Q: How do I know if I’m a candidate for cosmetic surgery? A: One of the first things that a plastic surgeon must determine is the presence of a functional problem causing the concern. Common functional problems are prior trauma or cancer causing a deformity, enlarged breasts causing pain, or excessive skin from massive weight loss. Aside from these issues, patients usually have a very good idea about what they want and often a very good idea of what procedures are available to correct their cosmetic needs. The doctor should explain the expected outcomes and decide if the patient’s expectations are in line with what can be delivered with a surgical procedure. The doctor must also determine the patient’s motivations for seeking out a cosmetic procedure. If all of these are in line with good reasoning and the patient is in good overall health, then they are excellent candidates for surgery.
Oliver P. Simmons, MD
Carolina Cosmetic Institute
Q: What is the best advice you can give to patients with obstructive sleep apnea?
A: In our practice, we treat many people who suffer from sleep disorders. Obstructive sleep apnea, or OSA, is a condition that causes interruptions in breathing during sleep. It can lead to a variety of serious complications that include high blood pressure, heart attack, heart failure, stroke, depression and diabetes. If you or a loved one has been diagnosed with OSA, please follow through with the plan of treatment prescribed by your physician and/or sleep specialist. With some general lifestyle changes and possibly using a Continuous Positive Airway Pressure (CPAP) device during sleep, you will see life-changing improvements in your health.
M. Christopher Marshall, MD
Carolina Pulmonary and Critical Care
at Lexington Medical Center
Q: Can I lose vision from diabetic eye disease?
A: The ocular complications of diabetes continue to be the most common cause of blindness among American adults 20 to 74 years of age. More than 40 percent of diabetic patients over the age of 40 have retinopathy. Diabetic retinopathy is damage to the retinal blood vessels leading to fluid buildup in the retina and growth of abnormal blood vessels. Leakage and bleeding from these vessels cause vision loss. Improved control of blood sugar levels and blood pressure reduce the rate of complications. People with diabetes should strive to maintain a Hemoglobin A1c level less than 7 percent, blood pressure less than 130/80 and have an eye examination at least annually. Diabetic retinopathy can be treated and vision stabilized or improved with office based intraocular administration of special types of medication and retinal laser procedures to reduce the need for surgery in the operating room. There are many clinical research studies to identify better methods to treat diabetic retinopathy.
Jeffrey G. Gross, MD
Carolina Retina Center
Q: What are the benefits of prenatal yoga?
A: Yoga is a practice for the spirit, mind and body, so it has many benefits during pregnancy. Yoga poses build flexibility, strength and stamina, and your body is opened and prepared for childbirth. Yoga also helps alleviate many of the common physical complaints of advancing pregnancy.
Yoga is taught along with breathing and imagery techniques that are useful for relaxation, stress relief, meditation and focus – all important skills to have as you navigate pregnancy, labor, childbirth and the changes to your life once your family grows. The spiritual path of yoga will aid your desire to be your best self and parent.
The benefits of taking a class are the attention and adjustments you get from the teacher that ensure you are safely in alignment in each pose, as well as the sense of community and fellowship you establish with other pregnant students.
Dr. Rachel E. Hall, M.D., RYT-200
Q: How do I know if I have a meniscal tear of my knee?
A: The knee is a complex joint of ligaments, bones, cartilage, muscle and synovial lining, so you should always see your primary care doctor or orthopaedic surgeon for knee complaints.The knee has two menisci, medial and lateral, which serve a primary shock absorbing and stabilizing function. In general, the menisci have poor blood supplies and are torn frequently in both young and mature athletes.There are many causes of knee pain. Meniscal cartilages can become worn or torn, but if the pain lasts longer than six weeks, it’s possible that you are suffering from a meniscal tear. Pain from disc tears can be located anywhere along the joint line, but most pain is in the back inner or back outer part of the knee where 80 percent of tears are located. In years past, surgery would remove the entire disc. Today, disc sparing surgery is used where only the torn portion of the disc is removed. Other techniques allow the repair of some 20 percent of meniscal tears, particularly in the vascular zone of the disc. These new techniques allow the repair of the disc through the same incision where the knee arthroscopy is performed. Not all repaired discs heal completely.
Visit www.mccainortho.com for a video on meniscal repairs and look at our Case Reports for laser prints of meniscal repairs.
Dr. Rick McCain
McCain Orthopaedic Center
Q: What is bioidentical hormone replacement therapy and how can it help me?
A: Bioidentical Hormone Replacement Therapy (BHRT) is a prescription alternative to conventional hormone replacement therapy (conjugated estrogens, medroxyprogesterone, testosterone gel, etc.). Bioidentical medications are plant-derived and chemically changed in a laboratory until they are identical to what your body would naturally produce. BHRT is customizable; in other words, it can be adjusted to fit your needs, unlike conventional HRT, which has a few standard dosage strengths.
BHRT can help alleviate symptoms in men and women that may be hormonally related, such as mood changes, sleep loss, fatigue, joint pain, low libido, hot flashes in women, mental foginess and weight gain. Many people do not realize that they do not have to suffer and that there is help. For more information call Midlands Medical Wellness Center at (803) 223-9328 or visit www.MidlandsMedWC.com
Dr.Jandrette Adu Boahene
Midlands Medical Wellness Center
Q: Who needs a Bone Density (Dexa) Scan?
A: A dexa scan is a quick, painless diagnostic test that measures bone density. Bone loss typically increases with age, which can lead to fractures from otherwise minor trauma like a fall. It is reversible if identified and treated appropriately.
Individuals in the following categories should consider getting a dexa scan: men age 65 and older; women entering menopause; and men and women whose X-rays suggest osteoporosis, who take drugs that cause bone loss, who have experienced one or more low-impact fractures, who have a disease known to contribute to bone loss and/or who have lost more than one and a half inches of their peak height.
Risk factors for osteoporosis include advanced age, family history, smoking, low calcium and vitamin D intake, high caffeine intake, alcohol consumption, menopause, low body weight, steroids and proton pump inhibitors, previous fractures and a sedentary lifestyle.
To improve bone health, participate in impact activities to strengthen bones, eat a healthy diet rich in calcium and vitamin D daily, and have your vitamin D blood level checked.
Lee Webb, RN, MSN, APRN, NP
Q: I think I may have a sports-related concussion. What do I need to do now?
A: Any sports-related head injury that is followed by certain symptoms should be evaluated by a physician trained to manage concussions. Symptoms may include headaches, dizziness, fogginess and amnesia, just to name a few. A medical history and clinical exam are components of a concussion evaluation. Baseline testing, done before possible concussion, is also very helpful in diagnosing the level of a concussion.
Balance, coordination and reaction time can all be affected after sustaining a concussion and can result in problems in the classroom, at work or behind the wheel. Concussed athletes are encouraged not to drive until they are cleared by a physician. Returning too soon to sports can put the concussed athlete at risk for prolonged symptoms. Even worse, permanent damage can result from second impact syndrome, which is when the brain responds abnormally and swells as a result of a second trauma before the first has resolved. Long term problems may occur as a result of concussion, including migraines, depression, seizures, memory problems and dementia. For these reasons, physicians monitor the resolution of symptoms, lowering the risk of complications. Athletes may resume activity once cleared by a physician and educated on what to watch for in the future.
Contact the Moore Sports Medicine Concussion Center for more information or to make an appointment at (803) 227-8170.
Craig M. Burnworth, MD
Q: Are heart attack symptoms the same in both women and men?
A: While women and men may both experience sudden chest pain or pressure, women are more likely to have pain in their back, jaw, neck or stomach. Women are also more likely to experience unusual fatigue, have cold sweats, dizziness, episodes of disturbed sleep and feelings of nausea or vomiting. They can also feel light-headed or faint.
Knowing your risk factors is the first step to avoiding heart disease. Common risk factors include family history of heart disease, smoking, high cholesterol, high blood pressure, a sedentary lifestyle, being overweight and diabetes. If two or more of these risk factors apply to you, your risk of heart disease is greatly increased. Working together with your doctor, you can take charge of these risk factors and significantly cut your risk of having a heart attack.
Dr. Lee Butterfield, Cardiologist
Palmetto Cardiology and Carolina Cardiovascular Associates
at Providence Hospital
Q: Who goes to the urogynecologist and why?
A: A female patient, that’s who! Urogynecology is a subspecialty of obstetrics and gynecology involving the evaluation of all the structures and systems of the female pelvis including organs, nerves, ligaments, muscles and blood vessels. A urogynecologist deals with the management and treatment of urinary issues like incontinence, voiding dysfunctions, chronic urinary tract infections, painful bladder issues and pelvic organ prolapse (also known as a “dropped bladder”). Women are benefiting from this subspecialty as it is exclusively designed to address these particular problems both medically and surgically.
Sadly, many women try to hide their problems and limit their lives, unaware of the effective treatments that are readily available. If you suffer from any of these issues, ask your doctor to refer you to a urogynecologist in your area.
Dr. Andrea Pezzella
Q: I have excessive fat around my midsection. How can I best get rid of it?
A: Diet and exercise are always the best ways to remove excessive fat from anywhere on the body. However, despite valiant efforts, there may be a stubborn area that just won’t go away. The traditional way to accomplish this was with liposuction, but now there’s Laser Lipolysis. It is quick and effective, permanently removing stubborn fat deposits, and it can be accomplished in an office setting using only local anesthesia. However, this method does necessitate the wearing of a tight garment for a week or two. There may be some minor bruising and fluid drainage from the tiny incisions required to do the procedure.
Recently, a totally non-invasive form of treatment for fat volume reduction and body contouring has become available. This device, called Exilis, delivers radio frequency energy to the skin and underlining fat, heating the tissue to a degree that effectively reduces wrinkles, tightens fat and shrinks the fat cells. Results are accomplished in four 30-minute treatments usually one week apart. This technique is considerably less expensive ($1,600) than liposuction ($3,000-$4,000). However, the results are not permanent and are more subtle in nature.
Call today for a consultation. Your medical history will be reviewed by Dr. Manly Hutchinson before either procedure is scheduled. Let us answer your questions and get you in those skinny jeans.
Dr. Manly Hutchinson, Jr.
The Laser and Skincare Center
Q: Why should I have yearly mammograms and what criteria must a patient meet for a breast MRI?
A: Current medical studies show a 40 percent or greater decrease in breast cancer deaths in all women age 40 or older who have annual screenings. The modern technique of full field digital mammography significantly improves the ability to visualize subtle abnormalities, even in women with dense breasts.
Breast MRI is indicated for pre-operative evaluation of newly diagnosed breast cancers and for high risk screening in women with a very strong family history of breast cancer or with positive genetic testing for breast cancer genes (BRCA I, BRCA II).
Dr. Tommy Cupples
Women’s Care At Image Care
Q: What is sciatica and how do you treat it?
A: Sciatica is a non-specific term used to described a condition in which the sciatic nerve is pinched. The typical pain pattern starts in the lower back and travels down the buttocks, lower legs and feet. In addition to the pain, other symptoms may include numbness, tingling or weakness. In most cases the sciatic pain only occurs on one side of the body but can occur simultaneously on both sides. The sciatic nerve can become pinched due to a herniated disc, bone spur or subluxation.
In order to treat sciatica, a thorough examination must be performed to assess the etiology of the pain. If it is caused by a herniated disc or bone spur, the treatment would include non-surgical decompression, injections or, in some cases, open-back surgery. The most common form of sciatica is due to a subluxation which can easily be treated by a chiropractor. A chiropractor experienced in specific adjustments to the affected area will help reduce the pinching of the sciatic pain.
Dr. Dan Handford