CARE magazine®—Summer2016 by CARE magazine®

Care Options and References for a Healthier Life

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magazine®

Relax your mind, relax your mind, Ooh, it'll make you live a great long time. Sometime you've got to relax your mind. —“Leadbelly” Huddie Ledbetter

A “Must-read” for Helpful, Trustworthy, Up-to-Date Health News, Ideas & Options

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Summer 2016

In this issue . . . 4

Anticipated spread of the Zika virus in the southeast U.S.

Dr. Jessica Coleman may be small in stature, but she’s big in personality! Dr. Coleman specializes in the management of kidney disease and hypertension

Climate change and the migration of infectious disease

—By Rose Ewing

careTALK

ParentPULSE – Keeping your baby sun-safe

Regional support groups

Microwave cooking and nutrition

Summer fun & relaxed entertaining

Healthy & wholesome recipes:

—By William B. Miller, Jr., M.D.

Worried about your drinking habits?

Sheperd Integrative Dermatology unveils sustainably designed medical facility in Mt. Pleasant

The simple food rule for great skin —By McLean Sheperd., M.D.

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- Honey-glazed bbq pork - Savory shrimp casserole - Asparagus & pasta salad SUMMER 2016

Pass the Peanuts, Please. By Elizabeth Dardes

Panic and the peanut may soon be coming to an end. The parents of children born with a peanut allergy may soon be worry-free when it comes to parties, lunch boxes, snacks, and the scrutinizing of labels. Peanut allergies are the most common and the most dangerous among nearly 8% of children with allergies, with reactions ranging from skin rashes to anaphylactic shock, which can be fatal.

peanut M&Ms. They are considered allergy-free when they can eat ten peanuts a day and only that amount indefinitely. Treatment usually lasts 12 months and is often covered by insurance.

Approximately 80% of children donâ&#x20AC;&#x2122;t outgrown this allergy. Only recently have allergy centers around the country been offering oral immunotherapy (OIT) for this allergy, which is a closely monitored trace of peanuts administered by a physician in order to build up immunity.

OIT is not FDA approved, and requires the final stage of clinical trials for its pharmaceutical-grade peanut formulation for approval; however, a number of physicians at allergy treatment centers and parents are eager for a decreased degree of worry despite any risk. On average, studies are showing a tolerance of five peanuts a day with no reaction for 84% of children after six months of OIT treatment.

Patients typically start with a 0.1milligram dose of peanut protein (specks of peanut flour that look like sand). Over the next several hours they are monitored while the dose is gradually increased to about 6 milligrams. If the protein is tolerated, patients are sent home with a supply of the tolerated dose that they are instructed to take daily. Patients return to the center every two weeks for larger doses until they eventually tolerate whole peanuts or SUMMER 2016

Stanford Universityâ&#x20AC;&#x2122;s Sean N. Parker Center for Allergy and Asthma Research oversees over 15 clinical trials across the country. Director Kari Nadeau has a wait list of 4,000 people wanting to join the trials. The initiative and the desire to curtail a dangerous peanut allergy are definitely present. With parents who must endure the panic of peanuts, the option for tolerance may be something to consider.

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Source: WSJ, 2016 3

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Options and References for Healthier Living

SUMMER 2016 Publisher and Editor:

Karen Mozzo

Associate Editors:

Elizabeth Dardes Rose Ewing

Distribution Manager:

John Lucas

Website Manager:

CyberZoo Ltd.

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care magazine® 843-524-8988 caremagazine@gmail.com

Zika Virus Structure Revealed, New Maps Show Potential Reach of Aedes Mosquitoes Researchers have revealed a “near-atomic level map” of the Zika virus. Published in Science, the three-dimensional image shows that Zika’s structure is similar to that of other flaviviruses, with one key exception: a variation in the E glycoprotein surface protein. This variation, according to an National Institute of Health news release, “could explain the ability of the virus to attack nerve cells, as well as the associations of Zika virus infection with birth defects and Guillain-Barré syndrome.”

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Elsewhere, the CDC has published maps showing the potential range of Aedes mosquitos in the U.S. (see page 5). Unlike prior maps, the new estimates have the Aedes aegypti mosquito (pictured above) reaching Indiana, Ohio, and Connecticut, but Colorado might now be off the hook. The South Carolina Lowcountry is a high-risk zone. Additional, updated information may be found at these links: http://www.nejm.org/page/zika-virus? query=pfw&jwd=000013505994&jspc=&

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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 or advertisements do not necessarily reflect the views or opinions of care magazine , its publisher or editors. ®

http://science.sciencemag.org/content/352/6284/467

By Amy Orciari Herman, JWatch.org Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

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SUMMER 2016

CDC’s Response to Zika

ESTIMATED range of Aedes albopictus and Aedes aegypti in the United States, 2016* Aedes aegypti mosquitoes are WA

more likely to spread viruses MT

ND MN

OR ID WY

SD IA

IL CO

NJ DE

like Zika, dengue, chikungunya and other viruses than other types of mosquitoes such as Aedes albopictus mosquitoes.

PA OH

NH MA RI CT

MI NE

TX HI

FL PR

These maps DO NOT show · Exact locations or numbers of mosquitoes living in an area Aedes aegypti

Aedes albopictus

· Risk or likelihood that these mosquitoes will spread viruses These maps show

WA MT

ND MN

OR ID WY NV

VT WI

MI IA

NE UT

IL CO

KS OK

NJ DE

· Areas where mosquitoes are or have been previously found

NH MA RI CT

PA OH KY

SC MS

· CDC’s best estimate of the potential range of Aedes aegypti and Aedes albopictus in the United States

LA FL

* Maps have been updated from a variety of sources. These maps represent CDC’s best estimate of the potential range of Aedes aegypti and Aedes albopictus in the United States. Maps are not meant to represent risk for spread of disease.

CS264451-F

SUMMER 2016

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CLIMATE CHANGE w e i V t Of

Poin

and the Migration of Infectious Disease By William B. Miller, Jr., M.D.

Zika is all over the news. Zika is surely dangerous, but it has its limitations and is likely to be well contained. However, its greater significance extends beyond any current spread. Instead, it exemplifies the crucial emerging trend of a novel infectious agent that has swiftly become a global threat. The common phrase, ‘this time is different’, is almost always wrong. Yet, our modern circumstances are distinctly unlike any previous era. Humans possess a unique ability for rapid travel. This unprecedented degree of mobility extends across every planetary habitat. Further yet, it now occurs during a phase of a rapidly shifting climate. Certainly, species migration or global climate change are not new, but it is only in this present moment that these factors can amplify through instantaneous global travel in a singular manner. In fact, the results of this unusual conjunction are already apparent. For example, Zika’s advance across Europe, to the Caribbean and to the Americas, has been extremely rapid. This is such an extraordinary event that at the beginning of this year, the World Health Organization declared Zika a global emergency in recognition of its rapid spread from continent to continent. Its rising incidence mirrors our prior concerns about the global scope of other recent epidemics such as Ebola or SARS. The World Health Organization notes that infectious diseases are emerging at a greater pace and spreading faster than ever before. There are at least 40 new infectious diseases that have emerged that were unknown 6

only a generation or two ago. For example, Zika was first identified in the 1950s and was initially confined to a narrow band of equatorial Africa and Asia. Monkeys were its primary host. Abruptly, it appeared in humans in Polynesia in 2013. Thereafter, it is suspected to have arrived in the Americas by plane, appearing in Brazil in that same year. Now it demonstrates pandemic spread throughout the Americas and the Caribbean. It is a flexible virus, too. It can be transmitted by mosquito bites, from mother to child, by sexual contact, or blood transfusions. Chikungunya virus is continuing as an emerging threat. Chikungunya is characterized by the sudden onset of fever accompanied by joint pains. It has a low mortality but is associated with a high frequency of chronic medical disabilities, some of which can be devastating. First identified in 1952 and initially confined to small outbreaks in West Africa, it has spread worldwide with millions of cases across Africa, India, and Asia. Only recently, it has appeared in the Caribbean and South America, and now, there are hundreds of cases on the US mainland. Each of these are examples of new vector-borne virus enemies. However, there are also consequential old players whose distribution can also be affected by climate and global travel. The spread of disease through travel is not itself new. For example, dengue fever is a mosquito-borne virus first described in China in about 200 A.D. For centuries, there were only sporadic epidemics. Yet, it surged dramatically after World War II and is now a major factor in childhood mortality in the Pacific and the Americas. It now affects tens of millions on an annual basis. Even malaria, an old and persistent scourge, is demonstrating an increasing speed of transmission attributed to socioeconomic factors that include land use, population growth and urbanization, migration changes and travel.

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SUMMER 2016

—continued from previous page

If this is our current reality, what is the appropriate response?

Expensive carbon projects are proposed by many climate enthusiasts. Those disputed schemes should be put aside. Instead, our scant resources should be directed towards relatively inexpensive ends with large rewards. The best means would be to concentrate on the remediation of infectious disease. This can be accomplished by mosquito nets, removal of standing water sources in endemic regions, research into improved treatments and vaccines, and a deeper understanding of the reproductive cycle of vector insects or other intermediary hosts. Clearly, our concerns about climate should emphasize coping with and conquering infectious disease as the truest common denominator of human health and welfare and proper planetary stewardship. Dr.Miller has been a physician in academic and private practice for over 30 years. He is the author of The Microcosm Within: Evolution and Extinction in the Hologenome. He currently serves as a scientific advisor to OmniBiome Therapeutics, a pioneering company in discovering and developing solutions to problems in human fertility and health through management of the human microbiome. For more information, www.themicrocosmwithin.com, or www.hologenome.com.

A risk-assessment map shows Aedes aegypti potential abundance for July 2016 and the monthly average number arrivals to the U.S. by air and land from countries on the Center for Disease Control Zika travel advisory. Red dots represent areas with potentially high abundance, while yellow dots represent potentially low abundance areas. Shaded regions represent the approximate maximum range of Aedes aegypti. Map credit: NASA

When living in, or traveling to areas with Zika and other diseases spread by mosquitoes, the CDC advises you take the following steps:

• Wear long-sleeved shirts and long pants.

To protect your child from mosquito bites:

• Stay in places with air conditioning and window and door

• Do not use insect repellent on babies younger than 2 months old. • Do not use products containing oil of lemon eucalyptus or

screens to keep mosquitoes outside.

• Sleep under a mosquito bed net if you are overseas or outside and are not able to protect yourself from mosquito bites.

• Use Environmental Protection Agency (EPA)-registered insect repellents with one of the following active ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. Choosing an EPA-registered repellent ensures the EPA has evaluated the product for effectiveness. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breast-feeding women.

• Always follow the product label instructions. • Do not spray repellent on the skin under clothing. • If you are also using sunscreen, apply sunscreen before applying SUMMER 2016

• Dress your child in clothing that covers arms and legs. • Cover crib, stroller, and baby carrier with mosquito netting. • Do not apply insect repellent onto a child’s hands, eyes, mouth, and any cut or irritated skin.

• Adults: Spray insect repellent onto your hands and then apply to a child’s face.

• Treat clothing and gear with permethrin or purchase permethrintreated items.

• Treated clothing remains protective after multiple washings. See

• Reapply insect repellent as directed.

insect repellent.

para-menthane-diol on children younger than 3 years old.

product information to learn how long the protection will last. If treating items yourself, follow the product instructions carefully.

• Do NOT use permethrin products directly on skin. They are intended to treat clothing.

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Source: CDC.gov

Our genes determine who we are. Thanks to a vast international undertaking called the Human Genome Project, we now know that the human genome—the complete set of genetic information for each person—is comprised of about 24,000 genes. But it turns out that the makeup of the human organism isn’t determined only by our human genes but also by the bacteria that live on and in us, most of them in our intestines. There are trillions of these bacteria and they and the genes they harbor make up the human microbiome. And just as the Human Genome Project mapped our human genes, the Human Microbiome Project is a worldwide effort to understand the role these bacteria play and how they influence our health. “Our genes do not determine a fixed destiny,” says functional medicine specialist Dr. Marsha Nunley, founder of H.E.A.L. Medical. “Genes provide an inherited potential but genes can be turned on and off and are influenced by any number of environmental factors, one of the most important of which is the action of the bacteria in the gut. Our microbiome affects our health in ways we are just beginning to understand. So the question becomes ‘what can we do to create a bacterial environment that supports optimal health and well-being?’”

The Microbiome: What Is It and How Does It Affect You? Studies of the bacteria that live with us date to the 17th century and the work of Antonie van Leeuwenhoek, the Dutch scientist known as “the father of microbiology” and for his contributions to the development of the microscope. He noted striking differences between the microbes that live in different parts of the human body and between samples taken from people in various stages of health and disease. “We’ve had the ability to observe these differences for centuries,” says Dr. Nunley. “What’s different and exciting now, is that new molecular techniques are making it possible to understand why these differences exist and use this knowledge to improve an individual’s health.” Scientists are cautious about drawing conclusions yet but their research points in directions that show great promise. When intestinal microbes from lean mice are transplanted into obese mice, the obese mice lose weight and when the reverse procedure is performed, the lean mice gain weight. In humans, transplanting the intestinal bacteria from a healthy person into a sick one effectively treats certain intestinal infections. It is becoming more clear that a diverse population in the gut is beneficial—that a robustly diverse environment is more resilient and resistant to invasion by disease-causing organisms. “It is also known that the diversity of the microbiome is fragile and that in industrialized Western populations the microbiome is less diverse than in rural, less-industrialized areas,” says Dr. Nunley. For example, antibiotics, both in prescribed drugs and in the feed of the animals we eat, is believed to diminish colonies of helpful bacteria. And we’ve done everything we can to reduce our exposure to bacteria in the food we eat and through the use of anti-microbial products such as soap and hand sanitizer. It appears that rural populations—people who live on farms, eat largely plant-based diets, and are regularly in contact with animals—have a more diverse microbiome than highly industrialized populations and much lower rates of chronic conditions such as obesity, type-2 diabetes, allergies, asthma, and cardiovascular disease.

Tips for a healthy microbiome • Use antibiotics only when medically necessary and avoid meat treated with antibiotics. • Eat a wide variety of organic whole grains and plant-based foods. • Don’t eat anything with a long list of unpronounceable ingredients. • Add fermented foods like yogurt, kimchi, sauerkraut to your diet. • Let kids play in the dirt and pet the dog! 8

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Marsha Nunley, M.D., is the founder of H.E.A.L. Medical and is board-certified in internal medicine, geriatric medicine, and palliative care. Dr. Nunley specializes in functional medicine, a systems-based approach to treating the whole person. www.marshanunleymd.com SUMMER 2016

Did you know? Men and Women Metabolize Food Differently Men and women process food differently. When dieting side by side, men appear to shed pounds easier and more quickly than women do. But is that really the case? According to Greg Caporaso, assistant professor in the Department of Biological Sciences at Northern Arizona University and assistant director of the Center for Microbial Genetics and Genomics, diet affects men’s and women’s stomach microbes differently, even when identical foods have been eaten. In addition, according to the paper “Lower sedentary metabolic rate in women compared with men,” R. Ferraro, S. Lillioja, A. M. Fontvieille, R. Rising, C. Bogardus, and E. Ravussin, affiliated with the National Institute of Diabetes and Digestive and Kidney Diseases and National Institutes of Health, Phoenix, and published in The Journal of Clinical Investigation, on average, women’s total energy expenditure, which is the number of calories burned for metabolic needs, including breathing, blood circulation, digestion and physical activity, is around 5 to 10 percent lower than men’s.

SUMMER 2016

The composition of the female body also differs from the composition of the male body. Men have more muscle mass and less body fat than women, which also can contribute to how easily men may be able to shed weight. Maintaining that muscle mass can push their metabolisms even further.

According to many studies, the following factors also come into play: At rest, women burn more glucose (sugars and starches) but less fat than men. Men and women burn and store body fat differently. Stress can inhibit fat loss in women. Diet trends, including fasting and calorie restriction, tend to be more beneficial for men than for women. To overcome these factors, women can work with their doctors, trainers and nutritionists to develop plans that take —MES their unique metabolisms into consideration.

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Worried About Your Drinking Habits? Want to Slow Down or Quit Drinking? Here are some strategies that can help you cut back or stop drinking.

For most adults, moderate drinking doesn’t cause any serious health problems. And if you don’t drink at all, there’s no reason to start! How can I tell if you’re at risk for a drinking problem? Drinking is a problem if it causes trouble with: - Your relationships - School or work If you believe that you have a drinking problem, it’s important to see a doctor right away. You can improve your health by drinking less or not drinking at all.

√ Take at least 1 day off from drinking each week √ Don’t drink when you are upset. √ Avoid places where people drink a lot, such as bars.

√ Don’t keep a lot of alcohol at home. √ Make a list of reasons to drink less or quit— and keep it with you. Set Limits and keep track of your drinking Step 1: Set a drinking limit. For example, you may decide to have no more than 3 drinks per week. Step 2: Write your drinking limit on a piece of paper. Step 3: Write down every time you have a drink for 1 week. Use a drinking tracker card to help. Other helpful tips: Take a day off from drinking. Choose a day each week (for example, Tuesday) when you will not drink. Don’t drink when you are upset. If you have a bad day or are feeling angry, don’t reach for a drink. Try taking a walk, calling a friend, or seeing a movie. Find healthy ways to manage stress..If you choose to drink, have only a moderate (limited) amount. This means: • No more than 1 drink a day for women • No more than 2 drinks a day for men One drink is a: • Bottle of beer (12 ounces) • Glass of wine (5 ounces) • Shot of liquor (1.5 ounces) 10

How will drinking less or quitting help you? Drinking only in moderation or not drinking at all can help you: Lower your blood pressure Lower your risk of injury, heart disease, stroke, some types of cancer, and liver problems Lose weight Save money

Who needs to avoid drinking completely? Don’t drink at all if you: - Are pregnant or trying to get pregnant - Are under age 21 (in most States) - Take certain over-the-counter or prescription medicines (check the medicine label) - Are recovering from alcoholism - Have a health condition that can be made worse by drinking (like liver disease) It’s also very important to avoid drinking if you plan to drive a car or use a machine (like a lawn mower).

Get Help - Ask for help if you need it. - Talk to a doctor or nurse if you are having a hard time cutting down on your drinking. Don’t give up! To find a doctor or treatment program near you. Call 1-800-662-HELP (1-800-662-4357) for information about treatment. Note: The health care reform law requires health care plans to cover screening and counseling for alcohol misuse. Depending on your insurance, you may be able to get these services at no cost to you. Check with your insurance provider about your plan.

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SUMMER 2016

Training the Brain to Fight Depression

By Elizabeth Dardes

Close to 1 in 5 Americans will suffer from major depression during their lifetime (2012, Psychiatric Research). A new treatment called neurofeedback, hopes to treat depression and anxiety, which are the most prevalent disorders in the field of psychiatry. Neurofeedback uses real-time scans to show patients how their brains are askew when anxious and aims to be more precise and individualized for each patient. It addresses for the patient a more thorough understanding of the cause of the anxiety and what is occurring in the brain at the time of it. It then proceeds to rationalize and eliminate it. Current treatments such as antidepressants and cognitive and behavioral therapy do not work for everyone, and susceptibility to another occurrence increases 50% after suffering one major depression. Neurofeedback research is focusing on obsessive-compulsive disorder, addiction, phobias, and traumatic brain injury. No therapy talk nor medications accompany the treatment. Patients lie in a resonance imaging scanner and are told to conjure memories while their brains are scanned. Brain activity related to their disorder is then analyzed and explained to the patient, who then can enhance or suppress that activity.

It is self-control and brain training, similar to muscle training (2015, Zilverstand). Although only a few years old and rather expensive to undergo, psychiatrists and researchers foresee its promise. Research results after two sessions of neurofeedback dropped depression scores 50%. The control group dropped 10%. The precent of participants in other studies did not improve, while 10% could not learn how to control the region of the brain affected. In terms of thinking happy thoughts (brain training,) women participants thought of childbirth and pets to increase “good feelings,” while men contemplated thrill seeking and sex. Neurofeedback may be new in terms of medicinal treatments, but the ideology behind it is centuries old. The act of positive thinking is a behavior that does not come easy for many, and is a behavior that has to be learned. Those with depression and anxiety focus more on the negative, and must be trained to disengage from it. The treatment suggests that the tangible scans promote a more thorough understanding of an individual’s brain activity when depressed, and may be an option and relief for the 20% of Americans who suffer. Source: Petersen, Andrea. WSJ, 2016

Offering Home Care in Hilton Head Island, Bluffton, Beaufort, Hardeeville, Ridgeland, Sun City and surrounding South Carolina communities.

Making Life Easier

Home Helpers of the Lowcountry • 843-837-3041 Email: help@homehelperslowcountry.com Web site: www.inhomecarelowcountry.com Licensed as an in-home provider of personal care • Personal care and bathing assistance • Dressing • Companionship • Continuing and recuperative care • Alzheimer's/ dementia care • Respite care • Transportation • Light housekeeping • Meal preparation

SUMMER 2016

Licensed as a home health agency • Skilled nursing • Physical therapy • Occupational therapy • Speech therapy • Medical social work • Wound care • Diabetic care and education • Medication management • Catheter and ostomy care

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Sheperd Integrative Dermatology proudly opened its new Mt. Pleasant facility and community of practice on April 21. The integrative dermatology practice sought to make its physical environment congruent with its approach to health and beauty services by garnering energy onsite from solar panels, harvesting rainwater, installing safer alternatives to building products, and introducing other leading edge features.

of concrete flooring for better energy efficiency, as well as wood flooring. Nontoxic insulation, sustainably sourced furniture, and energy efficient windows improve indoor air quality, and the windows in almost every room connect the inside to nature for restorative healing. Sheperd Integrative Dermatology’s new home features 100% LED lighting. The rooftop solar system aims to generate over 30 percent of the clinic’s power. Rainwater is harvested for irrigation, and a permeable parking lot assists with stormwater drainage. A community garden

Sheperd Integrative Dermatology Unveils Sustainably Designed Medical Facility

Led by Dr. McLean Sheperd, Sheperd Integrative Dermatology comprises a team of specialists that advocate a whole body approach to skin wellness, combining traditional medicine with other complimentary practices. Dr. Sheperd and her team address the unique physiology of each patient from many aspects, including dietary, environmental, emotional and hormonal factors. The new facility showcases their commitment to provide a healthy haven for total healing. “We can no longer consider human health in the absence of planetary health,” said Dr. Sheperd. “That is what inspired us to consciously build an exterior façade that matched our restorative healing practice. Both staff and patients will be able to enjoy nature, proactively embrace positive health, and be surrounded by a nontoxic environment. We’re more than your typical dermatology practice, we are offering a community for healing.” The facility, which is located on a bucolic setting at 912 Old Georgetown Road in Mount Pleasant, features areas 12

and bee hive engage and inform the community about more sustainable practices, blending nature with healing. Other conscious design elements include featuring grand oak trees throughout and a walking meditation labyrinth. The interior includes a community space for yoga and mediation and an overall design that illustrates respect for the local environment.

For more information, please visit McLeanSheperdMD.com or call (843) 216.3530.

About Sheperd Integrative Dermatology Sheperd Integrative Dermatology offers traditional dermatological services paired with alternative and complementary practices based upon the tenets of integrative medicine. In private practice for over 15 years, Dr. McLean Sheperd partners with each patient to treat the mind, body and spirit. This multidimensional tactic brings new light to the traditional treatment of cancers, infections, and inflammatory conditions.

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SUMMER 2016

Your Annual Skin Screening Make an appointment today with Sheperd Integrative Dermatology at their new patient care facility in Mt. Pleasant located at 912 Old Georgetown Road. On the corner of Chuck Dawly Blvd. and Coleman Blvd. Dr. McLean Sherperd is a dermatology veteran with 15 years of private practice experience in the Charleston area. After earning her undergraduate degree at the Univeristy of Virgina, she attended medical school at the Medical University of South Carolina where she graduated as Valedictorian. She completed her dermatology residency and fellowship in dermatopathology at MUSC, and is a board certified in both specialities. What types of insurance are accepted at Sheperd Integrative Dermatology? We accept all major insurance carriers. What forms of payment are accepted at Sheperd Integrative Dermatology? We accept cash, check, all major credit cards and Care Credit. Do you have early morning or evening appointments? We now have appointments available from 7:30 a.m. to 6:00 p.m.

What to Expect: Our full body skin screenings are performed by a provider in a comfortable and inviting environment. We examine your skin thoroughly, making note of any moles or spots of concern. If anything appears suspicious or worrisome, we will review all treatment options prior to deciding a course of action. Our belief is that your body is your own journey. Our role is to provide you with an expert opinion and guide you through the decided course of action if and when needed. Why should you get screened? Skin cancer is the most common form of cancer in the US. It is also very beatable with early detection. One in every five people develop some type of skin cancer over the course of their lifetime. On average five million adults are diagnosed yearly. We know that sun exposure and genetics can both contribute to skin cancer. We also see occurrences of skin cancer develop in areas where the sun has never reached. An annual skin screening from a dermatology provider can help detect cancers or precancerous growths sooner making them easier to treat. Call 843-216-3530 or go to www.mcleansheperdmd.com to make your appointment today for your annual total body skin screening. Our dedicated staff members will schedule an appointment to meet your specific needs based on your skin type and medical history.

Skin Cancer & Mole Screening Schedule your annual skin cancer screening now. It is an important aspect of your preventative health care. We thoroughly examine your skin from head to toe, using skin mapping techniques to measure and track abnormal skin growths from year to year. This allows identification of subtle changes over time, which can be a key indicator of malignancy. Anything out of the ordinary is tested for diagnosis or treated at the time of the visit.

912 Old Georgetown Rd, Mt Pleasant, SC 29464

Phone: (843) 216-3530 www.mcleansheperdmd.com

Dr. McLean Sheperd is a board certified dermatologist with a highly accomplished team of specialists, advocating a whole body approach to skin wellness. At Sheperd Integrative Dermatology, we pair traditional practices with holisitic and organic healing for a comprehensive and tailored treatment plan based on indivdual patient needs.

Our new location is open!

Cosmetic Treatments

• Botox/Dysport •Dermal Fillers & Collagen Stimulators •Kybella • Laser Hair Reduction •Fractional Skin Resurfacing •Sclerotherapy • Scar & Stretch Mark Treatments •Skin Tightening with Radio Frequency • MicroPeels •Facials •Men's Services and more

912 Old Georgetown Rd, Mt Pleasant, SC

Medical Treatments

• Skin Cancer & Mole Screening •Dermasurgery & Growth Removal • Skin, Hair & Nail Conditions •Eczema •Psoriasis •Acne •Hair Loss Integrative Wellness

• Hormonal Restorative Medical Program •Metabolic Program • hCG Medical Weight Loss Program •Yoga Therapy •Acupuncture SUMMER 2016

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The

Simple Food Rule For Great Skin By Dr. McLean Sheperd

As an artist, I’ve always been mesmerized by the color spectrum of a rainbow—the way light enters a raindrop and reflects into seven different beautiful hues: red, orange, yellow, green, blue, indigo, and violet. But I’m also a doctor, and I get to incorporate my appreciation for color into my integrative dermatology practice, too. That’s because eating a full color spectrum of fruits and vegetables can promote internal and external wellness. I believe that what you eat becomes you. Foods can be rich (or poor) in vitamins, minerals, antioxidants, bioflavonoids, and phytonutrients, all of which influence and affect our health. In my practice, we respect the connection between physical beauty and internal wellness by taking an integrative approach to skin care. When your mind, body, and soul are nourished by healthy foods, your outer being will mirror its inner beauty. So to create a reflection of overall health, start by eating a full color spectrum of fruits and vegetables every day. After all, just as the rainbow reflects what’s inside, so do we. Here are seven reasons eating a colorful diet can benefit your health and beauty:

Prevent disease Red foods: Lycopene, which is found in red fruits and vegetables, plays a big role in helping to prevent cancer throughout the body. This compound protects tissues exposed to UV radiation and is a potent, free-radicalfighting antioxidant. Free radicals are molecules found within all bodies that promote disease. Antioxidants, such as lycopene, fight these molecules so your immune system can keep you healthy. The best source of lycopene comes from tomatoes, watermelons, and pink grapefruit. 14

Get glowing skin Orange foods: It’s a known fact that eating a lot of carrots or foods rich in carotenoids can give the skin a sun-kissed appearance. And who doesn’t love that summery glow? Studies show that foods such as cantaloupe and sweet potatoes can make our skin appear healthier and give it a yellow glow that’s considered more attractive than a suntan—and certainly safer!

Reduce the risk of cataracts and stomach cancers Yellow-orange foods: Citrus plants, carrots, sweet potatoes, and yellow beets contain alpha- and betacarotene. These are important to have in your diet, because once in the body they turn into vitamin A. Research suggests that eating foods full of vitamin A, alpha-carotene, and beta-carotene can lower your risk of some stomach cancers. In addition, they help in hormone synthesis, healthy cell growth and turnover, and immune responses. Plus, bright yellow-orange egg yolks contain lutein and leaxanthin, which can reduce your risk of chronic eye diseases, including macular degeneration and cataracts.

Flush out toxins Yellow foods: A pH-balanced body is a healthy body. Yellow raw lemons not only boost the immune system but also aid in digestion and help cleanse the liver.

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SUMMER 2016

—continued from previous page

I recommend replacing your morning cup of joe with a steaming mug of lemon water to flush out toxins and to have an alkalizing effect.

Stay strong Green foods: A high consumption of leafy greens such as spinach, kale, and Swiss chard is critical in preventing age-related conditions. And a lack of vitamin K—leafy greens are a great source—in your diet can lead to cardiovascular disease and weak bones. Leafy greens also contain chlorophyll and nitrate, which can improve muscle energetics and metabolism. The good news: one cup of raw kale provides you with more than six times your daily dose of vitamin K!

Age gracefully Indigo foods: Resveratrol has been dubbed the longevity molecule, since it’s been suggested to help slow the aging process. In a 2013 study, it was found that resveratrol mimics the effect of calorie restriction (which we know slows the aging process) with similar effects on metabolism and aging.

SUMMER 2016

Foods in the indigo family contain resveratrol, anthocyanidins, and other compounds that protect the heart, plus support brain and bone health. So to promote healthy aging, eat more purple cabbage, blackberries, eggplant, beets, açai, blueberries, and red grapes. Added bonus: red wine is included! (As always, drink responsibly.)

Boost your immune system Whites and grays: Foods lacking in color can also be full of benefits for the body—and immeasurably tasty. Cauliflower, mushrooms, onion, and garlic all fall into this category. Garlic, for example, is a natural health remedy that strengthens the immune system; it’s known antiviral properties can fight infections, congestion, and the flu. Source: http://www.mcleansheperdmd.com/

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Originally published by MindBodyGreen http://www.mindbodygreen.com

Small in Stature, But Big on Personality, Lowcountry Physician

Dr. Jessica Coleman Wants People to Know There Is Hope for Those Battling Hypertension and Kidney Disease By Rose Ewing

“People hear this advice so much they sometimes tune it out, but I cannot stress enough the importance of drinking water, exercise, and watching what you eat,” says Dr. Jessica Coleman, of Nephrology & Hypertension Medical Associates in Port Royal, SC. “The kidneys are the filter of the body and they undergo the same wear and tear as the rest of the body, but they silently can become compromised, decline, and break down if you are not careful.” Dr. Coleman, formerly McAbee, lives in Beaufort with her high school sweetheart and husband of one year, Jimmy, and her 14-year-old Pomeranian, Rusty. She specializes in the management of kidney disease and hypertension, hoping to see at-risk patients early in the process. “My goal is to see patients before they reach the critical stage. As a doctor, I want to do more to help patients than just put them on dialysis. With early detection and prevention we can usually slow the decline of their kidney function.” Sometimes, she’ll get a call to see a 40-year-old adult in Beaufort Memorial whose kidneys are burned out, and most often there is not much she can do at that point. “In situations like that, I know this all could have been prevented by early detection,” says the Savannah native, who is small in stature, but big on personality. 16

From left to right standing behind Dr. Coleman: Dominique Rivers, medical assistant; Monica Riley, DNP, CDN; and Kym Lightsey, medical assistant.

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SUMMER 2016

Also making up her nephrology practice are Drs. Dana Kumjian, Rebecca Sentman, James Bazemore, and Erik Bernstein. They work primarily in the practice’s Savannah office with Nurse Practitioners Carol Strickland, Ashley Wilson, Codi Jones and Ann Hallock. In the Port Royal/Beaufort office, Dr. Coleman works with Nurse Practitioner Monica Riley, who holds a Doctorate of Nursing Practice and also is an accredited Certified Dialysis Nurse. With the growth of our Lowcountry area, Dr. Coleman’s practice has expanded. Patients can also be seen at the practice’s Okatie office in Legacy Office Park near the rear gates of Sun City. “Years ago, nephrologists got patients in the end stage of kidney disease when they immediately had to go on dialysis. That is no longer the case,” says Dr. Coleman, who advocates primary care doctors refer at-risk patients early. “I appreciate seeing patients closely in conjunction with their primary care doctor to develop an individualized plan of care appropriate to each unique person,” Dr. Coleman goes on to say. A persistent theme in her practice model, Dr. Coleman looks for a close relationship with each of her patients.

African Americans and Hispanics are biologically more at risk for hypertension and kidney disease, with Caucasians being third. Also, patients who have family members who have kidney problems should be more aware of the potential problems they may face. Sedentary lifestyles contribute to risk factors that are already there.

generations. Her husband’s family also has strong local roots. His grandfather was Georgia State Senator Tom Coleman, who served from 1981 to 1995, and was recognized in 1998 when a portion of I-95 from the Ogeechee River to the Savannah River was named the Tom Coleman Highway in his honor. A fellow Georgia Tech graduate, he remained a public servant and served as Chairman of the Georgia Department of Transportation and Board of Regents. Recently, the Savannah courthouse was also dedicated to his honor. “My husband and I love the Lowcountry and especially Beaufort,” says Dr. Coleman. “We have strong roots here and plan to stay here.” Active in the Beaufort community, she is most proud of her medal for participation in 2015’s Dragon Boat Beaufort races, which raises money for cancersurvivor support, grants and counseling. Her active lifestyle helps her take her own best advice of “drink lots of water.” Breaking into a smile, Dr. Coleman likes to tell the story when she and Nurse Practitioner Monica Riley were advising one of their Beaufort patients to adopt a healthier lifestyle, exercise and make better food choices. “The patient called prior to her upcoming appointment. She was very concerned that she had lost a few pounds,” remembers Dr. Coleman. While she encourages all of her patients to stay in close contact with her and advise her of any changes in their health, she was happy to explain to this patient “weight loss is expected when you watch what you eat and exercise.”

Unfortunately, high blood pressure, diabetes and poor kidney function are “silent killers” and often have no outward signs that something is wrong. No later than age 30, Dr. Coleman urges everyone to get a primary physician and have a physical, bloodwork and urinalysis once per year to insure kidney disease doesn’t “sneak up on” an unsuspecting patient. Hypertension, obesity and a genetic predisposition to kidney disease can increase your chances of having your kidneys fail.

Dr. Coleman received her undergraduate degree in biochemistry from Georgia Institute of Technology. She attended medical school at Mercer University in Macon, GA. She completed her residency, fellowship, and Chief Fellow year in nephrology at the University of Kentucky in Lexington. Her family has lived in Savannah for five SUMMER 2016

Dr. Jessica Coleman can be seen at Nephrology & Hypertension Associates, 1859 N. Paris Ave., Suite 212, Port Royal, SC 29935. Call 843-524-2002. Her office in Okatie is located at 16 Okatie Center Blvd. South, Okatie, SC, 29909. Phone 843-706-9955. Visit www.thekidneydocs.com to learn more.

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For important information on how to avoid kidney disease, see page 19. 17

Oral Cancer is On The Rise The American Cancer Society estimates that 39,000 new oral cancer cases will be diagnosed this year, and about 7,500 patients will have died of the disease in 2015. Oral cancer’s mortality rate is particularly high because it is often discovered late in its development. Many who do survive suffer long-term problems such as severe facial disfigurement or difficulties eating and speaking. The fact is that the earlier the cancer is detected, the more effective the treatment and the greater the chance of a cure. It is important to know the major risk factors. It may not come as a surprise that alcohol and tobacco users are three times as likely to get oral cancer, but the now-prevalent Human Papillomavirus is also a major risk factor. People with HPV are 30 times as likely to get oral cancer. The American Association of Oral and Maxillofacial Surgeons (AAOMS) are committed to educating the public about the risk factors and the importance of early detection. Everyone should perform an oral self-examination monthly and schedule an annual appointment with their dentist or oral and maxillofacial surgeon for a professional oral examination. The mouth is one of the body’s most important early warning systems. If any suspicious lumps or sores are discovered, it’s important to make an appointment for a prompt examination. —AAOMS.org

http://www.aaoms.org/images/uploads/ pdfs/oralcancerselfexam.pdf

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SUMMER 2016

Hyperthyroidism and Your Heart Hyperthyroidism occurs when your thyroid gland makes too much thyroid hormone or your dose of thyroid medicine is too high. The excess hormone “speeds up” virtually every system in your body. The symptoms often include nervousness, palpitations caused by a fast heart rate, feeling hot when others are comfortable, trouble sleeping, and weight loss despite being hungry all the time. If left untreated, hyperthyroidism does more to your heart than simply making it beat faster. The excess thyroid hormone makes it work harder, too. Many people diagnosed with a thyroid condition are surprised that such a tiny gland can have such a profound impact on overall health and well-being. But the thyroid gland plays an enormous role in human health. Throughout life, this busy gland is constantly producing hormones that influence metabolism. When disease causes your thyroid gland to slack off and underproduce thyroid hormone, or overwork and produce too much of it, you’ll know something isn’t right: Abnormal heart rhythms. Several heart rhythm disturbances can result from over-stimulation of the thyroid. The most common are sinus tachycardia, an abnormally fast heart rate that tops 100 beats per minute, and atrial fibrillation, a disorganized rhythm in the heart’s upper chambers. High blood pressure. In hyperthyroidism, blood vessels relax, lowering diastolic blood pressure (the second, or bottom, number in a blood pressure reading). But an excess of thyroid hormone also increases the force of the heart’s contractions, leading to an increase in systolic pressure (the first, or top, number). Chest pain. Whenever the heart beats more forcefully and pumps more blood, the heart muscle needs more oxygen. If a person with hypert-hyroidism also has clogged coronary arteries, they may experience the chest pain known as angina, which occurs when narrowed coronary arteries can’t carry all the extra blood the heart muscle demands. Heart failure. By forcing the heart to work harder and faster, an overactive thyroid can overtax it and cause heart failure, a condition in which the heart can’t pump enough blood to meet the body’s needs. The good news is that treating hyperthyroidism almost always allows your heart to recover. For additional information, buy Thyroid Disease from Harvard Health at http://www. health.harvard.edu, or call toll-free: 1-877-649-9457. SUMMER 2016

Ways To Avoid Kidney Disease: By Dr. Jessica Coleman

Get a Primary Care Physician: Everyone needs a primary care physician,” says Dr. Coleman. “They are the captain of the ship of your body.” She recommends patients see them at minimum once per year, or as often as the physician recommends. Make sure the PCP performs a physical exam, runs a metabolic blood profile and a urinalysis showing creatinine levels once per year. Creatinine is the number doctors use to see how well the kidneys are working. When your kidneys aren’t functioning properly, creatinine can accumulate in your body. A urinalysis will also help see if damage is being done to your kidneys. Exercise: Keep active and exercise. Movement stimulates the body and helps all organs do what they were made to do. Dr. Coleman recommends 30 minutes of exercise a minimum of three times per week under the supervision of a PCP. Exercise will also help improve muscle function and sleep, which will in turn benefit kidney function. Even moderate exercise such as walking will improve one’s overall quality of health. Water, Water, Water: “Drink lots of water,” says Dr. Coleman. Water flushes the toxins from the kidneys and keeps your entire body hydrated. “You want to keep flushing toxins out of your body. The best way to do that is with lots of water,” she says. Those living in the Lowcountry should be extra careful to drink enough water, as they can lose hydration easily through daily activity. Control Blood Pressure: Uncontrolled high blood pressure is the leading cause of kidney disease. Monitor your blood pressure. Try to keep your top number (systolic) below 130; your diastolic number (bottom) below 80. Salt is an enemy. It raises blood pressure and puts unneeded stress on your kidneys. Avoid Preserved Meats: Preserved meats such as lunch meat, bacon, pepperoni and red meat are high in uric acid and salt, which are hard on kidney function and also causes painful gout. Control Bad Cholesterol: Total cholesterol should be less than 200 mg. Good cholesterol should be above 50. Limit dining out, especially fast foods. It is suggested one eat more high antioxidant foods such as colorful fruits and vegetables, legumes, nuts and low or non-fat dairy products. Avoid Cigarettes: Smoking affects your entire body, including your kidneys. Smoking can also interfere with medications used to treat high blood pressure. Control Your Blood Sugar: Try to keep blood sugar levels (A1C) less than 7 percent. Uncontrolled diabetes accelerates loss of kidney function. It is suggested people try to consume high-fiber/ low-sugar foods.

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Regional Blood Drive Donation Centers Government issued photo ID is required to donate. Examples are a driver’s license, passport, military ID, student ID

OneBlood (formerly The Blood Alliance) 1001 Boundary St, Beaufort, SC 29902 (843) 522-0409 ZIKA and BLOOD DONATION SAFETY OneBlood anticipates the Food and Drug Administration (FDA) granting the blood center approval to use a new investigational test to screen blood donations for the Zika virus. Approval is expected in the coming months and likely sooner if there is an active outbreak of the virus in OneBlood’s service area. Once the FDA approves OneBlood to implement the Zika test they will begin testing a certain percentage of their inventory and have blood that has tested negative for the Zika virus available for hospitals to use for their high risk patients, such as pregnant women, women of child-bearing age and immunecompromised patients.

American Red Cross 59 Sheridan Park Cir # A, Bluffton, SC 29910 Phone:(843) 757-7437 The American Red Cross (ARC) is closely monitoring the spread of Zika virus. ARC implemented the FDA’s guidance to reduce the risk of transfusion-transmission of Zika virus. Those risk factors include: travel to or residence in countries on the Centers for Disease Control and Prevention (CDC) Zika Travel Information list within the last four weeks; diagnosis of Zika virus infection; existence of two or more Zika virus infection symptoms within two weeks of leaving an area with local transmission; or sexual contact within the last four weeks with a man who in the three months before sexual contact was diagnosed with Zika virus infection, or traveled to or resided in an area with local Zika virus transmission. Potential donors with any of these risk factors should schedule their blood donation for four weeks after the end of these defined risk periods.

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SUMMER 2016

care TALK © capsules of helpful health information Prenatal cannabis use appears to put both mother and baby at risk, according to a metaanalysis in BMJ Open.

Aspirin Recommended for Preventing CVD and Colorectal Cancer The U.S. Preventive Services Task Force (USPTAF) has recommended aspirin for primary prevention of cardiovascular disease and colorectal cancer in some high-risk adults in their 50s and 60s. The guidelines, an update of the group’s 2007 and 2009 recommendations, are published in the Annals of Internal Medicine:

The analysis included 19 observational studies that examined the effects of prenatal cannabis use on maternal outcomes and neonatal outcomes through 6 weeks of age. Women who used illicit drugs other than cannabis were excluded. Women who used cannabis during pregnancy, compared with those who did not, had 36% higher odds of developing anemia. In addition, cannabis users were 77% more likely to have a low-birth-weight infant. Further, infants exposed to cannabis in utero were twice as likely as unexposed infants to require a neonatal ICU stay. Prenatal cannabis use was not associated with other outcomes assessed, including preterm birth, neonatal length, and head circumference. The authors conclude, “As use of cannabis gains social acceptance, pregnant women and their medical providers could benefit from health education on potential adverse effects of use of cannabis during pregnancy.” For additional scientific information, read the BMJ Open article (Free) http://bmjopen.bmj.com/content/ 6/4/e009986 Source: http://www.JWatch.org By Amy Orciari Herman Edited by David G. Fairchild, MD, MPH SUMMER 2016

• Low-dose aspirin is recommended for adults aged 50–59 who have at least a 10% risk for a cardiovascular event in the next decade, low bleeding risk, and a life expectancy of at least 10 years; patients must also be willing to take aspirin daily for at least 10 years. • For adults aged 60–69 fitting the above criteria, the decision to start aspirin should be an individual one. • For patients younger than 50 and older than 69, there is not enough evidence to make recommendations. Dr. Harlan Krumholz, editor-in-chief of NEJM Journal Watch Cardiology, comments: “The recommendations are sensible, but people should realize that they are based on very few high-quality studies—and no recent ones. Ultimately, aspirin’s effects are felt to be modest, and the decision [to initiate treatment] is ideal for shared decision-making since there is some uncertainty about the relevance of the evidence to contemporary practice and a trade-off of risks and benefits.” Source: By Kelly Young, JWatch.org

Ways to Boost Your Memory As you’ve gotten older, have you noticed that you often find yourself marching around the house in a huff, searching for misplaced car keys or eyeglasses, or you just cannot remember the name of that new neighbor you met when walking the dog? It’s frustrating, to be sure, but not inevitable—and there are things you can do to help keep your memory sharp.

Memory-boosting tips Follow routines, such as leaving your car keys, glasses, and cell phone in the same place every day so that finding them becomes a “no-brainer.” Slow down and pay attention to what you are doing to give your brain’s memory systems enough time to create an enduring memory. Avoid distracting or noisy environments and multitasking — the major memory busters in today’s fast-paced society. Get enough sleep, reduce stress, and check with your doctor to see if any of your medications affect memory — all three are potential memory spoilers. Is it forgetfulness or Alzheimer’s? Worried that your minor memory slips mean you are headed toward Alzheimer’s disease? That’s probably not the case. Like it or not, science shows that the ability to learn new information and recall it, may decline somewhat after 50. You just can’t pull things out of your memory the way you used to at the same speed. But forgetfulness can be a serious issue if it’s starting to interfere with daily tasks and routines, such as managing your health care and finances. To read more about ways to improve your memory, buy a copy of “Improving Memory”. Visit http://www.health.harvard.edu, or call toll-free: 1-877-649-9457.

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Call 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

Kids Only Adventures – Summer 2016

Waterway Excursion

Kids—join the Coastal Discovery Museum each Friday this summer for fun adventures and explore coastal South Carolina. Kids only adventures are designed to provide participants with an in-depth and close-up look at our beautiful coastal waterways and the fascinating creatures that live here.

Saturdays at 10 a.m. (Please check available dates at the online event calendar). $35 per person. Reservations required.

Marine Exploration—June 17th, July 8th, July 29th Dolphins, birds, crabs? Explore the May River on the Spartina Marine Education Charter boat. Meet at Calhoun Street Public Dock in Bluffton. Check-in 8:30-8:45am Marine Exploration 9:00-11:00 / Pick up at 11:00 / ages 7-12 / $35 per child. Trawling Expedition! (June 24th, July 15th, August 5th) Venture out on a real shrimp trawler, learn how it works, trawl for shrimp, and examine other amazing critters that you might catch in our coastal waters. Meet at Hudson’s Seafood House on the Dock.Check-in 8:30-8:45am / Trawl Expedition 9:0012:00 / Pick up at 12:00 / ages 7-12 / $35 per child. Dolphin Cruise for Kids! (June 10th, July 1st, July 22nd, August 12th) Everyone loves dolphins! Look, listen, and learn as you cruise Broad Creek in search of Bottlenose Dolphins. Meet at Broad Creek Marina (zipline side of marina).Check-in 8:30-8:45am / Cruise 9:00-10:30am / Pick up at 11:00am / ages 7-12 / $20 per child REGISTRATION and RELEASE FORM must be completed in addition to making reservations. Reservations required: call 843-689-6767 ext. 223, or register online at www.coastaldiscovery.org

Dolphin Research Excursion Wednesdays and one Saturday per month through December—most cruises from 10am–noon (Please check the event calendar). Through May 2016: 5/11, 5/14, 5/18, & 5/25. Summer 2016: Wednesdays at 10 AM and 2nd Saturday of the month (6/11, 7/9, & 8/13) at 10 AM. $55 per person (ages 10 and over). Reservations required. This is a unique opportunity to be on a 2-hour scientific research cruise to study acoustic communication between resident dolphins in the May River and their prey. While USCB researchers visually identify and record dolphin vocalizations, marine biologist Captain Amber Kuehn will share what we have learned about these fascinating cetaceans and their prey. Space is limited to 15 participants and your fee helps support important dolphin research. This 2 hour exploration of Bluffton’s May River is aboard research vessel SPARTINA and is offered in collaboration with the USCB.

Explore the waterways around Pinckney Island. This 2 hour educational cruise will circumnavigate the Pinckney Island Wildlife Refuge through Skull Creek and Mackay Creek. Learn about the salt marsh, maritime forest, barrier islands, and the history of Pinckney Island. Kayak Tour of Jarvis Creek Tuesday–Thursday from 10 a.m.–noon; $32 adult; $28 child (ages 5–12; no children under 5). Provided by Jarvis Creek Water Sports Reservations required. Join a naturalist guide in a kayak exploration. Paddle through the salt marsh looking for bottle-nosed dolphins, wading birds and other local wildlife. Jarvis Creek is a small creek in the north end of Hilton Head Island not typically visited by recreational boaters. The absence of fast moving boats, the calm waters, and the many inlets and side creeks make it the ideal location to see wildlife. Given the physical requirements of this tour, no children under 5 may participate. Children ages 5 to 12 must be in a double kayak with an adult. Dolphin and Nature Cruise Wednesdays and Fridays at 3 p.m. through October. $19 adult; $13 child (ages 1–12) Departs from Broad Creek Marina on Marshland Rd. Reservations required. Join a museum docent in this cruise along the waters and salt marshes of Broad Creek. The Lowcountry’s Salt Marsh is home to many interesting creatures such as river outers, eastern oysters, blue crabs and a great species of birds. Among the most charismatic creatures found in the Salt Marsh are the Bottlenose Dolphins. Museum guides share their knowledge about this and many other of the fascinating creatures found in the salt water channels of Broad Creek. May River & Marine Science Expedition May River Expedition: Tuesdays from 10 a.m. – noon June through August. Please check the Event Calendar to confirm the time and day of the week for this cruise. Marine Science Expedition: Tuesdays from 10 a.m. – noon (Pinckney Island Area) from June through August. $40 adult; $30 child. Departure location provided after reservations are made. Reservations required.

Please visit www.coastaldiscovery.org to view the many other events and happening at the museum, for all ages to enjoy this summer!

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SUMMER 2016

Parent Pulse

helpful insights and tips for effective parenting

Keeping Your Baby Sun-Safe Babies—who are especially vulnerable to the damaging effects of ultraviolet (UV) light—need vigilant care from their parents to protect them from these dangers. Babies’ skin is thinner than that of an older child, meaning it burns much more easily. According to the Skin Cancer Foundation, research shows that nearly a quarter of infants become sunburned or tanned in their first summer, with more than half getting burned or tanned while they’re still under 2 years old. This can lead to a much higher risk of developing melanoma later in life, since sustaining 5 or more sunburns in youth raises the lifetime risk of this deadly skin cancer by 80%.

Sunburn signs & symptoms While babies can become sunburned after just 15 minutes of sun exposure, the signs and symptoms may not appear until 6 to 12 hours later. These include: Red, warm and itchy skin (for mild sunburn) Widespread burning (for severe sunburn) Blistered skin Painful skin Fever or chills Nausea Swollen face Dehydration Home treatment for a baby with mild sunburn includes cool baths and putting aloe vera gel or cool compresses on burned areas. But severe sunburn on an infant requires a more emphatic response and is treated like any other serious burn. Call your baby’s pediatrician or get emergency medical care. Babies can end up with grave or even life-threatening problems from too much ultraviolet light. It’s no joke.

Tips to prevent sun damage in your baby Limit your baby’s time in the sun between the hours of 10am and 4pm, or try to keep your baby out of the sun entirely in that time period. This is a simple avoidance technique that works because that’s when the sun’s rays are strongest. Dress your baby in a wide-brimmed hat and baby sunglasses (if they keep them on!). Look for sunglasses with 99% UV protection. Dress baby before going outdoors in lightweight clothing that covers their arms and legs. More and more clothing is being sold now that offers built-in UV protection. Babies and kids can even take a dip in the pool in these pieces. Slather babies over six months old in sunscreen on all visible skin areas. Buy broad spectrum sunscreen that blocks both UV-A and UV-B light. The SPF, or sun protection factor, of any sunscreen should be 15 or higher.” Apply sunscreen to baby’s skin at least 30 minutes before heading outdoors, since the sunscreen needs time to soak in. Reapplying sunscreen at least every two hours, and more often if baby spends time in the water or sweats profusely. SUMMER 2016

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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. You must dial AREA CODE 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., 10:15–11:45 a.m. for caregivers of someone with Dementia; Men’s Support Group, 1st + 3rd Mon. each month, 10:15–11:45 a.m. and Women’s Support Group, 2nd + 4th Mon. each month, 10:15–11:45 a.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: Every Wednesday 12:30 - 1:30, Helena Place Assisted Living, Port Royal; 843-521-9190 or 843-263-2062 • Alzheimer’s Family Services of Greater Beaufort Education and Social Day Program: Mon. & Wed., 10:00 a.m. - 1:45 p.m., Port Royal United Methodist Church. Friday; 10:00 a.m. 1:45 p.m, Wesley UnitedMethodist Church, Beaufort, 843-521-9190 or 843-263-2062 • Alzheimer's Family services of Greater Beaufort Living With Alzheimer's Disease Support Group: 2nd and 4th Monday of each month, 1:00 p.m. 2:00p.m., The Parlor, Carteret Street United Methodist Church, Beaufort, 843-521-9190 or 843-263-2062 • Alzheimer's Family services of Greater Beaufort Early Memory Loss Group: 2nd and 4th Monday of each month, 10:30 a.m. - 11:30 a.m., Port Royal United Methodist Church, 843-521-9190 or 843-263-2062 • Alzheimer's Family services of Greater Beaufort In-Home Respite: Available on an as needed basis; 843-521-9190 or 843-263-2062 BEREAVEMENT • PRUITT/United Hospice Grief support for recently bereaved: All situations– Contact Bereavement Counselor, 522-0476. • AGAPE Grief support Groups: Please RSVP to 803-842-9800 to attend the group: Ridgeland: 433 First Ave., 2nd Wednesday, 10:00am.; Beaufort: 907 Boundary St., 3rd Wednesday 10:00am.; Hampton: 1000 Pine St. E., Varnville, 4th Wednesday, 10:00am. • 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, Port Royal: 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

• Wellness Thrivers: Cancer Survivor Group first Tuesday of each month 6:30-8 pm 705 Bladen Street, Beaufort,. 843-770-9947 or contact Renee Sutton, LPC at reneesutton@healthierhealing.com DIABETES • Diabetes support groups: Beaufort, 522-5635; 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: adult1dgroup@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. • Mental Health Association Beaufort-Jasper: Information, referral, direct service, and emergency assistance; 682-2900. • NAMI Connection Recovery Support Group for Consumers : Hilton Head every Monday, 5:307:00 p.m. Contact R. Peters, 843-681-2200 ext. 1; Bluffton/Okatie every Wednesday, 6:30 pm8:00 p.m. Contact R. Peters, 843-681-2200 ext. 1; Beaufort, noon–1:30pm: BFTMedical Plaza, Rm 350, Call for info: 843-681-2200 ext. 1. • NAMI Caregiver Support Groups: 7:00 p.m. St. John’s Lutheran Church, Lady’s Island; Contact: John Aiello, 843-597-8122. 10:00 a.m. Lowcountry Presbyterian Church, Bluffton; Contact: Betty & Ted Cooley, 843-757-8597. Evening group in Bluffton by appointment only, 6:00-7:00 pm; Unitarian Universalist Church, 110 Malphrus Rd., Bluffton; Norma Van Amberg 843-681-2200 . 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.

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WEIGHT ISSUES • Community Health/ Weight Loss Classes For information, call Sheila 843-644-1991. • Overeaters Anonymous, Hilton Head: Fri.,10:30am, YANA Club, 706-3606; Bluffton: Tues., 6:00pm, St. Luke United Methodist Church, contact Lynne 271-2114; • Overeaters Anonymous (continued), 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 • 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 • 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; • 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 group: Port Royal/Beaufort: Shellpoint Baptist Church, 1st Thursday of the month, 1:30-3 p.m.; • 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 • Nursing Mothers of Beaufort: Third Friday, 1:00-2:30pm; 508 Scott St.; 919-606-4565. • 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

SUMMER 2016

A good guide to good carbs:

The Glycemic Index Picking good sources of carbs can help you control your blood sugar and your weight. Eating healthier carbohydrate-rich foods can also help ward off a host of chronic conditions, from heart disease to various cancers, and diabetes. One way to choose healthy carbs is with the glycemic index (GI). This tool measures how much a food boosts blood sugar. Using the glycemic index is easy: choose foods in the low GI category instead of those in the high GI category, and go easy on those in between. Low glycemic index (GI of 55 or less): Most fruits and vegetables, beans, minimally processed grains, pasta, low-fat dairy foods, and nuts. Moderate glycemic index (GI 56 to 69): White and sweet potatoes, corn, white rice, couscous, breakfast cereals such as Cream of Wheat and Mini Wheats. High glycemic index (GI of 70 or higher): White bread, rice cakes, most crackers, bagels, cakes, doughnuts, croissants, most packaged breakfast cereals.

Glycemic index and glycemic load offer information about how foods affect blood sugar and insulin. The lower a foodâ&#x20AC;&#x2122;s glycemic index or glycemic load, the less it affects blood sugar and insulin levels. Here is a link to a list of the glycemic index and glycemic load for more than 100 commonÂ foods: http://www.health.harvard.edu/healthyeating/glycemic Harry Ammon, Lowcountry region Instructor

843-521-1941 SUMMER 2016

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Microwave Cooking and Nutrition Almost every American home has a microwave oven. The convenience they offer is undeniable. But despite the widespread use of microwave ovens and their excellent safety record, some people have lingering doubts that cooking food with microwaves somehow makes food less healthy by zapping away nutrients. Does cooking with microwaves do that? Understanding how microwave ovens work can help clarify the answer to this common question. Microwave ovens cook food using waves of energy that are similar to radio waves but shorter. These waves are remarkably selective, primarily affecting water and other molecules that are electrically asymmetrical—one end positively charged and the other negatively charged. Microwaves cause these molecules to vibrate and quickly build up thermal (heat) energy. Some nutrients break down when they’re exposed to heat, whether it is from a microwave or a regular oven. Vitamin C is perhaps the clearest example. But because microwave cooking times are shorter, cooking with a microwave does a better job of preserving vitamin C and other nutrients that break down when heated. As far as vegetables go, cooking them in water robs them of some of their nutritional value because the nutrients leach out into the cooking water. For example, boiled broccoli loses glucosinolate, the sulfur-containing compound that may give the vegetable its cancer-fighting properties (as well as the taste that many find distinctive and some find disgusting). Is steaming vegetables better? In some respects, yes. For example, steamed broccoli holds on to more glucosinolate than boiled or fried broccoli. The cooking method that best retains nutrients is one that cooks quickly, heats food for the shortest amount of time, and uses as little liquid as possible. 26

Microwaving meets those criteria. Using the micro-wave with a small amount of water essentially steams food from the inside out. That keeps more vitamins and minerals than almost any other cooking method. But let’s not get too lost in the details. Vegetables, pretty much any way you prepare them, are good for you, and most of us don’t eat enough of them.

Microwaving food in plastic: Dangerous or not? Chances are good that you’ve at some point received an urgent “PLEASE READ THIS!” email about the dangers of microwaving food in plastic containers or plastic wrap, or run across an article about it on a website. The message is that chemicals leaching out of the plastic and into the food will cause cancer, reproductive problems, and other ills. Is there any truth to this, or is it just another Internet-fueled “urban legend”? As is often the case with such warnings, this one contains a small kernel of truth —and a lot of misinformation.

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SUMMER 2016

—continued from previous page

“microwave safe,” or words to the effect that they’re approved for use in microwave ovens.

Let’s cover the original misinformation first: The earliest missives warned that microwaved plastic releases cancer-causing chemicals called dioxins into food. The problem with that warning is that plastics don’t contain dioxins. Dioxins are created when garbage, plastics, metals, wood, and other materials are burned. As long as you don’t burn your food in a microwave, you aren’t exposing yourself to dioxins.

What about containers without a microwave-safe label? They aren’t necessarily unsafe; the FDA simply hasn’t determined whether it is or not.

Migrating chemicals

Is Styrofoam microwave safe?

When Good Housekeeping microwaved food in 31 plastic containers, lids, and wraps, it found that almost none of the food contained plastic additives.

Contrary to popular belief, some Styrofoam and other polystyrene containers can safely be used in the microwave. Just follow the same rule you follow for other plastic containers: Check the label.

There’s no single substance called “plastic.” That term covers many materials made from an array of organic and inorganic compounds. Substances are often added to plastic to help shape or stabilize it. Two of these plasticizers are • bisphenol-A (BPA), added to make clear, hard plastic • phthalates, added to make plastic soft and flexible BPA and phthalates are believed to be “endocrine disrupters.” These are substances that mimic human hormones, and not for the good. When food is wrapped in plastic or placed in a plastic container and microwaved, BPA and phthalates may leak into the food. Any migration is likely to be greater with fatty foods such as meats and cheeses than with other foods. The FDA long ago recognized the potential for small amounts of plasticizers to migrate into food. So it closely regulates plastic containers and materials that come into contact with food. The FDA requires manufacturers to test these containers using tests that meet FDA standards and specifications. It then reviews test data before approving a container for microwave use. Some of these tests measure the migration of chemicals at temperatures that the container or wrap is likely to encounter during ordinary use. For microwave approval, the agency estimates the ratio of plastic surface area to food, how long the container is likely to be in the microwave, how often a person is likely to eat from the container, and how hot the food can be expected to get during microwaving. The scientists also measure the chemicals that leach into food and the extent to which they migrate in different kinds of foods. The maximum allowable amount is 100–1,000 times less per pound of body weight than the amount shown to harm laboratory animals over a lifetime of use. Only containers that pass this test can display a microwave-safe icon, the words SUMMER 2016

The bottom line If you’re concerned about plastic wraps or containers in the microwave, transfer food to glass or ceramic containers labeled for use in microwave ovens. • Don’t let plastic wrap touch food during microwaving because it may melt. Wax paper, kitchen parchment paper, white paper towels, or a domed container that fits over a plate or bowl are better alternatives. • Most takeout containers, water bottles, and plastic tubs or jars made to hold margarine, yogurt, whipped topping, and foods such as cream cheese, mayonnaise, and mustard are not microwave-safe. • Microwavable takeout dinner trays are formulated for one-time use only and will say so on the package. • Old, scratched, or cracked containers, or those that have been microwaved many times, may leach out more plasticizers. • Don’t microwave plastic storage bags or plastic bags from the grocery store. • Before microwaving food, be sure to vent the container: leave the lid ajar, or lift the edge of the cover. Source: The Family Health Guide Order online at http://www.health.harvard.edu/stayinghealthy/microwaving-food-in-plastic-dangerous-or-not?, or call toll free 877-649-9457.

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Summer FUN! Relaxed Entertaining

Whether it’s intimate dinner with friends or a casual backyard barbecue with the family, hosting summer parties is always fun and exciting. The preparation, however, can be stressful and challenging. Use Colorful Tableware It’s the perfect season to play around with colors, so start with your tableware. Use brightly colored plates to add an eclectic feel to the table. Don’t worry if they don’t match—mismatched dinnerware makes the affair appear more laidback. Scour flea markets or yard sales for inexpensive but attractive china that you can mix and match.

Decorate with Seasonal Flowers You don’t need a full blown floral centerpiece to make your décor interesting. Just grab two to three empty jars and stick in a few stems or sprigs of seasonal flowers in each one. Wild flowers also work well for a rustic table setting.

Incorporate Food into the Décor To make things even easier, make food part of your décor and take advantage of seasonal produce to brighten up the table. An appetizer platter or a bowl of mixed berries can even double as your centerpiece.

Go for Mood Lighting Mood lighting is key to setting your party’s atmosphere. Turn off overhead lights and use lamps or candles. If the party is outside, hang paper lanterns together with string lights over the table or trees for a cozy ambiance. Don’t forget to light up pathways and steps to avoid accidents.

Stick to Easy Recipes To make your hosting duties as stress-free as possible, create a menu that’s easy to prepare and can be made ahead of time. Leave last-minute grilling a few hours before the party starts and set the table the day before. Appetizers, Salads and meats with a light angel food cake and popsicles for the kids. SUMMER 2016

Set Up a Beverage Station A dedicated drinks station is a great way to encourage people to start conversations with others. If it’s a large party, set up multiple stations so that your guests don’t have to line up for refills. For your guests who prefer not to, or don’t drink, serve this refreshing

Cucumber Mojito “mocktail”: Ingredients 8 cups water 4 medium cucumbers, peeled and coarsely chopped 1/2 bunch fresh mint 1 1/2 cups agave syrup, honey or natural sugar 1 cup lime juice Crushed ice 1/2 liter sparkling water or lemon-lime soda To serve: 1 medium medium cucumber, cut into thin rounds for garnish 1/2 bunch fresh mint lime wedges Instructions Combine water, cucumbers, mint, agave syrup and lime juice in a blender and pulse until smooth. Strain through a fine mesh sieve; discard solids. Combine cucumber mixture and rum in a large pitcher. Stir well. Refrigerate up to 4 hours. To serve, fill glasses with crushed ice. Fill halfway with cucumber mixture and top with sparkling water or soda. Garnish with a slice of cucumber, sprig of mint and lime wedge. Yield: 12 servings

Tips to Keep the Stress Less • Don’t be shy to ask for help. Delegate tasks like manning the grill or setting the table so you can focus on other things. • If your guests offer to bring something, say yes! Appetizers or dessert can be that one thing off your mind. • Make sure you’re well stocked on drinks and ice to minimize supply runs. • Avoid repeating flavors. If you use strawberries for appetizers, think of something else for dessert. A summer gathering is all about casual entertaining. Keep things simple and don’t worry too much about imperfections. Instead of slaving away at the kitchen all day, relax and enjoy the company of friends and loved ones.

Don’t forget throwing a party is supposed to be fun for both you and your guests. If your guests see that you are relaxed and enjoying yourself they too will relax and enjoy themselves. Even if there are hiccups in your well laid plans, or if something burns, or more people showed up and the food is getting tight, just take a deep breath, put your smile on, and steady on. It’s all going to be ok.

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Healthy & Wholesome

Summer FUN Recipes ingredients: 1½ pounds (or 5 thinly sliced) boneless center-cut pork chops 1½ tbsp canola oil ¼ cup honey Spice Blend (mix together in a small bowl): 1 tbsp cayenne pepper 1 tbsp smoked paprika ½ tsp Italian seasoning ½ tsp black pepper

Honey & Spice Glazed Pork Chops

Yields: 5 servings (1 serving = 1 pork chop)

preparation: 1 Pre-heat grill or broiler. 2 After rinsing off pork chops, pat dry with paper towels. In medium bowl mix oil and spice blend together and toss pork chops in mixture until evenly coated. 3 Place pork chops on cake rack lined sheet tray leaving space in between pork chops while placing on rack. 4 Broil or grill 2-3 minutes in pre-heated oven (set on broil) or grill, then turn over and cook for additional 2-3 minutes. 5 Brush pork chops with honey on the one side and grill or broil for additional 1-2 minutes or until lightly caramelized. 6 Remove pork chops from grill or oven and let rest 3-5 minutes before cutting.

Nutrition Per Serving — Calories 320 Protein 28 g; Carbohydrate 15 g; Total Fat 15 g: Saturated Fat 4 g, Trans Fat 0 g; Cholesterol 93 mg; Potassium 462 mg; Phosphorus 265 mg; Sodium 69 mg.

Source for all recipes: http://www.ultracare-dialysis.com/RecipeCenter/

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Used with permission of Fresenius Medical SUMMER 2016

Savory Shrimp Casserole Yield: Serves 4-6 (1 serving = 3 ounces)

ingredients: ¾ pound small raw shrimp (25-30), peeled and deveined 2 cups cubed Italian bread 1 cup coarsely crushed unsalted saltine crackers ¼ cup diced celery ¼ cup diced onion ¼ cup diced bell pepper ¼ cup unsalted butter ¾ cup low-sodium chicken stock 2 tablespoons chopped fresh thyme (or 1 tbsp. dried) ½ teaspoon black pepper ½ teaspoon dried sage ½ teaspoon dried oregano 1 teaspoon cayenne pepper 1 teaspoon garlic powder 1 teaspoon onion powder 2 tablespoons chopped parsley

preparation: 1 2 3 4 5 6 7 8 9 10

Nutrition Per Serving — Calories 126 Protein 3 g; Carbohydrate 16 g; Total Fat 6 g: Saturated Fat 3 g, Trans Fat 0 g; Cholesterol 16 mg; Potassium 108 mg; Phosphorus 38 mg; Sodium 155 mg.

Preheat oven to 375° F. In large sauté pan, melt butter on medium-high heat. Add shrimp and cook for 3-5 minutes, or until slightly pink and slightly raw in the middle. Remove shrimp from pan and place on a plate to cool and then chop into medium-size pieces. Put pan back on heat and add onions, celery and bell pepper and cook while stirring until soft, about 3-5 minutes. In small bowl, mix all dry spices, add to pan and stir. Add chicken stock, cubed bread and crushed crackers and stir until well incorporated and bread is moistened. Turn heat to low and add shrimp back to pan and stir for an additional 2-4 minutes. Turn off heat and serve. For a crispy top, you can then bake in a 4” x 7” casserole dish at 350° F for approximately 15 minutes or until top begins to brown.

Spaghetti and Asparagus Carbonara Yield: Serves 6 (1 serving = 1 cup)

ingredients: 2 teaspoons canola oil 1 cup diced onions 1 large egg, beaten 1 cup light cream ¼ cup low-sodium chicken stock

Nutrition Per Serving — Calories 417 Protein 14 g; Carbohydrate 51g; Total Fat 18 g: Saturated Fat 9 g, Trans Fat 0 g; Cholesterol 82 mg; Potassium 293 mg; Phosphorus 186 mg; Sodium 134 mg. SUMMER 2016

This dish can be served cold, as a summer pasta salad. Prepare according to recipe, let cool then cover bowl tightly with plastic wrap, chill in refrigerator overnight.

3 cups cooked spiral noodle pasta (cooked al dente)—about 1½ cups raw 2 cups chopped asparagus, about 1-inch long 1 tablespoon cracked coarse black pepper ½ cup chopped fresh scallions 3 tablespoons bacon bits (meatless) 3 tablespoons shredded Parmesan cheese

preparation: 1 In a large nonstick sauté pan, over medium-high heat, heat oil, sauté the onions until lightly browned. 2 Meanwhile, in a small bowl, whisk the egg and the cream until thoroughly mixed. 3 Lower the heat to medium and pour the cream mixture into the onions, stirring constantly with a wood spoon until it starts to thicken, about 4-6 minutes. 4 Add the stock, pasta, asparagus and black pepper and continue to stir for an additional 3-4 minutes or until warmed through. 5 Turn off heat and pour carbonara into a serving dish. Top with scallions, bacon bits, cheese, and serve. read caremagazine online at www.caremagazine.com

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