With the New Year come two major pandemic milestones noted in our headlines.
It might seem like forever ago, but the first awareness of COVID-19 for most of us came a little over a thousand days ago, in March of 2020. The virus was first detected in late 2019, however, hence the name COVID-19.
It’s hard to know what to think about the virus at this stage in its evolution. On one hand, it seems to be heading for the exits based on what we personally see every day: very few masks in evidence at stores or in crowd shots at huge gatherings like Georgia football games. On the other hand, public health people keep warning about new variants that seem to be surging here and there (and yes, we did say here).
One yardstick of where we are at this moment comes from the CDC’s COVID Data Tracker. It’s still currently registering more than 400,000 new cases per week in the US, and more than 2,500 weekly deaths. Those are horrible numbers, but they sound wonderful compared to March of 2021 when US COVID deaths exceeded 15,000 a week, or a month before that when deaths were well above 20,000 per week. The current numbers are wonderful in the same way that having your left big toe chopped off by your lawn mower is wonderful compared to losing your entire foot. It’s all relative.
Consider this: If our current rate of 130,000 annual COVID deaths happened instead in traffic accidents on US highway (instead of the roughly 42,000 people that we lose now), there would be a huge outcry about traffic safety and calls to do something. Why isn’t that happening when the deaths come from the virus? It’s all relative.
The number above has been much discussed as the most recent tragic milestone reached during the ongoing saga of COVID-19.
It sure would be nice if 100 million really was the number of U.S. cases. Instead, nearly every public health expert has made the point that this is merely the best guess of known cases. The actual number is surely far greater.
Even at “only” 100,000,000, that staggering number puts the U.S. in first place in all the world. We also lead the planet in COVID deaths, with more than 1,090,000 tallied in that column.
Although the official case count of 100 million was announced as officially reached in December, people who compile healthcare statistics for a living say we actually passed 100 million cases long ago. The real number is considerably higher.
Why the discrepancy? Quite a few reasons. For quite some time now, at-home testing has been a common way to determine new cases, and at-home tests are almost never reported.
Another more recent development has resulted in exactly the opposite effect: reduced at-home testing. Because of the widely publicized “tripledemic” of COVID, influenza, and
respiratory syncytial virus (RSV), people are writing off whatever symptoms they have as the flu when a given percentage of them are, in fact, COVID.
That casual response is possible for a couple of reasons: vaccinations have sharply reduced the severity of symptoms experienced by many people who wind up with COVID anyway. And for many, Omicron has been a milder form of COVID than the earlier Delta variant.
With countless uncountable cases strewn across the fruited plain for all the reasons above (and more), public health officials have turned to COVID hospitalizations as the most reliable number to count. True, that number may be drastically lower than the actual count, but it represents the most serious cases, the ones of greatest concern to public health officials.
Looking at the global picture as well as our own situation, doctors remind us the pandemic isn’t over. Test at home. They’re free. Don’t assume the flu. Masks are still an excellent protective tool in crowded public places and for people with one of the tripledemic’s three plagues. Stay home from work or school.
Maybe we can prevent that future article about the 200 million case milestone.
A friend of your daughter confided to you that she is being molested by her stepfather. She says that she is afraid of him. What do you do?
A. Tell the girl’s mother what she told you and let her mother deal with it.
B. This is a family problem. Listen to her and encourage her to tell her mother, but don’t get involved with it yourself.
C. Report what the girl told you to the local child protective agency and let them investigate.
D. Take the girl into your home and protect her from her stepfather.
If you answered:
A. This is not the best response in this case. If the girl felt that her mother could protect her, she would have told her rather than you in first place. This is a serious crime and it should be reported and investigated by the proper authorities.
B. Do not do this. The girl has come to you for help and you should help. This is a serious crime and it should be reported and investigated by the proper authorities. Tell he that you are going to report it to the people who can do something about it.
C. This is the best response. You can call the Georgia Department of Family and Children Services or the Department of Social Services in South Carolina. Another option is the Rape Crisis Hotline at (706) 724-5200 or the Sheriffs Department. Let her know that you are going to report it to the people who can do something about it.
D. You might have the best of intentions, but this could mean a whole lot of trouble and may, in fact, be illegal. It must be reported to the proper authorities. Tell the girl you are going to report it to the people who can do something about it.
Child sexual abuse is a serious problem. When a child chooses to come to you about it, you must do the right thing. The right thing in this case is reporting it to the authorities.
Dr. Proefrock is a retired local clinical and forensic child psychologist.
Since we’re just a few days into exercise season, specifically the I-haven’t-been-exercisingat-all-but-I-am-now season, it’s a good time to address a few words to people fresh off the couch, as well as regular exercisers who have been at it for awhile.
If you’ve read this column before, you know the myth is often in the headline. Does the headline above strike you as definitely unmythical?
If it does, read on, because it’s only partly unmythical.
While it’s true that there are more myths about stretching that we would be able to fit into this column, it’s also true that stretching has its good points.
But misinformation can lead to injury, so let’s try to decipher the real from the unreal.
But first, here is a very good suggestion: find a personal trainer and book yourself some time. It will be money well spent. You could hire the most expensive workout coach in a 500-mile radius and it would
still be cheaper and less painful than dealing with shin splints, road rash, twisted ankles, broken bones and whatever else we can inflict upon ourselves when we do too much too soon or do something the wrong way. Getting the advice of a trainer at the beginning of this season prevents getting entrenched in bad habits. It’s best to prevent them right from the start.
With that lengthy caveat out of the way, let’s address a few myths and half-myths.
One of the most famous might be the one about stretching before running, often done in the manner of the illustration above. She is engaged in what is known as static stretching, doing the deed when the body is at rest, standing still.
Not every sports medicine expert would endorse this practice. Think about it: your muscles are presumably ice cold when these stretches are done. What’s to prevent injury to those cold muscles being stretched to their limit? In
other words, shouldn’t there be pre-stretching to get ready for stretching, and pre-pre-stretching to get ready for pre-stretching? Where does it end? Or start? Opinions vary, but some suggest the antidote is simply starting the intended exercise gradually. In other words, walk before you run. Save static stretching for post-workout.
Another myth is suggested by the last 4 words at the bottom of the previous column: “stretched to their limit.” If someone is stretching so far that it hurts, they’re stretching too far and risking injury. The general rule is: stretch until you feel a slight pull. That’s far enough.
Stretching increases blood flow to the muscle groups being stretched, but source after source will tell us that there is no scientific evidence that stretched muscles are less prone to injury. Not that stretching and warm-ups are a bad thing if done properly. But to say a stretched muscle is one less prone to injury? That’s a myth
This time of year, rest and drink plenty of liquids seem to be the top two qualifications for being a flu fighter. Resting when sick is probably a no-brainer, but the emphasis laid upon hydration makes it almost seem like water is as good as medicine. So what’s the reason for recommending plenty of liquids when we don’t feel well?
Sickness can deplete fluids from the body and prevent their replacement. Just a few common symptoms of illness can readily illustrate the point: diarrhea, vomiting, and sweating can all drain large amount of fluids from the body. Then, because we don’t feel good, we aren’t eating and drinking as we normally do to replenish those lost fluids.
Thinking of the human body as a water-cooled engine (which it is), when fluid levels are low it can prevent cooling, making fever even worse. (Mild fevers are a good sign: it means that the body’s immune system is doing its job.)
Anything that upsets the body’s fluid levels and associated chemical balances of elements like electrolytes and potassium is going to have a negative effect on how we feel and how quickly we recover from illness.
Remembering that we are water-based more than anything else — nearly two-thirds of oery vehicle for all of the invasion-fighting warriors of our immune system. Dehydration can affect the body’s ability to fend off illness and infection.
The brain is even more water-centric than the rest of the body, coming in at around 75% water. Dehydration and the resulting effects that it has on blood volume and blood flow to the brain is one of the reasons why we often have headaches or feel dizzy when we’re sick.
It wouldn’t be accurate to say that drinking plenty of fluids will put the brakes on illness, but it will do two very important things:
1. Eliminate any extra aches and pains that would otherwise have been caused by dehydration, and
2. Help reduce the duration and severity of symptoms from the illness itself.
Some people prefer designed-for-hydration products like Pedialyte, but in a pinch water actually works well too.
There is another photograph of this eminent physician and researcher that might be immediately recognized by many readers. It’s the one usually used in articles about this man. This photograph, while it may not be as recognizable, highlights a little-known aspect of his career that was not only important, but daring and dangerous.
This doctor’s life and career literally took him all over the world, from North America to Europe to Asia.
Born in Montreal, Canada, in 1906, he graduated from McGill University in 1928, earning his medical degree there also, in 1932. Three years later he left Canada to accept a position as a research fellow specializing in pathology, obstetrics and gynecology at an institution you may have heard of: the Medical College of Georgia.
Yes, this is Robert Benjamin Greenblatt, M.D., a worldrenowned researcher who made important contributions to public health, specifically in the realm of sexual and reproductive health. More than 70 years ago he established the effectiveness of estrogens in managing the symptoms of menopause. A decade later he contributed to the breakthrough discovery of a drug that could induce ovulation; he made major steps in the treatment of endometriosis and fibrocystic breast disease. In 1966 he was at the forefront of the research that developed an oral contraceptive that changed the world. It came to be known as simply The Pill, and MCG received national attention as a result. He made major contributions to treating hirsute women, and wrote an entire book on the subject, Unwanted Hair: Ancestral Curse or Glandular Disorder
Dr. Greenblatt pioneered endocrinology as an independent medical discipline, and MCG’s Department of Endocrinology, chartered in 1946 with Greenblatt as its chairman, was the first of its kind in the country. He authored some 600 scholarly articles in medical literature, chapters in nearly 100 medical textbooks, wrote the annual update on “Advances in Endocrinology” for the Encyclopedia Britannica for nearly 20 years, and published 25 books, including his look at Bible characters through the lens of modern medicine (Search the Scriptures), and his analysis of the sexual nature of historical notables from Henry VIII to Hitler to Kennedy to Napoleon. But we’re still left with the mystery of the photograph above and the chapter of his career that was daring and dangerous. When was that?
In 1943, Dr. Greenblatt volunteered for military service, where he served as a Commander and Senior Medical Officer in the U.S. Coast Guard. His first posting was to Savannah, where he put the brakes on a venereal disease epidemic among sailors there. That was the easiest assignment of his service career. He went on to command a triage unit to treat wounded Marines on Okinawa; to devise a method of mass producing penicillin for battlefield use; and his most dangerous assignment, although its true risk was largely unknown at the time: he was among the first medical scientists to inspect the health aftermath of the atomic bomb dropped on Nagasaki. He returned to Augusta and MCG after the war, retiring from MCG in 1974. He died in 1987, and is buried in Westover Cemetery. +
This is one of those miscellaneous columns with a bit to say about a few seemingly unrelated things, but they all involve keeping more money in our own pockets.
As a senior living in a small household, I like to keep milk on hand, but have often seen it go bad before I can use it up. One day the milk I wanted was out of stock, but my shopper substituted a super pasteurized bottle of milk with a 4 month expiration date. I didn’t believe it was possible at first, but lo and behold, I still have an open bottle and it is still good. This will likely result in several hundred dollars a year in savings. Right now when every penny counts this was an awesome discovery of a product I didn’t even know existed. Yay for us all!
At a time when many of us, seniors or not, are dependent on receiving deliveries, it is only natural that the bad guys want to take advantage and trick us out of our hard-earned money. I discovered one way they do this when I placed an order for some Christmas presents to be delivered to me. One day I got an email stating that my order was on the way. The next day, I received three emails, all from different sources, but all with the same message. All were a variation of, “we want to deliver your packages, but to do that we need for you to send a confirmation of your address. I looked back at my receipt and noticed that the delivery was to be made by UPS. In my many years of experience, neither UPS, USPS, or FED-EX has ever asked for an address confirmation. They already have my address from my initial order.
That was my first clue that something nefarious was afoot. My next clue came when I called the company I had placed my order with. Had they actually used the delivery company indicated in their message to me confirming the sale? They answered
that they had and that item I ordered should arrive that very day. Things we order on our computers, if legitimate, should have easy tracking information, so at any point we can find out where our packages might be.
I got that pit-of-my-stomach awareness after talking to the company that some folks had been trying to scam me. I wondered how they knew I had ordered anything in the first place. The answer was that they didn’t need any information other than my email address to send me their messages. At a time when so many of us are ordering things online for delivery, a scammer would be correct a majority of the time to assume that we might have a package or even a lot of packages coming. Email addresses, including those who are customers of specific retailers, can be easily purchased from companies selling that information with no questions asked.
If I had replied with my address, an ugly network of thieves would have been alerted that packages would soon be arriving at my address. From that point, porch pirates would be waiting like vultures for the easy pickings of packages left on porches, including mine.
Fortunately, I was too smart for them. I didn’t open the emails. The need for address confirmation was in the subject line. I was alert enough to notice that all three messages came from three different locations and none of them were from a .com or commercial address, which emails from any of the legitimate carriers would have been using.
Sadly, the end of the holiday season won’t end attempts to scam us out of our packages and their contents. So be aware. Be suspicious. Be smart. Scam the scammers by simply deleting their phony messages! Then pat yourself on the back for not allowing yourself to become a statistic.
PS: My packages did arrive that day and were promptly brought indoors to safety.
Prepare yourself to be shocked, because I am about to share something embarrassing about myself that also affects a lot of older people and that needs to be talked about. It needs to be brought out of the shadows and into the light. That’s a fitting metaphor too because I am talking about toenail fungus. It thrives in dark, damp places, but is hindered by sunlight and dryness. Okay, maybe it isn’t a shock that I am sharing something embarrassing. In fact, it’s kind of my thing, my schtick, my raison d’être, for you all you fancy folks out there. For the rest of us, that means: My reason for being. Well, that is perhaps going a little too far, but I have utilized self-deprecating humor now for over half a century to defuse criticism whether it actually happened or I thought it was about to happen. If you can’t make them laugh with you, make them laugh at you, I always say. I’m not sure what that says about my psychological well-being, but maybe I will bring that up on my next visit to the therapist. Ah, but I digress.
I may have mentioned my problem with toenail fungus before when talking about my diabetes since they can go hand-in-hand. Or should that be foot in foot? No, that doesn’t work. Anyway, if I did already talk about it, just chalk that up to the memory problems that I’ve shared with you in past columns. Plus, even if I did dish previously, I have come to a fork in the road in my treatment of it and I found out something else about my dry feet that surprised me. That is also embarrassing, so this is going to be an extra shot to my ego today. Let me break it down for you.
On a routine follow-up visit to my doctor this past week, I got there and was told that I was confused and that my appointment was the next day. As soon as they said it, I knew they were right. So I already felt like an idiot, but when the doctor was examining me, I noticed that my left sock was on inside-out. Yet another embarrassing moment. But this proved to be a very fortunate accident. When I took my shoe and sock off, the doctor noticed my feet and toes, and examined them. He told me about a topical treatment for the toe fungus that was safer than the pills that I had rejected before because of the serious side-effects, for which I am at above-average risk. He also explained to me why my feet are
so dry, something no other doctor had ever told me: I have athlete’s foot.
When he told me that athlete’s foot was causing my severely dry feet, I thought he must be mistaken, and I told him so. Why? Because I’m no athlete. But seriously, I said he had to be wrong because my feet don’t itch. He explained that the factors that cause athlete’s foot can vary, and they don’t all cause itching. He looked more closely and was sure that was it. It’s likely a fungus, he informed me.
Based on his findings, he gave me a prescription for something that you paint onto your toenails like polish. I asked if they had a variety of colors to choose from but was told that clear was the only option. Oh well, so much for a fashion statement along with my medicine. He also prescribed some lotion for my feet to take care of the athlete’s foot. I now will have a regular regimen (another one to add to my collection) that will likely last about 12 months, but perhaps longer. The regimen includes scrubbing and cleaning my toenails with alcohol and filing them down every seven days, followed by a coat of the specially medicated nail polish. The lotion has to be applied every day and I have to change my socks at least twice a day instead of once a day as had been my habit. When I wear them, that is. Underwear too, of course. Once a day. Now pants? That’s another story for another time. Then, after a couple of weeks, I can stop the foot lotion, and switch to a powder that will be a little easier to deal with.
So, there you have it. I have again laid my potentially embarrassing medical issues out for all to know. I hope you appreciate it. I’ll probably be kicked out of or maybe even be banned from any bowling alley or skating rink I try to rent shoes or skates from for at least the next year, or until this blows over. The news cycle is fast moving these days, and people have short memories though. Plus, I think I only have about a dozen readers, so it shouldn’t be too bad. And only two or three of the twelve probably work at bowling alleys.
J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. He may be reached at johnbcollum@gmail.com
The Medical Examiner is truly fortunate to have such a strong base of loyal advertisers. Quite literally, they make this newspaper possible by providing half of the ingredients list for publishing success. The other half of the recipe is loyal readers. Without you, advertisers would have no interest in this publication. It’s great that they are here are you are here. And it’s even better when the two come together, so please let our advertisers know you value their support, or that you’re their customer in part because of their support here. It can be as simple as saying, “I saw your ad in the Medical Examiner and was wondering if you carry...” They’ll figure it out from there.
Of course, there are never as many advertisers as there are spaces in the paper where ads could go. Those empty spaces are filled with “house” ads, basically self-promotional ads for the Medical Examiner. We probably have way too many of those in some issues, so we’re going to start filling some of those empty spaces with articles. They’ll be brief but interesting variations on the “Medicine in the First Person” theme, and we’re going to call them “Short Stories.” Look for headlines like the one above. Some issues might have several “Short Stories,” some won’t have any. It depends on how much empty space we have to fill and whether we have stories or not. Full disclosure: most “Short Stories” are going to be tales we’ve seen or heard about down the road someplace else, not necessarily from the Aiken-Augusta area. But we welcome your short stories too. We would love to hear your short stories. Mail or email them to us using the address in the box on page 3. (Once in a while that box moves to a different page, but it is always in every issue.) We’ll be happy to give you credit for your story or keep your identity a secret, your choice. (It’s good to spell it out for us so we know for sure one way or the other.)
Thanks again for your support, and we hope you’ll enjoy “Short Stories.”
Sometime back, I got bored and had a hankering to go somewhere. Next thing I know, I was at Blind Willie’s in Atlanta with a few friends. We had good food and a bit of alcohol to ward off any impending infection. It must have worked. I lived right through it. I was the designated driver, however, so I only had a few sips a good 3 hours before driving home. Regardless of the situation, I never have more than one drink in one night. Or week, for that matter. Most of the things I do are fun, so I want to know exactly what was fun without having to ask someone if I had a good time.
After a while, out came our entertainment: Beverly “Guitar” Watkins, an Atlanta grandmother who played guitar behind her head at times to thrill us. Don’t remember the exact name of her band.
(most of the time)
A series by Bad Billy LaveauThey were in rare form. They are semi big-time blues singers. They’ve got golden fingers. They’re loved everywhere they go. For several hundred dollars a show they sing about peace and love. (She has since gone to play for Jesus. I shall miss her. I still watch her YouTube.)
Margaritas made us want to get up and dance. But my arthritic knees said NO! Besides, I was not part of the show. Those days are a long time gone. The 15mg of Mobic I take for arhritis probably helped, but it is not the Fountain of Youth I
had hoped for. Ralph Waldo Emerson wrote. “Youth is wasted on the young.” That man was brilliant.
Beverly’s band makes me laugh when they sing. They make me cry when they bend them strings.
Sometime later, maybe 10 pm or so (that is late for those of us of advanced maturity), we paid our tab and slipped out with spirits high and energy low. We went home not having heard a single four-letter word. Such are the blessing of hanging out with civilized people. No personal affronts. No shootings. No stabbings. No cops needed. No drug infused wrecks like on the wild side of town. Blind Willie’s is blues club for professionals and middle age people who heard that kind of music in college. Nearby streets are narrow. Parking difficult. Sidewalks and buildings are
older than my bones.
But if you are going to have a heart attack while out partying, Blind Willie’s is the place to be. I saw two doctors and a few nurses there (not to mention two Atlanta Falcons) soaking up the blues.
Beverly did the great Slim Harpo song, “Raining in My Heart” (Since We’ve Been Apart.). She made us all think back about love a long time lost. And she did Jimmy Reed’s “Baby, What You Want Me to Do,” which elevates women above men. Took my heart back to college days when I had hair and there were only two sexes. Life was easier than. Most everyone knew where they were going and why. Boys became men. Girls became women. Chromosomes determined sexuality. The “trans” debacle had not arrived to confuse us.
A short stroll down Memory Lane can warm the heart and revive the soul. We should all do it from time to time. It makes me cherish things I did (and did not do). Makes events have greater meaning because I now appreciate them more. And with my advancing age, I get to decide what to recall and what to forget. Things like almost failing French, but making the highest grade in my Modern Logic class. If I have to forget something, I prefer forgetting biochemistry and relishing Latin & Greek derivations.
That next morning, I slept a little late and woke up the better for having followed my temporary hankering. I am glad I made the trip, but don’t want to do it every week. Too tiring. I can remember and relive it in my mind as often as I like.
Maybe next year, a crew of us can pool our money for a limo to make the trip a little less tiring.
I have a regular patient that I have always greeted facetiously with “Don’t bother sitting down Mrs…… you won’t be here long enough.“ As our little tradition goes, she invariably punches me in the arm and sits down anyway (once she missed and caught me on the side of the head when I ducked). Yes, she always punches me. I mean, how rude can a patient get? Then she follows it up by dragging out a shopping list of her little miseries that we have been over a million times before. This has been going on for nearly 50 years. The rudeness of some patients is beyond belief. And to think, I delivered her children and now look after her grandchildren.
She came in with her husband for the first time the other day (there were some serious issues in the extended family they wanted to discuss). She greeted me with the usual punch in the arm. Her husband, who hadn’t seen that before and didn’t know the routine, blurted out “You can’t hit the doctor like that.” To which she replied, ”I can do whatever I want,” and punched me again.
What could I say or do except turn to the husband and say “Would you mind keeping your trap shut? That way I only get punched once.“ How rude of him! Setting me up for two punches when normally I only get one. +
A 20-something patient comes to ER. The chief complaint on the board is “private.” This should be good, I think. I go in, and he is visibly worried and depressed. He tells a story about how he slept with a woman, didn’t use protection, and then noticed “she had a plastic box on her.” She told him it was an insulin pump for diabetes, and he was mortified.
He came in immediately to be tested for diabetes. +
Registered
Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb
This soup is delicious and economical. The sweetness of the corn pairs perfectly with the slight spiciness of the peppers.
• 5 cups corn kernels, fresh or frozen; divided
• 5 cups reduced sodium chicken broth; divided
• 1 teaspoon oregano
• 2 roma tomatoes, chopped
• 3 teaspoon canola oil
• 1 medium sweet onion, chopped (about 1½ cups)
• 1 cup celery, chopped
• 2 poblano chilies, seeded and diced
• 2 garlic cloves, minced
• ¼ teaspoon pepper
• 1 (15 ounce) can black beans, drained and rinsed
• ¼ cup cilantro, chopped
• Lime wedges -- make sure to include! The lime juice is excellent in the soup!
• Salsa (optional)
Place about half the corn (2 ½ cups), two cups broth, oregano and tomatoes into a blender and puree until smooth, set aside. In a large pot (or Dutch oven) heat oil and add onions, chilies and celery, cook over medium heat until the onions are translucent (about 5 minutes). Add garlic and cook another minute. Transfer
the remaining three cups of broth, puree mixture, corn kernels, and black beans to the pan and bring to a simmer. Top with cilantro, salsa and serve with lime.
Yield: 6 Servings (Serving Size: 1 ½ cup)
Nutrition Breakdown: Calories 190, Fat 2g, Cholesterol 0mg, Carbohydrate 38g,
Sodium 550mg, Fiber 10g, Protein 9g, Potassium 573mg, Phosphorus 49mg.
Percent Daily Value: 20% Vitamin A, 230% Vitamin C, 6% Calcium, 15% Iron Carbohydrate choices: 2 Carbohydrates
Diabetes Exchange Values: 2 Starches, 2 Vegetables, ½ Lean Meat
There are others that have died in addition to the eight past publications pictured. The Senior News is no more. The Augustan (or “The New Augustan”) seems hard to find, but that could still just be a temporary COVID situation. And many people say The Augusta Chronicle is a mere shadow of its former self.
The good news is that one area publication is alive and well and going strong, and for that we have our loyal advertisers and loyal readers to sincerely thank. If you’re wondering, the name of that publication is shown below:
Eduardo, a Facebook friend from Augusta, asks:
“How can I avoid the lose weight-gain it back yo-yo I have been on so many times?
This happens to so many people I have to wonder, is it all pointless?”
This is an important question to answer, especially during “New Year’s Resolution season.” There is a flawed idea floating around that once you gain weight, you cannot permanently lose it. The rumor is that your body has a pre-determined metabolic weight “set point,” which, like the set point on a thermostat, always gets you back into a specific weight range, regardless of what you do. It is known as the “weight rebound” effect.
According to this philosophy, no one should bother trying to lose weight because not only will you gain your original weight back, but you will also gain back a few more for good measure. With this approach, you are simply a passive cog in your metabolic wheel, so just give up. You are pre-ordained to fail, so why bother? Anone who takes this idea to heart will probably end up depressed, despondent — and still overweight.
Like most urban legends, you can always find some buried truths among the tall tales. Evolving research does, in fact, indicate that the body does have a metabolic weight set point which operates to keep our weight within a certain limit. This metabolic set point works
against long-term weight loss goal and may be responsible for the weight rebound effect. However, no one is pre-destined to a life of being overweight. The good news is that we now understand that it is possible to change your weight set point and avoid weight rebound.
To do this, the most important rebound to avoid is LIFESTYLE rebound, rather than metabolic rebound. What do I mean by lifestyle rebound? It means going back to your old eating and physical activity habits once the dieting is over. It is “falling off the wagon.” Evidence is accumulating that we can re-set our metabolic weight thermostat and avoid the weight rebound effect by making very gradual changes to weight and lifestyle over a prolonged period. You must
be an active participant when you alter your eating and activity habits. You do not reach this goal by buying pre-prepared meals or by having someone else tell you what to eat in their latest fad diet book or on their blog. Rather, you need to be active, slow, deliberate and thoughtful in facilitating your very own transformed life habits. It is expected that you will “fall off the wagon” in your journey. It happens. And when it does, just pick yourself up and hop back on. You want the change to be slow, self-motivated, sustainable, lifelong and positive.
This approach means that you forget about quick weight loss diets. Those are the ones leading to “yo-yo” dieting. They do not help you re-set your metabolic weight set point. If your goal is to feel and look better in your summer clothes, begin this journey the autumn before, not in the spring. It means that with your weight loss resolution in January, you should not expect to see permanent effects until next January (or later). Remember, your goal is not simply to lose weight, it is to change your metabolic weight set point by permanently changing your life.
I would be a very wealthy man if I had a dollar for every time people have bemoaned to me all their unsuccessful diets. They have tried The Keto Diet, The Atkins Diet, Oprah’s Diet, The Paleo Diet,
The South Beach Diet, The Zone Diet, The GOLO Diet… on and on…what do you lose on these diets? You lose faith, not weight. You lose faith in your ability to permanently lose weight.
You do not have to spend money to find evidenced-based, medically sound information on healthful eating. A great place to start is the Academy of Nutrition and Dietetics website, eatright.org. Another website I use quite regularly is the National Institutes of Health (nih.gov). These are both evidenced-based, scientific sources of diet and nutrition information. As a starting point, learn the eating principles that are part of either the Mediterranean or DASH way of eating. These are lifelong approaches to eating and food, not diets. Lifelong physical activity habits need to change also. Find some physical activity that you like to do, not something you dislike. Hate to jog? No problem, walk your chocolate lab instead. You hate to ride a stationary cycle? No problem. Cycle down the canal towpath instead. Find something
What is the “No-Nonsense Nutrition” advice to begin 2023? It is possible to permanently lose weight, avoid weight rebound and change your body’s weight set point. You can do this by changing your LIFE and avoiding lifestyle rebound. Move, move, move every day, choose more fruit/veggies, more whole grain foods, more vegetable-based protein and foods that are lower fat, lower salt, lower sugar and lower calorie. Be an active participant in your quest for a healthy lifestyle. The more active you are and the more deliberate and slow the changes occur, the more successful you will be. The science on all this is evolving, so stay tuned. Most importantly, have Happy and Healthy New Year!
Have a question about food, diet or nutrition? Post or private message your question on Facebook (www.Facebook.com/ AskDrKarp) or email your question to askdrkarp@gmail.com If your question is chosen for a column, your name will be changed to insure your privacy. Warren B. Karp, Ph.D., D.M.D., is Professor Emeritus at Augusta University. He has served as Director of the Nutrition Consult Service at the Dental College of Georgia and is past Vice Chair of the Columbia County Board of Health. You can find out more about Dr. Karp and the download site for the public domain eBook, Nutrition for Smarties, at www.wbkarp.com Dr. Karp obtains no funding for writing his columns, articles, or books, and has no financial or other interests in any food, book, nutrition product or company. His interest is only in providing freely available, evidenced-based, scientific nutrition knowledge and education. The information is for educational use only; it is not meant to be used to diagnose, manage or treat any patient or client. Although Dr. Karp is a Professor Emeritus at Augusta University, the views and opinions expressed here are his and his alone and do not reflect the views and opinions of Augusta University or anyone else.
It has happened to us all: We start the year off strong in January by setting a New Year’s resolution. A few months later despite our initial motivation, not much progress has been made.
What happened?
A typical resolution might sound something like this:
“Eat healthier food”
“Improve my health”
“Exercise more often”
These resolutions may sound like worthy goals, but because there is no specific action behind the intention, they don’t necessarily move us in the direction we want to go.
But SMART goals help us turn this motivation into action. SMART goals are like following a map: they are the concrete actions you plan to take to get moving in the direction you want to go. Let’s look at what makes for a SMART goal so you can get moving toward your good intentions.
SMART stands for: Specific – This is the specific action you will take.
Measurable – The goal should be measurable, so you know when you’ve met your target.
Action-oriented – The goal should make you do something different. It should be an action you will take.
Realistic/Reasonable –The goal should be within your ability to get it done given your current life situation. Avoid setting your sights on things that aren’t realistic; reasonable, accomplished SMART goals build up the “I can do it” feeling and help us to feel confident to strive for other behavior changes as well.
Time-sensitive – The goal should have some sort of a timeframe so that you know you got it done or made progress.
Examples of SMART goals:
• Avoid the saltshaker at supper
• Walk 30 minutes at least 2 days per week
• When eating out, order water instead of soda or sweet tea
• Limit fast food to 1 time or less per week
• Stretch for 15 minutes at least 5 mornings per week
When setting SMART goals, be careful not to judge yourself against someone else’s goals. For example, let’s say you want to be more physically active. Try tracking your steps and set a goal to add 500 steps to your average at least 3 out of 7 days the following week. While that may end up not being as much as someone else, it really doesn’t matter. Let your goals build up your habits and increase your goals when you are ready.
We are much more likely to be successful when we feel successful. When setting SMART goals, it is suggested to limit ourselves to just a few. Having too many goals can be overwhelming. Instead, set 2 or 3 goals that you feel like you can live with. As you feel more successful, you will find yourself naturally taking other healthy steps.
Have a healthy and happy 2023!
• Rollnick, Stephen, William R. Miller, and Christopher Butler. Motivational Interviewing in Health Care: Helping Patients Change Behavior. New York: Guilford Press, 2008. Print.
• Frates, E. P., & Bonnet, J. (2016). Collaboration and Negotiation: The Key to Therapeutic Lifestyle Change. American Journal of Lifestyle Medicine, 10(5), 302–312. https://doi.org/1 0.1177/1559827616638013
More Americans have died on US roads since 2006 than in World Wars I & II combined
his article is not going to be about the kind of dent they can fix at Kendrick’s or Classic Collision. In fact, it’s about preventing the kinds of dents they fix by putting a huge dent in the rate of crashes on the roads. The more anyone pokes around the internet looking for information about highway safety, the more likely they are to eventually notice something curious: the word “accident” is rather scarce. Especially if you’re reading about alarming statistics where fatalities are trending sharply upward, or have hit levels unheard of in decades, or are in some way extreme. That has happened a lot lately. For instance, traffic deaths in 2020 were off the charts despite the fact that millions of drivers spent major chunks of 2020 in lockdown. Millions of fewer miles driven should have resulted in thousands of deaths being prevented. Instead, 2020 was the worst year for traffic fatalities in Georgia and most other states in more than 5 years, both in simple quantity and as measured by fatalities per 100 million miles driven or per 100,000 population.
One would expect articles about traffic accidents galore. And one would be disappointed.
Highway safety experts talk about crashes, not accidents. Why?
Simply put, crashes happen; accidents don’t.
The National Highway Traffic Safety Administration (NHTSA) tracked down data on some 2,189,000 crashes that occurred between July 3, 2005 and December 31, 2007. Of those crashes, 2% were caused by unknown factors, 2% fell under the general term “environment,” and another 2% were attributed to “vehicle.” The remaining 94% were caused by driver error. Technically and literally, they were not accidents. They were preventable mistakes.
Think about the implications of that. 94% of the actions that result in collisions are within the control of the driver to prevent. Talk about a huge dent! In the case of the NHTSA study, 2,046,000 of the 2,189,000 crashes were caused by driver error.
As the data was analyzed, the mistakes were divided into just four broad categories of error: Recognition error: driver inattention, internal and external distractions, and inadequate surveillance
Decision error: driving too fast for conditions, driving too fast for a curve, false assumptions of other driver’s actions, illegal maneuvers, and misjudgment of gap or speed of other vehicles
Performance error: Includes overcompensation and poor directional control Non-performance error: Most often involves the driver falling asleep NHTSA found that almost 75% of crashes were the fault of the first two factors (recognition error, 41%, and decision errors, 33%).
Their study found that sometimes multiple factors result in crashes. An inattentive driver (recognition) may hit a curve too fast (decision), skid on bald tires (vehicle), hit a patch of ice (environment), and then overcorrect (performance) before hitting a tree (environment again). NHTSA analysis concluded that in some cases preventing just one link in the chain of events leading to a collsion is enough to prevent the crash.
In the example just described, if the driver had simply been paying attention, the excess speed going into the curve may never have happened, preventing the skid - even though his tires were bald - avoiding the patch of ice and the resulting overcorrection and finally, the tree.
To put it another way, safe driving does more than prevent crashes, injuries and fatalities. It saves trees too. +
The world’s most salubrious mugs, created for us by the artists at Augusta’s Tire City Potters, are here! Win a chance to get one by entering our celebrated Mystery Word Contest! THANKS ALSO TO OUR CONTEST
Will he ever get one right?
Probably not.
Questions. And answers. On page 13.
Suicide isn’t beautiful. It’s not glamorous. It’s not Virginia Woolf, with pockets full of stones walking calmly into the water surrounded by trees and dappled sunlight with string music playing in the background as you slowly sink under the water.
Suicide is blood and vomit pouring out of your nose. It’s losing control of your bladder and bowels and soiling yourself. It’s blood all over the bathroom floor. Or, it’s bits of blood, brain, and bone sprayed against a wall, all over the front seat of a car, the back porch, or soaking into the bedroom mattress. And, do you know, those small pieces of bone and brain, even blood spatter, can be found days, weeks, months later, even after a major clean-up?
Imagine someone finding you. Now they’re traumatized at the sight. A law enforcement officer or a medical professional, well, we have seen a lot. But now imagine your friend finding you. Or your sibling. Or your mom. They are going to be devastated for a long time. They are going to feel guilty. They are going to wonder what they could have done to prevent it. And that image is not going to go away — ever.
I’ve written in passing about thinking about suicide when I was in my late teens. Nothing major had happened. I was just going through the trials of being in that in-between state when you’re not a child but not an adult. You want to be independent, yet you still need that family support. You want everything in life; even the smallest disappointment can feel like the world just ended.
But the more I researched methods, the more I started to think about the aftermath, which I think gets forgotten. Of course, you’re dead, so you really don’t care at that point, but I did. I started reading about what happens when you die and got totally grossed out. Pills, cutting, guns. Each brings its own problems with messiness. So, you start to think that the bathtub is the way to go. Easy to clean, right?
Then I thought about who would find me. No matter where you did it, eventually, someone would find you. Unless, of course, you went out into the woods or desert. But then maybe no one would find you, and you’d return to the earth and be a feast for worms and bugs, vultures and coyotes and yuck.
Obviously I put too much thought into it, which maybe was a good thing because the more I thought about it, the more life continued on, and some of it wasn’t that bad. And suddenly, more good things happened, which made up for the disappointments which became more reliefs because if this or that had happened, then this or that other thing wouldn’t have happened, and they made life so much better.
I wish I could have told this to that 20-something I treated who decided that life was no longer worth it, whom I worked on for probably 30 minutes longer than I should have only because they were so young. I’m sorry you couldn’t see beyond the events of that day.
I’m sorry your parents had to find you, dead and soiling yourself but still warm enough to think there might be some hope of life yet. My EMTs tried. My techs tried. I mentally thought about every medication and process to see if we could bring you back, but that last scan of your heart showed that image that I call “silent snow” that tells us that there is nothing left to do but continue to try to understand the why.
Veronica Bonales is an emergency physician“It is nearing dusk, her favorite time to feed. Although you heard her droning arrival, she gently lands on your ankle without detection, as she usually bites close to the ground. It’s always a female, by the way. She conducts a tender, probing, ten-second reconnaissance, looking for a prime blood vessel. With her backside in the air, she steadies her crosshairs and zeros in with six sophisticated needles. She inserts two serrated mandible cutting blades (much like an electric carving knife with two blades shifting back and forth), and saws into your skin, while two other retractors open a passage for the proboscis, a hypodermic syringe that emerges from its protective sheath. With this straw she starts to suck 3–5 milligrams of your blood, immediately excreting its water, while condensing its 20% protein content. All the while, a sixth needle is pumping in saliva that contains an anticoagulant preventing your blood from clotting
at the puncture site. This shortens her feeding time, lessening the likelihood that you feel her penetrat ion and splat her across your ankle. The anticoagulant causes an allergic reaction, leaving an itchy bump as her parting gift. The mosquito bite is an intricate and innovative feeding ritual required for reproduction. She needs your blood to grow and mature her eggs.”
If this book’s subtitle, which alludes to “our deadliest predator,” sounds a bit sensationalistic, consider that even in today’s “advanced” world,
mosquitoes still kill an estimated 725,000 people around the world every year. And we’re afraid of snakes that kill maybe 5 people a year in the US?
The Mosquito relates that ravenous clouds of mosquitoes in the Canadian arctic, where suitable targets are scarce, can cover a hapless caribou within seconds. And we mean literally cover, with a bite rate exceeding 9,000 per minute. That same bite rate would drain half the blood from an adult human within two hours.
Unfortunately, mosquitoes don’t limit their attacks to lone humans or caribou. They have felled huge populations, stopped mighty armies in their tracks, evaded multiple efforts to eradicate them, and in the process have changed the course of human history many times over.
Mosquitoes hold a deadly but large and fascinating place in human history.
+
The Mosquito — A Human History of our Deadliest Predator by Timothy C. Winegard, 496 pages, published in 2019 by Dutton
Word for this issue:
Moe: Did you get your blood test results back?
Joe: Yeah, my doctor says I have extremely low magnesium levels.
Moe: O Mg!
Moe: Looking back, how would you describe your life in 2022?
Joe: Disappointing. Very disappointing. Moe: Why?
man ran in to an airport and up to the nearest ticket agent and gasped, “Please help me. I have a family emergency. Please, I need to get to Chicago in the worst way!”
“In that case,” the agent calmly said, pointing to her left, “I would suggest Southwest.”
Moe: Why is COVID more dangerous than Southwest?
Joe: Because COVID is airborne.
A man (possibly the same one as above) ran into an emergency room and grabbed the first nurse he saw and gasped, “Please help me. I have a terrible headache and I keep seeing spots before my eyes.”
“That sounds serious,” said the nurse. “Have you seen a doctor?”
“No,” said the man. “Just the spots.”
A blonde was visiting the zoo and stopped at the big cat exhibit. She idly remarked to a man a few feet away, “You ever wonder what these tigers would tell us if they could talk?”
The man thought for a moment and said, “I think they might say ‘We’re leopards.’”
Joe: I found out that my universal remote control does not control the universe. Not even remotely.
Moe: How are your New Years fitness goals coming along so far?
Joe: I have to say, lifting weights has radically changed my life.
Moe: Already? Wow. How?
Joe: I dropped 30 pounds. On my toe. I can’t walk without crutches now.
Moe: What’s orange and sounds like a parrot?
Joe: I give. What?
Moe: A carrot.
A big tattooed biker-type dude walks out of a bar, but storms back in a minute later and yells, “Who owns the chihuahua tied up out front?”
A little man from the back of the bar meekly raises his hand and says it’s probably his.
“Then we have a problem,” yells the biker. “Your Chihuahua killed my Rottweiler.”
“What?...that’s impossible,” sputtered the little man. “How could your Rottweiler have been killed by my sweet, harmless Chihuahua?”
“It looks like he probably choked on him,” said the biker.
Dear Advice Doctor,
I don’t know if I should be writing to you or the Parenthood columnist on page 2. I have a teenager problem. The issue is not with my children, of course. They are perfect angels. It’s always other people’s kids. In my case, my son has fallen in with a trouble-maker, and he is corrupting my formerly perfect offspring. Naturally, my son can’t see the negative influence this bad egg is having on him. Everyone else can, though. My question: should I address this problem through my son, or through the other child?
— Striving to Restore Perfection
Dear Striving,
You raise an interesting point, one that seemingly has a different answer every year.
But that’s not necessarily a bad thing.
I’m sure you’ve noticed that there have been times when you didn’t have to specify bad egg. Bad was understood; bad was clearly implied by the word that followed it: egg.
It isn’t that way anymore. Science no longer banishes eggs to the same despised dietary categories as Twinkies, pork rinds and greasy fried foods.
How does it happen that a food like eggs is on the bad list one year and the next year gets a green light?
The answer: science happens. Once upon a time, cholesterol was at the top of the Most Wanted list for culprits in heart disease. As an article on WebMD puts it, “after 25 years of study, it has become evident that cholesterol in food is not the culprit -- saturated fat has a much bigger effect on blood cholesterol. Full-fat dairy products and fatty meats are examples of foods that are loaded with saturated fat and which trigger the body to produce cholesterol.”
So those changes in recommendations — this year something is ok, next year it isn’t — are actually good. They are signs of progress in our knowledge.
Eggs are good sources of iron, vitamins, minerals, and protein, but not good sources of calories and fat. They’re hard to beat, nutrition-wise. Yes, they do have about twothirds of the recommended daily limit on cholesterol. The American Heart Association says an egg a day is okay. Just go easy on other high-cholesterol foods on egg days.
I hope this answers your question. Thanks for writin g. Do you have a question for The Advice Doctor about health, life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.
No matter how you look at it, the pandemic is still a matter of concern — or at least should be — for a number of reasons.
For starters, right here in the US of A doctors are concerned about new variants that seem to be capable of evading capture by our immune systems, even ones fortified by vaccines and boosters. One, dubbed XBB.1.5, accounts for more than 40% of the confirmed COVID cases around the country, according to the CDC. Of course, plenty of us are still unvaccinated for one reason or another, and if vaccinated people can wind up COVID-positive, the unvaccinated are even more susceptible. No matter who ends up COVID-positive, it adds up to more exposure to everyone, whether they’re vaccinated or not. The more exposure there is, the more cases there will continue to be. As mentioned earlier, we’re coming down with 400,000 new cases every week as it is. Anything that can be done to reduce that number is a good idea.
Another major issue of grave concern is the current situation in China. There, a largely unvaccinated and unexposed populace — and a huge populace at that — is feared to be on the brink of a major explosion in COVID cases. To make matters worse, China is reportedly possessed of a very limited supply of vaccine doses. The experts may be wrong — and hopefully they will be on this one — but they’re predicting the possibility of hun
methods of infection control like mask wearing and hand washing. They know. So should we.
So where are we now? Barring something severe and unexpected, the days of mandatory restrictions and enforced shutdowns are behind us. Some CSRA hospitals have recently returned to mandatory masking for all employees and visitors; some doctors offices and nursing facilities haven’t relaxed their restrictions since early 2020.
But aside from those places, we’re in a largely self-governed era of the pandemic. Wear a mask if you want; don’t wear one if you’d rather not. It’s your call.
That doesn’t necessarily mean every decision is the right one, but in a majority of cases it’s each individual’s decision to make.
Having said that, there are still some self-imposed rules that should be in play, perhaps the most important of which is stay home when you’re sick. In simpler times it may have been a badge of honor to work through a cold. But those were not days when a pandemic, let alone a tripledemic, was scouring the planet. Also, we live in the #1 work-from-home era of all time. Most employers can accommodate a person who needs to work from home, especially if the alternative is the possibility of half the staff getting sick and being unable to work.
We also supposedly live in the most inclusive time in human history. Every lifestyle, no matter how “alternative” it may be, is supposed to be embraced. Voice your intolerance and you may lose your livelihood.
The point? If we’re supposed to accept lifestyle variations our grandparents could never have even imagined, why can’t we accept someone who is doing nothing more scandalous than wearing a mask at the store? Or maybe not wearing a mask at the store?
The goal — which may or may not be doable — is for us all do our level best to make sure we aren’t still dealing with this thing in another 1,000 days.
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