Bigger? Smaller? Implants? Uplift? Safe? Sorry? Scary? Sigh. Should we or shouldn’t we tamper
with our ta-tas? These are the February Pink Prescriptions questions all about breast augmentation, and our medical professionals—all board certified plastic surgeons—are here with the answers.

There's no need to be embarrassed or shy.There’s good news and lots of it in the world on vaginal rejuvenation! Our Pink medical and aesthetics experts discuss their favorite, newest treatments and procedures, and each one is more than happy to walk you through the process.

Your December Pink Prescriptions column is all about The “M” word. And we don’t mean merry. We mean peri – and menopause. We asked our local health experts to answer some before, during, and after questions. Here’s what they had to say:

Am I experiencing menopause or perimenopause? How do I know the difference?
Menopause is defined by no menstrual cycle for at least 12 months. It occurs when your ovaries stop making estrogen. Perimenopause is the time frame prior to menopause when you start experiencing menopausal symptoms, such as hot flashes, night sweats, mood swings, and menstrual irregularities.
Most women start experiencing perimenopausal symptoms in their 40s, while the average age of menopause in the U.S. is 51. If you are still having menstrual cycles, but experiencing the above symptoms, then you are likely in perimenopause. If you have skipped your period for several months and are wondering if it is due to menopause, your gynecologist can check a lab called follicle stimulating hormone (FSH), which is elevated after menopause.

Losing sleep over not being able to fall—or stay—asleep? If so, you’re not alone.
This month we went to our Lowcountry medical experts to find out some of the reasons—
and some of the remedies—for sleeplessness. Here’s what they had to say.

I wake up tired, what am I doing wrong?
You may not be doing anything wrong. One of the first questions we ask is whether you are snoring loudly, or have been noticed to stop breathing—both are possible signs of sleep apnea. Sometimes people can’t settle and have to move throughout the night, which is restless legs syndrome. If you think this is happening to you, discuss it with your physician as there are good treatments for both of these conditions that can give you a good night of restful sleep.

Snap ... crackle … POP!
If your hip and knee joints sound like a bowl of breakfast cereal when you stand up, sit down, or walk, what does it mean now and in the future? Why can body pain sometimes predict rain better than the local meteorologist? Should achy joints stay or should they go? We asked our Pink Magazine medical experts to weigh in on what can often be a very painful subject.

It’s #AnAppleADay month at Pink and it only makes sense to apply the theme to our monthly prescriptions column. We asked our expert local medical and health field resources a few theme-related questions we thought you might like answered, and we received a healthy dose of good advice return!

Does body shape, metabolism, or blood type
determine what kind of diet works best?
With so many different dieting options out there today, it is hard to determine which diet plan or program is right for you. However, there are some basic principles. Most important is finding a diet that you can continue on a long-term basis; weight loss and maintenance require a change in lifestyle for most. Some things to think about:
• Which diet has food that you actually like and will actually eat?
•  Can you afford the diet? Does it require purchased food, attending meetings, taking supplements?
• Do you need someone looking over your shoulder to keep you motivated or are you self-driven?
• Do you have accompanying medical issues that will affect your choice of diet plan or program?

Although considered by many to be a purely cosmetic concern, varicose veins are more than unsightly veins. If left untreated, large varicose veins may progress over time and lead to swelling, darkening of the skin, and pain.

1) What are varicose veins? Varicose veins are superficial veins in your legs that have enlarged due to increased pressure that builds up while standing. Varicose veins are tortuous, often bulging, and larger than spider veins. They vary in color from green, blue, to red, and cause heaviness, pain, aching, burning, leg swelling, and social embarrassment.

2) What are the causes? Abnormal veins, such as varicose and spider veins are present in nearly 40 percent of the adult population. They occur more frequently in women, but are also common in men, and are seen in all age groups, from the 20s through the 80s. Heredity, age, standing occupations, and weight gain, including that from pregnancy, are among risk factors associated with developing vein problems. Obesity, physical trauma to the legs, and hormone therapy can further aggravate your veins.

human body is a well-built machine offering warning signs just like your car. While these signs are not flashing lights, they are easy to detect by just paying attention. Obviously aches and pains are  warning signs indicating something is wrong. Another warning sign is your bodily fluids. That’s right, the stuff most of us think is gross, like poop, pee, discharges and blood, actually are magnificent storytellers about what’s going on inside our bodies. Here’s what we found out:

Why are facials important?

Skin is the body’s largest organ…not to mention it is the only organ constantly exposed to the elements. So considering that your face is the first thing people notice, it’s easy to see the importance of proper skincare. Though a facial is mainly meant to benefit the face, your entire body is relaxed during treatment. Along with decreasing stress, facials will improve acne, wrinkles, redness and uneven skin tone, making you look naturally younger. How? Through increased circulation, detoxification and exfoliation. They can even help undo some of the damage caused by too much sun exposure!

Even if you don’t have obvious skin issues, an esthetician can help you understand your skin and what it needs to stay healthy. You will never have the right products or equipment at home to get a professional effect. A knowledgeable, licensed esthetician will provide personalized skin recommendations and a regimen that will address your individual concerns. Once you’re on a great regimen, the esthetician will update it by season. It’s like having your own skin concierge! Regularly receiving facials will not only give you fast results, but also long-term results as well.

Kidney stones are on the rise; what should I know?
Important Questions to Ask Include: 1) How do I know if I have a kidney stone?  
2) Is there any way I can prevent one from occurring? 3) What are treatment options?

Kidney stones are one of the most common urinary tract problems, and while they occur more often in men, the number of women who experience kidney stones is increasing. Kidney stones are small, hard deposits made of mineral and acid salts that form inside the kidney and can vary in size and shape. Both men and women can experience kidney stones for a number of reasons, some of which can be controlled, like weight and drinking enough fluids, and others, which cannot, such as family history, or recurrent urinary tract infections. Symptoms may include pain during urination, severe pain in the back and side, discolored urination, blood in the urine, nausea, vomiting and even fever and chills. Some kidney stones pass out of the body without treatment and others require medical intervention. Treatment depends on the size and shape of the stone and could include pain relievers and fluids, surgery or extracorporeal shock wave lithotripsy (ESWL). With ESWL, shock waves from outside of the body target the kidney stone, causing it to break into smaller pieces, which are passed through the urinary system. Coastal Carolina Hospital provides ESWL on-site 24/7 for those who require this service.

Is this forgetfulness or something more serious?
Forgetting things is fairly common, particularly as we get older. I think about the brain as a file cabinet, the older we are, the more files and the longer it might take to find what we are looking for, but eventually we do. In patients with Alzheimer’s, the files have been removed, from the most recent back. This is why they don’t remember what they had for breakfast, and often times forget grandchildren.

Signs that are concerning for memory loss include lack of attention to personal care issues, leaving dangerous equipment (stoves, irons, etc.) on, or forgetting how to drive to known locations. Also, people may not be able to do normal things, such as balance a checkbook or pay bills. Often times they are not aware of the problems. There can be behavioral changes, from anger to withdrawal from social activities. We have a great resource in Memory Matters, where they will test your memory and give you advice to keep your memory as good as it can be.

What are the most popular types of birth control?
Approximately 62 percent of women between ages 15 and 44 use some form of contraception. The oral contraceptive pill is still the most popular. However there are quite a few other methods in which, based on each individual may be a better choice. Once a woman decides she doesn’t want more children, female sterilization via tubal ligation or blockage is a popular choice. Some couples opt for male sterilization via vasectomy. Both of these are the most effective means of birth control.

Sexually transmitted diseases, or more appropriately renamed sexually transmitted infections (STI) are bacteria and viruses transmitted through vaginal, oral, or anal sex. The most common are chlamydia, gonorrhea, mycoplasma genitalium, genital herpes (HSV), genital warts (HPV), hepatitis B/C, syphilis, trichomoniasis and HIV.

Human papilloma virus (HPV) has been around for a while but rarely discussed until recently. HPV has gained a lot of attention since vaccines have been developed to target the most high-risk types, which can cause cervical cancer. The vaccine is available to both males and females from ages 9-26. The reason to vaccinate is so when a child does become sexually active in the future, the immune system will be ready—the same idea behind most vaccines given to infants. Studies have shown that after a college female’s first sexual experience there is a 29 percent chance she will acquire some type of HPV and after three years about 50 percent will be infected.

Dependence on opiates, including prescription medication, such as oxycodone, hydrocodone, morphine and fentanyl, and street drugs (heroin), has reached epidemic proportions across the U.S. Many medical professionals and legislators regard this epidemic as a public health emergency. An overdose with these substances often results in death. More commonly, opiate dependency ruins lives by resulting in financial ruin, breakdown in relationships, and destruction of the family unit. As a result, crimes are committed to feed the dependency and jail time often occurs.

1.5 million Americans are diagnosed with diabetes every year.¹

After I was diagnosed with diabetes, my specialist told me to walk as much as possible. How does walking, or other exercise, help counter diabetes?
Walking can be a great way to increase physical activity because it does not require special equipment or a membership, just a good pair of shoes and a safe place to walk.

In today’s fast-paced, over-stimulated environment, stress is a given. However, anxiety, panic attacks and depression are not. These ailments are way more than “stress gone wild,” and require special care, and possibly medical attention, to keep them at bay.  
 
What can I do if anxiety is hindering my daily life?
Lifestyle changes can help alleviate the symptoms of anxiety. Effective techniques to reduce anxiety are: eating a healthy diet, limiting caffeine, alcohol and sugar intake, getting enough sleep, making time for your hobbies and talking to a friend or professional. We have long known these habits work.

I recommend three additional strategies that also work: Practice deep breathing. When anxious, we take short, fast breaths (hyperventilate) that deliver too much oxygen to our bodies. Hyperventilating explains our physical symptoms of anxiety: cold, sweaty hands, a rapid heartbeat. To counter those symptoms take deliberate deep, slow breaths. 

Unwanted hair keeps popping up in the wrong places...like my chin. What can I do?
Unwanted hair can be treated in a few different ways. Dermaplaning is great for removing unwanted facial hair including the vellus hair (peach fuzz). It leaves skin looking fresh and renewed! A dermaplaning treatment is performed by a professional using a surgical blade. 
 
Waxing is a quick, convenient hair removal option and can be used on virtually any part of the body.  It is most commonly used on the back, arms, legs, bikini line and facial areas, including the upper or lower lip, eyebrows and chin. There are a variety of wax options, and your esthetician will know which is best for your skin.

What is a stroke?
A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood and oxygen it needs, so it and brain cells die. Stroke can be caused either by a clot obstructing the flow of blood to the brain (called an ischemic stroke) or by a blood vessel rupturing and preventing blood flow to the brain (called a hemorrhagic stroke). Hemorrhagic strokes account for 13 percent of stroke cases, and there are two types: intracerebral (within the brain), and subarachnoid hemorrhage, which is bleeding between the brain and tissue covering the brain. A TIA (transient ischemic attack), or “mini stroke” is caused by a temporary clot.

What digestive warning signs would warrant a visit to my healthcare provider?
You should see your doctor if you are having any of the following symptoms:
• Difficulty swallowing. It feels like what you eat or drink is getting stuck somewhere between your throat and stomach.
• Unexplained weight loss.

The first thing people usually notice about someone is their smile. Nothing is more welcoming or as beautiful as a big, happy, toothy smile, and the best way to maintain your beautiful smile is to keep up on good dental health.

There is absolutely nothing good to say about varicose veins. No one wants them. Who enjoys having their legs look like a road map? Varicose veins can be unsightly, and in advanced states, uncomfortable, too. These bulging veins are associated with leg swelling, heaviness and pain, not to mention the potential for leg ulcers, which are a health risk.

Varicose veins occur because the venous valves controlling the upward flow of blood returning to the heart become incompetent and allow blood to fall (reflux) down the leg by the pull of gravity.

Q: It’s almost impossible to give my pet a pill. Is there anything that can make it easier?

A: It may be the smell, taste, or size of the pill that is unappealing to your pet. Fortunately, there are several forms of dosage alternatives that can be compounded to help. Orally administered medications can be formulated into flavored suspensions and capsules. Flavored suspensions can be concentrated so the amount to be given is less and more tolerable. Compounded flavored capsules may be given as is, or opened and sprinkled over food. Now the smell and taste—beef, chicken and fish—will make the medications more appealing for both dogs and cats.
If oral administration is not a good option, several medications can be formulated into a concentrated cream and applied topically inside your pet’s earflap, and sometimes to their paw.  This is helpful if your pet is anxious or aggressive when it comes to taking oral medications.  Also, for seizures, rectal gels are an option, when they are unable to take medications by mouth.
Lastly, sprays, adhesive powders, and shampoos are also options, depending on the type of medication.  These are good alternatives for hot spots and dermatologic conditions. Ask your pet’s doctor and see a compounding pharmacist to decipher which is best for you and your pet.
-Dr. Wilhelmina Fry, Stephens Compounding Pharmacy

Imagine going through life without an ache, pain and nothing to slow you down. Since there are no guarantees in life, women need to stay educated and in tune with their bodies to make a long, healthy life a possibility. Women need to take charge of their health and partner with their doctors by finding out their family medical history, educating themselves on health issues, and paying attention to their bodies. Understanding your body is key to staying healthy.

How does my biological make up effect my weight loss?
Generally men lose weight faster than women because men have a higher percentage of muscle mass. It is muscle that burns calories so men usually have a higher basal metabolic rate, too. Bigger people have more mass and burn more calories at rest. As we age muscle mass tends to decrease in both men and women, especially after menopause, which makes it more difficult to lose weight. To maximize weight loss it is important to make sure hormones are in balance, especially thyroid, and Vitamin D levels are adequate.

As we age, our bodies experience several changes due to decreases in production of our “sex hormones.” Five of the most common symptoms can be easily alleviated with Bio-Identical Hormone Replacement Therapy (BHRT).

Bio-Identical, “natural” hormones are derived from natural sources and are identical in chemical structure to those produced by our body. Synthetic estrogens are not the same as natural estrogens, nor are synthetic progestins the same as natural progesterone. Synthetic hormones and Bio-Identical hormones act very differently in the body and have different side effect profiles. The five symptoms below are taking into consideration hormone replacement with Bio-Identical hormones.

Are dry eyes caused by dehydration?

In most cases the answer is NO. Dehydration and environmental factors may worsen the dryness, but most dry eye symptoms are related to underlying Dry Eye Disease, which is very common, and many patients go undiagnosed and untreated. Symptoms such as burning, redness, foreign body sensation, intolerance of eye makeup or contact lenses, and blurred vision are most common. Women make up the majority of the patients with moderate to severe dry eye disease due to hormonal changes, and other systemic diseases such as Sjogren’s, lupus, rheumatoid, Crohn’s, rosacea, and psoriasis.

Which is better for weight  loss, diet or exercise?

We hear this every day in our center for medical weight loss; “I exercise but I can’t get this extra weight off!” Sadly, despite what those machines and computer programs say, we really burn 4-5 calories a minute during exercise. So after an hour of jogging, cycling, cross fit, or swimming, we have only burned 300 calories on average. It’s a common practice to eat something before exercising for energy or reward yourself after for a job well done. So, at best in the end of the exercise session we are calorie neutral and there is no weight loss benefit. Often the protein bar we consumed had more calories than we burned resulting positive calorie balance and weight gain. So the short answer is yes, exercise is great for a multitude of reasons but is a poor weight loss tool on its own, unless you are training for a triathlon, riding in the Tour de France and exercising 6-7 hours a day. 

“I wish I didn’t see quite so clearly,” said no one ever.
The eyes have it—they are boss, our windows to the world. Taking care of them is imperative to optimum vision, which is so important to our quality of life and staying active and independent. Don’t forget to have your eyes checked every year. Find an eye doctor and establish a relationship. He or she is a valuable resource in keeping your vision strong and letting you know all of the technology available today to try to stay
20/20 all your life.

One of the worse things to feel after a peaceful night of sleep is stiff. It makes even the youngest of us hobble out of bed and feel somewhat incapacitated. Inflexibility is inevitable as we age. It is also a side effect of inactivity and obesity in all ages—young and old. Staying flexible is not hard. However, the term move it or lose has never been truer than when it comes to keeping yourself free-flowing. Here’s what our experts had to say about flexibility:

What are the most common problems of not staying flexible?
The skeleton provides the body with support and our joints allow the skeleton to be flexible and move around more easily. We lose bone mass or density as we age and, for women, during and after menopause. Bones also lose calcium and some minerals and are easier to break.

Our strength and endurance changes as we age, as well. So, as we get older we may not feel like we have enough energy to exercise, but lack of exercise and activity may result in lack of flexibility.