OCTOBER 2012

VOLUME 1 NO. 3

Lights, Camera, Dance!

BEHIND THE SCENES OF OUR 2012 PINK GLOVE DANCE VIDEO

ers m i e h lz An A sease Di tory S Lovepg. 8

S

SI EE IN

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Her Beat Goes On: An LMC Open Heart Surgery Story

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Hot Flashes and Hormones: Managing Menopause

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contents
3 4 4 5 6 8 8 9 Surviving and Thriving: Leslie Wyatt Her Beat Goes On The Doctor Is In: Living with Breast Cancer Expecting to Expect? Fertility and Healthy Pregnancy A Day in the Life of a Midwife Lights, Camera, Dance! Pink Glove 2012 Foundation Focus Meet the Every Woman Bloggers Hold It! How to Stop Urinary Incontinence

Letter from the Editorial Team

As we welcome falls cooler temperatures, football games, harvest festivals and trick-ortreating, were reminded of the joy and change each new season brings. This issue of House Call focuses on Womens Services. At Lexington Medical Center, we offer comprehensive, compassionate care for women in all seasons of life. In this issue, you can read about our first-of-its-kind doula program for women having a baby, experience a day in the life of a midwife, find out how to navigate menopause and learn the inspiring story of one of our hospitals first female open heart surgery patients. And, we share the love story of high school sweethearts battling the cruelty of Alzheimers disease. Find out more about our passion for treating and raising awareness about breast cancer. Read about our entry in this years Medline Pink Glove Dance video competition and vote in the contest! House Call is full of interesting, relevant information about your health and the health of your family. If you have comments or story ideas, drop us a line at housecall@lexhealth.org or call (803) 791-2191. In Good Health, House Call Editorial Team Lexington Medical Center

10 An Alzheimers Disease Love Story 11 Alzheimers Disease Q&A with Dr. Donald Schmechel 12 Healing Art 12 Its Not Your Mothers Hysterectomy Advances in GYN Surgery 13 Womens Health Through the Decades 13 Ask the Doctor: Hot Flashes and Hormones: Managing Menopause 14 LMCs Doula Program: Take a Deep Breath and PUSH! 14 Calendar of Events 15 Welcome New LMC Physician Practices

In our next issue:

Photos from Womens Night Out 2012 Dee Dee Ricks Inspiring Story  Going the Extra Mile at the Lexington Medical Center Governors Cup Road Race

Stay Connected!
Visit our award-winning website www.lexmed.com for all the latest news about Lexington Medical Center. You can also stay up-to-date on calendar events and learn more about health topics important to you and your family.

Cant wait?
Visit the Lexington Medical Center blog at blog.lexmed.com to see photos from the events!

2 HOUSE CALL October 2012

[ Patient Story ]

Meet one of LMCs first female open heart surgery patients.

Open heart surgery patient Leslie Wyatt photographed at Wingards Nursery & Garden Center in Lexington.

SURVIVING AND THRIVING:

Leslie Wyatt Her Beat Goes On

Leslie Wyatt of Irmo knew something was wrong when she began to feel her heart race. She wasnt exercising or working in her garden. She was sitting still.
Dr. Michael Roberts, a cardiologist at Lexington Cardiology, diagnosed the 56-year-old with mitral valve prolapse. I was so surprised. I didnt even have a family history of heart problems, Wyatt said. Mitral valve prolapse is a heart condition in which the valve that separates the upper and lower chambers of the left side of the heart does not close properly. It does not generally affect a persons lifestyle. But in a small number of cases, mitral valve prolapse can cause blood to leak severely backwards. When I found out about the prolapse, Dr. Roberts said that we may not need to worry about it. My condition was considered mild. And for more than 10 years, Leslie had no reasons to worry. Then, in April 2012, she went to see her family doctor because of a persistent cough, chest pain, shortness of breath and fatigue. I really felt tremendous pressure like an elephant was sitting on my chest. But there was so much pollen in the air that I thought my symptoms had to be allergy related. I didnt even think about my heart. A month later, while on vacation at Myrtle Beach, her symptoms went from bad to worse. Leslie realized she needed to go to the emergency room. While at the hospital, tests revealed that she had congestive heart failure. She was admitted and given medication to remove fluid from her lungs. I thought I was dying when they said I had congestive heart failure. I was terrified. www.lexmed.com When she came home, she had a heart catheterization to determine the severity of valve leak. The results showed that her heart needed surgery. So on June 11, 2012, Leslie had a mitral valve repair. She was one of the first women to have open heart surgery in Lexington Medical Centers new heart program. Dr. Roberts gave me the choice of where to go for my surgery. And I chose Lexington Medical Center. I know I made the right choice. Dr. (Jeffrey) Travis at Lexington Cardiovascular Surgery is so passionate about what he does. He even took time to pray with me and that meant so much. Even though most open heart surgery patients stay in the hospital for seven days, Leslie only spent five days at Lexington Medical Center after her surgery. When I woke up in intensive care, I thought it would take forever to get over my surgery. But I was determined. This was not going to do me in. Her remarkable progress continued when she went home. Leslie surpassed all expectations in the hospitals outpatient Cardiac Rehabilitation program and regained much of her strength. According to Dr. Roberts and Dr. Travis, Leslie should never have to worry about her mitral valve prolapse ever again. Im so grateful to Dr. Travis and the staff at Lexington Medical Center for the exceptional care that I received. I am very blessed and ready to enjoy life with my loving husband and family.

Heart problems can happen to anyone. Women really need to take time to listen to their bodies and get help when they know something is wrong. Im so glad that I listened to my body.
Leslie Wyatt

[ Editorial ]

THE DOCTOR IS IN: Living with Breast Cancer

An editorial by Lynn Tucker, MD, FACS, surgeon and breast cancer expert at Lexington Surgical Associates, a Lexington Medical Center physician practice. This year, approximately 227,000 women in the U.S. will be diagnosed with breast cancer. That statistic includes 3,570 in South Carolina.
But there is some good news for them, too. Thanks to improved treatments and early detection, most women diagnosed with breast cancer will live long, inspiring lives. The latest treatments for breast cancer focus on the biology of each tumor. Weve learned that each case of breast cancer is unique and responds to treatment in its own way. Decades ago, women who were diagnosed with breast cancer all received the same course of treatment. And cases were managed based on the size of the tumor and if it had spread to lymph nodes. Today, we see breast cancer differently. We know that some small tumors may be very aggressive and require the highest level of treatment. And weve learned that some large tumors may respond well to minimal treatment. Importantly, new drugs for breast cancer have reduced death rates by 40% and recurrence rates by 50%. These drugs, given before surgery, have helped save the breasts of women who would have otherwise required a mastectomy. Now, with lessinvasive surgical techniques such as sentinel lymph node biopsy, women are spared some of the complications of surgery, such as lymphedema and chronic pain. We recommend yearly mammograms beginning at age 40. If you have a firstdegree relative who was diagnosed with breast cancer, begin mammograms ten years before the age at which she was diagnosed. For example, if your mother was diagnosed with breast cancer at age 40, you should begin screening at age 30. You can also speak with your doctor to help assess your risk of breast cancer. Women who are diagnosed with breast cancer in its early stages have very high survival rates. The future of breast cancer treatment lies in early detection and prevention. We advise patients to understand and control their risk factors. Smoking, excessive alcohol intake, lack of exercise, combination hormone replacement therapy and post-menopausal obesity all increase your risk of breast cancer. Maintaining a healthy weight, breastfeeding and living a healthy lifestyle can reduce your risk. Be aware of your breasts and talk to your doctor about any concerns you have. There are an estimated 2.6 million breast cancer survivors living in the United States today. With new treatments and more education about prevention, we are helping more women survive this devastating illness that 1 in 8 women will face in their lifetime.

Lynn Tucker, MD, FACS

Expecting to Expect? Fertility and Healthy Pregnancy

Having a baby is one of the most exciting journeys in life. At Lexington Medical Center, we love babiesmore than 3,300 are born at our hospital each year.
Our doctors enjoy speaking with future moms and dads about fertility and healthy pregnancies. Start taking a multi or prenatal vitamin with folic acid in it before trying to conceive, said Dr. Thomas Austin, OB/GYN at Sandhills Womens Care. Folic acid has been shown to reduce the risk of neural tube defects in infants. If you smoke, quit. And learn to manage stresswhich can negatively impact fertility. Your weight is important. Some women who are overweight can have Polycystic Ovarian Syndrome (PCOS), which is often associated with weight gain and missing menstrual cycles. One-third of women with PCOS will have trouble with fertility. Being overweight when you become pregnant puts you at a higher risk for gestational diabetes and other problems. Being too thin can also impact fertility and the ability to ovulate. If youre having a regular menstrual cycle every month, theres a 98% chance that youre ovulating. Meantime, be patient while trying to conceive. Technically, youre not considered infertile until youve tried to conceive for a year, Dr. Austin said. Statistically, 85% of couples conceive naturally but, on average, only 15% will become pregnant each month. Expectant mothers usually begin seeing their provider for prenatal care at 8 weeks. Be thorough and honest about your medical history with your physician, said Dr. Janis Keeton of Lexington OB/GYN. This allows us to make sure vaccines are up to date and to identify things in your health history that might put you at risk for pregnancy complications. A full health history is important to prevent preterm labor, which affects 10 to 12% of women, making it the most common pregnancy complication. Dr. Keeton also encourages husbands to play active roles during pregnancy. They should attend as many prenatal visits and classes as possible to make them feel more comfortable in the role of parent, she said. Keeton also adds that when fathers attend breastfeeding classes, mothers end up breastfeeding longer than women who attend by themselves. I dont think anyone has found the words to describe the stress of being a new momespecially a first-time momso I encourage them to continue healthy habits and ask for help when they need it.

A Lexington Medical Center Physician Practice

Thomas Austin, MD

114 Gateway Corporate Blvd. Suite 130 Columbia 2728 Sunset Boulevard Suite 202 West Columbia 803-788-0268 www.sandhillswomenscare.com

A Lexington Medical Center Physician Practice

110 East Medical Lane Suite 220 West Columbia 803-936-7476 www.lexobgyn.com Janis Keeton, MD

4 HOUSE CALL October 2012

A Day in the Life of a Midwife

No day is the same for Beverly Nedbalek, a certified nurse midwife at Lexington Womens Care. Thats because no two women are the same.

Beverly visits with new mom Anna McCleod and baby Tyler McLeod.

Beverly makes the rounds on LMCs Mother/Baby unit. We care for women of all ages even adolescentsproviding primary care to women, well-woman care related to reproductive health, annual gynecological exams, family planning and menopausal care, Nedbalek said. And they deliver babies at Lexington Medical Center. Being with a family when they bring in a new life is such a special time. Everything in the world just melts away. The word midwife actually means with woman. This concept sums up the midwifery services at Lexington Womens Carea combination of comprehensive care, clinical competence and partnership with patients. Our fort is patient education and flexibility. Midwives are geared toward being on the same page as our patient, informing them of responsibilities and what they can expect. We will also stretch ourselves to accommodate our patients wishes. On any given day, Beverly sees obstetric and gynecology patients. But when shes on-call, she spends the day focusing on OB patients. She starts the day with a report from the previous midwife, and goes to Labor and Delivery in the hospital to evaluate her patients. I make sure to talk with each mother and her nurse to get an overall picture of the patients experience. We want to make sure we have healthy mamas and healthy babies. Beverly then goes to the Mother/ Baby floor in the hospital to visit all postpartum patients as well as patients in labor. After completing rounds and discharging any patients, Beverly helps the other nurse midwives in the office.

To be a midwife, a registered nurse usually completes a three-year masters degree program in public health and midwifery. We also have to maintain advanced clinical nursing certifications and complete continuing education, pharmacology and other clinical/medical education each year. Its through this clinical expertise and a co-management system that the five certified nurse midwives at Lexington Womens Care are able to care for high-risk patients, too. Support from our physicians enables us to care for high-risk patients, such as those with gestational diabetes or hypertension, which means most women can benefit from the services of a midwife.

Beverly Nedbalek, CNM at Lexington Womens Care, has more than 20 years of experience as a midwife.

Beverly conducts a prenatal appointment with mom-to-be Christina Harman.

Beverly talks with LMCs nurse Addy.

ACCEPTING NEW PATIENTS

2728 Sunset Boulevard Suite 201 West Columbia, SC 29169 (803) 936-8100 7033 St. Andrews Road Suite 305 Columbia, SC 29212 (803) 749-9920

Beverly helps expectant mom Alexis Patterson during labor with her first child.

A Lexington Medical Center Physician Practice

Beverly holds baby Tyler McLeod.

www.lexingtonwomenscare.com

Find Lexington Womens Care on Facebook 5

www.lexmed.com

LIGHTS, CAMERA, DANCE!

This years production is a scripted video that tells the story of a woman who is a breast cancer survivor. That woman is Amy Kinard of Lexington, a nurse at Lexington Womens Care, who was diagnosed with breast cancer five years ago at the young age of 34. The dance became so popular that it was featured on national television, including ABC World News Tonight and Fox & Friends on the FOX News Network. The Pink Glove Dance brought together our employees for a common cause and they were so energized by it, we wanted to do it again, said Mark Shelley, director of Marketing at Lexington Medical Center, who is supervising and directing the hospitals 2012 Pink Glove Dance.

Were trying to make the point to women going through breast cancer to stay strong, Kinard said.
Its the second year in a row that Lexington Medical Center is entering the Pink Glove Dance video competition, an international challenge sponsored by Medline Industries, Inc.
LMC employee and breast cancer survivor Amy Kinard during the filming of 2012 Pink Glove Dance video.

In 2011, with more than 60,000 votes and 110,000 YouTube views, Lexington Medical Center clinched the first-ever Pink Glove Dance contest. The hospital beat more than 130 other health care organizations from around the United States and Canada with a dance choreographed to the Katy Perry song Firework, featuring hundreds of hospital employees dancing while wearing pink gloves.

On the 8th floor of Lexington Medical Centers North Tower, clinicians are bustling around in scrubs. A supervisor gives orders. And the attention is focused on breast cancer patients. But this is no regular hospital unit. There are lights camerasand dancing! Lexington Medical Center is filming its 2012 Pink Glove Dance.
6 HOUSE CALL October 2012

Behind the scenes of Lexington Medical Centers 2012 Pink Glove Dance Video

This years video is a high-energy, spirited production filmed around the Midlands, choreographed to the Katy Perry song, Part of Me, one of a handful of songs selected by Medline for the contest. A prominent theme in the video is Survivor From Day 1, noting the courage and strength right from the beginning for patients on a journey with breast cancer. Some of the dancers in the video wearing the pink Survivor from Day 1 t-shirts are Lexington Medical Center employees who are also cancer survivors. Local dance instructor Stacey Ashley volunteered to choreograph the dance for the second year in a row. Its more than a video or a

contest. Its a show of support for everyone fighting cancer, Shelley said. The video tells the story of a journey through breast cancer and ends with a huge celebration of hundreds of people celebrating breast cancer survivors. Today, Amy Kinard is a healthy, five-year breast cancer survivor. Women should know breast cancer is not the end of life, she said. Your life can be just as good, if not better, Kinard said. The winner will receive $10,000 for a breast cancer charity. If LMC wins, the hospital will donate its prize to the Vera Bradley Foundation for Breast Cancer Research, as it did last year.

VOTING ENDS OCTOBER 26TH.

The winner will be announced on November 2nd.

Go to www.pinkglovedance.com or scan the QR code below. Watch Lexington Medical Center dance.

If the Gamecocks can win back-to-back College World Series championships, maybe we can win back-toback Pink Glove Dance championships, said Mike Biediger, president & CEO of Lexington Medical Center.

Likeour video to cast your vote.

PLEASE NOTE: Voters must have a facebookTM account. Spread the word by sharing with your Facebook friends!
www.lexmed.com
7

FOUNDATION FOCUS

Meet up with new friends every day...

For generations, women have thrived on exchanging and sharing information.
In todays world, its become cool to blog as a way to communicate with everyone from your neighbor down

Nursing scholarships
Assistance for patients in need

the street to a perfect stranger on the other side of the world. So let us tell you about our Every Woman bloggers, a group of fascinating women from around the Midlands who make up our hospitals Every Woman blog, www.everywomanblog.com. Hand-selected by Lexington Medical Center in a blogger contest in 2011, these 10 women write about everything from crafts to breast cancer to divorce to the perfect handbag.

Roshanda Pratt
A former television news producer who has turned mompreneur, wife and ministry leader, Roshanda talks about everything raising children, crafts, fashion and other random things that life brings.

Elizabeth Webber Akre

Elizabeth is a food and wine enthusiast trying to balance life as a realtor, a Sunday school teacher, a daughter, a sister and a friend. Her two most important roles, however, are as a wife and being a mom to an energetic 6 year old!

Nationally-recognized Doula program

MOBILE MEDICAL UNIT
These are just a few ways the Lexington Medical Center Foundation supports our growing community. The Foundation continues to create new and innovative initiatives to ensure that quality health services and patient-centered care are available for people of the Midlands.
For example, the Lexington Medical Center Foundation began an exciting program called Women of Hope in 2011. Open to all women in the Midlands, Women of Hope hosts special events and networking opportunities to build camaraderie among members and raise awareness of critical health issues affecting women and their families.
For more information on other Lexington Medical Center Foundation programs, visit www.lmcfoundation.com.

Jordan Addison
Miss Black South Carolina USA 2011, Jordan is an avid blogger who loves sharing her experiences as a 20-something woman trying to balance life as a full-time student, worker, leader on her college campus, Christian, future educator, daughter, sister, friend and girlfriend.

Shannon Shull
A transplant to the Midlands region from Los Angeles, Shannon enjoys sharing her stories of surviving motherhood, starting a new business and falling in love with the South!

Katie Austin Summer Brons

A 20-something runner, writer and coffee enthusiast, Summer enjoys sharing her experience of finding the perfect balance of work, friends, family, relationships and me time for a healthy living lifestyle. A working mother and wife in a male-dominated computer-related profession, Katie loves connecting with people. As a breast cancer survivor, she is dedicated to raising awareness and bringing women together to fight this disease.

Crissie Miller Kirby Mary Pat Baldauf

Mary loves sharing her experiences as a 44-year-old woman striving to improve her life through exercise and healthier eating. She has lost nearly 100 pounds in the past two years. Staci Rutherford In the past five years, Staci has been helping women to look and feel their best with more than 4,000 articles on fashion, trends, designers and accessories on her blog. Her favorite accessory: handbags! She uses one word to describe herselfsurvivor. In the last 12 years, Crissie has survived college, marriage, having two children, a miscarriage and the heartache of a divorce; however, what has given her strength is sharing her experiences and connecting with women on life lessons learned.

Brady Evans
An avid blogger, Brady enjoys sharing her passion for healthy meals as well as the trials and tribulations of being a first-time horse owner.

You can help support the Lexington Medical Center Foundation today with a tax-deductible contribution. Please use the postage-paid envelope provided in this issue of House Call.
8 HOUSE CALL October 2012

Visit www.everywomanblog.com to read our bloggers latest entries.

Hold It! How to Stop Urinary Incontinence

by John Moore, MD, of Vista Womens Healthcare, a new Lexington Medical Center physician practice focused solely on gynecology.
Can you imagine getting up to deliver a speech to your PTA or employees and having to worry about what might happen if you cough, sneeze or laugh? Do you know where every bathroom is at your favorite store?
These are daily worries for millions of women. Urinary incontinencethe involuntary leakage of urineis treatable in the majority of cases and should be discussed with your physician if it is a concern for you. Your primary care physician will either initiate treatment or make an appropriate referral, usually to a gynecologist or urologist, if necessary. The two most common types of incontinence are stress incontinence and urge incontinence. Stress incontinence occurs when sneezing, laughing, coughing or exercising. It is usually caused by a weakening of the tissues that support the bladder or the muscles of the urethra. This weakening can be caused by pregnancy, childbirth or even just normal wear-and-tear from aging. Urge incontinence occurs when there is a strong, sudden urge and there is leakage before you can get to the restroom. Also called overactive bladder, it occurs when the muscles in the wall of the bladder contract too easily. The two types often occur together, a condition referred to as mixed urinary incontinence. Incontinence may be associated with other symptoms such as frequent strong urges to void even if the bladder is not full, urinating much more frequently than normal and bed-wetting. Identifying the cause of incontinence is essential to enable your physician to prescribe appropriate treatment for you. A thorough history and physical exam may identify treatable causes of incontinence such as bladder infections or medication side effects. A pelvic exam is necessary to detect loss of support of the bladder and urethra. In cases where the cause is not certain, your physician may ask you to keep track of how often and how much you urinate over several days. You may also be asked to undergo bladder testing to more adequately evaluate bladder function. Cystoscopy, where a thin lighted tube with a camera on it is inserted into the bladder, is sometimes needed as well. These tests allow a very accurate diagnosis and help your physician determine what treatments will work for your incontinence and, perhaps more importantly, which ones wont. There are many options for treating urinary incontinence. Lifestyle changes such as weight loss, smoking cessation, reducing caffeine intake and treating a chronic cough may help. Bladder training by voiding on a more frequent timed schedule, whether you need to go or not, may reduce urge incontinence. Kegel exercises tone the muscles around the urethra and vaginal opening, and often reduce both urge and stress incontinence symptoms.

[ Editorial ]

Medications in pill, patch or gel form are often prescribed for urge incontinence and can help John Moore, MD immensely. They may, however, have side effects such as dry mouth and constipation. Surgical therapy is usually reserved for stress incontinence and takes several forms. A bulking agent may be injected into the tissue around your urethra to help it stay closed, a procedure that is usually performed in the office. More invasive surgery to support the bladder and urethra is performed in the hospital and requires incisions in the vagina or abdomen. Finally, in cases where surgery is not an option, a device can be placed in the vagina to provide bladder support. Incontinence can be an embarrassing problem but isdefinitely a treatable one. Plan a visit with your physician today to discuss your concerns and regain your control!

Get control so you can let yourself go!

It may start with a giggle, a tiny sneeze, a cough or a sudden urge while standing in the frozen food section at the grocery store. Caused by weakened pelvic muscles, urinary incontinence is a disconcerting medical condition affecting one in three women. Get control by choosing from our network of expert physicians. Visit www.lmcWomensServices.com to find the doctor who is right for you. Youll be laughing again in no time.

A Lifetime of Choices

Lexington Medical Center

Visit www.lmcWomensServices.com
www.lexmed.com
9

A N

A L Z H E I M E R S

D I S E A S E

STORY
MARY SUE & LESTER BEDENBAUGH

Hey baby! Got a kiss for me? Lester Bedenbaugh greets his wife Mary Sue with an enthusiastic kiss as he comes by to pick her up and take her on a date. Mary Sues eyes light up.
Lester has been taking Mary Sue on dates ever since they became sweethearts at Newberry High School in the 1950s. Back then, Mary Sue was a class beauty. Photos show a gorgeous young woman and beautiful bride. The couple has been married for 54 years. They raised two children together and lived in the same house in Columbia for 40 years. But these days, they live apart. Mary Sue is a resident at Carroll Campbell Place, Lexington Medical Centers facility for patients with Alzheimers disease. Mary Sue was diagnosed with Alzheimers disease in 2001, at the young age of 63. Its a terrible, long, drawn-out journey that pulls your heart out by the roots, Lester said. Lester says he first noticed something was wrong about 12 years ago. Mary Sue always kept up with our bills and checkbook, he said. But, she couldnt balance the checkbook anymore. Then, she suddenly couldnt remember where their daughter lived, or how

many grandchildren she had. After some cognitive tests, doctors diagnosed Mary Sue with Alzheimers in 2001. At first, Lester cared for her at home. But meeting her increasing needs as the disease progressed became difficult. Like many people with Alzheimers, Mary Sue began wandering from the house. In Mary Sues case, she told Lester she wanted to visit her mother. She didnt remember that her mother had passed away years earlier. One night when Mary Sue wandered from the house, Lester needed to call the sheriffs department to help get her back home. He knew the
Lester Bedenbaugh visits with his wife Mary Sue Bedenbaugh at Carroll Campbell Place.

time had come for her to receive professional care. Mary Sue moved into Carroll Campbell Place in the fall of 2006. The Alzheimers has progressed. She no longer speaks and she now uses a wheelchair. Dozens of pictures in Mary Sues room show her and generations of family memories. But Lester isnt sure if she recognizes herself or the relatives in those pictures.I tell her who I am every day, said Lester, with tears in his eyes. You wonder what Alzheimers patients know and what they dont. But I dont think she has any recollection of being married to me. The pain of that reality is tough. So Lester says he focuses on the positives. She has no pain or discomfort. And shes happy when Im with her. He spends every day with her, taking her everywhere from the beauty parlor to the Riverbanks Zoo to a twice-a-year reunion with high school friends in Newberry. And, in a tradition not too many husbands could say theyve kept, Lester takes Mary Sue on a dinner date every night. He comes to Carroll Campbell Place at 3 oclock. They sip tea together at 4 and leave for dinner at 5. Shes a wonderful, sweet thing, says Lester with an unmistakable Southern drawl. Shes always been a beautiful, kind person who would do anything to help someone. And now he helps her. Its a date he wont break.
For more information on Carroll Campbell Place, visit www.lexmed.com.

10 HOUSE CALL October 2012

Q&A with Donald Schmechel, MD, of Southeastern Neurology and Memory Clinic

Ask the Doctor

A LZ H EI M ER S D I S E A S E
Lexington Medical Center welcomes Donald Schmechel, MD, to our network of care. He leads Southeastern Neurology and Memory Clinic, a new physician practice. A neurologist with additional training in geriatrics, Dr. Schmechel is passionate about the study and treatment of Alzheimers disease. House Call sat down to talk with him recently. Q: What is your experience studying and researching Alzheimers disease?
A: After a neurology residency and geriatrics fellowship at Duke University, I joined a Duke team of Alzheimers disease researchers. In 1993, this team discovered APOE, a gene that influences a persons risk for developing Alzheimers disease. Today, my work focuses on identifying people at risk for Alzheimers disease, educating them about the importance of early intervention and evaluating the role that medical and nutritional treatments play in helping to mitigate and slow the illness.

Q: What happens to the brain when someone has Alzheimers disease?

A: The brain loses nerve cells, suffers inflammation and forms plaques. This process begins in areas related to memory, emotion, judgment, language and spatial orientation. Over five to ten years, it progresses to parts of the brain related to eating and survival.

Q: What is most promising about Alzheimers research today?

A: Many researchers and clinicians are involved in the study of Alzheimers disease. They are researching, supporting caregivers and taking care of patients. The focus is working toward the goal of finding the right combination of elements that will slow or stop the progression of the disease.

Donald Schmechel, MD

Q: What does the latest research tell us about the causes of Alzheimers?
A: Alzheimers disease is a complex illness caused by genetic and environmental factors. The key genetic factors are variations in the APOE gene. About 25% of people carry a higher-risk APOE gene. About half of them will develop Alzheimers disease. Environmental factors range from a history of head injury to nutrition. Most cases of Alzheimers have multiple causes. Importantly, we know that if symptoms are treated early, there can be positive results including stabilization of the disease. Better intervention means better outcome.

Q: Where are we in finding a cure?

A: We are seeing success in patients who are treated in the mild stage with what is known as disease modulating therapies.

BY THE NUMBERS:

Q: What do you like to tell families of someone living with Alzheimers?

A: Alzheimers disease affects more than one person. There are ups and downs. Support for everyone in the family is essential. Importantly, treatment is available to minimize the illness in the early stages. If you have concerns that you may be developing dementia, talk to your doctor there are ways to minimize your risk.

Q: What should prompt someone to see a doctor about the possibility of Alzheimers disease?
A: If a person has a pattern of attention or memory problems, or behavior changes at home or at work, they deserve evaluation. Also, if a person is in a family with more than one person with Alzheimers disease, talk to your doctor.

ALZHEIMERS DISEASE IN SOUTH CAROLINA

80,000
people in South Carolina are living with Alzheimers disease As the population and life expectancy increases, the number of South Carolinians with Alzheimers is expected to grow

Learn more about Southeastern Neurology & Memory Clinic at seneurologyandmemory.com.

CARROLL CAMPBELL PLACE

of South Carolinians with Alzheimers live in nursing homes

50%

people in South Carolina die from Alzheimers disease each year

,500 1

www.lexmed.com

11

Cancer survivor Lisa Phillips (left) talks to teacher Heidi Darr-Hope during a Healing Icons art class at LMC.

Its Not Your Mothers Hysterectomy

ADVANCES IN GYN SURGERY
Hysterectomy is the second most common surgery among women in the United States, behind Caesarean section. Technology has changed hysterectomy dramatically for patients.
In our mothers generation, having a methods including changes in nursing care, hysterectomy sometimes meant a large incision antibiotics and post-operative techniques to and long recovery time. prevent complications have paved the way for Traditionally, it meant a three- to five-day less pain medicine and shorter hospital stays. hospital stay, then four to eight weeks at home And there is no external incision. recovering, out of work, said Dr. P.D. Bullard Jr., In these cases, patients are observed GYN at Lexington Medical Center. overnight in the hospital after the procedure and Patients had a lot more post-operative pain, go home the next day. Some patients may go too, requiring prolonged home immediately after use of medication. the surgery. And they Today, the latest can return to work in as advances include singlelittle as two weeks. incision laparoscopic These advances hysterectomy, minimally in surgical techniques invasive laparoscopic have dramatically hysterectomy and shortened a womans Single-incision laparoscopic hysterectomy at LMC. vaginal hysterectomy. hospitalization and Each is offered at Lexington Medical Center. recovery time, said Dr. Michael Ervin, OB/GYN Today, single-incision laparoscopic at Womens Health and Diagnostic Center. The hysterectomy can be performed through only a technology allows todays woman the ability to small incision under the belly button, said Dr. return to her active lifestyle faster. Elizabeth Lambert, OB/GYN. The single-incision and minimally invasive The minimally-invasive laparoscopic laparoscopic procedures also allow for less procedure involves a 1- to 2-centimeter scarring than the previous large incision during incision and 1-centimeter incisions in the lower abdominal hysterectomy. quadrants of the abdomen. Over the next five years, expect more While physicians have performed vaginal cases to be done with minimally invasive hysterectomy for more than a generation, new procedures, said Dr. Bullard.

HEALING
Lisa Phillips is a breast cancer survivor. She also works with cancer patients at Lexington Oncology.
Today, shes taking a break from work to participate in an art class for cancer patients called Healing Icons. Shes making the border of a frame for artwork representing the healing process of her cancer journey. Its so calming, Phillips said. And it helps bring into focus feelings about your cancer diagnosis that you were not even aware you had. Columbia artist Heidi Darr-Hope leads the class. Its free to any cancer patient at the hospital, paid for through the Lexington Medical Center Foundation. Each week, students meet in the Resource Room located inside Lexington Oncology on the hospital campus. During a series of six weekly classes, students create art including black-and-white pencil drawings, masks and paintings. They are in all stages of treatment from the beginning of chemotherapy to grappling with a recurrence of cancer. Its an amazing experience, Darr-Hope said. It seems simplistic, but theres rich information under it. Darr-Hope says the artwork helps patients express the range of emotions they often feel about a cancer diagnosis and how it will impact them and their family. Once people can freely express the anger and anxiety, they lay them on the shoulders of their artwork and become lighter, Darr-Hope said. Darr-Hope calls it a different kind of support group. Im encouraging anyone who feels lost in their cancer diagnosis to consider it because its a wonderful group, she said.
To learn more about the Healing Icons art class, call the LMC Foundation at 791-2540. 12 HOUSE CALL July 2012

P.D. Bullard Jr., MD, FACOG, FACS

Elizabeth Lambert, MD

Michael Ervin, MD

A Lexington Medical Center Physician Practice

Lexington Medical Park 1 2728 Sunset Boulevard, Ste. 310 West Columbia, SC 29169 (803) 936-8080 www.pdbullard.com

A Lexington Medical Center Physician Practice

A Lexington Medical Center Physician Practice

Lexington Medical Park 2 146 North Hospital Drive, Ste. 240 West Columbia, SC 29169 (803) 936-7590 www.carolinawomensphysicians.com

For more information on hysterectomy, visit the Health Library at www.lexmed.com.

Lexington Medical Park 1 2728 Sunset Boulevard, Ste. 106 West Columbia, SC 29169 (803) 936-7420 935 West Second Street Swansea, SC 29160 (803) 568-6153 www.whdcenter.com

Womens Health
THROUGH THE DECADES
by Bert Hutchinson, MD of River Bluff GYN

Q&A with Jim Estes, MD OB/GYN of Lexington Womens Care

Ask the Doctor

Managing Menopause
Q: What is the most common question patients ask you about menopause? A: Women want to know if hormone replacement therapy is safe. They worry
that taking estrogen after menopause may increase their chance for breast cancer, heart disease or stroke. There is some risk, but the risk is small. We know that 1 in 8 women will be diagnosed with breast cancer in her lifetime; women who take estrogen after menopause have a one in 7.8 chance of developing breast cancer. Estrogen can be an effective, safe treatment for menopause. The decision to treat should be individualized and based on the severity of symptoms. Its really a quality-of-life issue.

HOT FLASHES AND HORMONES:

Womens health requires attention and care throughout life. These hints may be useful as a checklist to ensure that every woman has her basic gynecologic needs met.

20s 30s 40s 50s 60s

Jim Estes, MD BY THE NUMBERS:

WOMEN TODAY WILL SPEND ABOUT

Begin regular gynecologic exams. You should have your first pap smear at age 21. It should be repeated every 1 to 3 years based on results. An annual pelvic exam is recommended. Continue regular exams. Obtain a thyroid screening at 35 and a baseline mammogram if there is a positive family history of breast cancer. Routine mammogram screenings are recommended every year. Menopausal symptoms may begin and require attention. Consider hormone replacement for menopausal symptoms, physical well-being and bone health. A colonoscopy is also recommended. Bone density testing is recommended and should be treated as needed.

Q: W  hats the biology behind menopause? A: First, physical signs begin years before the final menstrual period. In
perimenopause, estrogen levels gradually decline, but in a very erratic pattern, and it can last for 5 to 10 years, resulting in hot flashes, irregular periods, sleep disturbances, mood swings, low libido and vaginal dryness. During this time, the hypothalamus and pituitary gland try to drive the ovaries to make more estrogen. Menopause is the ultimate end point and is defined as occurring one year after a last menstrual period or the end of ovarian estrogen production.

1/3 to 1/2
OF THEIR LIFE IN MENOPAUSE

Q: W  hat causes a hot flash? A: You could say a hot flash occurs when your bodys thermostat is broken.
The temperature control center in your brain is set by estrogen. When estrogen levels drop during menopause, its like your bodys thermostat is on the fritz. Your body may think its too hot and try to cool off by sweating, which helps heat escape. Your heart may beat faster, too. It can be frustrating and scary.

THE AVERAGE AGE FOR MENOPAUSE

North American Menopause Society, (NAMS) is a great resource for menopause information: www.nams.com

52

Q: Besides medicine, what are some things women can do to help during menopause? A: Layer your clothes to help with changes in your body temperature and with hot flashes. Second, talk

These baseline checks are only a beginning to ensure your health. As always, diet, exercise and the recommendations of your physician provide the best assurances for a long and fruitful life.

to your partner about whats happening. Menopause is a physiological part of life, not a disease. If youre having trouble sleeping, try to wind down at night by doing something relaxing. And feel comfortable talking to your doctor about difficult-to-talk-about issues, including a decreased interest in physical intimacy. There are many things available to make women feel better during menopause. We almost always find something to help.

Q: Are there any patients who should not take estrogen during menopause? A: Absolutely. Contraindications to estrogen therapy include current or previous breast cancer, stroke or
deep venous thrombosisa blood clot. If a woman has a strong family history of breast cancer, we may advise her to try to work through menopause without estrogen treatment.

Q: Should women seek over-the-counter medicines to help with menopause symptoms? A: Many over-the-counter products may help somewhat with hot flashes, but be careful. Supplements
A Lexington Medical Center Physician Practice

Bert Hutchison, MD

146 North Hospital Drive Suite 330 W. Columbia, SC 29169 Ph (803) 865-9909 www.riverbluffgyn.com

are not Food and Drug Administration (FDA) controlled and you dont always know the risks of those products. From one manufacturer to another, and even from one batch to another, you can get wide variations in quality, purity, potency and safety. Many of these products contain products that act like estrogen called phytoestrogens, and they really may not be safe to take by themselves. The bottom line is that you need to talk to your doctor about what youre taking.
Learn more about Lexington Womens Care at www.lexingtonwomenscare.com. 13

www.lexmed.com

LMCS DOULA PROGRAM

Take a Deep Breath and PUSH!

Bringing a child into the world is one of the most joyous occasions a woman will experience. But it can be an anxious time as well.
Thats why Lexington Medical Center offers a free doula program to help expectant mothers and families through one of lifes most meaningful events. Recently, Stephanie Hodnette of Lexington delivered her third child at Lexington Medical Center. This was also the third time she had help from a hospital doula. I was actually able to deliver all of my children without medication because of the tremendous support from each of my doulas, said Hodnette. The mother to three young boys, Stephanie knew she wanted to attempt a non-medicated birth from her very first prenatal appointment for her first son. If not for the doulas coaching and help with pain management, I wouldnt have been able to deliver my children without medication. Their guidance and emotional support helped my husband and meespecially the first time, she said. Doulas are trained to work with a womans physician or midwife and her nurse to provide emotional encouragement and physical comfort measures during and after childbirth. They will also visit the new mother the next day, offering additional support, breastfeeding assistance and helpful information. All women, even those who have a medicated birth, can benefit from using a doula. With Stephanie, her husband and I took turns fanning her to help keep her cool. And as her breathing pattern changed, I alerted the nurse to her behavior, allowing her to transition into the pushing phase of delivery, said Irene Brinkmann, a Lexington Medical Center doula. Even though Stephanie and her husband are experienced parents, using a doula gave them a sense of peace. They knew that they had help, said Brinkmann. Importantly, doulas do not take the place of family members during delivery. Our doula offered encouragement to my husband, too. She suggested things he could do for me that I couldnt think of at the time, said Hodnette. We try to recognize the little needs that make the experience more comfortable for everyone: a rocking chair for an alternative laboring position; a

Stephanie Hodnette with youngest son Lane and Irene Brinkmann, Lexington Medical Center doula

warm blanket for a chilly, but excited grandma; an extra pillow in just the right spot; a washcloth on a hot forehead; the first drink of juice after the little one arrives; or taking a picture of the happy new family, said Brinkmann. Lexington Medical Center has one of the first hospital-based doula programs in the country and the only doula program in the Midlands.
To learn more, please call (803) 791-2631 or visit www.lexmed.com.

C ALENDAR OF EVENTS
OCTOBER 2012
18 Caring for You and Your Baby 23 Your Special Delivery Tuesday Series 20 Your Special Delivery Saturday Series 25 Super Sibling 23 Infant/Child CPR 20 Southern Surgical Group Patient Education Series Dr. Fryrear TOPIC: Hyper and Hypo Thyroidism Diagnosis and Treatment Options 25 Woman to Woman Support Group Mammography Van Schedule: 29 LMC Swansea 10, 23 LFP Northeast 12 LFP Lexington 15 LMC Gilbert 16 LFP White Knoll 19 LFP Ballentine 24 Sandhills Womens Care 25 Spring Valley Family Practice 26 LFP Lake Murray

NOVEMBER 2012
1 Bereavement Support Group 1 Preparing for Total Joint Replacement 1, 13 Caring for You and Your Baby 3 Governors Cup Road Race 3 Southern Surgical Group Patient Education Series Dr. Fryrear TOPIC: Thyroidism Medical and Surgical Options 3, 17 Your Special Delivery Saturday Series 5, 12, 15 Infant Massage 6 Multiple Sclerosis Support Group 6, 29 Super Sibling 6, 13, 20, 27 Your Special Delivery Tuesday Series 7 Us Too Support Group 8 Breastfeeding 8 Memories Support Group 8 Preparing for Hysterectomy 20 Infant/Child CPR 29 Woman to Woman Support Group Mammography Van Schedule: 5 LMC BatesburgLeesville 12, 28 LMC Swansea 14, 27 LFP Northeast

DECEMBER 2012
1 Southern Surgical Group Patient Education Series Dr. Fryrear TOPIC: Common Symptoms and Problems of Thyroidism 1, 15 Your Special Delivery Saturday Series 3, 10, 17 Infant Massage 4 Multiple Sclerosis Support Group 4, 13 Caring for You and Your Baby 5 Us Too Support Group 6 Bereavement Support Group 6 Preparing for Total Joint Replacement 6, 18 Super Sibling 13 Breastfeeding 11, 20 Infant/Child CPR 13 Preparing for Hysterectomy 13 Memories Support Group 27 Woman to Woman Support Group Mammography Van Schedule: 3 LMC Batesburg-Leesville 4 LFP West Columbia 6 Peterson & Plante Internal Medicine Associates 10, 27 LMC Swansea 11 Sandhills Womens Care 12 LFP Northeast 13 Spring Valley Family Practice 17 LMC Gilbert 18 LFP White Knoll 20 Wagener 21 LFP Ballentine 28 LFP Lake Murray

JANUARY 2013
1 Multiple Sclerosis Support Group 2 Us Too Support Group 3 Preparing for Total Joint Replacement 3 Bereavement Support Group 7,14, 21 Infant Massage 8, 31 Caring for You and Your Baby 8, 15, 22, 29 Your Special Delivery Tuesday Series 10 Preparing for Hysterectomy 10 Breastfeeding 10 Memories Support Group 10, 29 Infant and Child CPR 12, 26 Your Special Delivery Saturday Series 15, 24 Super Sibling 31 Woman to Woman Support Group Mammography Van Schedule: 7 LMC BatesburgLeesville 9, 22 LFP Northeast 11 LFP Lexington 14 LMC Swansea

Visit www.lexmed.com and select Calendar for details on classes and times.

14 HOUSE CALL October 2012

Lexington Medical Center proudly welcomes the following physicians and practices to our network of care.
Lexington Cardiology, formerly Columbia Cardiology, consists of physicians (l-r): Stephen E. Van Horn Jr., MD, FACC; their newest partner, William D. Brearley Jr., MD, FACC; Joseph J. Lawton, MD, FACC, FSCAI; Michael C. Roberts, MD, FACC; R. Robert M. Malanuk, MD, FACC; Amy Rawl Epps, MD, FACC; Taylor Williams, MD, FACC; Richard E. Umbach, MD, FACC; and S. Stanley Juk Jr, MD, FACC.

2601 Laurel Street, Ste. 260 Columbia, SC 29204 (803) 744-4900 131 Sunset Court West Columbia, SC 29169 (803) 744-4940 1 The Commons Lugoff, SC 29078 (803) 729-4610 www.lmclexingtoncardiology.com

A Lexington Medical Center Physician Practice

Lexington Sleep Solutions has expanded the practices locations to include Irmo and West Columbia. The practicing physicians are (l-r): Clarence E. Coker III, MD, Sarkis S. Derderian, DO, Mohamed S. Soliman, MD; M. Christopher Marshall, MD, and Paul M. Kirschenfeld, MD.
109 West Hospital Drive West Columbia, SC 29169 7043 St. Andrews Road Columbia, SC 29212 (803) 791-2683 www.lexingtonsleepsolutions.com

A Lexington Medical Center Physician Practice

Southeastern Neurology & Memory Clinic, located on the main campus of Lexington Medical Center, features the care of neurologist Dr. Donald E. Schmechel.
Lexington Medical Park 2 146 North Hospital Drive, Suite 500 West Columbia, SC 29169 803-936-7076 www.seneurologyandmemory.com

A Lexington Medical Center Physician Practice

Located in the heart of the Vista, Vista Womens Healthcare, with Doctors Harold Moore, Kathryn Moore and John Moore, specialize in gynecological treatment for women of all ages.
A Lexington Medical Center Physician Practice

700 Gervais Street, Suite 300 Columbia, SC 29201 (803) 254-3230 www.vistawomens.com

A Lexington Medical Center Physician Practice

Located in Northeast Columbia, Carolina Shoulder & Knee Specialists features the experienced care of Dr. Kevin Nahigian.
A Lexington Medical Center Physician Practice A Lexington Medical Center Physician Practice

Lexington Plastic Surgery, led by Dr. Todd Lefkowitz, provides aesthetic and reconstructive surgery services.
2728 Sunset Boulevard, Suite 107 West Columbia, SC 29169 (803) 936-7045 www.lexplasticsurgery.com

Lexington Interventional Pain Management and Dr. Erin Lawson specialize in the treatment of chronic pain conditions.
110 East Medical Lane, Suite 225 West Columbia, SC 29169 (803) 936-7035 www.lexingtoninterventional.com

810 Mallet Hill Road Columbia, SC 29223 803-419-6646 www.carolinashoulderandkneespecialists.com

www.lexmed.com

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PAID

Lexington Medical Center

This magazine is intended for general understanding and education about Lexington Medical Center and health issues. Nothing in the magazine should be considered or used as a substitute for medical advice, diagnosis or treatment. Readers with personal health or medical questions should consult their health care provider.

Best 100 Hospitals for Patient Experience

Lexington Medical Center was selected as one of Americas Best 100 Hospitals for Patient Experience by WomenCertified. The award honors hospitals that provide exceptional service to female patients. Winning hospitals received high marks from women for extraordinary service in meeting the needs of themselves and their families.
PRESENTS

Tuesday October 16, 2012

Columbia Metropolitan Convention Center
ALL PROCEEDS BENEFIT THE

OU D L O S

FOR MORE INFORMATION, visit www.womencertified.com.

Crystal Smith Breast Cancer Fund of the Lexington Medical Center Foundation

What a Difference Wellness Makes

This simple phrase captures the Health Directions experience where we care about your overall health and provide a variety of programs and services to meet your needs.
Theres something for everyone:  Specialized fitness classes Personal training Wellness assessments And because were part of Lexington Medical Center, you can be sure that our staff has the knowledge, experience and tools to help you feel better and be stronger for your everyday life.

WEST COLUMBIA: 3225 Sunset Boulevard West Columbia, SC 29169 (803) 791-2113 IRMO: 1674-E Lake Murray Boulevard Columbia, SC 29212 (803) 791-2132

www.lmchealthdirections.com
16 HOUSE CALL October 2012

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