pop star Shakira.
7 She became a U.S. citizen in 2014.
Vergara earned a perfect score on
the 100-question test and called the
process “very emotional.”
1 She got her start in a Pepsi commercial at
age 17 and soon after made her mark as a
television host on the Univision network.
7 THINGS YOU MIGHT NOT KNOW
ABOUT SOFIA VERGARA
WINTER 201612

15. PHOTOBYARAYADIAZ/GETTYIMAGES
importance of routine.
“The last thing I do at night is get my
pill ready, and the first thing I do in the
morning is take the pill before I jump
in the shower,” she told the Spanish-
language newspaper La Opinión. “I don’t
think about it anymore.”
Also helping Vergara and plenty
of others take the diagnosis off their
minds: The five-year survival rate of
papillary and follicular thyroid cancers,
when caught early, is nearly 100 percent.
OTHER THYROID ISSUES
Cancer isn’t the only factor that can
affect thyroid function.
The hypothyroidism that Vergara
developed as a result of physically los-
ing her thyroid can also be triggered by
autoimmune disorders—that’s when
the body’s immune system mistakenly
attacks and destroys cells—such as
Hashimoto’s disease.
Left untreated, “it really creates emo-
tional problems, decreasing the quality
of life,” Bianco says.
Hypothyroidism affects nearly 1 in 20
Americans ages 12 and older. Symptoms
may include fatigue, dry skin, feel-
ing cold, heavy menstrual periods and
weight gain. It can be treated with thy-
roid hormone replacement therapy.
But feeling exhausted or bloated
doesn’t always mean the thyroid is to
blame. Doctors can confirm thyroid
problems with blood tests that gauge
whether levels of the thyroid-stimulating
hormone, or TSH, are out of whack.
Affecting about 1 in 100, a far less
common condition—hyperthyroidism,
sometimes called “overactive thyroid”—
is the opposite scenario. That’s when,
often prompted by an autoimmune
disorder called Graves’ disease or an
inflammation known as thyroiditis, the
thyroid gland produces more hormones
than the body needs.
Among the side effects: heavy sweating
or excessive warmth, vision problems,
sudden weight loss and constipation.
“You feel like you’re sitting waiting
for the roller coaster to take off; your
heart’s running at 90 miles an hour,”
Tuttle says.
In this case, hormone-blocking medi-
cation is a first line of defense, although
radioactive iodine ultimately may be
required to disable the thyroid (or sur-
gery to remove it).
Thyroid cancer, hypothyroidism
and hyperthyroidism all can cause an
enlarged thyroid gland, called a goiter.
But a goiter does not always mean there
is a thyroid problem.
Where noncancerous nodules are
concerned, your doctor may choose to
monitor growth over time before taking
further action.
GREATER AWARENESS
Thyroid cancer is the most rapidly
increasing cancer in the U.S. Although
still rare, it was expected to include
about 62,450 new cases in 2015, accord-
ing to the American Cancer Society.
That, experts say, doesn’t signal
an epidemic but instead means greater
awareness and detection of thyroid
disease, thanks to public advocates
like Vergara and to more advanced
diagnostic methods.
Recurrence, though, is a risk—even
years after surgery—which means con-
tinuing a dialogue with one’s doctor
and living healthfully are key.
By working with a personal trainer to
develop an exercise plan and maintain a
balanced diet, Vergara is doing her part.
With a bit of wiggle room, of course.
The ever-feisty Gloria of Modern Family,
after all, wouldn’t stand for cutting out
all the fun.
“You have to live your life and be
happy,” Vergara told the Huffington Post,
noting that she continues to enjoy des-
sert and the occasional cocktail. “But
it’s important to go to the doctor, to
have your checkups, to work out, eat
healthy, everything. Do everything
that you can.” I
WINTER 2016 13
FACTORS THAT
AFFECT YOUR
THYROID:
Although the root causes of thyroid prob-
lems and cancer are mostly unclear, there
are ways to gauge your risk.
3GENDER: “Women are much more
likely to develop hypothyroidism than men,
by a ratio of 10-to-1,” says board-certified
family medicine specialist Neal Shealy, MD,
of Beaufort Memorial Harrison Peeples
Health Care Center.
3AGE: The risk of hypothyroidism—the
second most common endocrine health
problem behind diabetes—increases as
you age. “About 2 to 3 percent of older
women will develop an underactive thy-
roid,” Shealy says.
3AUTOIMMUNE DISEASE OF THE
THYROID: “The radiation, radioactive
iodine or surgery used to treat Graves’
disease can lead to hypothyroidism,”
Shealy says. “You start out with an over-
active thyroid and end up with an under-
active thyroid.”
3GENETICS: Find out whether your fam-
ily has a history of thyroid disorders. Genes,
in some circumstances, can play a role.
EVENT
Find Support
The Thyroid Cancer Survivors’
Association offers a host of
local meetup groups—as well
as phone and email support
networks—throughout the
United States and in other
countries for survivors and
their families. Visit thyca.org.

16. MAKING
THE BIG STORY
WINTER 201614

17. Most of us think about our health every day,
whether we’re trying to eat right or living with
chronic disease. With a little patience and a plan, we
can take small steps to reach our goals and feel better.
BY STEPHANIE CONNER
PHOTOBYSVETIKD/GETTYIMAGES
OF EVERY DAY
THE BEST
WINTER 2016 15

18. You can
feel better
in just 30 days,
without a major
life overhaul
HEALTHIER DIET
If we are what we eat, most Americans are in
trouble. Big time.
And it can feel like an insurmountable feat to
go from drive-thru cheeseburgers and processed
snacks to salads and nutrient-dense foods.
But it might be easier than you think. “You
don’t start off by running a marathon,” says
Jessica Crandall, a registered dietitian nutritionist
and spokeswoman for the Academy of Nutrition
and Dietetics. “You start by running that first mile.”
Or maybe even walking that first mile.
ONE MONTH TO A
SMALL
CHANGES
No need to reinvent the
wheel. Little tweaks to
your food and exercise
routine can pay off.
PHOTOBYHEROIMAGES/GLOWIMAGES
WINTER 201616

19. So let’s take it slow, making one sim-
ple change every day or two for a total
of 19 small changes over 30 days. We
started on a Sunday; you, of course, can
start whenever you feel the time is right.
DAY 1 (SUNDAY): Prepare for the
workweek by packing snacks you can
keep in your desk drawer, like a healthy
trail mix or dried fruit, advises Marjorie
Nolan Cohn, a registered dietitian
nutritionist and spokeswoman for the
Academy of Nutrition and Dietetics.
DAY 2 (MONDAY): “Make breakfast
a priority,” Crandall says. “It sets the
tone for the rest of the day.” Consider
a hard-boiled egg and low-fat cottage
cheese for a high-protein meal that will
leave you satisfied.
…
DAY 4 (WEDNESDAY): Pass on soda
at lunchtime and sip on water instead.
…
DAY 6 (FRIDAY): Don’t want to miss
happy hour? Go ahead and participate,
but opt for a wine spritzer, which waters
down the vino, cutting the alcohol,
sugar and calories.
DAY 7 (SATURDAY): Date night! Skip
the pasta and choose a fish or grilled
chicken dish instead.
DAY 8 (SUNDAY): For brunch, get in
the habit of forgoing high-carb pancakes
and French toast. “I encourage my cli-
ents to do an omelet—something that
has a more solid protein,” Cohn says.
DAY 9 (MONDAY): Replace the mayo
on your sandwich with mustard to cut
calories but retain flavor.
DAY 10 (TUESDAY): Go to bed early.
“It’s been proven that … sleep plays a
major role in weight loss—and in keeping
weight off,” Cohn says. Sleeping about
eight hours a night can regulate hormone
levels and help minimize cravings. “Plus,
if you go to bed before 11 p.m., you won’t
have that midnight snack.”
…
DAY 12 (THURSDAY): Read the
menus of your favorite restaurants and
choose a few nutritious go-tos. “You can
get perfectly healthy takeout,” Cohn
says. Look for meals with lean proteins
and plenty of veggies.
DAY 13 (FRIDAY): Get rid of all the
chips in your pantry. If you feel you
need to snack on something crunchy,
Crandall suggests almonds.
DAY 14 (SATURDAY): Hit the
farmers market for fresh fruits and
vegetables—in as many colors as you
can find.
…
DAY 17 (TUESDAY): Progress check!
And no, not the number on the scale.
People often have unrealistic expec-
tations of how quickly they’ll lose
weight once they start a healthy eating
plan, Cohn says. “Are you feeling bet-
ter? Is your skin clearer? Are you able
to concentrate at work better?” she
says. “What other positive things are
you feeling?”
…
DAY 20 (FRIDAY): Try another
change to happy hour. “Drink a glass
of water before each glass of alcohol,”
Crandall says, to decrease liquid calories.
…
DAY 22 (SUNDAY): Get ready for
the workweek. If your office has a
freezer, Cohn suggests bringing pre-
cooked chicken, veggie burgers and
vegetables to microwave for lunch.
DAY 23 (MONDAY): Start ordering
your burger without the bun to cut out
calories and waistline-expanding carbs.
…
DAY 26 (THURSDAY): Make it a
habit to ask your waiter about replacing
french fries with a fresh veggie.
DAY 27 (FRIDAY): Having a hard
time passing on luscious desserts? “Fruit
is always a great option,” Crandall says.
You can even drizzle some melted dark
chocolate over it.
…
DAY 29 (SUNDAY): Change up your
morning java. Swap out full-fat milk for
a low-fat version or milk substitute, and
lay off the sugar. Try cinnamon or nut-
meg to flavor coffee instead.
DAY 30 (MONDAY): Make a commit-
ment to build on your successes. Small
changes, Cohn says, lead to a healthier
lifestyle that you’ll be able to maintain
over time. So keep going! n
WINTER 2016 17
GET MOVING
Whether you’re on Day One or Day
30, you’ll always help your health by
adding exercise to your routine.
“You achieve the maximum benefit
combining exercise with a healthy
diet,” says Kristen Clark, a wellness
coach at the Beaufort Memorial
LifeFit Wellness Center.
Here are a few simple ways to
get exercise:
3MOVE MORE. “Take the stairs
instead of the elevator, park
farther away in the parking lot or
walk the dog an extra 10 minutes,”
Clark suggests.
3INCORPORATE STRENGTH-
BUILDING EXERCISES INTO YOUR
ROUTINE. “You don’t need special
equipment,” Clark says. “You can do
squats using a chair or plank on the
floor or against a counter.” A trainer
can help you learn the proper form,
or you can pick up an exercise DVD at
the library.
3GAUGE HOW YOU FEEL. “Look for
things outside of the scale that show
improvement,” Clark says. “You may
find your clothes fit better or you have
more energy.”
CALL
Pump It Up
LifeFit Wellness Center is now
offering the internationally rec-
ognized Les Mills BODYPUMP,
a 60-minute barbell workout
designed to tone your body in
the fastest way possible. Call
843-522-5635 to learn more.

20. LIFE WITH
DIABETES
What to expect
the first week,
month and year
after a diagnosis
PHOTOBYLINDSAYUPSON/GLOWIMAGES
Diabetes. You heard the word—but things are hazy
after that. So now what?
The diagnosis is life-changing for sure, but with
realistic expectations and a commitment to making
healthy decisions, you’ll be in control.
And you’re far from alone. About 1.4 million
Americans receive a diabetes diagnosis annually,
according to the American Diabetes Association (ADA).
That’s roughly 27,000 per week or 3,800 per day.
The ADA also estimates that while there are
21 million Americans who have been diagnosed with
diabetes, about 8.1 million people have diabetes but
don’t know it. The good news is that when you have a
diagnosis, you can take action.
It seems hard to
believe at first, but
you will adjust to
life with diabetes.
DIAGNOSIS:
DIABETES
WINTER 201618

21. THE FIRST WEEK
First, the basics: Insulin is a hormone
produced in the pancreas that helps
your body use the glucose (sugar) you
take in through food. When you have
Type 2 diabetes, your body either
doesn’t make enough insulin or doesn’t
use it well. When your body’s cells
aren’t able to use the glucose for energy,
it stays in the blood, raising blood glu-
cose levels, which can cause serious
complications. What to do?
EDUCATE YOURSELF. The first step
is to seek out diabetes education, says
Andrew Rhinehart, MD, author of I Have
Diabetes!! Now What? (2009).
Diabetes is different from a lot of con-
ditions. It’s not as simple as taking a pill
every day, Rhinehart says. “With diabe-
tes, you have to worry about what to eat,
exercise, medications, injections ... It
goes on and on. It’s incredibly complex.”
The ADA and the American
Association of Diabetes Educators
(AADE) are helpful resources.
“If people walk into a recognized
or accredited program, they are going
to learn everything they need to learn
about diabetes,” AADE spokeswoman
Joanne Rinker says.
BUILD A CARE TEAM. Rhinehart
advises surrounding yourself with a
team that includes a diabetes educator,
a primary care doctor, a dietitian and a
pharmacist. At some point, you may also
need an eye doctor, an endocrinologist,
a podiatrist or other specialists, in case
you face any complications.
FIND SUPPORT. It’s hugely helpful
to have supportive loved ones, but going
beyond your personal network can be
beneficial, too. Look into community
support groups, where you can continue
your education and build relationships
with other people who have diabetes.
THE FIRST MONTH
You’ve started to build your team, and
you’re more knowledgeable about the
disease. What’s next?
SET GOALS. When you receive your
diabetes diagnosis, your doctor will talk
to you about your blood sugar levels.
Working with your doctor or educator,
you’ll probably set some long-term and
short-term goals for how you’ll bring
these numbers into a healthy range.
START AN EXERCISE PROGRAM.
“Exercise is free medicine,” Rinker says.
“Every time you do it, you are work-
ing to decrease your blood sugar at that
moment—as well as for hours after
you’ve completed the exercise.”
Your diabetes educator can help you
establish a plan that works for you. But
rest assured, you don’t need to become a
gym rat. Regular walking is a great start.
GET YOUR FAMILY ON BOARD.
Most likely, your daily meal plan will
change. Talk to your family about those
changes and why they matter. What’s
helpful is that a diabetes diet is simply
eating healthy foods, Rhinehart says.
So the whole family can eat your diet—
and everyone benefits.
THE FIRST YEAR
You’ll start to adapt to your health
changes and—if all goes to plan—
feel better.
CHECK IN REGULARLY. Experts
recommend getting your blood sugar
levels checked and seeing your doctor
every three months in the first year.
As you do, your doctor may modify
your medication regimen.
“If you’re working hard with your
team … there’s no reason you can’t
reach the majority of your goals within
a year,” Rhinehart says.
ESTABLISH CALM AND CONTROL.
The good news? “You’ll likely feel
better—and more in control—by the
end of the first year,” Rhinehart says.
“The sense of being overwhelmed
will go away,” he says. “You will be able
to manage this.” I
WINTER 2016 19
HOW TO
SUPPORT A
LOVED ONE
WHO HAS
DIABETES
A diabetes diagnosis affects the
whole family. Here are some things
you can do to help your loved one
feel better:
3CHANGE YOUR DIET, TOO.
“The diabetic meal plan is what
everyone should be eating, so make
it a family affair,” says Jenny Craft,
a registered dietitian and certified
diabetes educator with the Beaufort
Memorial LifeFit Wellness Center.
3JOIN IN ON EXERCISE. “We all
need a good daily dose of exercise,”
Craft says. “Find something that
you both enjoy doing, like danc-
ing, swimming or taking a walk on
the beach.”
3GO TO CLASS. Support your
partner by attending diabetes edu-
cation classes and learning every-
thing you can about the disease.
3OFFER ENCOURAGEMENT.
“People with diabetes, especially
those who have been newly diag-
nosed, need lots of support and
praise to keep them motivated,”
Craft says. “Support them as they
work to make good choices.”
CALL
Getting Control
At the Beaufort Memorial
Diabetes Care Center, diabetes
experts can help you develop
a plan to control the disease.
For more information, call
843-522-5635.

22. Breathing is easy to take for granted. Awake or asleep, sitting
or running, it just happens.
But if you have chronic obstructive pulmonary disease
(COPD), breathing isn’t so automatic. An umbrella term that
includes emphysema and chronic bronchitis (and sometimes
asthma), COPD is a lung disease that can cause wheezing,
shortness of breath and tightness in the chest, as well as a
cough that produces a lot of mucus.
A person with COPD must cope with the condition every
day, and it is progressive, meaning it will worsen over time.
But although there’s no cure, there is good news for the
11 million people in the U.S. who have COPD: With the
right steps, it’s possible to improve lung health and increase
quality of life. Start here.
Get the
most out
of life when you
have chronic lung
disease
BREATHE BETTER
Lung disease
doesn’t need
to sideline you.
COPING
WITH COPD
PHOTOBYHEROIMAGES/GLOWIMAGES
WINTER 201620

23. UNDERSTAND
YOUR CONDITION
Education about what COPD is can be
very helpful, says Dawn Lesley Fielding,
respiratory therapist, educator and author
of The COPD Solution. Sometimes people
know their doctors have put them on
medication or oxygen, but they don’t
understand why, she says.
“The first thing we always do is talk
about the disease itself,” she says. “Once
they understand what’s going on and
why they need the medication or oxygen,
it relieves a ton of anxiety.”
So what is happening? The airways in
the lungs become inflamed, and less air
flows in and out of the lungs, says Albert
A. Rizzo, MD, senior medical advisor for
the American Lung Association.
As the flow of air decreases, there
is less oxygen going to the cells in the
body and expelling carbon dioxide gets
harder and harder.
COPD is a broad term, and depending
on your particular illness, you may have
different symptoms from someone else.
STAY ACTIVE
“When you have any lung condition that
affects your breathing, the tendency
is to do fewer things that cause you to
be out of breath,” Rizzo says. “But get-
ting deconditioned actually makes your
breathing worse.”
Participating in a pulmonary reha-
bilitation program with a clinical
professional can help you learn how
to exercise safely, Fielding says.
Ultimately, when you’re in better
physical condition, flare-ups won’t be
as severe as they otherwise could be,
Rizzo says. And if you’re able to find
ways to continue to do the things you
love, you’ll have greater quality of life
and be less susceptible to depression.
QUIT SMOKING
Smoking very often causes COPD, and
according to the U.S. Centers for Disease
Control and Prevention, the best way to
prevent COPD is to not smoke (or to quit
if you already do). Smoking is to blame
for upward of 80 percent of COPD-
related deaths. (Other causes include
genetics, exposure to irritants, including
secondhand smoke and air pollution, and
workplace exposure to dust and fumes.)
But knowing all of that doesn’t dimin-
ish the task at hand.
“There are ways to quit,” Rizzo says.
“But it’s not easy by any means.”
Your doctor can provide you with
resources for quitting—be sure to ask.
Seek out support groups and a quit
counselor. And talk to your friends and
family, too, says Rizzo: “People need to
understand they can’t smoke around
someone with COPD.”
MIND YOUR
MEDICATIONS
Working with a respiratory therapist
or a physician, walk through your pre-
scribed medications. Understand which
ones are for emergencies and which are
for regular use.
Most important, learn how to take
them correctly. Some inhalers require
one quick breath, while others call for a
long, slow one, Fielding says. To allow
the medication to work properly, you
need to follow instructions.
TRY BREATHING
EXERCISES
Take the time to learn techniques that
will help you breathe better in the long
run. Knowing how to bring breathing
under control when you’re out of breath,
for example, could prevent a hospital
stay. Other exercises are designed to
help strengthen your diaphragm—the
main muscle involved in breathing.
Ultimately, Fielding says, every person
with COPD is different.
“They have to listen to their body
and what their body is telling them they
need,” she says. n
WINTER 2016 21
STAY HEALTHY THIS FLU SEASON
Influenza can be rough on anyone, but if you have a respiratory illness like chronic
obstructive pulmonary disease (COPD), peak season can be especially dangerous.
Here are a few things to keep in mind this year.
1. GET YOUR FLU SHOT EARLY—AND MAKE SURE IT’S THE APPROPRIATE
VACCINE. Fluzone High-Dose vaccine, which contains four times the amount
of antigen in regular flu shots, is recommended for patients 65 and older, says
certified adult nurse practitioner Jenny Martin of Beaufort Memorial Lowcountry
Medical Group.
2. WASH YOUR HANDS REGULARLY. Simple hand-washing is one of the best
things you can do to keep germs at bay.
3. AVOID LARGE CROWDS DURING FLU SEASON.
4. IF YOU’VE BEEN EXPOSED TO THE FLU, SEE YOUR PROVIDER. “You should
be tested,” Martin says, “since the protocol for treatment is different for exposure
than for a confirmed case of the flu.”
CALL
A Bridge to Home
To ensure COPD patients
don’t end up back in the hospital,
Beaufort Memorial’s Bridge to
Home team provides patients
with the follow-up care they need
to stay well. Call 843-694-1722
to learn more.

24. WHEN
CANCER
PHOTOBYVOSTOK/GETTYIMAGES
WINTER 201622

25. HITS
HOME
A diagnosis strikes the whole family. Information
and communication can help parents and kids cope
BY STEPHANIE THURROTT
L
isa Perrier of Natick, Massachusetts, was 41 when she was blind-
sided by a breast cancer diagnosis in 2008. And while the surgeries,
chemotherapy and radiation brought challenges, dealing with the
“new normal” of life with cancer was possibly even more difficult for her
and her family, which included a toddler son.
WINTER 2016 23

26. “I felt like I needed to run my house,
but there were times when I didn’t have
enough energy for that. There were
times when I couldn’t even change a
diaper,” Perrier says.
Feeling overwhelmed during such a
trying time is typical. After a cancer
diagnosis, “there are so many day-to-
day changes from what life has always
been like,” says Rachel Cannady, stra-
tegic director of cancer caregiver sup-
port for the American Cancer Society.
She notes that roles in the family often
change with a cancer diagnosis. In
Perrier’s case, she had to rely on her
husband, Bill, to take on some of the
parenting and household responsibili-
ties she had normally handled.
But those role changes are just the
start of dealing with cancer as a family;
read on for what to expect.
Anxiety Affects Everyone
One of the biggest challenges of a can-
cer diagnosis—for all members of the
family—is dealing with the unknown.
That was the case for the Perriers.
“From the day we got the diagnosis,
there was still so much uncertainty.
What was it? What was it going to
mean? It was scary,” Perrier says.
“When you’re newly diagnosed, not
knowing the treatment plan or how
things are going to change can be over-
whelming. Everything gets disrupted,”
says Katie Binda, a Massachusetts-based
licensed independent clinical social
worker and therapist who specializes in
coping with cancer.
Binda recommends finding a men-
tal health professional to talk to and
stresses the importance of taking care
of yourself—and that goes for everyone
in the family. Gentle exercising such as
yoga or walking, getting lots of sleep
and managing stress with massage,
meditation, mindfulness or other prac-
tices can help. Sharing your fears, anxi-
eties and concerns with each other may
also ease worry.
Perrier found that her anxiety
decreased once treatment started.
Then she could focus on just getting
through the next surgery, chemotherapy
treatment or radiation session and
not worry about what would come
after that.
Genevieve Stonebridge, a clinical
counselor at InspireHealth, a non-
profit supportive cancer care center in
Victoria, British Columbia, points out
the importance of balance. “Make sure
your life is not dedicated to cancer,
and you have other things going on,”
she says.
Anxiety can come at any point, and
the end of treatment can be a particu-
larly stressful time. “People rarely focus
on what to do when treatment ends,
but for most people that’s when the
emotional experience hits really hard,”
Binda says.
Perrier agrees. “When I wasn’t being
monitored on a weekly basis and I didn’t
have appointments every week, I stopped
having something to focus on. The
hardest part was figuring out how to
get back to a normal life when normal
was no longer what I thought it should
be,” she says. Talking to a therapist or a
counselor can be helpful at this stage.
PHOTOSBYHEROIMAGES/GLOWIMAGES
WINTER 201624

27. Accept a Helping Hand
One common problem for people with
cancer and their families? Not knowing
what help might be needed. Stonebridge
suggests making a list—maybe you need
your laundry done, or your kids need a
ride to soccer, or your caregiving part-
ner needs a night off. And if someone
offers help and you don’t know what you
need offhand, ask them to text you once
a week to ask, or to stop by with coffee
or breakfast on a specific day.
The effects of chemotherapy were a
big unknown for Perrier. “I knew I was
going to get sick, but would it be in five
minutes or would it take a day?” Well-
timed offers of help could dovetail with
the days when she didn’t feel well.
Perrier appreciated offers of playdates
for her young son. “After a lot of treat-
ments, I either couldn’t leave the house,
or I could drive but not go into someone
else’s house. There were a handful of
people who reached out and offered to
pick James up for a playdate. That made
me feel like he was being taken care of,”
she says.
When seeking help, think beyond con-
crete needs and include emotional sup-
port, too. “You can ask someone, ‘Take
care of my husband. He’s suffering,’”
Stonebridge says.
That’s a technique that helped Perrier.
“Bill was afraid to talk to me because he
thought it would make me more upset.
So when his family said, ‘What can we
do for you?’ I said, ‘Take care of Bill.’
I needed his family to talk to him and
make sure he was OK.”
Caregivers, in particular, need to feel
comfortable asking for help. “Recognize
that this has a great impact on you.
You’re not getting treatment, but you’re
living and breathing all aspects of the
experience,” Binda says. “You can be
just as afraid and just as overwhelmed
as the person with cancer.”
And while it may be hard, understand
that you and your family can’t control
the way other people react to the cancer
diagnosis. Some people may be over-
bearing with offers of help, while others
run the other way.
“I felt like I needed
to run my house, but
there were times when
I didn’t have enough
energy for that.
There were times
when I couldn’t even
change a diaper.”
TREESILLUSTRATIONBYJAMIEFARRANT/GETTYIMAGES
WINTER 2016 25

28. Are the Kids All Right?
Parents are often unsure about what to tell children
regarding a cancer diagnosis in the family, or how best
to communicate.
Keep your information age-appropriate, but don’t shy
away from the word “cancer.” Your kids will overhear
it somewhere—from a friend’s parent, from neighbors,
when you think they are out of earshot—so it’s better that
they hear it from you first. Try to find out what they know
and encourage them to come to you with their questions
and concerns.
Don’t forget to talk to your children about their lives
outside of the cancer experience. “When children have
a parent going through serious treatment, they may not
feel as though they can come home and share the normal
struggles of childhood,” Cannady says.
On the other hand, giving children age-appropriate
responsibilities can help them feel included. Ask your kids
to do their own laundry or to sit with the family member
who has cancer while you run errands, for example.
From the beginning, be sure to tell your child’s school
what’s going on. “Teachers are with your kids all day
long,” Binda says. “They will see if there are changes or
if kids are acting out.”
The Silver Lining
Two years after her diagnosis, Perrier finished her sur-
geries and treatments. Follow-up exams every two years
since have not shown any signs of cancer; she is now 49.
She points to her husband’s support as a key factor in cop-
ing. “I never felt alone,” she says. And friends and family
also made a lasting difference. “Some people reached out
because they wanted to help but couldn’t think of a good
way to help. But that counted,” she says.
While battling cancer can be overwhelming, survivors
and their families often point to positive outcomes like
better relationships and a new attitude toward life.
“A cancer diagnosis brings into perspective your role
within the family and as a partner,” Cannady says. While
stressful, she says, “it’s also an opportunity to re-evaluate
your relationships and find ways to grow and bond. A lot
of times people reprioritize, and the illness experience
can be very beneficial for the relationship quality and for
a perspective on life in general.” I
PHOTOBYWESTEND61/GLOWIMAGES
WINTER 201626

29. WHAT ABOUT ME?
A child with cancer has unique needs that can demand a lot from
families. Healthy siblings may feel sidelined as energy and attention
focus on the one who has the disease.
Genevieve Stonebridge, a clinical counselor at InspireHealth,
a nonprofit supportive cancer care center in Victoria, British
Columbia, says siblings of children with cancer have seven needs:
1 Acknowledgment and attention. Siblings need to know
they matter, even when a brother or a sister is battling cancer.
Stonebridge says, “Ask a sibling how they are doing, not just,
‘How’s your sister?’”
2 Family communication. It’s important to talk to siblings—in an
age-appropriate way—about the cancer diagnosis, treatment and
side effects. Parents may think they are protecting children by staying
silent, but without information children often imagine the worst.
3 Inclusion in the family. It’s hard for siblings to watch someone
they love suffer, and they want to help. They can play games or
watch videos with their sibling. Skype chats, text messages and letters
can keep them connected if treatment requires travel.
4 To know that it’s normal to have difficult emotions and
uncomfortable thoughts. Siblings may feel anger, confusion,
frustration, jealousy, hatred or guilt. Parents can help by giving the
sibling a safe space to work through emotions.
5 Their own support. Siblings need help from family members,
teachers and coaches, and professionals like social workers and
counselors. It can also be good for siblings to talk to siblings of other
children with cancer.
6 To be a kid. Children need to play and keep up their
extracurricular activities. They can be responsible for their chores
and homework, but they shouldn’t feel the burden of caring for their
parents emotionally.
7 Humor, laughter and lightheartedness. “It’s a hard time, but
we can laugh, play and have a good time,” Stonebridge says. “It’s
important to have balance. Just because you’re dealing with a crisis
doesn’t mean there can’t be wholehearted living.”
TREESILLUSTRATIONBYJAMIEFARRANT/GETTYIMAGES
WINTER 2016 27
CALL IF YOU
NEED ME...
When a cancer diagnosis strikes, well-
meaning friends and family will want
to help. But they may not know what
you need.
“Here in the South, everyone wants
to bring over pound cake,” says Katy
Jones, an advanced oncology certified
nurse practitioner at the Beaufort
Memorial Keyserling Cancer Center.
“Assess what you need and be honest
about it. If you don’t want a truckload
of food, tell them.”
Be willing to give up control and ask
for help with daily chores on the days
during your chemo treatment that you
feel sick or drained. “Your friends want
to help, so let them pick up the kids
from school or do the dishes,” Jones
says. “It makes them feel good.”
Jones also suggests setting up an
account at a local restaurant where
friends can contribute. “That way, you
can order the amount of food you need
when you need it,” she says.
CALL
Cancer Care
The Keyserling Cancer Center offers
a full range of support services,
including breast care coordinators,
support groups and nutrition coun-
seling. For more information, call
843-522-7800.

30. PHOTOBYGUSTOIMAGES/GETTYIMAGES

31. A PRIMER ON IMAGING EXAMS LETS YOU KNOW WHAT TO EXPECT
BY SHELLEY FLANNERY
TAKE A
LOOK
INSIDE
X
-RAY, CT, MRI.
To most people, medical imaging is just a bunch of abbreviations
that mean basically the same thing: lying on a table while a
technician takes pictures of your insides. And that’s essentially
correct. But it’s also much more nuanced than that. Different imaging tests are
used to check for different issues, and each has its own procedure for getting the
best image. If you’ve ever wondered what exactly these tests do and what you can
expect from your next imaging appointment, read on.
WINTER 2016 29

32. TOPIMAGESBYEXACTOSTOCK/GLOWIMAGES|SPREADPHOTOBYNICKVEASEY/GETTYIMAGES
WHY IMAGING?
Imaging tests are generally performed
for one of three reasons: to screen for a
common disease, to diagnose a condition
or to determine the extent of a disease.
They assist in assessing a wide range
of issues from torn muscles and broken
bones to aneurysms and cancer. They’re
invaluable tools of modern medicine
that allow patients to avoid exploratory
surgery and unnecessary treatments. But
patients should be familiar with what
exactly is being ordered and why.
“It’s important for patients to know
why they’re getting a test and ask ques-
tions,” says Elliot K. Fishman, MD, a
radiologist, an author and a member
of the Radiological Society of North
America. “Physicians shouldn’t order a
test just because we can. Ask your physi-
cian why one test is being ordered over
another, and what exactly they’re trying
to find with the study.”
Next ask what you can expect during
the imaging appointment and how you
should prepare. Here are some basics to
get you started:
X-RAY
How it works: Using a small amount of
radiation, the X-ray unit takes pictures
of the dense structures inside the body.
What it’s used for: Diagnosing bro-
ken bones, pneumonia and dental prob-
lems. Standard mammography uses
X-ray to look at breast tissue.
What to expect: You’ll need to lie
still on a table or stand in front of an
imaging plate for a few seconds while
the technician captures the image.
“For classic, simple things, X-ray is
very good and very low-cost,” Fishman
says. “It’s good for certain things, like if
you’re worried about a fractured hip, a
fractured wrist—a fractured anything—
or pneumonia. The limitations are you
can only see things that are dense, and
it’s a flat, 2-D image, so subtleties are
very hard to see.”
CT SCAN
How it works: Computed tomography
(CT) scans use focused X-rays to create
cross-section images of the body, allow-
ing for clearer images as compared with
simple X-rays.
What it’s used for: Diagnosing such
issues as abdominal pain, blood clots,
cancer, congenital heart defects, herni-
ated disks, inflammatory bowel disease
and internal bleeding.
What to expect: You’ll lie still on a
table that will pass through a large circu-
lar machine that looks like a doughnut.
It’s not confining. You may need to hold
your breath for a few seconds while the
machine takes an image. Some tests
require a contrast dye be consumed or
injected beforehand to make parts of
the body show up better on the images.
“CTs are the big workhorses of
medicine today,” Fishman says. “You
can look at it and accentuate a tissue,
whether it’s air, lungs, soft tissue, nose,
muscle or bone, and also you can make
3-D imaging. It’s very good for picking
up abnormalities, especially pneumonia,
tumors, cancer and aneurysms.”
ULTRASOUND
How it works: Ultrasound uses sound
waves to create an image. No radiation
is involved.
What it’s used for: In addition to its
most notable use of looking at babies
in utero, ultrasound also helps doc-
tors diagnose conditions of the organs,
including the heart, kidneys, liver, ova-
ries and thyroid.
What to expect: This one is easy—
you don’t even need to worry about
holding still. You’ll lie on a table and,
after applying some cold gel, a techni-
cian will run a wand over the area of
the body being looked at to create mul-
tiple images.
“Ultrasound uses sound waves, which
allows you to look at fluid and soft tis-
sue,” Fishman says. “It doesn’t have the
detail of CT, but it’s good for fluid den-
sity or when an area is surrounded by
fat. It’s most often used on the uterus,
ovaries, gallbladder and thyroid gland,
because they’re close to the surface of
the body.”
WINTER 201630

33. MRI
How it works: Like CT scans,
magnetic resonance imaging
(MRI) creates cross-section
images of the body, but it uses
strong magnets and radio waves
rather than radiation to create
the images.
What it’s used for: Examining
organs and diagnosing torn
ligaments, tumors, metastatic
cancer, and brain and spinal
cord conditions.
What to expect: You’ll lie
on a table, and markers will be
placed on your body with tape to
indicate where the images should
focus. You’ll be given earplugs,
as the machine is quite loud dur-
ing testing. The table will then
slide into the machine’s long,
cylindrical opening. The test can
take anywhere from 30 minutes
to two hours, depending on the
images being captured. If you
have any issues with claustro-
phobia or an inability to lie still
for long periods, tell your doctor.
He or she may prescribe a medi-
cation to help you relax or even
order sedation.
“MRI is a good problem-
solving tool,” Fishman says.
“There’s no radiation involved,
and it’s very good for looking at
soft-tissue changes—meniscus
tears, ligamentous injuries, spine
and disk disease—as well as car-
diac function, vascular issues,
and the brain and spine.” I
WINTER 2016 31
WHAT ABOUT THE
RADIATION?
Many people are wary of radiation exposure
from X-rays and CT scans, but the benefits
of imaging tests far outweigh any radiation-
associated cancer risks, says Beaufort Memorial
Chief of Radiology Phillip Blalock, MD.
One of the great developments of modern
medicine, medical imaging has revolutionized
diagnosis and treatment, almost eliminating the
need for once-common exploratory surgeries
and other potentially risky procedures.
“The radiation dose from a chest X-ray is
the equivalent of what you get just living on
the planet over the course of a month,” Blalock
says. “The human body is engineered to heal
itself from low levels of radiation.”
In recent years, advances in the technology
have reduced the amount of radiation expo-
sure needed to create an image. “If you are
concerned about a test, talk to your doctor,”
Blalock advises. “There may be an alternative,
such as an ultrasound or MRI, that does not
expose you to radiation.”
WEBSITE
Imaging Tests, Decoded
Don’t know the difference between a
CT scan and an MRI? Go to bit.ly/2brm7eY
for an explanation of how different imaging
tests work.

34. THE QUICK LIST
PHOTOSBYTHINKSTOCKANDCGINSPIRATION/GETTYIMAGES
Make changes one at a
time. Rome wasn’t built
in a day, and neither is
a healthy lifestyle.
2Pay attention to
how you feel when
you exercise and eat
healthy foods. Note positive
changes other than the number
on the scale.
6
Quit smoking. It’s easy to
say and hard to do, but it’s
so important.
5
Want to improve your diet?
Enlist your family’s help. You
need the support, and every-
one will benefit from your example
of better nutrition.
4
Do you know a
family that’s facing
cancer? Offer to help
by doing something
concrete, like
picking up dinner
or taking the kids to
soccer practice.
1
Listen to your
body. If you’ve
been feeling
off lately—extra
tired, fluctuat-
ing weight—see
your doctor.
Make swaps: mustard
for mayo, almonds for
chips, water for soda.
7 9
If you have a chronic
disease, look for a
local or online support
group. Meeting other people
with similar challenges will give
you strength.
8
Go to bed! Sleep
is imperative
for good health
and can assist
in weight loss.
10
Make sure you’re
informed about
imaging tests your
doctor orders.
Don’t be afraid to ask questions.
3
WANT MORE HEALTHY IDEAS? Check out our spring issue, all about understanding your body.
10
THINGS TO
REMEMBER FOR
AN ACTIVE LIFE
4
body. If you’ve
off lately—extra
tired, fluctuat-
ing weight—see
chips, water for soda.
7 9local or online support
group. Meeting other people
with similar challenges will give
you strength.
10Don’t be afraid to ask questions.
WANT MORE HEALTHY IDEAS? Check out our spring issue, all about understanding your body.
8
Go to bed! Sleep
WINTER 201632

35. PHOTOBYTHINKSTOCK
ANTIANXIETY
MEDICATION
RISKS
Fatal overdoses from antianxiety medications spiked
considerably from 1996 to 2013. Statistics show that fatal
overdoses involving antianxiety drugs—benzodiazepines
such as Valium and Xanax—reached 3.07 per 100,000 adults
in 2013, up from 0.58 per 100,000 in 1996.
When these drugs are taken with other drugs or alcohol,
the results can be deadly. And research suggests that special
caution be exercised with the elderly because of side
effects that may be more pronounced in this population,
such as sedation.
Bottom line: If you suffer from anxiety, panic
disorders or insomnia, talk to a doctor or a behavioral
health specialist about the risks and benefits of
treatment options.
THISJUSTINGOOD-FOR-YOU NEWS, CUES AND REVIEWS
WINTER 2016 33

36. IT’S NOT FISHY
If you haven’t been pulled in hook, line
and sinker, it’s time to get on the fish band-
wagon. The health benefits are plentiful.
Research continues to show that the
omega-3 fatty acids found in fish can
reduce the risks of heart attack, stroke,
mental decline and prostate cancer. In
fact, researchers have found that eating
about two weekly servings of fatty fish—
salmon, herring, mackerel, anchovies or
sardines—reduces the risk of dying from
heart disease by 36 percent.
There is a catch. Pollutants make their
way into water and can be absorbed into
fish. Research shows, however, that the
heart-protective benefits of fish drastically
outweigh risk of harm from contaminants.
One notable exception is for pregnant
women, who should avoid certain fish
because of the risk of birth defects from
some pollutants.
Which one is better for
burning calories?
CARDIO
STRENGTH
TRAINING
PHOTOSBYTHINKSTOCK
RECIPE
Great Catch
Reel in a few new seafood
recipes by visiting heart.org/
recipes. Doesn’t warm, wintry
fish stew with tomatoes and
spinach-stuffed baked salmon
sound good?
THISJUSTINGOOD-FOR-YOU NEWS, CUES AND REVIEWS
ANSWER: CARDIO,
BUT DO BOTH.
Toe to toe, cardio wins a calorie-clobbering fight.
Strength training, however, increases muscle
mass, which ups your metabolism (the
rate at which you burn calories).
And because muscles also burn
more calories per hour than
fat does, strength training
plays an important role
in calorie burning.
So forgive the trick
question—but you need
to do both.
The American College
of Sports Medicine recom-
mends at least 150 minutes
of moderate-intensity exer-
cise per week and strength
training two or three
days a week.
WINTER 201634

37. ANOTHER
REASON TO
AVOID LATE-
NIGHT SNACKS
The midnight munchies may be bad for more
than your waistline—especially if you’re a breast
cancer survivor.
New analysis out of the Women’s Healthy Eating
and Living study conducted between 1995 and 2007
suggests that breast cancer patients who go less
than 13 hours between dinner and breakfast had a
36 percent chance of breast cancer recurrence.
While the findings do not establish a cause-and-
effect link between late-night snacking and cancer,
previous animal-based studies have found that
prolonged nighttime fasting does fight off high
blood sugar, inflammation and weight gain—all of
which can lead to poor outcomes for cancer.
TRUEORFALSE
The stomach flu causes vomiting
and diarrhea.
FALSE. The stomach “flu” isn’t the flu at all. It’s gastro-
enteritis, which is inflammation of the stomach and intes-
tines that can lead to vomiting, diarrhea and cramping.
Norovirus is the most common cause of gastroenteri-
tis, and stats show it’s as sinister as its name sounds. The
Centers for Disease Control and Prevention estimates that
the virus causes 19 million to 21 million illnesses each
year. Peak time is November to April. Protect yourself by
washing your hands frequently and not sharing bites of
food or eating utensils with others.
1.9MILLION
In the 2014–15
flu season, flu
vaccinations prevented
an estimated
1.9 million illnesses—
that’s greater than
the population
of Philadelphia.
966,000
Nearly 1 million
flu-associated doctor
office visits were
prevented (the
number of people
who fit in Manhattan’s
Times Square).
67,000The flu vaccine
prevented an
estimated 67,000
flu hospitalizations,
equal to the number
of seats in the Seattle
Seahawks’ stadium.
It’s not too late to
get your flu shot.
Flu activity peaks in
January or later. Just
remember that it
takes about
two weeks
after vaccination
for antibodies to
develop—so do
it ASAP!
Source: Centers for Disease
Control and Prevention
(2014–15 flu season)
THEFLU
PHOTOBYTHINKSTOCK
WINTER 2016 35
ENDOMETRIOSIS
MAY TRIGGER
HEART RISKS
Women with endometriosis, listen up. A
new study suggests your risk for heart dis-
ease may be 60 percent higher than that of
women without the disease. Those younger
than 40 are especially hard hit, with a three-
times-greater risk for heart disease than
women without the health condition.
The abnormal growth of uterine tissue
outside the uterus, endometriosis affects
about 10 percent of women of reproduc-
tive age in the U.S. While the reasons for
the link are speculative, higher levels of
inflammation or poor cholesterol numbers
could be at play. So could the treatments
for endometriosis, which can involve the
removal of the uterus and ovaries.
“Women with endometriosis need to
be vigilant about cardiac risk factors, given
their potentially increased risk of coronary
artery disease,” says Beaufort Memorial car-
diologist Stuart Smalheiser, MD. “Diets low
in saturated fats, daily exercise, and blood
pressure and cholesterol monitoring and
control may be necessary.”
WEBSITE
Know Your
Numbers
People with prediabetes
and diabetes are at higher
risk of heart disease.
Keeping blood sugar, blood
pressure and cholesterol
in healthy ranges is critical.
To find out what those are,
visit bit.ly/2ayoQ6w.

38. WORKOUTS
THAT WORK:
CROSS-COUNTRY
SKIINGFor a sport that reduces pressure on joints while burning big-time calories, con-
sider cross-country skiing. Glide your way to these head-to-toe health benefits.
3YOUR EYES: Cross-country skiing improves visual acuity (clarity or sharp-
ness of vision).
3YOUR HEART: The activity gets your blood pumping and carries oxygen and
nutrients to the body’s organs.
3YOUR MUSCLES: Cross-country skiing’s diagonal stride works your major
muscle groups, which is better than just working arms or legs alone.
3YOUR BALANCE: Shifting your body’s weight as you glide over uneven
surfaces can increase your balance, which is important for fall prevention as
we age.
Want to try before you buy? Rent a pair of skis from a sporting goods store
or recreation center.
WHEN
LOSS
IS MORE
If you are among the 1 in 3 Americans
struggling with obesity, National
Institutes of Health research suggests
you don’t have to shed tons of
weight to see real health gains.
Losing just 5 percent of weight—
an average of 12 pounds—resulted
in metabolic changes that lowered
risk for diabetes and heart disease
in study participants.
THISJUSTINGOOD-FOR-YOU NEWS, CUES AND REVIEWS
APPLEPHOTOBYNIKAMATA/GETTYIMAGES;MAINPHOTOBYTYLERSTABLEFORD/GETTYIMAGES
TOOL
Dear Diary
Writing down what you eat
daily can help you see the
good, the bad and the ugly.
Download the American
Heart Association’s food
diary by visiting heart.org
and searching “food diary.”
WINTER 201636

39. An ARRHYTHMIA is an abnormal heart rhythm.
Sometimes that means a quick fluttering, or a feeling as though your
heart “skipped a beat.” But in severe or long-lasting cases, it can trigger
fatigue, fainting, chest pain, heart attack or death.
Your doctor can order tests to track your heart’s electrical impulses,
and there are medicines and treatments to control arrhythmia.
JARGON WATCH
BACK ON YOUR FEET
With total knee replacement
becoming increasingly common—
more than half of Americans older
than 60 live with arthritis of the
knee and could benefit from a new
joint—greater gains are being made
in pain management after surgery.
A report from the Journal of the
American Academy of Orthopaedic
Surgeons outlines newer pain
management strategies that are
reducing medication side effects
and returning people to active lives
more quickly.
If you’re headed for knee replace-
ment surgery, talk to your doctor
about pain control methods such
as pre-surgery nerve blocks and
intraoperative pain injections. These
can reduce unwanted side effects
and the overall amount of narcotic
medication required.
WHATARE
THEODDS
of someone
older than
65 falling in a
given year?
PHOTOYELLOWSIGNBYTHINKSTOCK;PHOTOTOPRIGHTBYFANCY/GLOWIMAGES
You might want to sit down
for this one. If you’re older
than 65, your odds of falling
are a whopping 33 percent.
Falls are serious. In fact, 1 of
every 5 falls results in a broken
bone or a head injury. If you fall,
it’s important to tell your doctor
and get checked out.
WEBSITE
Stay on Your Feet
Learn more about what you
can do to prevent falls. Visit
cdc.gov and search “falls.”
WINTER 2016 37

40. THE TRUTH BY ALLISON MANNING
Mental illness is
not something you
“power through.”
TRUEORFALSE:
Depression is always about
something specific.
FALSE. Depression is an illness that looks
for problems, Winston says. The brain roots
around for issues in life that inspire worthless-
ness, hopelessness or guilt. A sufferer might
feel like a loser, a bad parent or an ineffective
worker. “That wasn’t the cause of why you’re
depressed,” Winston says. “You’re depressed
because you have the illness.”
Depression is much more than simply being in a funk.
It’s a persistent feeling of sadness and a loss of inter-
est in things that used to be pleasurable; the physical
symptoms include fatigue and irritability. But even with an esti-
mated 350 million people worldwide suffering from depression,
a lot of myths persist. Sally Winston, PsyD, a clinical psychologist
who is a founding clinical fellow of the Anxiety and Depression
Association of America, helps us parse some of them.
THE TRUTH ABOUT
DEPRESSIONThe invisible illness is more complicated
than just feeling down in the dumps
PHOTOBYLAFLOR/GETTYIMAGES
WINTER 201638

41. TRUEORFALSE:
More women than men are
diagnosed with depression.
TRUE. This may be related to bio-
logical factors, such as hormonal
changes associated with pregnancy,
motherhood and menopause. It may
also be related to the cultural and social
pressures put on women. For Winston,
how men and women deal with the ill-
ness makes a difference. Women are
more likely to talk about and accept the
fact that they’re depressed, she says,
while men may mask depression with
drinking or other substances.
TRUEORFALSE:
Depression can be fatal.
TRUE. Left untreated, the feelings
of hopelessness, sadness and guilt can
overwhelm a person to the point where
they don’t want to live any longer. In that
case, sufferers should seek immediate
medical help. Worldwide, more than
800,000 people die because of suicide
every year, and it is the second-leading
cause of death in people ages 15 to 29.
TRUEORFALSE:
Depression has no real treat-
ment. Depressed people will
always be depressed.
FALSE. Depression is a highly treat-
able condition, Winston says, provided
the person gets help. “Hopelessness
in depression is a feeling, not a fact,”
Winston says. “And people who feel
hopeless when they’re depressed, they
believe they’re in a hopeless situation.
But it’s actually just a feeling, and
there’s nothing hopeless whatsoever
about depression.”
TRUEORFALSE:
Treating depression
is as simple as taking an
antidepressant.
FALSE. “The number of people who
just take a medication and are fixed is
relatively small,” Winston says. Many
more people need a combination of
therapy and medication. And it can take
some time to figure out the right type
of medication—or combination of
medications—to feel well. n
WINTER 2016 39
DEPRESSION
DICTIONARY
This mental illness can manifest
itself in diverse ways. “The diag-
nosis is based on the intensity
and duration of the depression,”
says licensed professional coun-
selor Richard Archer of Sea Island
Psychiatry. Categories include:
Major depression: (also called
clinical depression): The person
suffers from symptoms most of
the day, nearly every day.
Adjustment disorder: Any life
change—retirement, going away
to school, illness—can cause this
stress-related mental illness.
Persistent depressive disorder:
This is a chronic depression that
lasts at least two years, though
symptoms may be less severe than
in major depression.
Postpartum depression: Some
women feel extreme sadness and
anxiety after giving birth. “A role
change adjustment can cause men
to suffer postpartum depression,
too,” Archer says.
Seasonal affective disorder:
Some people feel depressive
symptoms in the winter, when
there is less natural sunlight.
Bipolar disorder: This condi-
tion is different from depres-
sion, but someone with bipolar
disorder experiences low moods
like depression, coupled with
extreme highs.
CALL
Finding Help
The Anxiety and Depression Association of America (adaa.org)
has tools to find a therapist, support groups and other resources. If
you or someone you know is feeling suicidal, call the National Suicide
Prevention Lifeline at 800-273-8255.

42. HOW TO BY CARRIE SCHEDLER
PHOTOBYIMAGESOURCE/GETTYIMAGES
Getting an upsetting diagnosis from the
doctor is hard enough. But you can’t bear
the news alone. Eventually, you’ll have to
share with loved ones that you’re going to be facing a
tough time.
Going into the conversation with a supportive
mentality can make a world of difference, says Mary
Kelleher, a licensed marriage and family therapist and
a clinical member of the American Association for
Marriage and Family Therapy. She specializes in dealing
with chronic illnesses.
“You have to make it clear that what you’re
going through, you’re going to face it as a team,”
Kelleher says.
Here are her tips for talking your family through
difficult news.
Take a deep breath.
Your demeanor when you break the news will have a
huge impact on how people take it, Kelleher says, so
finding as much calm as you can before you begin the
conversation will help. “If you present it as a crisis, peo-
ple will feed off your fear,” she says. Even if the news
is indeed crisis level, you can breed a more supportive
HOW TO
SHAREA
DIAGNOSIS
When you’ve received difficult health
news, you need support. Here’s how to
tell your loved ones
Don’t bear the
burden of an
illness alone.
WINTER 201640

43. environment by trying to settle your-
self down first. Go into the talk only
after you’ve asked yourself: What are
my needs? How will this affect the
person I’m telling?
Know your audience.
This is particularly important if there
are children you’ll need to speak to
about your diagnosis. Different age
groups will have different kinds of
concerns: Preschoolers may worry
you’ll go away and won’t come back
(so give them a talk that’s light on
details of your condition but heavy
on details of how you or a trusted
family member will support them);
school-age kids stress about how
your diagnosis will directly affect
them (have answers to questions
like, “Will we need to move? Will I
have to quit my after-school soccer
league?”); and teens may get thrown
into a bit of existential despair (be
ready to listen and help them talk
through big questions like, “Why
do bad things happen to good
people?”). Pay attention in the days
and weeks after you’ve shared your
diagnosis for signs your child is with-
drawing or acting out. “You need to
be really aware and look for indica-
tions they may be struggling with it,”
Kelleher says.
Understand they
may not take
the news well.
It’s natural to withdraw in the face
of potentially devastating news.
“People have all sorts of hidden
beliefs about illness,” Kelleher says.
You have no idea whether, say,
your diabetes diagnosis triggers
memories of the suffering a cher-
ished aunt may have gone through
with the same condition.
Allow them to react, and reassure
them it’s OK with you that they’re
upset about the news. Then, when
they’re ready to learn more, offer
to set up an appointment with your
primary care physician for the two of
you so your doctor can explain what
your diagnosis really means. “The
reality is, the more support a patient
has, the better the outcome tends to
be,” Kelleher says.
Emphasize that
you’ll get through
it together.
Make it clear to friends and fam-
ily that while you’re the one who
is dealing with the physical effects
of illness, you understand that
your diagnosis will take a toll on
them, too. Just telling someone
that you’re in this together can be
remarkably helpful for the cop-
ing process. “It’s the difference
between it being a tragedy and
a difficult moment in your life,”
Kelleher says.
Consider outside help.
If you’re particularly worried about
sharing the news with your loved
ones, talk to your doctor about
bringing in a family therapist whose
practice focuses on dealing with
medical issues (your physician may
have referrals). A therapist is a great
resource to call upon the moment
you start feeling overwhelmed,
because he or she will understand
the toll that illnesses can take on
both you and your loved ones.
“When you’re sick, it doesn’t just
affect your body, it affects your
emotions and relationships as
well,” Kelleher says. “Struggling
alone can make the journey a lot
more difficult.” n
WINTER 2016 41
A CHRONIC
CONVERSATION
Sharing difficult news with people one
time is hard enough, but what if you’ve
been diagnosed with a condition for
which you must enlist friends, family
members or co-workers in your con-
tinued care?
Start by developing step-by-step
instructions if you have a medical
event. Clearly denote what steps
should be taken and in what order.
“You’ll also want to prepare an
advance directive, a written state-
ment of your wishes regarding medical
treatment,” says Beaufort Memorial
Oncology Services clinical coun-
selor Jennifer Codding. “In addition,
you should have a medical power of
attorney that allows you to appoint
a person you trust to make medical
decisions on your behalf, including the
decision not to resuscitate.”
Distribute the care “cheat sheet”
and legal directives to those closest
to you in case of emergency. Keep this
document in your common spaces,
too, like near your desk at work or on
the fridge at home.
WEBSITE
End-of-Life Wishes
Make it easier on your loved ones
and spell out the life-prolonging
treatments you would want should
you be unable to speak for yourself.
To learn more about advance direc-
tives, go to bit.ly/2bsQRLP.

44. QUIZ BY JENNIFER RICHARDS
caption
Sometimes
all you need
is Dr. Dad.
Bumps, burns, sprains and strains don’t scare
you. With your first-aid kit of ice packs, bandages
and aspirin, you’re prepared for life’s injuries
and ailments.
But some symptoms should send you straight to the near-
est emergency department, says Jay Kaplan, MD, president of
the American College of Emergency Physicians.
How do you know when to treat minor issues at home and
when it’s time to hurry in for medical help? Kaplan walks us
through some warning signs:
PHOTOBYSUSANCHIANG/GETTYIMAGES
FREAKOUTOR
CHILLOUT?
You can handle everyday scrapes
and bruises. But do you know
when it’s time to stop treating at
home and head to the emergency
department for professional help?
WINTER 201642

45. VIDEO
Heart Attack in Women
Learn about the symptoms you might not expect by watching a short
video starring actress Elizabeth Banks at bit.ly/1bdKZ49.
Q
In a mad rush to get dinner on the
table, you grab the handle of a hot
pan. Ouch! Your skin immediately
gets red and starts to blister a little.
Is it: A minor burn or a third-
degree burn?
MINOR BURN. Yes, it hurts. But if you
grabbed the pan and put it down right
away, you’re probably safe to treat it with
cold water, cold compresses and acetamin-
ophen or ibuprofen for pain, Kaplan says.
Even if the skin starts to blister, you’re
probably still in the clear to treat it with
antibiotic ointment. Don’t pop that blister,
though. The broken skin invites bacteria
that could lead to infection, Kaplan warns.
And if red streaks move up your arm,
you’ve splashed yourself with hot oil, or
the skin looks doughy but isn’t painful, get
to the emergency department. These are
signs of a more significant burn.
Q
Your son took a tumble down the
stairs and hit his head against the
wall as he tried to break his fall.
You check him all over and nothing
seems broken, but a knot is popping
up on his head.
Is it: A bump or a concussion?
BUMP. He didn’t lose consciousness.
He seems like his normal, albeit clumsy,
self. And he’s not repeating the same
questions without seeming to hear the
answer, something called perseveration.
Such behavior would indicate concus-
sion, Kaplan says. Nausea and vomit-
ing would be other worrisome signs,
perhaps caused by increased pressure
inside the skull. If those symptoms sur-
face, seek care, Kaplan says.
For now, it’s best to keep a close eye
on him over the next 24 to 48 hours to
make sure he’s with it and not feeling
nauseated or overly sleepy.
Q
Dashing to an afternoon meeting,
you round the corner of your office
and turn your ankle. Aside from
wishing you’d worn sneakers, you’re in
pain and wondering whether something
is broken as you hobble to the confer-
ence room.
Is it: A break or a sprain?
SPRAIN. Look, you’re still walking on
it without too much trouble, right?
That’s a good sign of a sprain rather
than a fracture. You’ll want to stay off
the ankle, elevate it and apply cold com-
presses for 20 to 30 minutes at a time
for about four hours, Kaplan says.
“The more you keep it elevated, the
less swollen it’s going to be. The less
swollen it is, the more quickly it will
heal,” he says.
Q
After an evening of too many
chips and some really spicy Mexican
food with friends, you’re feeling
nagging discomfort in the lower part of
your chest.
Is it: Indigestion or a heart problem?
PROBABLY INDIGESTION. But, as
Kaplan notes, you don’t mess around
with chest pain. If you’re having pain
that you can’t explain from say, catching
a football against your chest or having
tried to eat your weight in habanero-
laden salsa, you’re best served getting
medical attention. This is particularly
true for someone who has a family his-
tory of heart problems, is overweight,
has high blood pressure or cholesterol,
or smokes cigarettes, Kaplan says.
Q
You’re really sick and have been
running a fever that won’t come
down. You’re bedbound and sore
all over, particularly around your neck.
Is it: A run-of-the-mill virus
or meningitis?
COULD BE MENINGITIS. Many people
consider a fever high when it reaches
102 and might head to the emergency
department, though the fever is prob-
ably treatable with acetaminophen or
ibuprofen, Kaplan says. But the addition
of neck stiffness and headaches might
signal something serious such as men-
ingitis, an infection that causes swelling
of the membranes around the brain and
spinal cord.
Get to the emergency department
“if there’s a stiff neck or alteration in
consciousness, they’re not taking in flu-
ids or not acting themselves,” he says. n
WINTER 2016 43

46. AT A GLANCE BY SHELLEY FLANNERY
ISCHEMIC STROKE
HEMORRHAGIC STROKE
Blood leaks into the brain
through a burst blood vessel
Blood unable to pass clot
INSIDEASTROKE
Knowing what happens before, during and
after a brain attack could help save your life
Time is of the essence when it comes to stroke.
But that doesn’t mean these so-called “brain
attacks” come out of nowhere. The disease
process leading up to a stroke takes months, years or
sometimes even decades to transpire.
ILLUSTRATIONBYTHINKSTOCK
3
Stroke patients who
get to the emergency
room in less than
three hours from
symptom onset are
less likely to have
stroke-related dis-
ability three months
later, compared with
patients who waited
to seek treatment.
Call 911 right away.
HOURS
WINTER 201644

47. DOWNLOAD
Free Caregiving Guide
The National Stroke Association put together a helpful resource for
caregivers called the “Careliving Guide.” Go to stroke.org and search
“careliving guide.”
STROKE
SYMPTOMS
SUDDEN
NUMBNESS OR
WEAKNESS
in the face, arm or leg, especially
on one side of the body.
Sudden
CONFUSION
or difficulty speaking
or understanding.
SUDDEN
DIFFICULTY
SEEING IN ONE
OR BOTH EYES.
SUDDEN
DIFFICULTY
WALKING
OR DIZZINESS,
loss of balance or lack
of coordination.
Sudden
SEVERE
HEADACHE
with no
known cause.
First, some definitions: Ischemic strokes
occur when a blood clot obstructs a ves-
sel that supplies blood to the brain. They
account for 87 percent of all strokes.
Hemorrhagic strokes occur when a weak-
ened section of blood vessel bursts and
leaks blood into the brain. They account
for 13 percent of all strokes but 40 per-
cent of all stroke deaths.
Some people will get a warning, called
a transient ischemic attack (TIA), or
ministroke, before having a full stroke.
A TIA is a stroke that spontaneously
resolves itself. Approximately 40 percent
of people who have a TIA will go on to
have a full stroke, often within five days.
Strokes are the fifth-leading cause of
death and the No. 1 cause of disability
in the U.S. But the good news is that
up to 80 percent of all strokes can be
prevented through proper nutrition,
exercise, smoking cessation and the treat-
ment of underlying risk factors, such as
high blood pressure and high cholesterol.
See what’s going on inside the blood ves-
sels before, during and after a stroke so
you can learn how to protect yourself.
WHAT’S HAPPENING:
ISCHEMIC STROKE
BEFORE: Blood vessel in the
brain becomes narrow because of
plaque buildup.
DURING: Blood clot forms at the site
of the plaque buildup or in the heart
and travels to the site of the buildup in
the brain and gets stuck. Blood supply is
reduced or cut off beyond the blockage.
Without adequate blood (and oxygen),
brain cells begin to die.
AFTER: Depending on how long blood
flow was suspended, the parts of the
body controlled by the areas of the
brain where oxygen was deprived may
be disabled. Function may return with
time and rehabilitation.
WHAT’S HAPPENING:
HEMORRHAGIC
STROKE
BEFORE: A section of blood vessel in
the brain becomes weak or balloons out
(aneurysm) because of age, high blood
pressure or congenital defect.
DURING: The weakened section of
blood vessel bursts and blood leaks into
the brain, causing swelling and pressure,
which leads to cell and tissue death.
AFTER: Depending on how long the
pressure persisted, the parts of the
body controlled by the areas of the brain
where cell and tissue death occurred
may be disabled. Function may return
with time and rehabilitation.
WINTER 2016 45

48. IN THE MARKET BY LEXI DWYER
In the past few years, kale
has morphed from a trendy-
restaurant staple (with celeb-
rity fans like Gwyneth Paltrow) into an
ingredient so mainstream that McDonald’s
now uses it in salads. And that’s a good
thing, because 1 cup of raw kale packs a
serious nutritional punch. “Kale is awe-
some and can’t be overestimated,” says
registered dietitian Libby Mills, a spokes-
woman for the Academy of Nutrition
and Dietetics.
Not only does that cup of kale offer
more than 100 percent of the A, C and
K vitamins you need each day, but it’s
also rich in phytonutrients called flavo-
noids. These naturally occurring plant
chemicals are thought to help lower
cholesterol and also fight heart disease
and cancer. And people on dairy-free
diets will be happy to learn that 2 cups
of raw kale have almost 20 percent of
the recommended dietary allowance for
calcium, as well as magnesium to help
the body absorb it.
When shopping for kale, look for crisp
leaves that are free of holes and discolor-
ation. Before cooking, remove the tough
rib in the center and either discard it or
chop it up well for a crunchy boost of
fiber. (Mills saves them to make smooth-
ies later.) Here are her three favorite
ways to prepare kale:
1STEAMIT
Not only is this method simple, but it
also preserves many valuable nutrients. Place
chopped kale leaves into a steamer pot set over
boiling water. Cover and steam 5 to 10 minutes,
removing when kale is bright green. Top with a
simply prepared dressing like soy sauce blended
with sesame oil, or lemon juice mixed with
olive oil.
3BAKECHIPS
Remove ribs and tear kale leaves into
bite-size pieces. Place kale on a rimmed baking
sheet and toss with olive oil and salt. Bake 12 to
15 minutes at 350 F and garnish with cayenne
pepper, Parmesan cheese or lemon zest.
THREE WAYS TO
COOKKALEIt’s hearty, nutritious and flavorful: If this leafy winter vegetable
had a résumé, it would be packed with accomplishments
2MAKEASALAD
If you’re not using baby kale, remove
ribs and slice leaves into thin strips. Place kale
in a bowl with lemon juice and tenderize it
by massaging it for a few minutes with your
fingertips; the leaves should soften and turn a
brighter shade of green. Add olive oil and other
salad ingredients and toss well.
PHOTOBYJENNIFERBOGGS/AMYPALIWODA/GLOWIMAGES
WINTER 201646