CARE magazine® by CARE magazine®

❤ re Ca Options and References for a Healthier Life

15 20 Y R UA BR E F

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Cholesterol and its Relation to Heart Disease

Considering Cosmetic Surgery? The Link between “Respectful Treatment” and Medical Errors Food Additives– What are the “Dirty Dozen?”

— Optimize Your Brain — attend a special Memory Matters event details on page 18

Organized Playrooms Aid Classroom Success for Your Child A “Must-read” for Helpful, Trustworthy, Up-to-Date Health News, Ideas & Options

• Area Support Groups & Community Events • Regional Blood Drives • Healthy Recipes www.caremagazine.com

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February 2015

CONTENTS

In Every Issue 10

Region Hospitals & Clinics

Professional Forum

RegionPULSE -Optimize Your Brain -What Do YOU Think?

20 care TALK© Capsules of Healthy Information

Features 4

February is Heart and Stroke Awareness Month

Community Calendar and Family Events

Regional Support Groups

Regional Blood Drives

‘Hearty’ Recipes Chicken & white bean chili Gluten-free chocolate cookies

5 6 Ways to Prepare for a Stroke Emergency

Cholesterol and its Relation to Heart Disease

ParentPULSE Organized playrooms

Care and Planning are Essential when Considering Plastic Surgery

Family Fun page

A special report from Consumer Reports®: The Link Between “Respectful” Treatment and Medical Errors

Good Health Habits Can Help Stop Flu Germs

Donating Blood is Vital for Life

The Dirty Dozen Guide to Food Additives www.caremagazine.com

Chicken & whilte bean chili—page 28

Februar y 2015

care magazine

Options and References for Healthier Living

FEBRUARY 2015 Publisher and Editor:

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John Lucas

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Memory Matters

care magazine® is a “Registered U.S. Patent and Trademark” and belongs to The Catalyst Media Group, Inc. All rights reserved. No part of this publication, including advertisements, may be reproduced or utilized in any form, or by any means, electronic or mechanical, including photocopying, or by any information storage and retrieval system, without written permission from the publisher. Photos, unless otherwise credited: Photospin.com or 123.rf.com © 2015 and may not be used without written permission or a paid subscription.

care magazine® is intended as a reference and options source only, not as a guide to self-treatment. Information contained within is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You, the reader, assume full responsibility for how you choose to use this information. Guest columns do not necessarily reflect the views or opinions of care magazine , its publisher or editors.

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February is Heart and Stroke Awareness Month What is Stroke? A stroke occurs when the blood supply to part of the brain is suddenly interrupted or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells. In the same way that a person suffering a loss of blood flow to the heart is said to be having a heart attack, a person with a loss of blood flow to the brain or sudden bleeding in the brain can be said to be having a "brain attack."

Hypertension and Stroke Risk Of all the risk factors that contribute to stroke, the most powerful is hypertension, or high blood pressure. People with hypertension have a risk for stroke that is four to six times higher than the risk for those without hypertension. One-third of the adult U.S. population, about 50 million people (including 4070 percent of those over age 65) have high blood pressure. Forty to 90 percent of stroke patients have high blood pressure before their stroke event. A systolic pressure of 120 mm of Hg over a diastolic pressure of 80 mm of Hg is generally considered normal. Persistently high blood pressure greater than 140 over 90 leads to the diagnosis of the disease called hypertension. The impact of hypertension on the total risk for stroke decreases with increasing age, therefore factors other than hypertension play a greater role in the overall stroke risk in elderly adults. For people without hypertension, the absolute risk of stroke increases over time until around the age of 90, when the absolute risk becomes the same as that for people with hypertension. Like stroke, there is a gender difference in the prevalence of hypertension. In younger people, hypertension is more common among men than among women. With increasing age, however, more women than men have hypertension. This hypertension gender-age difference probably has an impact on the incidence and prevalence of stroke in these populations. Antihypertensive medication can decrease a person's risk for stroke. Recent studies suggest that treatment can decrease the stroke incidence rate by 38 percent and decrease the stroke fatality rate by 40 percent. Common hypertensive agents include adrenergic agents, beta-blockers, angiotensin converting enzyme inhibitors, calcium channel blockers, diuretics, and vasodilators.

How Do You Recognize Stroke? Symptoms of stroke appear suddenly. Watch for these symptoms and be prepared to act quickly for yourself or on behalf of someone you are with: ● Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body. ● Sudden confusion, trouble talking, or understanding speech. ● Sudden trouble seeing in one or both eyes. ● Sudden trouble walking, dizziness, or loss of balance or coordination. ● Sudden severe headache with no known cause. If you suspect you or someone you know is experiencing any of these symptoms indicative of a stroke, do not wait. Call 911 emergency immediately. There are now effective therapies for stroke that must be administered at a hospital, but they lose their effectiveness if not given within the first 3 hours after stroke symptoms appear.

Every minute counts!

Source: http://www.ninds.nih.gov/disorders/stroke/detail_stroke.htm#251801105

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Februar y 2015

6 Ways You Can Prepare for an Emergency As a stroke survivor, you know all too well what it feels like to be in an emergency medical situation. You’re scared and anxious, your family is worried, and emergency responders are working hard to find out more about you and your medical history. You can’t predict an emergency, but you can plan for it. Follow these tips to better prepare you and your family for an unexpected medical crisis.

1. Keep an updated medical history, including a list of all your medications (and what they do) on a form. Keep copies in your home, car, and wallet.

2. Wear a piece of medical identification jewelry. Emergency responders are trained to look for jewelry that can give them access to your medical conditions, medications, and allergies. This can help get you quicker and more effective treatment. A bracelet or necklace can give first responders information that you may not be able to.

3. Educate your family, friends, and co-workers. Everyone should know the warning signs of stroke. It’s easy when you remember to think F.A.S.T.

4. Add ICE to your cellphone. Identify your emergency contact as ICE in your phone. ICE stands for “In Case of Emergency.” That way, an emergency responder will know who to contact. If your phone is password protected, open your notes and enter your emergency contact’s name and phone number. Then take a photo of that note with your iPhone and make it your wallpaper.

5. Teach your children how to call for help. Make sure your children know how to call 9-1-1 and what they should tell the dispatcher. This should include your address and a description of what’s happening.

6. Finally, do everything you can to stay healthy. Following your doctor’s orders, exercising and eating healthy foods all will help you maintain better health. “StrokeSmart” is National Stroke Association’s premier informational offering for the stroke community. A subscription includes a print magazine, e-newsletter and access to a companion website that will bring you the stories and news of a community and world impacted by stroke—all for free. Print subscriptions are free to U.S. residents only at http://www.strokesmart.org/ Februar y 2015

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Cholesterol and its relation to heart disease High cholesterol levels have long been directly linked to heart disease. But as more research into cholesterol and its relation to heart disease is conducted, some doctors are shifting their views on the relationship between the two. Statistics from the American Heart Association indicate that 75 million Americans currently suffer from heart disease. And even though one-quarter of the population takes cholesterol-lowering medication and have reduced the fat content of their diets, the AHA estimates that more Americans will die of heart disease than ever before. More revelations are coming to the forefront regarding cholesterol and heart disease. New research has shown that statin drugs are ineffective at reducing mortality rates in most populations. Furthermore, according to the Framingham Heart Study, which is the longest-running and most comprehensive study on heart disease to date, it was demonstrated that cholesterol intake in the diet had no correlation with heart disease. The study found that men and women with above average cholesterol levels had nearly identical rates of heart disease compared to those with below average cholesterol rates.

Cholesterol levels may not have the same relationship to heart disease as once believed.

Another potential eye opener is that, in addition to cholesterol not affecting heart disease risk, eating high-cholesterol foods does not elevate blood-cholesterol levels as doctors once thought. Ancel Keys, who is considered the “father” of the theory that cholesterol contributes to heart disease, now says that there’s no connection between cholesterol in food and cholesterol in the blood.

If not cholesterol levels and the foods one eats, what, then is responsible for heart disease? Many medical professionals and researchers now believe the primary causes of heart disease are inflammation and oxidative stress. According to Dr. Dwight Lundell, a heart surgeon and author of the book, “The Great Cholesterol Lie,” foods like refined sugars and vegetable oils used to preserve processed foods may lead to the inflammation that ultimately causes heart disease. Inflammation is the body’s immune response to a foreign invader. Foods high in sugar and saturated fat can exacerbate inflammation. Bacteria and other unwanted substances in the body also contribute to inflammation. To combat inflammation, people can adopt a healthy eating style. Fatty fish, whole grains, leafy greens, fiber, and nuts can help reduce inflammation. 6

Exercise also can reduce inflammation. Research from Mark Hamer, PhD, an epidemiologist at University College London, found that, regardless of BMI or weight, study participants who completed 2.5 hours of moderate exercise each week—about 20 minutes a day—lowered their markers of inflammation by at least 12 percent. When a person exercises, muscle tissue releases a protein molecule called cytokine, which likely prompts an inflammation drop. Just about any type of workout that raises heart rate is effective in helping with inflammation. The public may have been misinformed about just how vital it is to reduce cholesterol levels. Contrary to popular belief, high cholesterol may not have the same connection to heart disease as doctors once thought. In fact, inflammation may be the bigger component in heart disease risk.

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Februar y 2015

4 Tips for Anyone Considering Plastic Surgery

DOCTORS who CARE •HEART HEALTH

A Little Care in Planning Can Avert a Nightmare “Decades ago, I think it’s fair to say there was a stigma that plastic surgery was for those with too much money and vanity, but now it’s known to help people who have perfectly healthy reasons to alter their bodies—from breast cancer survivors to people with breathing obstructions,” says Dr. John Zannis, (www.zannisplasticsurgery.com). “However, plastic surgery is a multi-billion dollar industry in the United States, and some of the doctors performing these procedures are not certified,” Zannis says. “Their patients are at risk not only of botched surgeries, but of undergoing unnecessary procedures for the wrong reasons.” Here are his prerequisites for plastic and cosmetic surgery: • Don’t undergo a procedure that makes you unrecognizable, unless you’re correcting disfigurement. Whether you want to gain more confidence because you’ve recently reentered the dating scene or you’ve decided upon aesthetic improvements for your career, there’s something distinctly American about continued self-improvement throughout one’s life. “Make sure to choose a procedure with a surgeon who grasps the idea of undergoing improvements while maintaining a recognizable appearance.”

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CENTER FOR OCCUPATIONAL & ENVIRONMENTAL MEDICINE 7510 North Forest Drive North Charleston, SC 29420

843-572-1600 • www.coem.com ALLAN D. LIEBERMAN, M.D., F.A.A.E.M. WILLIAM J. WEIRS, M.D., F.A.A.E.M. BETTINA HERBERT, M.D., F.A.A.P.M.R, I.F.M.C.P.

• Board certification by the American Board of Plastic Surgery is a must! Just like everyone else, doctors want to make money. In many cases, doctors aren’t required to be certified to inject Botox or perform other procedures. We’ve all heard the plastic surgery nightmares, which are often caused by a botched surgery, a surgeon who didn’t explain to the patient the overall change to a face with oversized lips, or a combination of the two. • Do it for your own reasons and not someone else’s. It’s one thing to seek breast enhancement in order to boast one’s own confidence; it’s another to do so to please a boyfriend. “It’s your body,” Zannis says. “Be clear that you are the one who wants to change your body.” • Avoid the rabbit hole of too much cosmetic surgery. You don’t have to have a single bad surgery to miss the mark of your intended self-improvement. It’s possible to get several excellent procedures done with a result of diminishing returns. “If you think your nose could be better or you’d like help eliminating fat in places that, no matter how much you diet and exercise, simply will not go away, then a procedure may be in order,” Zannis says. “And, you may want multiple procedures done. If this is the case, keep in mind the overall picture of what you’re going for.” Dr. John Zannis is board certified by the American Board of Plastic Surgery. He studied human biology and studio art at Stanford University and medical degree from the University of Cincinnati College of Medicine. Zannis received his formal training in general surgery and plastic and reconstructive surgery at Wake Forest University under the guidance of world-renowned plastic surgeon Dr. Louis Argenta. During this time, he performed more than 5,000 surgical procedures and covered all aspects of plastic surgery.

Februar y 2015

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Consumer Reports®

Finds Striking Link between “Respectful” Treatment and Medical Errors Nearly 30 percent of U.S. patients said they experienced a preventable medical error in new CR survey; About one in four reported that medical personnel didn’t always treat them “like a person”

In a new report that explores the important role of patient “engagement”, that is open communication with respect and dignity, Consumer Reports has found a striking link between respectful treatment in the hospital and preventable medical errors. It examines the relationship between patient communication and hospital errors, including hospital-acquired infections, drug errors, and other types of preventable harm. The article, featured in the February 2015 issue of Consumer Reports and at ConsumerReports.org, also includes findings from a new, national survey of patients’ hospital experiences and a list of the U.S. hospitals that score the highest in both patient respect and safety. Consumer Reports’ new survey of 1,200 people who were recently hospitalized, found those who said they rarely received respect from hospital staff were two and a half times more likely to experience a preventable medical error—such as a hospital-acquired infection, drug error, or an unplanned trip back to the hospital—as those who felt they were usually treated with respect. A quarter of respondents said hospital staff didn’t always treat them as adults able to be involved in

their own care. And about a third said staff didn’t always listen to them without interrupting, and the same percentage felt their wishes about treatment were not always honored. And, 20 percent of patients surveyed believed they weren’t always treated fairly and without discrimination. “For more than ten years, we have collected stories from harmed patients who commonly express frustration about not being listened to by staff and doctors during their hospital stay,” said Lisa McGiffert, Manager of Consumer Reports’ Safe Patient Project. “We encourage patients to speak up when they feel that their wishes are not being heard. This survey validates that doing so might actually save your life.” Every day almost 2,000 people on average pick up an infection in the hospital and about 1,100 preventable drug errors occur. Overall, hospital medical errors are linked to 440,000 deaths annually. Consumer Reports’ study suggests patients will have better outcomes when hospital staff carefully listens and patients speak up and ask questions. A growing number of health experts believe lack of respect is an ingrained part of medicine that can contribute to medical errors.

Consumer Reports believes patients can increase the odds of a good hospital experience and set the stage for positive interactions by following this checklist: Choose the right hospital. An analysis of data from Consumer Reports’ ratings of almost 2,600 hospitals supports the idea that patient satisfaction and patient safety are connected. The full story and consumerreports.org contains a chart of the hospitals that scored high and low in both areas. A Consumer Reports subscription (editor’s note: reasonable cost/good value) is required for comparison. http://www.consumerreports.org/health/doctors-hospitals/hospital-ratings.htm.

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Februar y 2015

—continued from previous page

Help providers see you as a person. Once you get to the hospital, chances are you won’t know

the folks taking care of you, so it’s important to remind them you are more than just a diagnosis. Share personal things about yourself, such as photos and stories and add personal details when you describe your medical problems to a doctor. Invite your doctor to have a seat. The increased use of electronic devices by medical staff to

collect data is having a real impact on doctor-patient communication. A patient can change this dynamic by inviting their doctor to sit down and have a conversation, making it easier to communicate. Have “your people” with you. In the Consumer Reports survey people who had family or friends

as their health advocate were 15 percent more likely to say they had been treated with respect and 12 percent more likely to recommend their hospital to others. Know when errors are likely to occur. If you know when and where errors are more likely to

occur, such as at shift changes or transitions such as moving from ICU to a hospital floor, be sure to have your advocate present. It can also be helpful to have an “inside troubleshooter” and an often untapped resource is the hospital ombudsman, or patient advocate, an intermediately between patients and staff, available at many facilities. Fewer than half of those surveyed by Consumer Reports knew such a person was available, and almost no one, just 4 percent, asked to see one. Keep the concept of partnership in mind. There is a good and a bad way of challenging your

doctor. The notion that “you are the expert when it comes to your body and the doctor is the expert when it comes to medicine” is a good rule of thumb. There should be a spirit of teamwork that includes shared observations, knowledge and information and asking questions—but not making accusations. Write things down. With doctors, nurses, technicians, medical students and social workers in

and out of your room, it can be very hard to keep track of what they are all doing, especially when you are ill. Keep a journal and pen, or an e-device, ready at your bedside to take notes and write things down to share. If you don’t understand something, ask again. Medicine is complicated and full of technical terms and sometimes doctors, who are immersed in it, forget you haven’t studied it. Feel comfortable to politely remind them that you may need them to slow down and translate into plain English, so you can fully understand.

The full report, “How Not to Get Sick(er) in the Hospital,” which includes Ratings of almost 2,600 U.S. hospitals, is featured in the February 2015 issue of Consumer Reports, and at ConsumerReports.org. The survey was funded with a grant from the Gordon and Betty Moore Foundation. This release was printed with permission from Consumer Reports

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Regional Hospitals, Centers and Clinics

BEAUFORT–JASPER–HAMPTON COMPREHENSIVE HEALTH SERVICES www.bjhchs.com

PORT ROYAL Port Royal Medical Center, 843-986-0900 ST. HELENA ISLAND Leroy E. Browne Medical Center, 843-838-2086 CHELSEA Ruth P. Field Medical Center, 843-987-7400 HARDEEVILLE Donald E. Gatch Medical Center, 843-784-2181 HAMPTON 200 ELM St.,803-943-2233 RIDGELAND Ridgeland Family Medical Center, 843-726-3979 SHELDON Elijah Washington Medical Center, 843-846-8026 ESTILL Estill Medical Center, 803-625-2548

BEAUFORT MEMORIAL HOSPITAL www.bmhsc.org

BEAUFORT

995 Ribaut Road, 843-522-5200

KEYSERLING CANCER CENTER: (Affiliated with Duke University Medical Center)

PORT ROYAL

1680 Ribaut Road, 843-522-7800

COASTAL CAROLINA HOSPITAL www.coastalhospital.com

HARDEEVILLE 1000 Medical Center Drive, 843-784-8000

HAMPTON REGIONAL MEDICAL CENTER www.hamptonregional.com

VARNVILLE

HILTON HEAD HOSPITAL www.HiltonHeadRegional.com

HILTON HEAD ISLAND 25 Hospital Center Blvd., 843-681-6122

MUSC–Medical University of South Carolina www.MUSChealth.com

CHARLESTON

171 Ashley Avenue, 843-792-1414

HOLLINGS CANCER CENTER at MUSC http://hcc.musc.edu

CHARLESTON

86 Jonathan Lucas Street, 843-792-0700

SURGERY CENTER of Beaufort www.BeaufortSurgery.com

BEAUFORT

1033 Ribaut Rd., 843-322-5800

US NAVAL HOSPITAL www.nhbeaufort.med.navy.mil

BEAUFORT

1 Pickney Blvd, 843-228-5600

SCDHEC PUBLIC HEALTH REGION 8 REGION 8 HEADQUARTERS www.scdhec.net/health

BEAUFORT

1407 King St., 843-525-7603

CHILDREN WITH SPECIAL HEALTH CARE NEEDS

BEAUFORT

843-525-4080

GOOD NEIGHBOR MEDICAL CLINIC gnmc1402@embarqmail.com

BEAUFORT

30 Professional Village Dr., 843-470-9088

PREGNANCY CENTER & CLINIC OF THE LOWCOUNTRY- FREE prenatal care through 16 weeks

HILTON HEAD ISLAND 843-689-2222 www.pregnancycenterhhi.org

MEMORIAL UNIVERSITY MEDICAL CENTER www.memorialhealth.com

SAVANNAH, GA 4700 Waters Avenue, 912-350-8000

ST. JOSEPH/CANDLER HOSPITAL SYSTEM www.sjchs.org

SAVANNAH, GA St. Joseph's Campus: 11705 Mercy Blvd., 912-819-4100 Candler Campus: 5353 Reynolds St., 912-819-6000

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503 Carolina Avenue W., 803-943-2771 or 800-575-1435

Februar y 2015

Healthcare-Associated Infections Dropping but Still Fall Short of Goals Rates of many healthcare-associated infections appear to be declining in U.S. acute care hospitals, according to a new CDC report. Among the findings: • Central line-associated bloodstream infections decreased 46% between 2008 and 2013. • Surgical site infections for 10 procedures dropped 19% during that time. Hospital-onset methicillin-resistant Staphylococcus aureus bacteremia (MRSA) fell 8% between 2011 and 2013, while Clostridium difficile infections dropped 10%. Catheter-associated urinary tract infections increased 6% from 2009 to 2013. This is the second consecutive year in which the infection rate increased, “signaling a strong need for additional prevention efforts,” the report states. The authors note, that despite the improvements, infection rates still fell short of national targets set in 2009. They note that one in every 25 hospital patients in the U.S. contracts an infection during their stay. By Kelly Young, www.JWatch.org. Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, FASAM See more at: http://www.jwatch.org/fw109744/2015/01/15/ healthcare-associated-infections-dropping-still-fall?query=pfw#sthash.OuHZVhHM.dpuf and at: http://www.cdc.gov/HAI/stateplans/state-hai-plans/sc.html

Februar y 2015

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The CDC will continue to measure progress at the state and national levels. Prevention goals are most likely to be met with targeted efforts to cut infection types shown to be lagging behind and to make further progress on the infection types headed in the right direction. Preventing HealthcareAssociated Infection (HAIs) is possible, but it will take a conscious effort by clinicians, healthcare facilities and systems, public health, quality improvement groups, and the federal government to work together toward protecting patients and saving lives. â&#x20AC;&#x201C;CDC.gov For information regarding specific infection rates visit http://www.cdc.gov/ HAI/surveillance/ Good news note: our regional hospitals have updated policies and are working to/have improved on statistics stated in these reports.

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Februar y 2015

Preventing the Flu: Good Health Habits Can Help Stop Germs No one likes to get sick, but this is the time of year the flu strikes. Here is a list of good health habits that can help stop germs and prevent you from getting the flu: Avoid close contact. Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too. Stay home when you are sick. If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness. Cover your mouth and nose. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Clean your hands. Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub. Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Practice other good health habits. Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

Why Organ, Eye, and Tissue Donation?

• 123,953 people are waiting for an organ • 18 people will die each day waiting for an organ • 1 organ donor can save up to 8 lives

Source: http://www.cdc.gov/flu/protect/habits.htm Februar y 2015

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Professional Forum

news from, about + for our regional healthcare professionals

New Pediatrician Joins Beaufort Memorial Hospital Medical Staff To better serve its youngest patients, Beaufort Memorial has added another pediatrician to its medical staff. Dr. Anca Dumitriu is the newest member of Beaufort Pediatrics, a seven-physician practice located at 964 Ribaut Road, across the street from the hospital’s main campus. A native of Romania, Dumitriu moved to Beaufort this summer after completing a pediatric hematology/oncology fellowship in June at the Medical University of South Carolina. During her three years at MUSC she was honored with Physician of the Month and Pediatric Subspecialty Fellow of the Year awards. Dumitriu earned her medical degree in Bucharest and went on to complete her pediatric residency at Geisinger Medical Center’s Janet Weis Children’s Hospital in Danville, Pa. Her postdoctoral experience includes a year-long fellowship in neurosurgery at Geisinger and a six-month fellowship at the Cleveland Clinic’s Brain Tumor and Neuro-Oncology Center. She is married and has one child. Founded more than 30 years ago, Beaufort Pediatrics is a thriving practice providing sick and wellness care for children ages birth to young adulthood. Its medical team includes Drs. Joseph Floyd, Lawrence Coleman, Kurt Ellenberger, William and Kim Martin, Shayla Bergmann and pediatric nurse practitioner Kristin Dalton. All of the physicians are board certified and can be reached at 843-524-5437. Beaufort Memorial Hospital has a total of 14 pediatricians on its medical staff. For more information on the physicians, visit www.beaufortmemorial.org.

Two OB-GYNs Join Beaufort Memorial Hospital’s Medical Staff Two OB-GYNs recently hired by Beaufort Jasper Hampton Comprehensive Health Services (BJHCHS) have joined Beaufort Memorial’s medical staff, adding to the number of doctors delivering babies in the hospital’s Birthing Center. 14

Dr. Octavio MeléndezCabrera, a board-certified physician with 20 years’ experience, and Dr. Niles Ita, who completed her residency this summer at Howard University Hospital, are both new to the area. Dr. Meléndez-Cabrera, fluent in English and Spanish, moved to the Lowcountry from New Jersey, where he had been a physician in a hospitalowned practice for four years. A graduate of the Universidad Central del Caribe in Puerto Rico, he ran a solo private practice in Puerto Rico from 1996 to 2009 and served as an associate professor at the Ponce School of Medicine. His fields of interest include pelvic laparoscopic surgery.

Dr. Ita earned her Bachelor of Science degree in Chemistry at Emory University in Atlanta in 2005 and spent the next 10 months working at the Good Samaritan Health Center before moving to Washington, D.C., to study medicine. While at Howard University, she participated in medical missions sponsored by Nexos Voluntarios, National Organization for the Advancement of Haitians and Sustainable International Medical Missions. She also was a founding member of the New Freedman’s Clinic, a free student-run health care center affiliated with Howard University Hospital and the College of Medicine. Beaufort Memorial’s Birthing Center is the only maternity facility in the Beaufort County area to feature a Level II special care nursery. An extensive renovation of the center is scheduled to begin next year as part of an initiative to improve birthing services in the community. For more information, visit beaufortmemorial.org or call (843) 522-5112. To make an appointment with Dr. Meléndez-Cabrera or Dr. Ita, call the BJHCHS Port Royal or Chelsea clinic at (843) 986-0566 or (843) 987-7400, respectively.

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Februar y 2015

Professional Forum

continued . . .

New Women’s Cancer Care Services now Available in Myrtle Beach

Hillman Foundation Announces Second Round of ‘Innovations in Care’ Program

Coastal Comprehensive Women’s Center now providing surgical breast oncology in Myrtle Beach, is offering women’s cancer care services to the local community. The center will offer expert breast cancer surgery, provided by a fellowship-trained breast surgeon. Randal Croshaw, M.D., is the medical director at Coastal Comprehensive Women’s Center and a fellowshiptrained and journal-published surgical breast oncologist. Dr. Croshaw specializes in the evaluation and comprehensive treatment of benign and malignant breast disease. Dr. Croshaw earned his medical degree from the University of South Carolina in Columbia before moving on to complete a residency in general surgery at Palmetto Health Richland. He went on to complete a fellowship in surgical breast oncology at Allegheny General Hospital in Pittsburgh, Pennsylvania. Dr. Croshaw is a member of the American Society of Breast Surgeons and the American College of Surgeons. Coastal Comprehensive Women’s Center is located at 199 Village Center Blvd., Suite 100 Myrtle Beach, SC. Call 843-236-4330, or visit www.21stCenturyOncology.com

Multi-year initiative continues support for transformative, nursing-driven models of health care The second round of funding for the Hillman “Innovations in Care’ Program, has been announced. The Rita & Alex Hillman Foundation mission is to improve the lives of patients and their families through nursing-driven innovation. The Foundation will release a formal Request for Proposals for the 2015 grant cycle on February 2. It will hold an informational webinar for those interested in applying to the program on February 17. Brief initial applications will be due on March 16. More information is available on the Foundation’s web site at: www.rahf.org/ . The Hillman ‘Innovations in Care’ program seeks bold, creative, patient- and family-centered approaches that challenge conventional strategies, improve health outcomes, lower costs, and enhance patient and family caregiver experience. The Foundation is particularly interested in the areas of maternal and child health, care of the older adult and chronic illness management. The Foundation will award two grants of up to $600,000 each, in late 2015.

Pediatric and Adult Home Care Services When a Family Member Needs Specialized Care at Home At PSA Healthcare, we understand that working through the process of arranging home nursing care can be challenging. We are available to assist you in developing a plan for a child or an adult, who needs specialized care in the home.

Contact us to learn more! PSA healthcare is currently seeking applications for LPNs and RNs in the SC Lowcountry and Coastal Georgia region.

Apply online at psahealthcare.com toll-free 866-825-7729 office 912-961-1017

Februar y 2015

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RegionPulse

healthy news + community happenings

Optimize your brain Let the adventure begin! Save the date! March 12, 2015 at the Hilton Head Beach and Tennis Resort If your New Year’s resolution is to take better care of yourself, start with your brain. Make a resolution to attend a conference hosted by Memory Matters and featuring Dr. Paul Nussbaum, author of the national bestselling book “Save Your Brain”, named one of the top five brain fitness books/DVD’s by AARP. Dr. Paul Nussbaum, PhD and co-founder of the popular online program Fit Brain, (recently purchased by Rosetta Stone) has presented his views on brain health at the United Nations, National Press Conference, CSPAN and now Hilton Head Island. Dr. Nussbaum educates the general public on the basics of the human brain and how to keep the brain healthy over the entire lifespan. We are all concerned about improving our memory but what if you could not forget anything? Sean Conlon remembers every detail about things that have happened throughout his life. According to leading neurobiologists at the University of California, Sean possesses an extraordinarily rare ability called Highly Superior Autobiographical Memory (HSAM). First documented in 2000, researchers

have since identified fewer than 100 people in the world with this little understood condition. These folks, like Conlon, remember not only the front-page events, but also much of what they did everyday—and what happened immediately around them—verified by research and interviews with family, friends, and colleagues. “I’d call it “a condition”, it’s not a superpower,” Conlon says with a laugh. “If it were a super power, I’d be able to change things.” Hmmm… Dr. Nussbaum will engage in a lively conversation with Sean to learn about how this condition affects his daily life. In addition, Memory Matters will be conducting a mini Brain Boosters class at this event. This 10 week class is offered at Memory Matters three times a year. Signing up for the spring class at this event would be a great way to get you started on the road to developing habits to keep your brain operating at optimum capacity. Over 20 vendors specializing in offering information and products to help promote a healthy lifestyle will be available throughout the day. Dr. Nussbaum’s book will be available for sale and he will be doing a book signing.

Tickets are only $65.00 and include lunch. They are now available and can be purchased by stopping by Memory Matters, 117 William Hilton Parkway, Hilton Head Island, or calling the office at (843) 842-6688. Register now and let the adventure begin!

What Do YOU Think? Dr. Hughes, of Hughes Dental in Bluffton, reaches out to Care magazine readers with the following questions. The questions posed in this article are up for debate.

Regarding metal or amalgam fillings… Patients often mention their health concerns about amalgam metal fillings.

The E.P.A.’s research notes that the average ‘silver filling’ contains enough mercury, (more toxic than lead and arsenic), to contaminate a 5-acre lake and declare it unsuitable for drinking and fishing. Yet the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and an effective restorative material. The controversy continues. Today’s modern dentistry uses quality resin composites as the alternate restorative material. At slightly more cost, the choice would be up to you.

What do you think?* *Despite undeniable scientific evidence about the dangers of Mercury poisoning, the A.D.A. still claims amalgam poses no health risk.

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Februar y 2015

What Do You Think? . . . continued from page 16

Regarding using therapy dogs to calm nervous patients… Some dentists are using therapy dogs with great success!

Earlier this year, Therapy Dogs International. described these “gentle” and friendly dogs as receptive to physical contact. Therapy dogs, like Brooke, pictured here, help patients “ease tensions, lower blood pressure and increase positive attitudes.” Though not all patients will enjoy having a dog around during a dentist visit, Brooke, owned by a New York dentist, is only called upon once a month and is always accompanied by a human staff member. She’s given a good scrub down before each visit and the office is cleaned thoroughly when she leaves. The 4-year-old golden retriever now comes in to the office on the last Thursday of the month, by appointment only. Dubbed “Brooke Day,” the doctor says his furry friend has been a very big hit with nervous patients and the kids.

What do you think of this dentist’s helper? To reply to Dr. Hughes, snap this QR code (at left) with your smart phone. It will take you to his Facebook page, where you may leave your reply. Visit www.hughesdentalonline.com for additional information. To make an appointment at Hughes Dental, SunGate Medical Center (near Sun City) at 10 William Pope Drive, Suite #2, Okatie, SC, please call (843) 705-7066. See his ad on page 9.

South Carolina’s largest hospice is proud to call the Lowcountry home! Let Agapé Hospice, along with the expertise and resources of Agapé Senior, help you and your family during your greatest time of need.

For Every Reason... For Every Family...

We Will Be There.

1-800-411-AGAPÉ (1-800-411-2427) Februar y 2015

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Close your eyes and point your finger on a map and let it linger, Anywhere you point your finger to, there’s someone with the same type blood as you!

And they may be in need of your blood donation! The Blood Alliance is your community blood bank, providing blood and blood products to local hospitals. They are a not-for-profit organization and currently serve residents in Northeast Florida, and regions of Georgia and South Carolina. The Blood Alliance (TBA) is dedicated to providing the people in the communities they serve with quality blood services. In partnership with volunteer donors, they are committed to maintaining an adequate supply of blood components, a competent and professional staff, and high performance standards through current knowledge and approved technology. You depend on your local hospitals to be there when you need them. Your local hospitals depend on TBA. They can’t do it without you!

pounds may donate blood every 56 days (unless deferred for another reason). Donating is safe and easy, takes about an hour to complete, and includes: Registration • Medical History • Mini-physical Drawing Blood (5 - 8 minutes) • Refreshments Why donate to The Blood Alliance? When you donate blood to The Blood Alliance, you are giving back to your community. Blood donated with TBA stays in the community to benefit local patients, which is not the case with other agencies. Population growth, medical advances and increasing blood safety measures are causing an increase in local demand that exceeds our donation rates. There is no substitute for human blood. It cannot be manufactured or harvested. The only way to fill patient needs is with volunteer donors like you. Their recruitment staff actively seeks community groups, churches, businesses, and educational facilities to sponsor blood drives.

The Blood Alliance follows regulations established by the Food and Drug Administration (FDA), OSHA, Department of Transportation, the states of Florida, Georgia, and South Carolina, and the standards of the AABB (American Association of Blood Banks). They have an outstanding long-term record of quality and safety, confirmed by FDA, state, and AABB inspection records. From administrative to medical, The Blood Alliance cares about people, about our community, and about saving lives. They want you to know: • 4.5 million Americans would die each year without lifesaving blood transfusions • Every 21/2 seconds someone in our country needs blood • There is no substitute for human blood. Since blood must be provided by human donors and has a life span of only 42 days, it is a very precious resource needing constant replenishment • Blood is used daily for all types of surgical operations, accidents, acute burn victims, and for those with catastrophic diseases such as leukemia and hemophilia Who can donate blood? Anyone in good health, at least 17 years of age (16 years old with parental consent), and weighing at least 110 18

African-American Donors It’s important that blood donors reflect the ethnic diversity of the patients who receive their blood. Since children with sickle cell disease often need many blood transfusions, it is best for them to receive blood that very closely matches their own. Patients with sickle cell disease—primarily in the African-American community —are less likely to have complications from blood donated by African-Americans. To Donate, please call to make an appointment: 888-99-TBA-HERO (888-998-2243) Or visit www.igiveblood.com

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Februar y 2015

Regional Blood Drives February 2015 Government issued photo ID is required to donate. Examples are a driver’s license, passport, military ID, student ID

Wednesday, March 04 Beaufort Academy 240 Sam’s Point Road Bloodmobile

The Blood Alliance For appointments, please call

LOWCOUNTRY Fixed Site Donor Center 1001 Boundary St., Suite A

843-522-0409 iDon8

or, use free app at

Thursday, March 05 Beaufort County Government Center 106 Ribaut Rd Bloodmobile

SEABROOK Tuesday, February 10 Whale Branch Early College High School 169 Detour Road / Parking lot Bloodmobile

Give Blood. Save Lives. FACT: Your donation of

one pint of whole blood takes about an hour and

can save three lives .

BEAUFORT

CALLAWASSIE ISLAND

Wednesday, February 04 Battery Creek High School 1 Blue Dolphin Dr Bloodmobile

Monday, February 02 Callawassie Island 22 Callawassie Club Drive Bloodmobile

If you’re already a blood donor,

SUN CITY

If you’re not, we ask that you please consider it.

Friday, February 13 Beaufort Donor Center 1001 Boundary Street, Suite A Friday, February 20 Beaufort Medical & Administrative Center BMAC Building 990 Ribaut Rd BMAC bloodmobile Monday, February 23 Beaufort Memorial Hospital 955 Ribaut Rd Bloodmobile Friday, February 27 Lowcountry Medical Group BMH/Lowcountry Medical Group 300 Midtown Drive Bloodmobile Monday, March 02 Technical College of the Lowcountry 921 Ribault Rd Bloodmobile

Monday, February 09 Sun City Hilton Head 114 Sun City Lane Portable Pinckney Hall

HARDEEVILLE Thursday, February 05 New River Auto Mall 265 Drivers Way Bloodmobile

BLUFFTON Friday, February 06 Beaufort County Library - Bluffton 120 Palmetto Way Bloodmobile

THANK YOU!

Make your appointment TODAY. Call the Lowcountry Donation Center

843-522-0409

HILTON HEAD ISLAND Sunday, February 15 St. Andrews by the Sea 20 Pope Ave. Bloodmobile

Providing Outstanding Blood Service in South Carolina, Georgia and Florida

SAVANNAH Tuesday, March 03 Joint Rotary Drive @ Quality Inn 2001 Boundary Street Bloodmobile Februar y 2015

Tuesday, February 17 Savannah College of Art and Design 201 W. Oglethorpe Ballroom www.caremagazine.com

care TALK

DASH diet named best overall diet The Dietary Approaches to Stop Hypertension (DASH) diet has earned the top spot in U.S. News & World Report’s 2015 Best Diet rankings, earning 4.1 out of 5 stars for best overall diet. To do well in this category, a regimen “had to be relatively easy to follow, nutritious, safe, effective for weight loss and protective against diabetes and heart disease.” Close runners-up include the TLC Diet, the Mayo Clinic Diet, Weight Watchers, and the Mediterranean Diet. Coming in 34th (and last) place is the Paleo Diet. Diets were also ranked in seven sub-categories. Weight Watchers earned the top slot for Best WeightLoss Diet, the Biggest Loser Diet and DASH tied for first for Best Diabetes Diet, and the Ornish Diet won for Best Heart-Healthy Diet. By Amy Orciari Herman, JWatch.org See more at: http://www.jwatch.org/ fw109717/2015/01/07/dash-diet-namedbest-overall-diet?query=pfw #sthash.ab5IseRC.dpuf

Recommendations on medical television talk shows: Where’s the evidence Medical evidence is lacking for many recommendations made on The Dr. Oz Show and The Doctors.

Television is an important source of health information, but the content of popular medical talk shows has not been examined rigorously. In this study, researchers assessed recommendations made on two internationally syndicated medical television talk shows and evaluated the evidence to support these recommendations.

capsules of helpful health information Forty episodes each of The Dr. Oz Show and The Doctors that aired during the first 5 months of 2013 were selected randomly, and >900 recommendations made during these episodes were identified. The most common recommendation made during The Dr. Oz Show was dietary advice; during The Doctors, the most common recommendation was to consult a healthcare provider. A benefit was specific for only 40% of recommendations, the magnitude of benefit was described for <20% of recommendations, and possible harms and costs were mentioned infrequently. Of 160 randomly selected recommendations (80 from each show), only 54% were supported by case studies or higher-level published evidence. In fact, evidence contradicted or was not found for 54% and 38% of recommendations made on The Dr. Oz Show and The Doctors, respectively. Author’s Comment: Unfortunately, only half of the recommendations made on The Dr. Oz Show and The Doctors are supported by published evidence, and these recommendations usually are nonspecific with regard to benefits (e.g., “vitamin E improves brainpower”), harms, and costs. Until medical talk show producers and hosts improve the quality of recommendations made on their shows, consumers and clinicians should be skeptical about these recommendations. By Paul S. Mueller, MD, MPH, FACP reviewing Korownyk C et al. BMJ 2014 Dec 17. Citation(s): Korownyk C et al. Televised medical talk shows—what they recommend and the evidence to support their recommendations: A prospective observational study. BMJ 2014 Dec 17; 349:g7346.(http://dx.doi.org/10.1136 /bmj.g7346)

Generic Drugs and Switching Prescriptions Generic drugs are as effective and safe as the brand-name drugs they’re based on. They have the same active ingredients and must work the same way as their brand-name counterparts to be approved by the FDA. www.caremagazine.com

That means they have the same risks and benefits, too. Three-quarters of the approved drugs on the market are available in a generic form. The FDA estimates that generic drugs cost 20 percent to 70 percent less than their brand-name counterparts. To see what generic drugs the FDA has approved lately, and for general information on generic drugs, visit the FDA’s Office of Generic Drugs at http://www.fda.gov/ AboutFDA/CentersOffices/ OfficeofMedicalProductsandTobacco /CDER/ucm119100.htm To find out if there’s a generic drug that would work just as well for you as the brand-name drug, talk to your doctor or pharmacist. Say you want the most effective drug at the best price. Each state has a law allowing pharmacists to substitute generic drugs for many brand-name products as long as your doctor doesn’t specify that the brand-name drug is required. Contact your state’s board of pharmacy to learn more.

Switching Prescriptions Sometimes, pharmacies and insurance companies get rebates or other incentives when they convince a plan member to switch drugs. But there may be other reasons. If you’re uncomfortable about the switch, ask your pharmacist or physician some questions: - Will the new drug work as well for my condition? - Are the side effects or risks different? - Is the dosage the same? - Is there a business connection between the pharmacist and the drug manufacturer? - Will the switch save me or my benefit plan money, or cost me more? Look up information on specific generic and brand-name drugs on the Drugs and Supplements page at MedlinePlus.gov. Februar y 2015

SERVICES PROVIDED: • Family Practice • Pediatrics

• Internal Medicine • Ronald McDonald Care Mobile

• OB/GYN

• Dental Care

• Imaging Services

• Pharmacy Services

• Home Health Nursing

• Best Chance Network: Breast Cancer Care + Prevention

• Ryan White HIV Services • Medical Social Work • Nutrition Counseling • Community Outreach • Diabetes Initiative • WIC Services

8 Convenient Locations Accepting same-day appointments

We are HERE FOR YOU Port Royal Medical Center 1320 S. Ribaut Road Port Royal/Beaufort • 843-986-0900 Ruth P. Field Medical Center 721 Okatie Hwy. 170 Chelsea • 843-987-7400 Leroy E. Browne Medical Center 6315 Jonathan Francis, Sr. Road St. Helena Island • 843-838-2086 Donald E. Gatch Medical Center 522 Stiney Road Hardeeville • 843-784-2181

Elijah Washington Family Medical Center 211 Paige Point Road Sheldon • 843-846-8026 Ridgeland Family Medical Center 1550 Grays Highway Ridgeland • 843-726-3979 Hampton Family Medical Center 200 East Elm Street Hampton • 803-943-2233 Estill Family Medical Center 454 Second Street East Estill • 803-625-2548

www.bjhchs.org Hablamos el espanol

Most Insurance Plans Accepted

Community Calendar of Healthy Events Please e-mail your healthy events a month in advance of publication date to editor@caremagazine.com

February 23-27

Amazing auction items! For tickets, call Jill Saba 843-681-2200 or email:

Crisis Intervention Training Hilton Head Island Sheriff’s Department This highly acclaimed 40-hour program is designed to educate and prepare police and security officers to recognize the signs and symptoms of mental illness and to respond safely to de-escalate conflict. REGISTRATION IS LIMITED. Call the office for further information and registration. National Alliance for Mental Illness (NAMI) Beaufort County 117 Wm Hilton Parkway, Suite K PO Box 24128 Hilton Head Island, SC 29925 843-681-2200 nami@hargray.com www.namibeaufortcounty.org

sarah.eliasoph@namibeaufortcounty.com

Do you have a family member with mental illness? Have you struggled to understand the diagnosis?

FREE 12-Week Program for caregivers of individuals with mental illness New Classes Begin Soon 9 a.m.-Noon 1211 Harrington Street, Beaufort Registration is required for this FREE Class. Call NAMI Beaufort County, 843-843-2200 or email nami@hargray.com NOTE: This is the First NAMI Familyto-Family Education Class in the City of Beaufort! We need 12 people registered to begin.

NAMI Homefront Be looking for the new 6-week education class for family, friends and loved ones of Military Service Members and Veterans in the Beaufort area starting soon. We are pre-registering now. 22

Beaufort Memorial Hospital to host Fifth Annual

Dance for Your Health Saturday, February 21 8 to 11 a.m. Sun City’s Pinckney Hall, 114 Sun City Lane (event open to public) Now in its fifth year, this FREE community wellness event can help you prevent falling behind on your New Year’s resolution to trim down and tone up. The program will include introductory dance classes, professional dance performances, mini health seminars and health screenings. Instructors from Bluffton’s Fred Astaire Dance Studio will be teaching www.caremagazine.com

participants basic steps to dances like salsa, shag and swing. The miniclasses will be held every half hour. On the main stage, dance professionals will be performing routines like those seen on “Dancing with the Stars”. Throughout the event, BMH experts in cardiology, gynecology, orthopedics and primary care will be available to answer questions. In addition, several of the physicians will be presenting 20-minute seminars on a variety of health topics. Participants also will have the opportunity to have free blood pressure and $10 cholesterol screenings. Dance for Your Health is open to the public, both Sun City residents and nonresidents, but registration is required. To sign up, visit www.beaufortmemorial.org or call (843522-5585.

SAVE the DATES Saturday, April 11 Annual March of Dimes Walk Naval Heritage Park Port Royal March for Babies raises funds for vital research to help prevent premature birth and birth defects. Funds raised also support community programs that help moms have full-term pregnancies. South Carolina continues to have one of the highest premature birth rates in the country, and the March of Dimes urges everyone to join the fight for stronger, healthier babies. Register for March for Babies at marchforbabies.org. For the latest resources and information, visit marchofdimes.org/southcarolina. Find us on Facebook and follow us on Twitter. Februar y 2015

Community Calendar —continued

Saturday, April 11 Walk MS: Charleston, SC Hampton Park 30 Mary Murray Drive Charleston, SC 29403 Registration begins at 8am and the walk begins at 9am Walk MS connects people living with MS and those who care about them. It is an experience unlike any other - a day to come together, to celebrate the progress we’ve made and to show the power of our connections. When you participate in Walk MS, the funds you raise give hope to the more than 18,000 people living with MS in North and South Carolina. The dollars raised support life-changing programs and cutting-edge research. Every connection counts. Register now, connect with others and start fundraising today at www.walkMS.org or by calling 704-525-2955.

Beaufort County Library “For Learning, For Leisure, For Life”

For current events at all Country Branches Call 843-255-6430, or visit beaufortcountylibrary.org

Word Search solution

Coastal Discovery Museum Programs Call the Coastal Discovery Museum to register at 843-689-6767, ext. 223 or online at www.coastaldiscovery.org. The Museum is located at 70 Honey Horn Drive, Hilton Head Island. February 11 at 3:00 pm. South Carolina Artificial Reef System The South Carolina Department of Natural Resources has created one of the most successful and best managed artificial reef systems on the Atlantic Coast. David Harter, president of the Hilton Head Island Sportfishing Club and Director for the Hilton Head Reef Foundation will provide an above-water and underwater tour of how Beaufort County’s inshore and offshore were built and how to fish them. The cost is $7 per person and reservations are required. Saturdays, February 14 and 28, then every Saturday in March, 10:30 am until 12:30 pm Sweetgrass Basket Making Classes Learn about the history of the Sweetgrass basket, one of the Lowcountry’s best known art forms, from a local Gullah basket maker. Then, try your hand at starting a basket of your own using locally found natural materials. The cost is $65 per adult and reservations are required. February 17 6:00 pm Star Night—star-gazing program This program, led by Marie McClune, will show you how to “star hop” to locate other constellations in the Winter Hexagon. The program begins inside the Discovery House with a brief introduction before heading outside. The focus will be on the constellations Taurus, Canus Major, Canis Minor, Gemini and Auriga among others. Charge is $12 per adult, $7 per child (ages 6-12) for this two-hour program. Please bring a flashlight and a set of binoculars for the field portion of the program. Attendance is limited and reservations are required. February 18 at 3 pm. Identifying Beaufort’s Unknown Confederate Soldier Penelope Holmes Parker will present this program as part of the “History Forum of the Lowcountry”. For 150 years the Beaufort National Cemetery held a marker indicating the grave of an “Unknown Confederate Soldier.” While researching the history of the William Wigg Barnwell House in Beaufort, our presenter uncovered the identity of this “unknown” soldier. No charge for Museum members, $10 for all others, and reservations are required. February 14 and 28 11:00 am until 1:00 pm Waterway Excursion The 2-hour educational cruise will explore the waterways around the Pinckney Island Forest Preserve on board the Tammy Jane. You will learn about the salt marsh, maritime forest, barrier islands, and the history of Pinckney Island. A naturalist on board will help with identifying any plants or animals that are visible. This adult-oriented cruise is $35 per person and reservations are required. The cruise leaves from the Hudson’s Dock on Squire Pope Road. Lowcountry Through the Lens – a photographic exhibition Monday through Saturday, 9:00 am–4:30 pm; Sunday, 11:00 am–3:00 pm. February 21: Photographing Blue Birds and Much More – Jerry Griffin February 28: Rust as Art – Bill Schmitt

Februar y 2015

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Regional Support Groups To have your free listing included in this column, email info to editor@caremagazine.com. The information updated at the time of printing. Please check with individual organizations or groups for updated times, dates and locations. AREA CODE is 843, unless otherwise noted. AIDS • HIV-AIDS Support: Free, confidential HIV testing and counseling; Access Network Group and personal support: www.theaccess-network.org/ Beaufort/Jasper Counties: 379-5600; Hampton/Colleton Counties: 803-943-0554 ALZHEIMER’S + DEMENTIA • Alzheimer’s + Dementia Caregivers support: HHI/BLUF: Every Wed., 9:45 –11:15 a.m. for caregivers of someone with Alzheimer’s; Men’s Support Group, 1st + 3rd Mon. each month, 9:45 –11:15a.m. at Memory Matters, 117 Wm. Hilton Pkwy., 843-842-6688. Call 842-6688,or www.memory-matters.org. • Alzheimer’s Family Services of Greater Beaufort Caregivers Support Group: 12:30-1:30 p.m., Wednesdays, Helena House, Port Royal, 521-9190 or 252-8754. • Alzheimer’s Family Services Education & Social Day Programs: BFT: Mon., & Wed., 10:00 am-1:45 pm; Port Royal United Methodist Church, Friday, 10:00 am-1:45 pm, Summit Place; AFS services call: 521-9190. • Early Diagnosis Support Group: 1-2PM 1st Tuesday of each month at Memory Matters. Are you 65 or under and been diagnosed with some form of dementia? We help with support and resources. Please call if you are coming: 843-842-6688. Call 757-9388 for information. • Early Memory Loss Group: 2nd and 4th Thur., 10:00 am–noon, Helena House, Port Royal, Call Louise Blanchard, 521-9190. BEREAVEMENT • Grief support for recently bereaved: All situations–United Hospice, Contact Bereavement Counselor, 522-0476. Beyond Now: 6 p.m. first Thursday, Island Hospice, Hardeeville, 208-3660. Friends of Caroline Hospice, 525-6257; Tidewater Hospice, 5 p.m., Thurs., 757-9388. • Tools for the Journey: An Educational Support Group from Island Hospice. Bluffton (Grace Coastal Church): First Wed., 1:00pm – 2:00 pm. Beaufort (Beaufort Medical Plaza): Second Tues., 2:00 pm - 3:00 pm. For topic information being discussed, call Jennifer Massey at 843-986-0949. • Pregnancy & Infant Loss Support Group- 2nd and 4th Wed., 6:00pm, at Hospice Care of the Lowcountry, 7 Plantation Park Dr. Unit 4, Bluffton. www.Zoe-foundation.org CANCER • Cancer Care Connect: (through BMH), 1-800-813-4673 or 1-212-712-8080 • Cancer support groups: - Keyserling Cancer Center, 4 p.m. first Wednesday, Beaufort: 522-7807 - Friends of Caroline Hospice, Port Royal: 525-6257; WISH - Women in Search of Help, a breast cancer support group for the newly diagnosed; 3rd Monday of each month: 5:30 PM, Keyserling Cancer Center. Call 522-5897. • I Can Cope Cancer Support: HHI: 842-5188; DIABETES • Diabetes support groups: Beaufort, 522-5560; Hampton County, 803-943-3878 ext. 216; Hilton Head: 681-5879; Hardeeville/Bluffton: 784-8172; JDRF Adult Type 1 Support Group: monthly meet-ups, Bluffton library 6:00 p.m. Email: adultt1dgroup@gmail.com; Facebook: JDRFAdultType1SupportGroupHilton Head/Bluffton

MENTAL HEALTH • Coastal Empire Mental Health: Beaufort: 1050 Ribaut Road, 524-3378 HHI: 151 Dillon Rd, 681-4865 Ridgeland: 1510 Grays Hwy, 726-8030 Varnville/Hampton: 65 Forest Dr., 803-943-2828 Walterboro: 2004 N Jefferies Blvd, 843-549-6536. • Depression & BiPolar Support Alliance: Hilton Head: 682-2900 • Mental Health Association Beaufort-Jasper: Information, referral, direct service, and emergency assistance; 682-2900. • NAMI Connection Recovery Support Group for Consumers : Every Monday, 5:30-7:00 p.m. NAMI, 117 Wm. Hilton Pkwy, Ste. K, Hilton Head (corner Squire Pope Rd.) Friday, February 6, 12:00 noon-1:30 p.m. Beaufort Medical Plaza, Room 350 Friday, February 20, 12:00 noon-1:30 p.m. Beaufort Medical Plaza, Room 350 • NAMI Caregiver Support Groups: Every Wed., 6:30 pm - 8:00 p.m. USC-B Gateway to Hilton Head (Hardeeville), Library Room 144; Monday, February 16, 7:00 p.m. St. John’s Lutheran Church, Lady’s Island Tuesday, February 24 10:00 a.m. Lowcountry Presbyterian Church, Bluffton • NAMI Evening group in Bluffton by appointment. Call NAMI Office 681-2200 • Crisis Intervention Training Monday, February 23 Friday, February 27, 8:30 a.m. until 4:30 p.m. Sheriff’s Office, 58 Shelter Cove Lane, HHI

SUBSTANCE ABUSE • Adult Children Of Alcoholics: Noon Wednesday, 6:30 p.m. Thursday, YANA club. Mary, 290-8774. • Al-Anon: 8:00 p.m. New Beginnings, Alano Hall, Port Royal; 6:30 p.m. Sunday, YANA club, HHI; Noon Monday Brown Bag, St. Helena Episcopal Church, Beaufort; 7:00 p.m. Monday, YANA club, HHI; 10:30 a.m. Wednesday, St. Luke’s United Church, Bluffton; Noon Wednesday, Sea Island Presbyterian Church, Beaufort; 7:00 p.m. Thursday, St. Luke’s Episcopal Church, HHI; 7:30 p.m. Thursday, St. Peter’s Catholic Church, Beaufort; 7:30 p.m. Thursday, United Methodist Church, Bluffton; Friday, 12:15 p.m. YANA club, HHI. • Alateen: 8:00 p.m. Monday, Alano Hall, Port Royal; 7:30 p.m. Tuesday, United Methodist Church, Bluffton; Al-Anon + Alateen, 785-9630. • Alcoholics Anonymous: Meeting info: 785-2921 or 888-534-0192; en Español: 247-2713; visit www.area62.org. YANA club, 681-9262. • Crossroads Addiction/Dependency Christ centered Recovery & Support program: Grace Coastal Church, Okatie; lapgar@hargray.com • Narcotics Anonymous: Hilton Head, Bluffton and Lowcountry environs: 852-3001. • Smoking Cessation Classes: Freedom from Smoking: Beaufort: 522-5635; 522-5200; Hilton Head: 681-5651.

WEIGHT ISSUES • Community Health/ Weight Loss Classes Fun, Supportive and Educational: Tuesdays, 6:00pm; Bluffton and soon in Beaufort. For information, call Sheila 843-644-1991. • Overeaters Anonymous, Hilton Head: Fri.,10:30am, YANA Club, 706-3606;

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Bluffton: Tues., 6:00pm, St. Luke United Methodist Church, contact Lynne 271-2114; Beaufort: Sun. & Mon., 6:00pm, Beaufort Memorial Hospital, 846-1347 • Take Off Pounds Sensibly www.tops.org: Port Royal: YMCA, Thurs., 6:30 / 7:00pm; OTHER MEDICAL • Asthma Management Program, Wheeze Busters: Beaufort:, 522-5635 • Better Breathers: Hilton Head: 877-582-2737 • Cardiac Support Group: Beaufort: 522-5635 • Chronic Pain Support Group of the Lowcountry: Mon., 1 p.m., Beaufort, 522-8569 • Fibromyalgia support groups: Hilton Head: 837-5911or 342-3434; • Healthy Hearts Support Group: 2nd Thursday each month 10:30-noon at Bluffton-Okatie Outpatient Center; Call Greg Estes, 522-0476. • Hearing Loss Support Group ‘SHHH’: Lowcountry: Russ Cooper, 705-6312, or Bob Perkins, 705-6118. • Lowcountry Huntington Disease support: Sandra, 912-964-0455 • Liver Transplant support group: Savannah: SJCH 912-819-8350 • Lung Disease support group, Better Breathers Club: Beaufort: 522-5635, staff available from 6 a.m. to 8 p.m.; • Med-I-Assist prescription assistance program for the uninsured (Sheldon): Thurs., 10 a.m.-2 p.m. Mt. Carmel Baptist Church, 367 Keans Neck Rd. Appointments: 843-846-8703 • Multiple Sclerosis support groups: meets monthly, call for time/location Bluffton: contact Betty Brusco, 757-4402; Hilton Head: Terry Doyle, 681-1981; • Myositis Association: Danielle Haines, RN; 341-7737 • National Fed. of the Blind: Monthly meetings: Hilton Head, Bob Martin, 342-9180; Beaufort, Ruth Collier, 524-9247. • Osteoporosis Exercise & Education Program: Beaufort:, 522-5593 • Ostomy Association of the Lowcountry: Support group meets monthly. Call, 766-4528. • Parkinson’s Disease support groups: Port Royal/Beaufort: Helena House, 1st Thurs. every month, 1:30-3:30pm; www.psglc.org; Hilton Head: Ellen Forwalk 681-3096; Bluffton: Muriel Coleman, 987-3505 • Pulmonary Disease Support Group: BMH Call Toni Rehkop at 522-5830 Stroke Survivors Group, Beaufort: & Bluffton: 522-5993; 522-7445 • Syncope Support Group: STARS-US; 785-4101; www.stars-us.org OTHER SUPPORT GROUPS • CAPA - Child Abuse Prevention Association; Serving the Lowcountry region; 524-4350 • CODA - Citizens Opposed to Domestic Abuse: Women’s and children’s support groups for victims and survivors of domestic violence: Bluffton: Thursdays, 5:30-7:00 p.m.; Beaufort: Tuesdays, 5:30-7:00 p.m. , 770-1070. www.codabft.com • Meals on Wheels: Hilton Head: 689-8334 • Parent/Caregiver Support (for non-offenders) at Hope Haven: Beaufort, Jasper, Hampton, Colleton: 800-637-7273; www.hopehavenlc.org • Survivors of Suicide: Renee Pigat, HHI: 681-7814

Februar y 2015

WISE

information = a healthier YOU!

Heading Back to a Gym in the New Year? Be Aware of Fungal Infections Anyone can get a fungal infection, even people who are otherwise healthy. Fungi are common in the environment, and people breathe in or come in contact with fungal spores every day without getting sick. These microscopic marauders are often present in even the best-kept gym environments—simply because fungus likes moisture and warmth. However, in people with weak immune systems, these fungi are more likely to cause an infection. Fungus is all around us, on floors, in dirt, and on other people. It is hard to avoid forever, making certain parts of the skin more vulnerable. A fungus is a superficial skin problem, not an internal one. It does not spread by going inside the body. Cortisone creams, tried by many patients, help fungus grow! The rash may get less red and itchy at first, but spreads out and recurs, itchier than ever, when the cortisone is stopped. A fungus sheds “spores”, like tiny seeds, which wait for the right moment to grow into new fungus. The most common place for these spores to collect is in shoes. Therefore, after effective treatment, a fungus may recur quickly where spores are present. Fungus doesn’t care what color the socks are. White socks offer no advantage. Absorbent cotton or wool socks are best. The tendency for fungus to recur in many adults, especially on the feet and toenails, is a genetic condition. Their skin cannot recognize the fungus as foreign and get rid of it. After having a fungus there for a while the body’s immune system learns to live with the fungus and no longer tries to get rid of it. Children only rarely get fungal infections of the feet, especially before the age of five. Their bodies still react vigorously to the fungus. For some reason, they are more likely to get it on the scalp than adults are. Some Rules for Prevention: Remember, nothing works one hundred per cent. Try combinations of these ideas:

Keep feet clean, cool and dry. Change socks. Wear shoes that “breathe” like leather, rather than plastic. Make sure shoes fit correctly and are not too tight. Apply an anti-fungal cream, like Lotrimin or Lamisil, or a prescription antifungal cream to the bottom of the feet, and on the nails, about twice a week. This may help prevent early re-growth of the fungus. In some cases, an oral medication may be prescribed. Avoid walking barefoot, especially in bathrooms, locker rooms, gyms, on carpeting, and in public bathing areas. Wear slippers or stand on a towel or piece of paper. Keep toenails short, cut straight across and avoid ingrown nails. Do not use the same clippers on abnormal nails and normal nails. Family members and close personal contacts should treat any fungus infections they may have to avoid trading back and forth. Apply an anti-fungal powder, like Zeasorb-AF to the shoes every day, to keep spores from growing. Discard old shoes, boots, slippers and sneakers. Do not share footwear with others. If one has had a body fungus, in the groin or elsewhere on the skin, consider using an anti-dandruff shampoo, like Selsun Blue on this area twice a month. Lather up and leave it on the skin for about five minutes, then wash off completely. In some cases a preventive medication may be prescribed.

Use the medicine completely and as recommended by your healthcare provider. The fungus may till be present long after it is no longer visible as a rash. Februar y 2015

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Sources: NIH.gov, CDC.gov, and www.aocd.org

What is the “Dirty Dozen Guide to Food Additives?” The Environmental Working Group (EWG), a non-profit dedicated to protecting human health and the environment through research, education and advocacy, launched its “Dirty Dozen Guide to Food Additives” in November 2014 to educate consumers about which food additives are associated with health concerns, which are restricted in other countries, and/or which just shouldn’t be in our foods to begin with. EWG hopes the new guide will help consumers avoid unhealthy foods and also influence policymakers to develop more stringent rules for food producers moving forward. According to EWG, more than 10,000 food additives are approved for use in the U.S., despite potential health implications. Some are “direct additives” deliberately formulated into processed food; others are “indirect,” that is, finding their way into food during processing, storage or packaging. Either way, some have been linked to endocrine disruption, heart disease, cancer and a wide range of other health issues. Topping EWG’s list are nitrates and nitrites, both typically added to cured meats (like bacon, salami, sausages and hot dogs) to prolong shelf-life and prevent discoloration. “Nitrites, which can form from nitrates, react with naturally occurring components of protein called amines,” reports EWG. “This reaction can form nitrosamines, which are known cancer-causing compounds.” The group reports links between nitrite and nitrate consumption and cancers of the stomach, esophagus, brain and thyroid.

baking, but small but still significant unconverted amounts can remain, putting eaters everywhere at risk. EWG would like to see the U.S. government follow Canada’s and the European Union’s lead in banning the use of potassium bromate in foods altogether. Other additives on the Dirty Dozen list include propyl parabens, butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), propyl gallate, theobromine, diacetyl, phosphates and aluminum. Many artificial colors can also cause health issues, reports EWG, as can thousands of “secret flavor ingredients” that food makers add to foods without oversight in the name of protecting trade secrets. For more information on these foods and how to avoid them, check out EWG’s free “Dirty Dozen Guide” online at www.ewg.org/research/ewg-s-dirty-dozen-guide-foodadditives/food-additives-linked-health-risks.

EarthTalk® is written and edited by Roddy Scheer and Doug Moss and is a registered trademark of E–The Environmental Magazine (www.emagazine.com). This article is reprinted with permission.

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The World Health Organization considers nitrites and nitrates to be probable human carcinogens; California’s Office of Environmental Health Hazard Assessment is now considering a similar designation. Interestingly, some nutritious foods like spinach and other leafy vegetables contain nitrates naturally, but EWG says that “human studies on nitrate intake from vegetables have found either no association with stomach cancer or a decreased risk.” Another troubling but nevertheless common food additive is potassium bromate, used to strengthen bread and cracker dough and help such items rise during baking. But potassium bromate is listed as a known human carcinogen by the state of California and a possible human carcinogen by the International Agency for Research on Cancer. Animal studies have shown that regular exposure to potassium bromate can cause a variety of tumors, is toxic to the kidneys and can even cause permanent DNA damage. Most of the potassium bromate added to foods converts to non-carcinogenic potassium bromide during the process of

Avoiding GMOs: The Easy Way There are two surefire ways to avoid GMO/GE ingredients:

– Don’t buy processed foods – Buy USDA certified organic To get that USDA Organic label on a product, it can’t contain genetically engineered (GE) ingredients— along with other restrictions—like not using ingredients grown with chemical fertilizer.

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Februar y 2015

What do salad greens, fruit, yogurt, nuts, oatmeal and black beans have in common? They’re all staples of a well-stocked, healthy kitchen! Having the right foods on hand is! essential for eating well consistently and losing weight. Being prepared takes the guesswork out of healthy choices, and once you ditch the junk food, chances are you won’t even miss it!

Stock your pantry with these healthy items Making smart food choices is easy when you’re prepared. Keep these smart choices on hand:

Fruits and vegetables Fresh fruits Fresh vegetables Pre-cut fresh vegetables Salad in a bag Frozen fruits Frozen vegetables (no sauce) Frozen chopped onion and green peppers Canned fruits (packed in their own juice or water) Dried fruit Low-sodium, low-fat pasta; pizza and tomato sauces Canned diced tomatoes 100 percent fruit juice, including calcium-fortified (but limit juice intake to 4 ounces a day)

Dairy Fat-free or 1 percent milk Low-fat or fat-free yogurt Low-fat or fat-free cheese Frozen yogurt or fruit sorbet

Whole grains Whole-grain breakfast cereal Rice: brown (regular and instant), wild, blends Oatmeal Whole-grain bread Whole-grain pita bread Whole-grain pasta Whole-grain crackers Low-fat microwave popcorn

Protein Low-fat refried beans Black, kidney or navy beans Low-sodium water-packed tuna Other fish with omega-3 fatty acids Skinless white-meat poultry Soy cheese Tofu Dry-roasted nuts Individually frozen skinless chicken breasts Individually frozen salmon, cod or other fish Frozen shrimp or scallops Frozen vegetable burgers

Cooking staples Fresh garlic and onions Olive oil Canola oil Coconut oil Red wine and/or balsamic vinegar Fat-free cooking spray

As you can see, eating well at home doesn’t require expensive or unusual ingredients, and you certainly don’t have to be a master chef. Whole-wheat pasta tossed with loads of veggies, salads, and whole-grain wraps or quesadillas are all easy meal options. You can even put together a snack plate and include your favorite raw veggies, nuts and healthy dips, like hummus. Source: http://diet.mayoclinic.org/diet/eat/stock-your-pantry?xid=nl_MayoClinicDiet_20150108 Februar y 2015

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Chicken and White Bean Chili The FoodChannel recipe

Here’s a crowd-pleasing, white-meat alternative to chili made with beef. Ideal for basketball or football watch parties, tailgating and casual gatherings. This recipe version makes for a nice alternative to a beef chili, featuring generous chunks of tender chicken and a kick of spice. Foodie Byte: For a spicier chili add more red pepper. To garnish you can top with cilantro, sour cream or cheese.

Yield: 2 quarts

Preparation Heat oil in Dutch oven over medium heat. Add onion, garlic, cumin, oregano, and dried red pepper. Sauté for 5 minutes. Remove from pan. Season chicken with salt and pepper, add oil to pan and sauté chicken approximately 5 minutes. Add onion mixture, beans, reserved liquid, broth, chiles and cream to chicken. Simmer until chicken is tender and cooked through, about 15 minutes. Season to taste with salt and pepper. Garnish.

Prep Time: 20 minutes Cook Time: 30 minutes Serves: 8

Ingredients 1 pound boneless skinless chicken breast 3 cans (15-ounce) cannellini beans, drain and reserve 1/2 cup liquid 1/4 cup corn oil 1 large onion, chopped 4 large garlic cloves, chopped 1 tablespoon ground cumin 1 teaspoon dried oregano 1/4 teaspoon dried crushed red pepper 1 cup chicken broth 2 cans (4.5 ounce) diced green chiles 1/2 cup whipping cream Optional garnishes: Sour cream Cheddar cheese, grated Fresh cilantro, chopped 28

Nutritional Information Calories 337, Carbohydrates 30g, Cholesterol 57mg, Fat 14g, Fat Calories 128, Fiber 9g, Protein 23g, Saturated Fat 4g, Sodium 714mg. Daily Values: Calcium 101.52mg 10%, Phos 136.45mg 14%, Copper 0.03mg 2%, Zinc 0.42mg 3%, Panto 0.88mg 9%, Biotin 0.87mcg 290%, Iodine 2.62mcg 2%, Magnesium 18.46mg 5%, Iron 2.79mg 16%, Vitamin B6 24%, Vitamin C 11%, Vitamin B12 2%, Vitamin D 2%, Vit E-a-Toco 5%, Vitamin A 5%.

Percent Daily Values are based on a 2,000 calorie diet. Source: http://www.foodchannel.com/recipes/ recipe/chickenand-white-bean-chili/#ixzz3OujH9gGQ www.caremagazine.com

Februar y 2015

Gluten Free Chocolate Cookies The FoodChannel recipe

More and more people are looking for great taste in a gluten-free version, and here’s a delicious recipe. It’s part of The Food Channel’s Chocolate Trends report that says “we want our chocolate regardless of our dietary needs”. Foodie Byte: This recipe was inspired by one found in the book by Diane Mott Davidson, “Sticks and Scones.” Considered comfort food in it’s original form, the recipe has been altered so that those with gluten intolerance can be comforted as well!

Yield: approx. 24 cookies

Preparation Sift together the flour, cocoa, baking powder, and salt. Set aside. Melt the chocolate and butter in microwave, then add the sugars, eggs and vanilla. Stir in the flour mixture. Add nuts (optional) Cover the bowl and refrigerate for about 30 minutes. Preheat the oven to 350°F.

Prep Time: 60 minutes Cook Time: 10 minutes

Ingredients 1 1/2 cups gluten free flour 1/3 cup unsweetened cocoa 1 1/2 teaspoons baking powder

Grease two cookie sheets, or use parchment paper. Drop by teaspoonsful onto cookie sheet. Bake 10-11 minutes; cookies will be flat. Do not overbake; the cookies will firm up as they cool. Source: http://www.foodchannel.com/recipes/ recipe/gluten-free-chocolate-cookies/#ixzz3Ouk4X2D9

1/2 teaspoon salt 1 bag (12 oz.) dark chocolate chips 1 stick organic butter, softened and divided 3/4 cup brown sugar 3/4 cup granulated sugar 3 eggs (or equivalent egg substitute) 1 1/2 teaspoons vanilla extract 1/2 cup nuts (optional)

Februar y 2015

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ParentPulse

helpful insights and tips for effective parenting

A Thoughtfully Organized Playroom May Positively Influence Your Child’s Success in School 2.

Creating a pretend play center will invite creative play. Studies reveal a link between pretend play and the development of language skills. It has been found that children who engage in pretend play have better language skills—both receptive language (what a child understands) and expressive language (the words she speaks). Pretend play can also help enhance their relationships with others as children grow older.

Playtime is a very important aspect of every child’s day. Play is the true work of a child. Children are busy when they are playing, and they are learning when they play. For example, when children are looking, pouring, bouncing, hiding, building, knocking down, climbing, running, and play-acting they are still learning! However, a room stuffed full of toys will not invite creative, independent, sustained play. Playrooms must be well organized with learning centers where everything is in place so that when kids want to create, build or pretend, they have everything they need right at their fingertips. Maria Montessori knew this and incorporated organized ‘play’ into her early childhood teaching system. Today, there’s a ‘Smart Playrooms’ team, Karri Bowen-Poole and Chris Simpson, who share their four reasons why a playroom encourages success in school.

1. An organized playroom allows children to engage in creative, independent play. This type of play has positive effects on the brain and on a child’s ability to learn. In fact, recent research has shown that creative, independent play may function as an important, if not crucial, mode for learning. You can encourage creative, independent play in children by providing open-ended toys and creating an organized space for playtime. 30

3. An organized block center with age-appropriate building materials and plenty of floor space will encourage children to build. Block play is linked to better math skills. Researchers found that 4-year olds who played with blocks were more likely to achieve high math scores in high school. In order to encourage powerful block play at home, it’s recommended that parents have an efficient system of block storage and organization in the playroom. 4.

Organized block centers inspire complex building and creating. This type of building teaches creative, divergent problem-solving. Psychologists recognize two major types of problems. Convergent problems have only one correct solution. Divergent problems can be solved in multiple ways. Because kids can put together blocks in a variety of ways, block play is divergent play. Recent research found that children who played with blocks performed better on divergent problems. They also showed more creativity in their attempts to solve the problems. Divergent play with blocks prepares children to think creatively and better solve divergent problems.

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Source: www.smartplayrooms.com

Februar y 2015

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Februar y 2015

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