Your Health Today - Fall 2016 by Augusta University

your

health TODAY Fall 2016

The Art of the Matter SKETCHING TO COPE WITH CANCER

Early Recovery After Surgery /////////////////

Stay Flu-Free with the Facts augustahealth.org/yourhealthtoday

TABLE OF contents

features 4 5 6 7 8 9

Cancer Prevention The Art of the Matter Healthy Moves for Breast Cancer Survivors Neuroscience Epilepsy and Pregnancy Focus on Women A Physician’s Struggle with Infertility Heart-Healthy Living Test Your Knowledge About Cholesterol Digestive Health Early Recovery After Surgery

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Kids Make Their Mark At the Children’s Hospital of Georgia at Augusta University (CHOG), we’re dedicated exclusively to kids. So, when it came to choosing a new logo, of course, we asked for their input first! After a fun focus group on the CHOG playground, we put the kids’ creativity to work. The result: a new logo with the look of our Augusta University shield mark but with a childlike twist. We can’t wait to show off our new look created for kids by kids! Be sure to visit augustahealth.org/chog for more information.

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Augusta University Extends the Academic Health Center Difference to Sandersville Augusta University and its health system are now sharing expertise in health care operations and management with the 56-bed Washington County Regional Medical Center (WCRMC) in Sandersville, Georgia. This relationship allows the state’s only public medical school and affiliated health system to expand options for Georgians in the Sandersville area. Augusta University Health and WCRMC already collaborate to deliver advanced comprehensive stroke care through an award-winning telemedicine program pioneered at the Medical College of Georgia at Augusta University. A secure internet connection enables Augusta University neurologists to assess and guide lifesaving treatment for stroke patients at WCRMC without actually being there.

Family Health Stay Flu-Free with the Facts

4 Trick-or-Treat Safety Strategies

The material in Your Health Today is not intended for diagnosing or prescribing. Consult your physician before undertaking any form of medical treatment. For more information, please call 800-736-CARE (2273) or visit our website at augustahealth.org. Images may be from ©iStock and/or ©Fotolia. Copyright © 2016 Augusta University

FIND YOUR OWN

Healthy Eating Pattern

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very five years, the U.S. departments of Agriculture (USDA) and Health and Human Services (HHS) release a joint report detailing nutritional guidelines for the general public. A big change you’ll see in the new 2015-2020 Dietary Guidelines is a focus on the overall eating pattern, rather than on individual dietary components such as food groups and nutrients. The new version of Dietary Guidelines presents three different examples of healthy eating patterns: •H ealthy U.S.-style. Those who follow the U.S.-style healthy eating pattern and eat 2,000 calories a day have 2.5 cups of vegetables, 2 cups of fruit, 6 ounces of grain, 3 cups of dairy and 5.5 ounces of protein each day.

•H ealthy Mediterranean. This eating pattern offers more protein and fruits and less dairy in a daily 2,000-calorie diet. Those following the Mediterranean eating pattern eat 2.5 cups of vegetables, 2.5 cups of fruit, 6 ounces of grain, 2 cups of dairy and 6.5 ounces of protein per day. •H ealthy vegetarian. This is an eating pattern that contains no meat, poultry or seafood. The vegetarian eating pattern includes more legumes (beans and peas), soy products, whole grains, and nuts and seeds. It also only recommends 3.5 ounces of protein in a 2,000-calorie diet, which is still within the daily recommended amount. The report emphasizes the importance of making small, gradual shifts in food and beverage choices so eating a healthy diet can feel more manageable.

Fall INTO Healthy Eating PITA

Pizzas

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et creative with healthy toppings, and bake up a pizza that’s good

for you! Prep time: 10 minutes Number of servings: 4 (serving size = 1 pita pizza) Ingredients: 1 cup tomato sauce 1 cup grilled boneless, skinless chicken breast, diced (about 2 small breasts) 1 cup broccoli, rinsed, chopped and cooked 2 tablespoons grated Parmesan cheese 1 tablespoon fresh basil, rinsed, dried and chopped (or 1 teaspoon dried) 4 (6½-inch) whole-wheat pitas

Directions: 1. P reheat oven or toaster oven to 450° F. 2. F or each pizza, spread ¼ cup tomato sauce on a pita, and top with ¼ cup chicken, ¼ cup broccoli, ½ tablespoon Parmesan cheese and ¼ tablespoon chopped basil. 3. Place pitas on a nonstick baking sheet, and bake for about 5-8 minutes, until golden brown and chicken is heated through. Serve immediately. Nutritional information per serving: 275 calories; 5 g total fat; 1 g saturated fat; 32 mg cholesterol; 486 mg sodium; 7 g fiber; 20 g protein; 41 g carbohydrates; 362 mg potassium Recipe courtesy of the National Heart, Lung, and Blood Institute.

augustahealth.org

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CANCER prevention

The Art OF THE MATTER Sketching to cope with cancer

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f you visited the

Georgia

Cancer Center at Augusta University, you’d find sketches straight out of a fantasy, complete with hearty heroes and heroines, formidable fiends and legendary landscapes. If you looked a little closer, you’d notice the photos and read the descriptions of what each sketch represents, giving you a glimpse into something very real. Behind the drawings, photos and descriptions is the spirit of a brave cancer survivor, Roel Wielinga of Thomson, Georgia — the author and illustrator. The Living Walls at the Georgia Cancer Center tells his story, each sketch so vividly symbolizing a particular episode in Roel’s treatment. He attributes the great detail of his artwork to the different person that cancer has made him. “When something like cancer gets thrown in your face, you end up with a more open mind,” Roel said. “All of the things that you used to take for granted you now notice.”

In August 2009, right around the time of the Wielingas’ wedding anniversary, Roel was diagnosed with acute myeloid leukemia, a rapidly progressing cancer of the blood and bone marrow. Within three days, he was admitted to the hospital and was deemed in remission in October of that year.

The formidable fiend invades

Using talent as treatment

In June 2009, Roel was at the grocery store when he felt dizzy and was unable to stand up straight or hold his balance. In the coming days, he started feeling progressively weaker and struggled with staying focused. Walks with his beloved wife of 20 years, Marian, got shorter. Suddenly, he experienced more acute symptoms like bleeding of the gums, bruises and muscle spasms. When the muscle spasms in his back became severe, he decided it was time to go to the doctor. [ 4 ]

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INTERESTED IN KNOWING MORE?

Marian and Roel Wielinga

Roel felt overcome by the urge to draw, which wasn’t anything uncommon for him. However, his sketchbook was at home, and he was unable to leave the hospital. So Marian, a retired art teacher, went home to get it. Over time, his sketches told a cohesive story. “He started drawing [during his treatment], because that’s what he does,” Marian said. “He used it as a release for what he was going through and realized that it was working for him and could work for others.”

Learn more about expressive therapies and other supportive care options at the Georgia Cancer Center. To learn about our cancer services and providers, call us at 706-721-6744 or visit augusta.edu/cancer. To read other stories like Roel’s, visit augustahealth.org/stories.

Dr. Amy Allison, director of the psycho-social oncology service at the Georgia Cancer Center said that the process of creating can be therapeutic for many people. “Expressive therapies, such as art and music therapy, can serve as an outlet for expressing your feelings about illness, treatment and life itself,” Allison said. “In addition, the process of seeing, hearing and exploring the work you create through art and music therapy can distract you from health issues.” Roel agrees. “The most powerful thing that we have is our minds,” Roel said, “because the mind controls how the body functions. So I visually represented what was going on in my mind through artwork.”

Healthy Moves FOR

BREAST CANCER SURVIVORS

5 ways to take control and stay well

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oing through treatment for breast cancer changes you.

It can change your perspective on health and life, too. As a breast cancer survivor, you might have renewed energy to take charge of your health — or you might just need a break! Wherever you are in your recovery, it’s important to take care of yourself. Making healthy lifestyle changes is a good place to start. The key is focusing on health factors that are in your control instead of worrying about risks that you can’t control. 1. Eat a healthy diet. Good nutrition is one of many factors that can affect the immune system and your overall health. Fill your plate with vegetables, fruits, lean protein and whole grains. Also, make sure that you’re getting enough calcium and vitamin D in your diet. If you have questions about nutrition or if you’re facing challenges with eating, talk to your doctor or get help from a registered dietitian. “Aim to maintain a healthy weight after a breast cancer diagnosis,” said Sarah Deen, clinical dietitian and certified specialist in oncology nutrition at the Georgia Cancer Center at Augusta University. “Key strategies that can help include keeping active, watching your portion sizes and limiting the calories and fat that you eat. It’s also important to choose a variety of foods from all food groups to ensure that you get enough vitamins, minerals, fiber and other nutrients.” 2. Get exercise. Getting back into an exercise routine (or starting one) can be very beneficial for survivors. Talk to your doctor before starting an exercise regimen and start slowly. Aim for 150 minutes of aerobic activity every week, as well as strength training exercises at least two days a week. 3. Limit or avoid alcohol. Women should limit alcohol consumption to no more than one drink per day. Research suggests that women who drink regularly (two to five drinks daily) have a higher risk of breast cancer compared with women who drink one drink per day or none. 4. Don’t smoke. Smoking and chewing tobacco increase your risk of many kinds of cancer. Quitting helps to reduce your risk of cancer returning. Your doctor can help you devise a plan to quit smoking. 5. Seek support. Coping with changes after treatment can be stressful, and some breast cancer survivors experience feelings of depression. Talk to your doctor if you’re feeling stressed, anxious or depressed. Join a support group for cancer survivors, and reach out to friends and family for social support as well.

augustahealth.org

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neuroscience

Epilepsy AND Pregnancy New clinic makes having healthy children possible

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omen who suffer from

epilepsy — a neurological disorder marked by sudden, recurrent seizures that are associated with abnormal electrical activity — have a lot to consider. Those concerns range from the impact of hormones on seizures, choosing seizure medications and birth control, pregnancy, parenting, menopause, bone health and more. That’s why Dr. Debra Moore-Hill, a physician with Augusta University Neurosciences Center of Excellence, offers a clinic dedicated to women and the issues they face with epilepsy, just one of them being pregnancy.

Identifying and satisfying a need Moore-Hill is one of only two adult epileptologists in the area, both of whom are at Augusta University — whose epilepsy program holds level 4 status, the highest accreditation possible, for its comprehensive adult and pediatric epilepsy program. She started the clinic, the only one in the area and the second in Georgia, earlier this year after seeing a need from her female patients of childbearing age. Surprisingly, these patients were never advised on family planning while managing epilepsy.

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They also held the mistaken belief that pregnancy should be avoided entirely and, therefore, feared it. “It is possible to have healthy children,” Moore-Hill said. “We counsel women so they have the information and tools necessary for a healthy, less worrisome pregnancy.”

A proactive approach Moore-Hill, a mother herself, counsels female epilepsy patients of all ages regarding their family planning considerations. It’s important to do this as early as possible, ideally before conception, for the following reasons: • Anti-seizure medications can cause oral contraceptives to become less effective. • Anti-seizure medications can cause birth defects, and dosage needs to be adjusted based on the patient’s weight, which changes during and after pregnancy. • Seizures during pregnancy can harm the baby. “I work to counsel them on how epilepsy and the treatments affect pregnancy and motherhood, and vice versa, and inform them of their options,” Moore-Hill said. “My patients are critical in the decisionmaking process.”

DO YOU OR A LOVED ONE STRUGGLE WITH EPILEPSY? Call us today at 706-721-4581 or visit augustahealth.org/neuro to learn about our neurosciences services and providers.

Moore-Hill sees pregnant patients at least monthly, depending on level of seizure control, to make proactive changes to the course of treatment. As an academic health center that’s equipped with the latest technology, patients can also benefit from the epilepsy monitoring unit for observation. This ensures the ultimate goal: that our patients remain seizure-free. Moore-Hill carries that a step farther by helping her patients to make the dream of having children a reality. “It’s not just about epilepsy in my clinic,” Moore-Hill said. “We talk about their vacations, careers and families. After all, epilepsy affects all of these things.”

FOCUS ON women

A PHYSICIAN’S STRUGGLE WITH Infertility

How experience was her best teacher

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t was the first day of

residency at Augusta University for Dr. Hamer Titus. She was meeting her fellow residents, and one of them shared that she was pregnant. This was just a few weeks after a very difficult time in her life. Just shy of a month before, Titus was vacationing in Myrtle Beach, S.C., with her husband, Kyle, and family celebrating her graduation from the University of South Carolina School of Medicine and resting up for her residency, which would begin July 1, 2014. Titus awoke in the middle of the night on June 6 in excruciating pain and knew something wasn’t right. An at-home pregnancy test told her that she was, indeed, pregnant. Things went from not right to wrong; as a recent medical school graduate, she knew that she was experiencing one of two things. So Titus called her obstetrician and gynecologist (OBGYN), and he asked her to come in right away. During the examination, he didn’t say much, but his turning the screen away from her so she couldn’t see it said it all. He finally told her that she was experiencing an ectopic pregnancy, when the fertilized egg implants outside the uterus, and it had progressed far enough along that it required emergency surgery. All this took place after three rounds of intrauterine insemination (IUI) in Charleston during her fourth year of medical school. Infertility specialists recommend three rounds of IUI before moving on to in vitro

fertilization (IVF), which can be costly, so Titus felt hopeless. “I was constantly around women who were experiencing the happiest day of their life,” said Titus, “and it made me angry when I’d see women who could care less about being pregnant.”

A turning point in the journey to motherhood In October, a few months after Titus’ residency began, she was on a rotation with the infertility specialty and met Dr. Larisa Gavrilova-Jordan. In fact, Titus approached GavrilovaJordan after the lecture and shared what she had been through. GavrilovaJordan wanted to see her right away. “When I saw what she was doing, I was truly amazed,” Titus said. “I felt like I was in good hands with her. It’s important for people to have that faith in their doctor.” On Dec. 24, 2014, just two months after meeting Gavrilova-Jordan, Titus got the call — she was pregnant. “I was amazed by how quickly the process moved,” Titus said.

Advice from a patient and physician As both a patient and OBGYN, Titus stressed that you shouldn’t wait too long to seek help, whether it’s from an infertility specialist or your OBGYN. She recommended being aware of options and not assuming that nothing is out of reach; she also pointed out that not everyone has to get IVF. “Infertility is a lot harder when you keep it to yourself,” said Titus.

Kyle, Graham and Hamer Titus, MD

“I found it helpful to be open and honest about what I was going through rather than keeping everything bottled inside.” Titus’ education and professional experience started off as a painful reminder of what she couldn’t have but, at the same time, made her an informed patient. Through this experience, she earned the ultimate reward of a beautiful pregnancy and healthy child. On Aug. 5, 2015, the Titus family celebrated the first birthday of their son, Graham. And she came out of it as a better physician.

IF YOU’RE EXPERIENCING INFERTILITY, THERE’S HOPE Augusta University Reproductive Medicine and Infertility Associates can help. Call us at 706-722-4434 or visit augustahealth.org/ infertility. To learn about our women’s health services and providers, call us at 706-721-4959 or visit augustahealth.org/womens.

augustahealth.org

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HEART-HEALTHY living

Quiz: TEST YOUR

KNOWLEDGE ABOUT CHOLESTEROL

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an you tell fact from

fiction when it comes to cholesterol and your health? Answer the questions below to find out your cholesterol IQ.

1 2

My body makes all the cholesterol it needs.

Foods labeled low cholesterol are low in fat.

Even people who are thin are at risk for high cholesterol.

3 4

The higher your levels of triglycerides – a fat found in the bloodstream and fat tissue – the better.

People should start cholesterol screening at age 20.

5 6

Symptoms of high cholesterol include headaches and weight gain. Taking medicine is the only thing people need to do to reduce high cholesterol.

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Answers

1. True. Your body, especially your liver, makes all the cholesterol it needs. Cholesterol — a waxy substance found in your blood — also comes from some of the foods we eat. The amount of cholesterol your liver makes depends on the types of foods you eat. 2. False. Many foods labeled “low cholesterol” may be high in saturated fats, which contribute to high cholesterol levels in the blood. We need some fat in our diets, but when you add fat, opt for monounsaturated fats such as olive oil, canola oil and peanut oil. Try to keep the amount of fat in your diet to between 20 and 30 percent of your daily calorie intake (1 tablespoon of monounsaturated fat per meal). 3. True. Anyone with any body type can have high cholesterol. High cholesterol can be a genetic (or inherited) trait. People who have family members with high cholesterol may be at higher risk for having high cholesterol themselves. While people who are overweight are more likely to have high cholesterol, thin people should regularly be screened for high cholesterol, too. 4. False. High triglyceride levels, 200 mg/dL and above, contribute to hardening of the arteries. Aim for levels less than 150 mg/dL. 5. True. Atherosclerosis, or arterial clogging, occurs over many years,

so it’s important to start checking total cholesterol starting at age 20. If your levels are within normal ranges and you have no other risk factors for heart disease, have your total cholesterol checked at least every five years or according to your doctor’s recommendation. 6. False. Often, people don’t know their cholesterol is too high, because they don’t have any symptoms. That’s why it’s important to have your cholesterol checked regularly by your health care provider. 7. False. Lifestyle habits are a major factor in determining your cholesterol levels, and you can change them to take better control of your health. Your doctor will ask about your lifestyle habits, such as whether you smoke, are overweight or eat foods that are high in saturated and trans fats. If your cholesterol is still too high after quitting smoking, losing weight, being physically active and eating a heart-healthy diet, your doctor may prescribe medication. Maintaining a heart-healthy lifestyle is important, even if you’re taking cholesterol-lowering medication.

NEED SOME BRUSHING UP ON YOUR CHOLESTEROL? For more information or to learn about our heart and cardiovascular services and providers, call us at 706-721-2426 or visit augustahealth.org/cardio.

DIGESTIVE health

Early RECOVERY AFTER SURGERY

New program within our surgical home helps you get back to yours

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ow long will I be off

my feet or out of work after surgery?” This concern unfortunately keeps many from getting the health care they need to live long and well. A national program available to patients at the Digestive Health Center at Augusta University (DHC) — the most progressive in the area — eliminates that concern with a concept called a “surgical home.” Literally speaking, this is a place in which patients receive surgery, but to the DHC and its partners in anesthesiology, this means much more.

Our surgical home The surgical home for colorectal surgery includes surgery and anesthesiology. Dr. Alan Herline, vice-chair of the Department of Surgery, associate director of the Digestive Health Center and section chief of Minimally Invasive Digestive Diseases Surgery, represents surgery, and Dr. Robin Schwartz, perioperative surgical home director, represents anesthesiology. Physical and occupational therapy representatives are also included in the surgical home. These groups work together to develop and implement procedures to ensure patients recover as quickly as possible. “We know that patients recover better in their home environment,”

Herline said. “This allows our patients to get back to doing the things they want to do in a timely manner with fewer complications and infections.”

How it works If a patient has a colon mass, his or her physician may contact the DHC or colorectal surgeon directly, regarding screening or follow-up. The DHC then coordinates appointments with the colorectal surgeon and anesthesiology team on the same day for the patient’s convenience and to allow the DHC to plan how the surgical home will best take care of the patient. The patient then sees the colorectal surgeon, learns about the concept of a surgical home and schedules the operation. During the morning of surgery, the patient visits with the colorectal surgeon and anesthesiology team and begins the early recovery process. The operation is performed in a minimally invasive manner, which includes laparoscopic or robotic techniques, using the smallest incisions possible. After the operation, the patient is on goal-directed discharge, which means that being discharged isn’t based on time, but on meeting certain recovery milestones. The anesthesiology team remains with the patient until he or she recovers and is turned over to the primary care physician.

Alan Herline, MD

Better health outcomes “By using these steps, we’ve experienced a significant decrease in infections and pneumonia,” Herline said, “which are two of the more common complications after colon and rectal surgeries.” Using these steps helps physicians identify what’s unique about each patient and, therefore, effectively treat him or her, as well as provide optimal care so the patient can recover as quickly as possible.

DID YOU KNOW? About half of all colon cancer deaths in the United States could be prevented if everyone age 50 and older get screened. To make an appointment and learn about colorectal screening or our digestive health services and providers, call us at 706-446-4887 or visit augustahealth.org/digestivehealth.

augustahealth.org

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FAMILY health

STAY Flu-Free WITH THE FACTS 3 myths set straight

[W]

ith flu season just around the corner, it’s time

to take the necessary steps to stay healthy. One step is separating myths about the flu from the facts. “When caring for patients, we strive to deliver patient-centered care every time,” said Dr. Ashley Saucier, a primary care physician at Augusta University Family Medicine. “This means sharing the most up-to-date evidence about a treatment and letting you decide what is best for you.”

MYTH Getting a flu shot is all you need to do to protect yourself from the flu. FACT Being vaccinated can’t guarantee that you won’t get the flu. You should take additional steps to protect yourself, such as avoiding people who have the flu, washing your hands often and maintaining a healthy lifestyle to support your immune system. That includes eating right, exercising, getting enough sleep and managing stress.

MYTH A flu shot can give you the flu. FACT No, a flu vaccine can’t cause flu illness. The flu shot is made from either “inactivated” viruses that aren’t infectious or no viruses at all. People who develop flu-like symptoms after receiving a flu shot were going to get sick anyway. Their illness is not a result of having received the vaccine.

Now that you know the facts, take the next step in protecting yourself and your family from the flu: Get vaccinated.* Augusta University Health makes getting a flu shot quick and easy. Call 706-721-2273 or visit augustahealth.org for more information. * People who have a severe allergy to chicken eggs, as well as certain other individuals, should not be vaccinated without first talking to their doctors.

MYTH You should wait to get vaccinated so your immunity lasts through the end of flu season. FACT The Centers for Disease Control and Prevention (CDC) recommends that flu vaccination begin soon after the vaccine becomes available, if possible by October. Immunity lasts through a full flu season for most people. However, as long as flu viruses are circulating, it’s not too late to be vaccinated, even in January or later.

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THE MORAL OF THE STORY: GET A FLU SHOT

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“Remember, prevention is the best medicine,” –Ashley Saucier, MD

4 TRICK-OR-TREAT

SAFETY STRATEGIES

How to have a happy and healthy Halloween

[A]

s a parent, these

Halloween statistics can strike fear into your heart: • Twice as many child pedestrians are killed walking on Halloween than on other days of the year. • Only 18 percent of children use reflective materials on their costumes. • 1 in 9 parents allows children age 5 or younger to trick-or-treat without adult supervision.* “The Children’s Hospital of Georgia at Augusta University’s (CHOG) emergency department saw 18 patients last Halloween,” said Debi Deeder, pediatric trauma program manager at CHOG. “While we’re honored to serve the community with our pediatric emergency and trauma services, we want you and your kids to stay safe this Halloween and always.” You can keep your little ghost safe from bumps in the night by following these four safety tips: Talk with kids about basic 1 safety rules beforehand. These include never entering a home

and waiting for mom or dad to check candy before enjoying any treats. It doesn’t hurt to review year-round rules, like not getting into a stranger’s car and looking both ways — and not at electronic devices — before crossing the street. Avoid common costume 2 dangers. Costumes should be well-fitting and made of flameretardant materials without extra fabric or footwear that could contribute to falls. Be sure your child can see well (especially if wearing a mask), and add reflective tape to clothing and provide a flashlight if he or she will be trick-or-treating at night. Teens should avoid novelty contact lenses unless OK’d by an eyecare professional — otherwise, they pose serious vision risks. Provide adult supervision. 3 A responsible adult should accompany younger children, and older children should stick to familiar, well-lit areas. Arrange a designated meeting place and time with teens before they head out on their own.

Drive safely. Take care to drive slowly on Halloween, taking extra time to look for kids at intersections and making turns slowly. Be on high alert between 5:30 and 9:30 p.m., which is peak trick-or-treating time.

*Safe Kids Worldwide, “Halloween safety: A national survey of parents’ knowledge, attitude, and behaviors.”

THE AREA’S ONLY CHILDREN’S HOSPITAL IS HERE FOR YOU 24/7 If you think your child is ill or injured, don’t take a chance. Come to the emergency department, and we’ll assess your child’s health as fast as possible. For any other pediatric needs, call 706-721-KIDS (5437) to schedule an appointment or visit augustahealth.org/chog to learn more.

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At Augusta University Health, we offer you and your family a one-of-a-kind advantage when it comes to health care. As the region’s only academic health center, we connect you to more specialists in more specialties, offer you the absolute latest advances in medicine and partner with you and your family to provide the highest level of personalized attention. The men and women at Augusta University are united by one passion: improve health and life, one person at a time.

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