Ask the Experts: Medical Q&A
Q: I have been feeling sad lately; does that mean I’m depressed?
A: Many people feel sad or down at times. That can be a normal reaction to life’s stressors and struggles. However, when feelings of intense sadness, hopelessness and lack of enjoyment in your usual activities lasts for days or weeks, then the “sadness” may be clinical depression. There are an estimated 19 million American adults living with depression. Depression is when you have at least five of the following symptoms for at least two weeks: feeling worthless or guilty; fatigue; indecisiveness; impaired concentration; insomnia; excessive sleeping; decreased interest or pleasure in almost all activities; recurring thoughts of death; weight loss or weight gain. There can often be physical symptoms that manifest when people are depressed. Some of these include joint pain, back pain, gastrointestinal symptoms or sleep disturbance, just to name a few. If you are concerned about depression, seek care from your primary care provider. They can evaluate your symptoms and provide treatment and/or refer you to a mental health professional.
Tracy R. Barefield, MD
Center for Primary Care
Q: Why would I use integrative therapy in addition to traditional physical and occupational therapy?
A: Integrative therapy proves successful for individuals who have seen little progress with only traditional physical and/or occupational therapy. Integrative therapy techniques include aquatic therapy, Crystal Myofascial Release, dry needling and Reiki. Aquatic therapy is ideal for individuals suffering from joint pain or for those in need of low-impact exercise. Crystal Myofascial Release treatment is a unique technique in which the therapist uses crystal energy during manual therapy to release fibrosis in muscle fascia. It’s been extremely successful for fibromyalgia and chronic pain patients as well as for sports injuries. Dry needling, similar to acupuncture, promotes biomechanical and chemical changes within the muscle without the use of drugs by targeting the body’s own unique mechanisms of tissue healing and pain relief. This safe, low-cost option can work in conjunction with aquatic therapy. Any combination of integrative therapy modalities can make a huge difference in your journey to health and wellness!
Hima Dalal, OTR/L
Vital Energy Wellness and Rehab Center
Q: Tummy tuck, is this the right surgery for me?
A: A tummy tuck or abdominoplasty, also known as a mommy makeover, removes excess fat and skin. The surgery restores weakened or separated muscles creating an abdominal profile that is smoother and firmer. Many strive for a flat and well-toned abdomen through exercise and weight control, but sometimes these methods alone are not enough to achieve one’s goals. Scheduling a consultation with a board-certified plastic surgeon is the first step. During an appointment, your health care professional should be able to discuss the different variations of abdominoplasty and make an individualized plan that will allow the patient to achieve their goals.
The recovery time for a tummy tuck surgery varies among individuals. Patients should plan on taking about two weeks off from work and most resume full activities after four to six weeks.
Donen Davis, JD, MD
Donen Davis Plastic Surgery, LLC
Q: Is Invisalign® as effective as traditional braces?
A: Yes, for most treatments. Aligners are another tool that orthodontists use to move teeth. Invisalign® has been a pioneer for orthodontic treatment to allow for all types of movements. These include correcting crowding and spacing to openbites and underbites. The material of the aligners has improved as well. The SmartTrack plastic material has an elastic property that allows for better aligner fit while still maintaining rigidity and excellent esthetics and comfort. Aligners can be adapted to incorporate elastics just as traditional braces would do to correct poor bites. Invisalign Teen® has been a great addition to orthodontic practices. This version has an indicator that responds to oral temperatures to alert the orthodontist to if there is a compliance issue. Invisalign Teen® even allows for unerupted teeth and will incorporate them into the treatment once they come in.
Edward Davis, DMD
Q: How can people thrive as they age?
A: We’re never too young or too old to live healthier. We want to enjoy all life has to offer, travel and stay independent for as long as possible. A fitness routine or healthy lifestyle now sets the stage for living that type of life as you age. Staying active, eating well and exercising regularly are proven to help fight heart disease, diabetes, obesity and other issues while boosting your physical, mental and emotional wellbeing. Walking every day, attending a yoga class, swimming and dancing are beneficial activities, but you can even exercise sitting down. You and your doctor will know the appropriate level of activity for you. If you can, go for it!
Elizabeth Dickerson, RN
Still Hopes Episcopal
(803) 739- 5022
Q: Why would an infant need chiropractic care?
A: Infants experience physical stress in the womb, again during natural birth or when being pulled by their head and neck from the cesarean incision. Muscles of the neck are strained, nerves may be compromised, and babies develop torticollis (stiff neck) or plagiocephaly (flattened skull). They may also develop related symptoms of biomechanical and neurological stress which include colic, nursing difficulties, not sleeping well, reflux or discomfort when being held. Pediatric chiropractors are specially trained and educated to care for infants. While a parent holds the baby, we use precise corrective procedures, with pressure similar to what you would use when checking the ripeness of a tomato. This allows us to correct the subluxations or neurobiomechanical stress, and the infant naturally heals and restores function and health. Today’s parents are looking for safe, natural options to help their babies. Pediatric chiropractic care is one of those options.
Shelly Jones, DC
Chiropractic Wellness Center, Inc.
Q: Do I have a choice where to go for my radiology test?
A: Yes! When your doctor recommends a test such as an MRI, CT, X-ray or ultrasound, you have a choice where that test is performed. Choose a facility that offers convenient, high-quality radiology services at a price you can afford. The cost of radiology exams can vary greatly depending on where you go. Some local facilities offer rates that can be 40 to 60 percent less expensive than area hospitals. Ask if the radiologist’s fee is included in the bill you will receive or if that charge is separate. You don’t have to sacrifice quality for cost! Inquire about onsite radiologists, state-of-the-art radiology equipment and registered technologists. Knowing your options can save you time and money.
Robin E. Daum-Kowalski, MD
Q: Why do I get so many sinus infections?
A: Sinus infections, though common, are also frequently misdiagnosed, resulting in treatment that is either ineffective or only temporarily helpful. If nasal congestion and facial pressure pain are your major symptoms, you may actually be experiencing migraine headaches rather than sinus infections. Migraines can affect people of almost any age, including children, and are often triggered by rainy weather and hormonal changes. Additional symptoms can include chronic fatigue, stomach upset, dizziness, a sensation of postnasal drainage and hypersensitivity to strong odors, bright lights and loud noise. Imaging studies such as CT and MRI scans are not always helpful in revealing the underlying cause, since abnormalities such as small polyps and cysts are commonly seen in the sinuses and rarely cause symptoms. Make sure your doctor takes the time to determine the true cause of your symptoms before making any treatment recommendations.
J. Cameron Kirchner, MD
CENTA Medical Group
Q: How do you treat burns?
A: If there is any question whether the burn is severe enough to be checked, call your health care professional. Do not apply any medication or grease to the area. Flush the burn with cold water for five to 10 minutes, clean the area with mild soap and water or Betadine®, and take acetaminophen for pain.
Kiersten Lofton, MD
Palmetto Pediatric and
Q: Should I expect a series of three injections for every pain management procedure?
A: No. The only injections commonly done in a series of three are for knees with sodium hyaluronate. For other areas such as the neck/arm or low back/leg, a single injection should be performed and the results reviewed to determine if it needs to be repeated or if something more effective can be done. In 2016, every treatment performed by a qualified interventional pain specialist provides feedback to help move forward with the best options. A physician trained to do radiofrequency ablations can extend the duration of many treatments, which is preferable to repeating the same treatment over and over.
Steroid injections must be performed judiciously and at reasonable intervals, based on results. It is recommended to use four different types of steroids (cortisone) depending on the age, size or body part being treated. The dosage is kept as low as possible while still being effective and in this way side effects can be minimized.
Jennifer D. Stanislaus, MD
Palmetto Pain Management, LLC
Q: Why is a good night’s sleep so important?
A: Sleep is your body’s time to recharge its batteries. Without enough sleep, any condition that you’re prone to gets stronger while your defenses get weaker. If you’re prone to seizures, your seizure tolerance diminishes. If you struggle with OCD, you’ll be less resistant to mental looping. If you battle anxiety, you increase your risk of a panic attack. If your body is fighting a cold, you’re more likely to catch it full-blown if you lack sleep. Missing needed sleep is like hitting the turbo button on whatever health issues you are battling. Fortunately, there are methods to start improving your sleep today: establish regular sleep times, exercise in the morning, reserve your bed only for sleep, and disallow digital screens from the sleep area.
Christopher Perry, MD
Providence Midlands Pulmonary, Critical Care
& Sleep Medicine
Q: After I have my first screening colonoscopy, what is the next step?
A: Good for you! Screening for colon cancer is important and a colonoscopy performed by an experienced physician is the single best test to detect and remove precancerous polyps. There are guidelines regarding when to repeat a colonoscopy. It depends on the size, type and number of polyps detected. If there is no family history of colon cancer and the prep and examination are excellent and there are no polyps, you may be able to wait 10 years before repeating an examination. If there are one or two small polyps, the recommendation is to repeat the procedure in five years and if there are three or more polyps, or if the polyps are larger or look more aggressive under the microscope, the recommendation is three years. These are only guidelines and may be modified depending on other circumstances. Remember, colon cancer is preventable!
March Seabrook, MD, FACG
Consultants in Gastroenterology
Q: Is there relief for people suffering with chronic back, neck, arm or leg pain, even after spine surgery?
A: Yes. Spinal cord stimulator is a well-established pain treatment. This device delivers electrical pulses to the spinal cord to mask or interrupt the transmission of abnormal pain signals to the brain. The pulses are sent by small electrodes placed near the spinal cord that connect to a compact battery-powered generator, which is implanted under the skin. This procedure can be done on an outpatient basis.
SCS technology has improved significantly in recent years. The newest high-frequency systems have been proven to provide more relief in both back and leg pain compared to traditional spinal cord stimulators. This therapy also relieves pain without the tingling or buzzing patients have experienced in the past.
Steven B. Storick, MD
Midlands Orthopaedics & Neurosurgery
Q: I am considering breast augmentation surgery, but I am concerned about scarring. Where are the incisions placed?
A: There are several options for the placement of incisions, and a consultation with a board-certified plastic surgeon will help you figure out which option will best minimize visible scarring. Placement depends on a patient’s body type, degree of ptosis (sagging) and desired breast size. The most common locations for incisions are inframammary (in the fold), peri areolar (around the areola) or trans axillary (in the underarm). A patient with a well-developed fold and some volume loss after pregnancy would likely prefer an incision in the fold. A patient with little or no fold and a tight skin envelope would benefit from a trans axillary incision. During your consultation, be sure to look at photos of patients with your body type, so you can see the beautiful results that can be achieved.
Richard J. Wassermann, MD, MPH, FACS
Plastic Surgery Consultants, LLC
Q: How do cataracts affect my vision?
A: A cataract is a clouding of the eye’s natural lens that typically occurs with age. Cataracts usually form slowly over a long period of time. Some say that their vision with cataracts is similar to looking through a dirty car windshield. If your vision has become blurry, cloudy or if your glasses don’t seem to work like they used to, you may be developing a cataract. You may also have difficulty driving at night or experience sensitivity to sunlight or bright lights. You may notice you need more light to read or see halos around lights. Surgery is the only way to remove cataracts and restore vision. Although traditional cataract surgery is very effective and successful, when considering your surgical options, laser assisted cataract surgery can offer a host of benefits over the traditional procedure and can help you experience your best possible outcome.
Garner J. Wild, MD
Columbia Eye Clinic