Medical Examiner 2-2-24 by Daniel Pearson

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FEBRUARY 2, 2024

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EVERY BREATH YOU TAKE

Here’s an example: have you ever noticed that you often get heartburn when you’re stressed out? It’s not your imagination. Published research has found that since stress slows digestion, it nearly doubles a person’s odds of getting heartburn. However, a study published in The American Journal of Gastroenterology indicates that deep breathing can prevent heartburn and even eliminate the need for heartburn meds. The two research studies just cited specifically refer to what is often

called 4-7-8 breathing. Perhaps you’ve heard about it. The technique involves slowly inhaling while counting to four (that is, for four seconds), holding the breath for seven seconds, then slowly exhaling while counting to eight. Repeat for three minutes. A similar technique for deep breathing has been shown in studies to banish socalled brain fog and improve mental focus, even for soldiers in intense combat situations. A Harvard Medical School

study learned that slow, deep breathing can reduce or even reathing is obviously pretty eliminate high blood pressure and important. Nobody is about can help slow down a racing heart. to argue that point. But it’s Of course, something we do probably fair to say that many of us 17,000 times every day is going don’t fully realize how important to happen on autopilot most of breathing is well beyond its role as the time. But learning controlled part of our respiratory system. breathing techniques and having Considering that all of us have them at our disposal when needed been breathing since we were can be very useful in all kinds of roughly 2 seconds old, you would situations. think we would have the routine For instance, someone who is down by now. We should be quite hyperventilating just before a job good at something we do around interview or a very important 17,000 times every day. Instead, presentation at work can effectively people regularly make significant use 4-7-8 breathing to calm the breathing mistakes in certain panic and regain control. situations, and when they do there is But employing measured, mindful a price to pay. breathing doesn’t have to wait for Ok wait, you’re saying, how can a panic attack or a bout of raging anybody breathe wrong? You inhale, heartburn. For instance, instead of I HAD A BAD EXPERIENCE you exhale. It’s not complicated. If immediately reaching for your phone I was breathing wrong wouldn’t I at red lights, train yourself to use (and it involved breathing) faint or be blue in the face? deep breathing while stopped, Points well taken. Breathing is and even when driving. If you Several years ago I went through a stretch of debilitating anxiety and panic attacks. not complicated. But believe sometimes toss and turn Most of it was related in some way to my job at Plant Vogtle, which regularly required it or not, as simple as when you should be speaking in front of groups of people (usually small groups, but sometimes 70 to 100 people, and breathing is, sometimes sleeping, try the old on rare occasions up to 1,000). Things got progressively worse to the point where waking up in the it can be done wrong. 4-7-8 to help you middle of the night drenched in sweat and gasping in panic was common. I decided to get help from a doctor. It’s not like relax and drift off. I made an appointment and told the doctor about my escalating panic attacks. She listened attentively and then said, we’re oxygenHarvard “I understand why you’re here. You want drugs. You want me to give you some pills and send you on your way. Well, starved Health suggests let me tell you something: that goes against all of my medical training and violates my professional ethics. You’ll by breathing that deep breathing have to get your pills elsewhere. But if you’d like to come back tomorrow I’ll give you a printout of some improperly, but there should be part of breathing exercises that may help.” Do you think I went back the next day? Are you kidding? Why are situations where we everyone’s routine for 10 would I go back to a doctor who insulted me and accused me of being a drug addict? could enjoy health benefits to 20 minutes every day. by breathing differently. Try it and breathe easy. + But that’s not the end of the story... See page 5.

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FEBRUARY 2, 2024

THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

MEDICAL MYTHOLOGY

PARENTHOOD by Dr. Warren Umansky, PhD

You’re not sure if you want your third-grader to have a cell phone. On the one hand, most of her friends have cell phones and she loves to play games on it, watch TikTok, view YouTube videos, and follow friends on Instagram. On the other hand, your daughter is not doing well in school, fusses about going outside to play, and is always tired in the morning when it’s time to get up for school. What do you do? A. All of her friends have phones and I don’t want my child to be left out. She needs to have one. B. The phone is an unnecessary distraction. Until she is doing better at school and at home and can be more responsible, she won’t have one. C. Her grandmother is planning to give her a phone for her birthday and I can’t tell her no. D. The phone will keep her busy when she is home so I can get my things done. If you answered: A. “All of her friends” are not your children. You set the expectations for your child and those expectations should be high. Just as you are the role model for your child, your child can be the role model for her friends. B. You know in your heart that this is the right choice! Your child might fuss initially at your decision but then will settle in to using time more productively. C. You can tell grandma “No!” You’re the parent and you’re in charge of making decisions like that. D. When you become a parent, the child’s needs come first. Enjoy the time with your child. Phones don’t provide good memories of parenthood. Phones interfere with healthy activities. Children should be reading, playing outdoors and in sports, building, playing dress up, drawing. It’s your job to provide the environment where those become the preferred activities. + Dr. Umansky has a child behavioral health practice in Augusta.

GLUTEN-FREE DIETS ARE HEALTHIER Whenever you see that less than -est qualifier — not healthiest but healthier — you have to ask, compared to what? Are gluten-free diets healthier than eating pure lard? Yes, they truly are. Are gluten-free diets healthier than “regular” diets? It depends. A strict gluten-free diet is absolutely healthier for someone with celiac disease (CD) or gluten intolerance. For those people, going gluten-free is a medical necessity. Gluten is a structural protein naturally found in wheat, barley, rye, and sometimes (but not always) oats. Structurally, gluten gives the dough of grain products its elasticity, and after baking it provides the chewy texture in some grain-based foods. As innocuous as it is for most people, someone with CD or gluten sensitivity who eats anything containing gluten is likely to experience stomach pains, bloating and gas, diarrhea (and/or constipation), nausea, vomiting, and weight loss. All of that would definitely get anyone’s attention. The only known cure for CD is a lifetime of avoiding

anything containing gluten. The good news is that less than 2% of us suffer from any form of gluten sensitivity, from mild to severe. Yet according to surveys, 20 to 30% of the general public is buying and consuming gluten-free foods, some in an attempt to go gluten-free, others merely buying the occasional item in a gluten-free version. Why? Many read the list of gluten’s negative side effects for gluten-sensitive people (as listed above), and the only thing they read is “weight loss.” Hey, if you don’t have CD, maybe that’s the only side effect you’ll have. Unfortunately, that’s not how it works. In fact, doctors warn against going gluten-free without having CD or gluten sensitivity. Such people are at risk for serious nutritional deficiencies. Gluten has gotten an unde-

served reputation as harmful and even poisonous. It is only harmful to those with CD or gluten intolerance. There is no published research supporting a gluten-free diet as a beneficial factor in weight loss. As for another rumored effect of gluten: there is no evidence that gluten-free diets are an effective treatment for people with autism. Medical researchers and food scientists alike say people with diagnosed CD are harmed by what the journal Gastroenterology described as CD’s “fad component.” For example, restaurant servers may not take diner’s dietary requirements seriously, believing them to be mere preferences, not medically necessary. The same lax attitude toward avoiding gluten cross-contamination has been documented in commercial food processing, and one medical journal noted that “Medical professionals may also confuse medical explanations for gluten intolerance with patient preference.” The examples in the preceding paragraph are on one hand inexcusable; food safety and accurate labeling is of paramount importance. On the other hand, millions going gluten-free when just 1-2% of the population actually needs to be is seen by some as a recipe for ignored warnings and false alarms. +

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Many young people hear this all the time from their parents, and maybe their grandparents and teachers too. “Stop slouching!” “Put your shoulders back!” What is so all-fired important about posture? Let’s start with teenagers. Poor posture gives off a definite slacker vibe. Visually, it’s as unattractive as can be, and nobody wants that at any time of life. It might take a little conscious effort to make a habit of not slouching along, bent over life someone 50 years older than you are, but when life transforms from schooling to a work, good posture becomes more than just how a person looks. Whether a person goes on after high school or college to a desk job or one that is physically demanding, good posture is all-important. Heavy lifting using poor posture can result in injury and pain that might not go away for a long time. And believe it or not, sitting at a desk looking at a computer screen all day has its own set of physical demands that can be made much more demanding and painful with poor posture. For anyone and everyone, the most common problems resulting from poor posture comprise quite a list, starting with headaches. Pain and tightness in the neck and back can cause such headaches, or the neck and back can just politely can pain only without adding a headache too. Either way, it’s not fun, especially considering it’s all avoidable. When it isn’t avoided and poor posture persists, headaches and neck and back pain can be chronic, and reduce a person’s quality of life considerably. Poor posture can also cause major shoulder pain, especially in desk job settings. According to the Mayo Clinic, because of poor posture some people experience knee and hip pain, jaw pain, foot pain, fatigue, and even breathing problems. In other words, posture — whether good or bad — can affect a person from head to toe. Proper posture helps prevent undue strain on the spine, muscles, and joints throughout the body. Unfortunately, poor posture seems to be much more common that ideal posture, but gven the benefits of good posture, it’s worth the conscious effort to make it happen. +

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FEBRUARY 2, 2024

AUGUSTAMEDICALEXAMiNER

#206 IN A SERIES

Who is this?

his well-known man isn’t necessarily famed for his contributions to medicine, but considering that things like breathing (see pages 1 and 5) and eating are vital components of health and wellness, he deserves to be profiled here among the greats of medicine. He made pioneering strides in agricultural science which protected the soil and benefited countless millions. Of course, this is the one and only George Washington Carver, and the fact that he is known at all, let alone as a distinguished scientist, is a minor miracle. He was born in Missouri before the abolition of slavery, the exact year unknown. His “owner,” Moses Carver, had purchased George’s parents in October 1855 for $700. (According to the inflation calculator at officialdata.org, that would be the equivalent of more than $24,000 today.) A week after George was born (circa 1864) he and his mother and sister were kidnapped and sold to slave traders. An investigator Moses hired found only George. Soon after, slavery was abolished, and the Carvers raised George and his older brother James as their own children, teaching them the basics of reading and writing. Carver’s lifelong pursuit of knowledge was not without many setbacks. For instance, after earning his high school diploma* he applied to several colleges before finally being accepted at Highland University in Kansas. When he arrived there and they discovered he was black, the offer was rescinded. Not to be deterred, he later applied for a loan to use for education ($300, or about $9,700 in 2024 dollars). With those funds he eventually (in 1891) became the first black student at what is now Iowa State University. His (white) professors encouraged him to follow up his degree in Agriculture there with a master’s degree. He subsequently became Iowa State’s first black faculty member. In 1896, Booker T. Washington invited Carver to head the department of agriculture at Tuskegee Institute (now Tuskeegee University) in Alabama, a position he held for nearly 50 years. Among his accomplishments: recognizing the need for and the benefits of crop rotation as a way to improve yields and avoid soil depletion; he introduced “new” crops like soybeans, sweet potatoes, and his beloved peanuts to farmers who had been planting only cotton year after year. His many patents and inventions earned him a job offer at an annual salary of over $100,000 from Thomas Edison (Carver declined), as well as friendships with Henry Ford, Gandhi, both Presidents Roosevelt, and President Coolidge. Carver was one of the first to show white America that blacks were capable of intellectual achievements, and in the process he paved the way for a better life for people in the South and around the world. + * He grew up as simply “George,” and sometimes “Carver’s George.” He attended high school in a town that had another George Carver, so he chose a middle initial at random to avoid confusion. Someone later asked him if the “W” stood for Washington, and he thought, “Sure, why not?”

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age BY J.B. COLLUM

gifts upon us and this included our grandchildren. On top of that, we had decided to give the grandchildren and our adult children some gifts too. So instead of crying and ranting and raving and maybe even going to urgent care, I sat in my recliner in my incredibly uncomfortable position, in pain, and oohed and aahed over the gifts being opened while watching mostly just with my left eye and having the kids bring their gifts over to my right when they weren’t in my limited field of view. I had already taken my regular morning arthritis medication and it doesn’t allow me to supplement with ibuprofen, so I took some extra strength acetaminophen and soldiered on. The gift-giving mostly went well despite my awkward situation, but the rest of my plans for the weekend were now completely shot. I had two funerals to attend that weekend but had to settle for attending via Zoom. I had planned to do some work around the house, but those plans were put on hold. I tried a lot of things to alleviate the pain, most of which were probably ill-advised, like having someone try to “pop” my neck and back, among other things. I also tried a heating pad and that at least seemed to soothe it some. Mostly though, I just stayed in bed curled up in my ridiculous looking position while trying to watch TV and occasionally browse the web on my phone. At some point on Sunday, in another effort to alleviate the pain, I reached back with my right hand and was simply rubbing the part of my neck that the pain was emanating from. Shortly after starting this, I heard a combination crunch and pop. Not something you necessarily want to hear from a middle-aged body. At the onset of the sound, the pain spiked, but then the relief flowed in afterward and I was able to resume a normal non-T-rex/non-Hawkian posture once again without suffering lightning bolts of pain down my back and arm. It was still a little tender and so I took it easy the rest of the day, but at least enjoyed the last little portion of my weekend. What is the lesson of my story? I don’t really know if there is one, but I am going to try to get something good out of it anyway. Here is my attempt: Just because you could get hurt exercising, don’t let it stop you from trying. If even a little low-impact game of bounce the balloon from a recliner can result in an injury, it’s obvious that things can happen. I’m not saying you should take up skateboarding and BMX biking in middle age, but don’t hold back from exercise just because of what might happen. If you don’t exercise (and eat right too) you know for a fact that bad things will happen as you age, so consult with your doctor and stay as active as your health allows. +

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Exercise for middle-aged folks is important, but don’t get hurt doing it. My trips to the gym have been on hiatus lately due to various factors (not the least of which is laziness), but in my defense, it didn’t start that way. I’ve had some injuries and illnesses that got in the way initially, and after that it was hard to get started again. I still have the best of intentions in regard to getting back to it, but for that to happen, I have to not overdo it when playing sports. Let me give you an example. Last weekend, it was decided by two of our grown children that our wedding anniversary would be celebrated on Saturday morning. They wanted to make us breakfast and then shower us with gifts. Not ones to ever turn down free food that we don’t have to prepare or clean up after, or gifts for that matter, we quickly were convinced to play along. After a delicious breakfast of homemade French toast, bacon and eggs, we repaired to the den to await our presents. While waiting for all of the pieces to be put in place for the celebration to begin, my son and grandson were bouncing a balloon back and forth in my general vicinity. Yes, I know, this is probably not the first “sport” that popped up into your mind when I mentioned getting hurt during sports. Okay, I get it. It isn’t like it’s in the Olympics or anything and I probably won’t get much street cred for admitting I play it sometimes, but at least it is better than being a couch potato, alright? Anyway, when the purple balloon finally strayed close enough (yes, it was purple too. Shut up), I got into the action by knocking it toward one of them and so it became a threeway game. Although I was playing, I stayed in my recliner and only took my turns when the balloon got close enough. On what was to be my final play of the game, the balloon was just slightly out of reach, so I pushed myself up a bit and extended my right arm an extra distance to reach the balloon, and although I successfully knocked the balloon into play, something in my previously injured neck decided that this particular maneuver just wasn’t something it had agreed to in the union contract, and so it made a sickening crunching sound and sent waves of pain down my back and arm in protest. My involuntary reaction was to draw my left arm up in a manner that resembled a tyrannosaurus rex arm more than a human one. Simultaneously, I discovered that the only position for my neck that didn’t cause excruciating pain was twisted slightly to the right side, looking up, and resting on my right shoulder. No offense to the late great scientist Stephen Hawking, but if someone had walked in without knowledge of what had just happened, they would probably scold me for mocking the man because I looked for all the world as if I were imitating his posture. I wasn’t trying to. It was just survival. Let me be clear. Just because that position involved the least amount of pain is not the same as saying that it was comfortable or that there was no pain. It was very uncomfortable, and the pain was quite intense. That said, what was I to do? The family was now ready to bestow their

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I LOOKED LIKE STEPHEN HAWKING

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

I HAD A BAD EXPERIENCE

In hindsight (see page 1 if you don’t know what I’m talking about), I don’t blame that doctor for her reaction. I really didn’t know what I wanted, but I was pretty sure it would come in prescription form. In fact, when she said all I wanted was drugs, I think I agreed. “Yes, if that’s what will help me.” Her very unprofessional response (in my opinion) sent me away, never to return for her xeroxed breathing exercises. What a New Age quack I thought, or words to that effect. Not long after I happened to be outside when a neighbor I had never met was in his yard as I walked by. In the course of our conversation he told me he was a psychologist who worked at the VA treating people for various anxiety disorders like PTSD, panic attacks, etc. I had heard that term — panic attacks — for the very first time just the day before, and instantly recognized that’s exactly what I was frequently experiencing. And now I meet someone who treats people with panic attacks for a living. Is this a great country or what? Fortunately for me, my neighbor, Dr. Ralph Bruno, also saw patients who were not at the VA. I couldn’t make my first appointment fast enough. I remember bringing up the subject of medications at that initial appointment. Some other doctor had given me Xanax, which I would take when something was coming up that day involving public speaking. Xanax worked ok, but once the panic-inducing event was over I was sleep-walking the rest of the day, if not literally sleeping. All for maybe a 5-minute talk. Dr. Bruno’s side private practice included a psychiatrist. He explained that psychologists can’t prescribe drugs, but if it came to that his psychiatrist colleague could handle the Rx duties. But he explained to me why I didn’t want to go that route: Drugs are expensive. They have side effects. You can forget to take them. You can forget to refill the prescription. Prescriptions run out. And if an unexpected trigger event occurs, you can’t put everyone in time-out for an hour while you take a pill and wait for its effects to kick in. So drugs were a decidedly less than desirable option. Instead, guess what he taught me? You’re not going to believe it: breathing exercises! I know, right? But what a blessing that has been. Learning to breathe properly to control stress and anxiety — and yes, even fullblown panic — is a hugely powerful and beneficial skill to acquire. I’m not sure if I would have been able to pick up the skill from a handout from Doctor #1, but getting what was esentially in-person lessons during my appointments at Dr. Bruno’s office certainly did the trick. Those breathing exercises changed my life for the better, and I use them frequently to this day, decades later. Thank you, Dr. Bruno, I guess I’d have to say my bad experience ultimately turned into a very good experience. + — Dan Pearson Medical Examiner publisher

AUGUSTAMEDICALEXAMiNER

THE COSTS OF DYING Kaye, an accountant, was active until her late 70s. Then, DDD (Degenerative Disc Disease) set in with progressive and hostile intent. She went the orthopedic route: 3 spinal surgeries over a two-year period. Each helped … temporarily. The cost was big, but Medicare helped greatly, as well as her supplemental insurance. When no other surgical help was possible, she went into Pain Management. It took a year to get a reasonable level of pain control, a pain reduction of about 40%. Medication and three rounds of nerve ablation offered varying results. Quality of life and pain levels were fluid, even with two years of the best of care in Pain Management from David Baker, DO. She became more and more dependent upon her husband and family (attorney son and school teacher daughter). Exercise became intolerable. Her appetite

BASED ON A TRUE STORY (most of the time) A series by Bad Billy Laveau

disappeared. Weight crashed from 127 to 105. Depression was mild considering everything. Anything outside the home was near non-existent. Car rides, even a couple miles to the grocery or a doctor’s office, were excruciating. Church pews were intolerable. TV streaming of church services was helpful. Hours of watching Olivia solve crimes on Special Victims Unit helped pass the time. Quality of life was miserable at best. Opioids reduce pain, but have undesirable side effects. She did not want to take opioids, but there was no other way to blunt the

constant, unbearable pain. She lapsed into negative metabolism and finally into “Failure to Thrive,” an umbrella term describing loss of appetite, weight loss, a lack of interest in other people or social activities, memory loss, trouble thinking, and trouble with daily activities such as getting in and out of bed, walking, bathing, dressing, and using the bathroom. Her protein intake declined. Weakness prevailed. Cognitive function fell. Gait was unstable and highly questionable. Energy level was low. Proprioception (her body self-awareness) declined. Ability to swallow steadily diminished. It was a sad downward spiral. Heart rending. A five-day stay at Doctors Hospital confirmed all the above. IVs corrected electrolyte imbalance, notably potassium and magnesium. Clearly, Failure to Thrive syndrome. Incurable.

FEBRUARY 2, 2024 She was discharged to Hospice care. Agape Care provided daily nursing care: Adrianna, RN. Autumn, CNA. Crystal, Social Worker. Dana, RN on weekends. (Actually, I think these ladies were sent by God to help out in times of great need.) Then came the hardware. Hospital bed. Over-the-bed table. The shower chair which she could not use because she could not get to the shower. But the chair helps the caregivers do their work. Instructions: Maintain hygiene. Gently encourage intake of liquids and medications. Food as tolerated. Don’t put anything in her mouth that she doesn’t request. Not food. Not water. But she must have her pain medication, even though her pain level decreased when she became immobile. Family members helped, as did neighbors. The heavy load fell upon her husband, a “Covid long hauler” with limited exercise tolerance. Her 8-pound Chi-Weiner rescue dog, Daisy, was an active

doorbell and comfort giver. Daisy sleeps by her bedside, guarding or nursing, I’m not sure. Maybe both. Her home was rearranged, closing off the top floor and moving her to the downstairs mother-in-law suite. Her husband sleeps in the den to be near her. The family is in an upheaval. Nobody can find anything anymore due to the rearrangement. The dollar cost, so far, is in the lower six-digits. Fortunately, she has supplemental insurance and Medicare, both of which she had paid dearly for over many years. The outcome is certain and undesirable. Through a lifetime of conservation and preparation, she needs no (nor would she ever desire) public assistance. The cost of death is high. It is paid not only in dollars, but even more so in bitter tears and heartache. To quote Jackie Wilson: “My heart is crying, crying … lonely tear drops. My pillow is never dry … of lonely tear drops.” +

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AUGUSTAMEDICALEXAMiNER

FINE HOMES DESERVE OVERHEAD

by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb

PEANUT BUTTER & BANANA SMOOTHIE BOWL When it comes to making smoothie bowls, anything goes. This recipe could easily be tweaked. For instance, you could use cow’s milk or almond milk instead of the soymilk; add some Greek yogurt to boost the protein even more; or swap out the peanut butter for another nut butter you like.

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Ingredients • 1 cup plain or vanilla soymilk • 2 frozen bananas • 3 tablespoons peanut butter • 2 tablespoons cocoa powder • 1 tablespoon chia seeds • ¼ teaspoon pure vanilla extract Optional toppings: Crushed Graham crackers, chopped peanuts, O-shaped whole grain cereal, chia seeds, coconut chips, sliced banana Directions Place the soymilk, bananas, peanut butter, cocoa, chia seeds, and vanilla in a blender and blend until smooth. Pour into individual bowls

Remember: SALUBRIE

and garnish with your choice of optional toppers. Yield: 2-3 Servings (serving size: ¾ cup) Nutrition Breakdown: Calories: 270 Fat: 13g, Saturated fat: 2.5g, Carbohydrates: 34g, Sodium: 130mg, Fiber: 7g, Protein: 10g

Each smoothie bowl has 15% of the daily requirement for calcium and vitamin C. Recipe by Meal Makeover Moms Kitchen at http://www. mealmakeovermoms.com/ kitchen/2015/06/23/peanut butterandbananasmoothie +

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NUTRITION Miley, a Facebook friend from Canada, asks “I need your advice on which type of olive oil is the best.”

Olive oil is a recommended part of the Mediterranean Diet. In addition, February is Heart Month and olive oil is “heart-healthy.” However, if you have been to the supermarket recently, you know that the price of olive oil has skyrocketed. Climate change has brought droughts to Italy and Spain, and this has directly affected olive trees and olive oil production. With olive oil prices so high, I have been recommending switching to other healthier oils for cooking. I recommend using olive oil sparingly, for example, for salad dressings. When I do buy olive oil, I usually look for extra-virgin olive oil, also known as EVOO, which is extracted from olives by pressing the olives in the traditional fashion. On the other hand, non-EVOO is usually extracted using heat or other manufacturing chemical processes, which tend to destroy some of the molecules in the olive oil. It is important to be aware that there are issues with EVOO: most EVOOs sold in the United States are falsely labeled. Approximately, 60% of the olive oils labeled EVOO and being sold in U.S. supermarkets are not EVOO. In addition, there is not convincing scientific data supporting the claims that EVOOs are heathier than any other type of olive oils. The evidence-based conclusion is to buy the least expensive olive oil, which is usually the store brand. If prices have put olive oil out of reach for you, switch to other “healthier” oils, like canola oil. You can also cut down on the amount of olive oil you use by putting the oil in a sprayer bottle and, instead of pouring the oil, spritz it into your non-stick sauté pan or onto your salad. Spritzing rather than pouring is always a good idea when using oils. Remember that all oils are extremely high in calories, so cutting down on the amount of oil you use is an important

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FEBRUARY 2, 2024

thing to do. Besides canola oil, sesame oil and avocado oil are two other oils that are considered “healthier” vegetable oils. They all have the same types of “healthier” fat, although sesame oil is higher in polyunsaturated fat and lower in monounsaturated fat than olive oil. But again, any of these oils would be fine. What are the factors I use when considering which oil to buy? They are taste, price, and the smoking point of the oil. Using this approach, sesame oil is great when making Asian dishes. Sesame oil has an extraordinarily strong flavor, a flavor which complements Asian food. Because it is so flavorful, you need to add only a little bit of oil for the taste you

are after. Also, try adding a little bit of sesame oil to the pan the next time you are sautéing salmon for dinner. It adds a wonderful flavor to the salmon. If you want to use higher heat to caramelize your vegetables, add a little bit of sugar (to increase the browning, not for taste or calories) and use a vegetable cooking oil that has a higher smoking temperature. Cooking oil is considered to have a higher smoking point if it does not smoke until it reaches 400° F or higher. For example, canola oil is a higher smoking point oil. If the oil starts to smoke, then immediately lower the heat. When an oil smokes, it means that the oil is close to catching on fire, so lower the heat at once. What is the “No-Nonsense Nutrition” advice for today? The Mediterranean Diet recommends using olive oil, but if the cost of olive oil puts it out of your reach, do not despair. There are other “healthier” vegetable oils you can substitute. Good nutrition does not depend on focusing on this molecule or that product. It means that your overall eating pattern is vegetable-based, not animal-based. It means that you eat high-quality carbs that are reliable sources of fiber and whole grains. Buy less expensive oils, do not deep-fry foods and use the more expensive oils sparingly, for flavoring what you eat rather than as your “go-to” oil for cooking. +

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, Dr. Karp book, nutrition product or company. His interest is only in providing freely available, evidencedbased, 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.

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Tell us about your medical experiences

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EMAIL: Dan@AugustaRx.com MAIL: POBox 397 Augusta GA 30903 Your story can be “by Your Name,” “by your pen name,” or “by Anonymous.”

FEBRUARY 2, 2024 “EVERYONE HAS A STORY”

HEADING FOR A FALL When I fell, the blow to my head caused the trauma doctor said that there was no brain a severe concussion. A concussion is a type bleeding indicated by the tests. of traumatic brain injury caused by a bump, I was released to go home in the care of my blow or jolt to the head or body that causes the daughter, Donna, who is a nurse. When we got head to move rapidly back and forth. In turn, home, I became so dizzy that Donna said we that head movement results in the brain being could not risk another fall, so EMS was called bounced around inside its protective casing in for me the second time that day to take me the skull. back to the hospital. SOME OF THE LESSONS I LEARNED My concussion caused The dizziness continDURING REHAB me to spend 14 days in ued throughout my stay the hospital, then eleven in the hospital and even more in a non-acute rehab • A non-invasive catheter for females at times at the rehab makes life easier for everyone: the patient facility. facility for physical and with limited mobility, caregivers, and staff. occupational therapy. I learned that the diz• “Shower caps” are available with water ziness was caused by a Having gone through and shampoo inside that enable a person malfunction in the inner that experience, I want to shampoo their hair and towel dry with- ear due to the jolt to my to share what I learned, as well as some of the re- out getting out of bed. head caused by the fall. search I discovered about • Uniform colors provide a visual of each A Patient Information concussions (and recover- staff member’s department and duties. Fact sheet I was given For example, nursing staff may wear blue explained it like this: ing from one). scrubs, housekeeping might wear red, What happened to “There is a collection of and dietary (the food bringers!) might cause the injury? I was tiny crystals inside your wear green uniforms. walking into a shipping ear. They play a valuable store with a package I was • Patient call button alerts visible outside role in their correct porooms are also color-coded in some going to send. I lost my sition, but dizziness can facilities. They might normally blink green, occur when the crystals balance as I stepped up but may flash red if the call button is used are dislodged from their on the sidewalk outside from the bathroom the store. Rather than correct position. They • Rehab is not a process to be rushed; falling right then, I tried can move into one or you have to do the work, but it’s also unsuccessfully to regain more of the semi-circular necessary to take the time to let healing my balance three times canals and either contin+ take place. in the next few seconds. ue to float around or beAll I managed to do was come attached to another increase the momentum of my fall and make part of the ear.” my inevitable landing even worse. I am very appreciative of the caregivers who Two store employees looked out the window took care of my physical needs — but also my and saw me lying on the pavement out in the emotional needs with smiles, laughter, comparking lot. They ran out to check on me and passion, and assuring me that I would heal then called EMS, who took me to the hospital and be well. Thank you. + emergency room. After two CT scans (computed tomography) — Dolores Eckles and an MRI (magnetic resonance imaging), Evans, Georgia

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CRASH

COURSE

More Americans have died on US roads since 2006 than in World Wars I & II combined We wanted to do a follow-up on Crash Course from a month ago, in the January 5, 2024 issue (you can read the back copy in your family scrapbook or go to https://issuu. com/medicalexaminer/docs/1.5.24 and read it online, page 10 as always). As you recall, there is a growing consensus in the field of highway safety that more attention needs to be directed toward things like safe vehicles and safe roadway design, and less effort aimed at traffic enforcement. Why? One of the most important reasons is that traffic enforcement is reactionary. It takes action only after the unsafe action has occurred, but even then, only if was directly observed, or if it results in a collision. Enforcement may act as a deterrent to the driver who gets a ticket, but what about the tens of millions of other drivers on the roads? In addition, traffic enforcement is often unpleasant for everyone involved, in part because in city after city, in case after case, enforcement is carried out unequally and therefore unjustly. Simple traffic stops can escalate by both parties until violence results, and then days or weeks of destructive rioting sometimes ensue. Compare all of that with the growing interest in safer cars and safer road designs, which means enhanced safety for every single mile driven on every single road and every single vehicle, and for all the passengers in all those vehicles — not just when the cops are watching. One approach is constant safety through design, meaning it happens with or without the driver’s active participation or even awareness. The other depends on whether each driver is conscientious and responsible enough to drive safely even when police aren’t around, which is the vast majority of the time. One important point: no one at any level of traffic safety, from national and federal organizations on down to local municipalities, is suggesting that safe design is the entire answer, or that enforcement should be eliminated. In fact, as recently as December 2023 the World Health Organization (WHO) noted that lax enforcement of traffic laws is one of the top contributors to roadway death and injury. They stated, “If traffic laws [...] are not enforced, they cannot bring about the expected reduction in road traffic fatalities and injuries related to specific behaviours. Thus, if traffic laws are not enforced or are perceived as not being enforced, it is likely they will not be com-

plied with and therefore will have very little chance of influencing behaviour. “Effective enforcement includes establishing, regularly updating, and enforcing laws at the national, municipal, and local levels... It includes also the definition of appropriate penalties.” (Underline ours) Sometimes, at least locally, it seems like traffic enforcement has already been largely abandoned as a tool for improving safety and protecting the lives of every driver. Of particular interest is the ever-growing trend of running red lights. Once upon a time, it was rare to see a car cross in front of traffic that just got a new green. The new normal: it’s not at all unusual to see that. It’s not even uncommon to see two or three cars cross an intersection late enough that cross traffic already has a green. This past weekend one of our team of RTIOs (Roving Traffic Investigators and Observers) noted what may be a new record: the RTIO was first in line at a red light; oncoming cars were turning left in front of the RTIO on a green arrow. Their green arrow finally ended and the RTIO’s light went green. However, the stream of left-turning cars never stopped; five or six cars ran their red light. In fact, they kept coming until finally the two lanes of traffic that had a green light more or less aggressively asserted their right to drive forward. Note: the left-turners did not have a flashing yellow left-turn arrow. Half a dozen cars running a red light is a red flag for lax enforcement, not because of that one light, but because that one light, even with its world-record-red-light-running status, is just the tip of the iceberg. It’s symptomatic of red light running all over town. Traffic enforcement, for all of its limitations and faults, still has a crucially important role to play in making roads safer for everybody. Safe design is a slow and gradual systemic process; enforcement can act in the moment with surgical precision. Unfortunately, we desperately need both approaches. According to WHO statistics, about 1.2 million people worldwide die each year as a result of road traffic crashes, with another 20 to 50 million people injured. Highway crashes are the leading cause of death for children and young adults aged 5–29 years. The only direction those numbers need to go is down, by whatever effective means necessary. +

FEBRUARY 2, 2024

BE QUIET!

Please stop what you’re doing for one minute and think about 1-MINUTE MEDICAL how the vast majority of us go through our daily lives. We face a never-ending onslaught of noise. Music is streaming through our earbuds; we’re on cellphone calls; we’re watching non-stop videos on YouTube, TikTok and Instagram; Sirius is on in the car; the TV is always on at home. Many people rarely get to experience what the lady below is enjoying: thoughtful, meditative silence. Despite its rarity, quiet is an important ingredient in a healthy life. Why is the experience so rare? Because it will not happen by itself. Anyone who wants to enjoy some real peace and quiet is going to have to make it happen, and it may require creativity. Maybe your five or ten minutes of silence will need to occur in your car out in the driveway or in the parking lot at work. Wherever you get your daily dose of silence (yes, daily), make deep breathing and quiet, positive thoughts part of the experience. +

FRONT DESK ! TURE A E F NEW

FOLLIES

+ 10

...wherein we share amusing medical mis-speakings and misspellings we have overheard, or that have been shared with us.

The patient listed “toxic sock syndrome” in her medical history. The patient said he had previously suffered a torn menial hibiscus. “They told me I have an unbiblical hernia.” READERS: What have you heard? Please share! EMAIL: Dan@AugustaRx.com or MAIL: PO Box 397, Augusta GA 30903

NEVER MISS AN ISSUE: SUBSCRIBE (SEE P. 13) OR VISIT ISSUE.COM/MEDICALEXAMINER 24/7

The blog spot — posted by Jennifer Lycette, MD, on Jan. 6, 2024

IT IS LITERALLY IMPOSSIBLE TO BE A WOMAN IN MEDICINE A monologue in the style of America Ferrera’s character Gloria in the Barbie movie (original script by Greta Gerwig). It is literally impossible to be a woman in medicine. You can be at the top of your class in medical school and residency, and yet you will never think you’re good enough. Like, we have to always be infallible, but somehow, we’re made to feel it’s never enough. Even when we become attendings. As a woman in medicine, you have to be assertive but not too aggressive. And you can never say you want to be ambitious. You have to say you want to be successful, but also you have to be humble. You need a nice wardrobe but can’t ask for equal pay because that’s crass. You have to be a leader, but you can’t be bossy. You have to run the code, but you can’t talk over other people. You’re supposed to find time to be a mother, but don’t expect anyone to cover for you when you take maternity leave. You have to constantly be thinking of your CV, but also always be a team player. You have to ignore men’s bad behavior, which is ridiculous, but if you point that out, you’re gaslighted. You’re supposed to stay attractive for men but not so attractive that you stand out or that you threaten other women because then the nurses won’t respect you or follow your orders. Always be the last one to leave and always be resilient. But never forget that the system is rigged. So find a way to acknowledge that but also always be resilient. You have to never get tired, never be wrong, never brag, never ask for time off, never sleep, never fail, never be late, never be out of childcare. It’s too exhausting! It’s too contradictory and nobody gives you a medal or a raise. And it turns out, in fact, that not only does research show patient outcomes are better for women physicians than men, but also you’re still not getting equal pay. To the tune of two million dollars less over the course of a career. I’m just so tired of watching myself and every other woman in medicine tie herself into knots to reach some impossible standard that doesn’t exist. And still, despite all our hard work, we often won’t be called “Doctor.” +

BE ATTRACTIVE. BUT NOT TOO ATTRACTIVE.

Jennifer Lycette is a novelist, award-winning essayist, rural hematology-oncology physician, wife, and mom.

11 +

AUGUSTAMEDICALEXAMiNER

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AUGUSTAMEDICALEXAMiNER

The Examiners +

I’m an atheist. What about you?

by Dan Pearson

You actually believe in God?

No way. Not me.

How can you believe in something you’ve never seen?

Sure, absolutely.

Well, I believe that Home Depot employees exist...

PUZZLE

19 22

25 30

36 40 43 46

Simply unscramble the letters, then begin exploring our ads. When you find the correctly spelled word HIDDEN in one of our ads — enter at AugustaRx.com

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, FEB. 11, 2024

We’ll announce the winner in our next issue!

3 9 E X 9 1 7 A 3 M8 7 2 I 5 6 N 6 E 4 1 R

S U 1 4 2 D 3 4 1 O 7 K 1 3 5 U 5 4 7

DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.

33. Flat shelf 38. Bobbins 39. Another name for Aaron 46. Existing in a specific place 47. Embarrassed 48. Lubricant 50. Dog type? 52. Augusta rarity 53. ____ Park neighborhood 54. Tea type 55. Portico 56. Promote 57. Ultimatum word 58. Dock 61. Gehrig’s initials?

Solution p. 14

QUOTATIONPUZZLE T T T S

O E S S R R A T O F E U K O P S B O E H E H H E S

A P R T Y P P E W H

A N S S I Y I

2 8 9 1 4 5 6 3 E 8 7 5 4 1 6 7 9 3 2

— Martin Luther King Jr.

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once. Black squares indicate spaces between words, and words may extend onto a second line. Solution on page 14.

Use the letters provided at bottom to create words to solve the puzzle above. All the listed letters following #1 are the first letters of the various words; the letters following #2 are the second letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.

N 1 2 3 4 5 6

S 6 7

1 2

H 1 2 3 4

1 2 3

H 1 2 3 4

1 2 3

H 1 2 3

1 2 3 — George S. Patton

1 2 3 4 5 6

1.B B Y Y W I S H H H 2.O O O O O U H I S I 3.GUUUCTTWE 4.NNTCH 5.CEO 6.MES 7.S

SAMPLE:

1. ILB 2. SLO 3. VI 4. NE 5. D =

3 7 6 1 9 2 5 4 8

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

20 21 ACROSS 1. Friday starter, sometimes 24 6. Bobby and Barry 26 27 28 29 11. Corn holder 14. Mad 34 35 15. Revolutionary path 37 38 39 16. Mineral spring 41 42 17. Stair part 18. Mother-of-pearl 44 45 19. Former soldier’s abbrev. 49 50 20. Exceptional or significant 22. Knight follower 52 53 54 55 24. Medical prefix 59 60 61 25. Skin eruption 26. Impurifier 63 64 30. Masters champ (‘04, ‘06, 66 67 ‘10), to friends by Daniel R. Pearson © 2024 All rights reserved. 34. Kent’s girl 35. Snakelike fish 36. Came up DOWN 37. Of the ear 1. Word before ball or bug 38. Ostentatious 2. Eye part 40. Mild oath 3. Coarse file 41. Hebrew letter 4. Part of Aiken’s triple crown 42. Imitate a 49-er 5. Three lines of verse 43. The Hague (in Dutch) 6. Walton Way landmark 44. On the ocean 7. By mouth 45. Rebellion 8. WAGT network 49. Submerged 9. Without delay; frankly 51. Swiss capital 10. Harsh 52. Protect 11. Area abbrev. 55. Evade 12. Store door word 59. WTC setting 13. Sheet of matted cotton 60. Shallow flat dish 21. Wrath 62. Garlic-flavored 23. Censure, reproof mayonnaise 25. Once more 63. Lyric poem 26. Hilo greetings 64. Serf of ancient Sparta 27. Sees 65. Habitual drunkard 28. Join 66. Marry 29. Ages 67. Analyze a metalic 31. Masters legend Ben compound 32. Son of Abraham 68. Store door word

WORDS NUMBER

THE MYSTERY WORD The Mystery Word for this issue: ANNLIUFEZ

EXAMINER CROSSWORD

FEBRUARY 2, 2024

9 5 3 7 2 6 4 8 1

1 4 2 8 5 9 3 6 7

7 6 8 4 3 1 9 2 5

FEBRUARY 2, 2024

13 +

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE

The

Advice Doctor

news: we all get to be on TV tonight…”

ha... ha...

swarm of bees is flying through the countryside when one of the worker bees at the back flies up to the front and asks the queen if there is any chance of stopping for a bathroom break anytime soon. The queen bee says, “Hang on a bit longer. There is a BP station coming up in a couple of miles.” Moe: Somebody broke into my house and stole 20% of my couch. Joe: Ouch! A man appears in a court proceeding to have his name legally changed. “What is your name currently?” the court clerk asks. “George Sewage,” replies the man. “I can certainly understand why you want to change that,” says the clerk. “What would you like your new name to be?” “Jim Sewage,” the man replies. A pilot’s voice comes on through a plane’s intercom system.“Ladies and gentlemen, this is your captain speaking. First, a bit of a good

A man on vacation in Las Vegas visits a casino and, hoping for an insider tip, asks a security guard which machine people get the most money from. The guard pointed to an ATM. A group of super heroes meet to discuss their plan to defeat the evil Count Dracula. Wonder Woman says, “The problem is, we don’t know where Dracula could be hiding! He moves around so much, we’ll never find him!” “I’ve been tracking his locations for the past 72 hours,” Batman replies, “Based on his movements I have good reason to believe he’ll be at the local cemetery, hiding in the crypt tonight.” “Guys, I think I’ll sit this one out,” says Superman. Moe: How are your analogy classes going? Joe: I forgot to tell you I dropped out. Moe: Why? What happened? Joe: The whole thing was like...well, like...I don’t know, almost like... Moe: Are you going to that funeral this weekend? Joe: On Sunday? Yeah. That will be a sad day. Moe: True. And the day before that will be a sadder day. Moe: What’s the difference between gray and grey? + Joe: One is a color and the other is a colour.

Why subscribe to theMEDICALEXAMINER? Staring at my phone all day has certainly had no Effect on ME!

Because try as they might, no one can stare at their phone all day.

Dear Advice Doctor, I have worked in a very unpleasant job environment for the past three years. Last week there was a particularly unpleasant day and on the spur of the moment I quit. I went straight over to where a friend of mine works and was hired on the spot. I don’t like it here at all. Do you think I should give this place a little more time, start all over again someplace else, or go back to my old job and tell them I’ve had a change of heart? — Confused Dear Confused, I’m glad you wrote to bring this important matter to the minds of readers of this column. It’s amazing to think back that nearly 57 years ago, someone’s change of heart was one of the biggest news stories of the year. On December 3, 1967, South African cardiac surgeon Christiaan Barnard performed the world’s first humanto-human heart transplant. It was headline news all over the world. The recipient of the new heart, Louis Washkansky, died 18 days later of pneumonia, but the floodgates were opened: only three days later the world’s first pediatric heart transplant was attempted. The infant’s new heart stopped beating after only 7 hours. It was an inauspicious beginning, but then, many pioneering procedures and innovations are. Today, some 3,500 heart transplants are performed around the world each year, and post-operative survival now averages 15 years. The progress didn’t come quickly or easily. The first suggestion of the possibility of heart transplantation was in a 1907 medical journal, but it took decades for a human to get a new heart. That momentous event happened at the University of Mississippi Medical Center 60 years ago last week, on Jan. 24, 1964. Things did not go too well, and the surgeon, James D. Hardy, was ostracized for the procedure, even though he was already noted for performing the world’s first lung transplant. There were ethical questions about Hardy’s heart transplant attempt, perhaps because the donor heart came from a chimpanzee, and perhaps because the consent form signed by the comatose recipient’s stepsister failed to mention that. Every misstep along the way paved the way for better steps to come. Despite their relative prevalence these days, heart transplants are still a major, last-resort procedure. I hope this answers your question. Thanks for writing! + 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.

SUBSCRIBE TO THE MEDICALEXAMINER Why read the Medical Examiner: Reason #8 +

By popular demand we’re making at-cost subscriptions available for the convenience of our readers. If you live beyond the Aiken-Augusta area, or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house! NAME ADDRESS CITY STATE ZIP Choose six months for $24 ____ or one year for $42 ____. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

BEFORE READING

AFTER READING

+ 14

1 3 5 5 4

THE MYSTERY SOLVED The Mystery Word in our last issue was: SYMPTOMS

...cleverly hidden on the picture of Dr. Henderson in the p. 16 ad for AIYAN DIABETES CENTER

THE WINNER: TOM LAVIN! If that’s your name, congratulations! Send us your mailing address using the email address in the box on page 3. The new Mystery Word is on page 12. Start looking!

FEBRUARY 2, 2024

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED F I R S T B O N D S C O B I R A T E O R B I T S P A R I S E R N A C R E R E T E S P E C I A L E R R A N T P E R I A C N E A D U L T E R A N T P H I L L A N E E E L R O S E O T I C S H O W Y E G A D H E T H P A N H A A G A S E A I N S U R G E N C E S A N K B E R N S H I E L D S I D E S T E P N Y C P L A T E A I O L I O D E H E L O T S O U S E W E D A S S A Y E N T E R

SEE PAGE 12

The Celebrated TheSUDOKUsolution MYSTERY WORD CONTEST 2 8 3 9 1 7 5 6 4

...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.

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QuotatioN QUOTATION PUZZLE SOLUTION The surest way to be happy is to seek happiness for others. — Martin Luther King Jr.

WORDS BY NUMBER Success is how high you bounce when you hit bottom. — George S. Patton

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