MEDICALEXAMINER Tales from the morgue GETSHOT! TM
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APRIL 16, 2021
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Many moons ago I was working in a hospital in the Atlanta area where I was always into something. I did not have access to the autopsy room but I wanted to sneak in and take a look around, especially since I was always told no. I kept hearing that I did not have proper credentials to go inside and snoop, but I was determined to get in. Finally I had this not-so brilliant idea to go through the morgue to enter into the autopsy room. There is only a flap separating the two rooms. A security guard was usually there, and one time while he was putting in the code to open the door to the morgue, I saw the numbers and memorized the code. I waited for him to take a coffee break, and I typed the code in. I was in the morgue! Most of the lights were off and there was one body in the room, an older woman lying on the slab. I thought, wow she looks like she is just sleeping and I went about my business. In the back of the autopsy room was my goal: various specimens preserved for educational use. At the time of my breaking and entering I was also an Anatomy and Physiology student, so I was in heaven. There would be a good heart, and right next to it a necrotic heart. So many organs. There were shelves of spina bifida babies. I was fascinated that I finally got in! Then out of nowhere, the lights came on. I have to hide. If I am caught, I can get fired. I hid behind a wall. It was a professor and his students coming to examine the lady on the slab. He started off, “here lies an 87 year old woman who died of natural causes.” He started asking his students
I thought I saw the body move.
Longtime Examiner readers fondly remember “Musings of a Distractable Mind,” the long-running Examiner column by local physician extraordinaire Rob Lamberts, M.D. He returns here in a short series (this is Part 3 of 3) addressing COVID concerns, vaccine questions and more.
I’m young and healthy; I don’t need no stinkin’ vaccine I actually find my 65+ patients are overwhelmingly getting the vaccine. I have had only one patient in that age group say she wasn’t getting it. The resistance comes from people who are at lower risk, See 3/5 & 3/19 specifically those under 50 years of age. The fact is, most of these issues for 1 and 2 people are not afraid of the virus. To them it is an abstraction, not a real threat to their lives. So why get “some foreign substance shot into my body” when the risk is not very high? The case-fatality rate (the percent of people who die from COVID infection) in the general population is around 1%, with the vast majority of them being older people. But the case fatality rate among people under 50 is approximately 0.3%. This group represents approximately 150 million people. If 75% of those people contract the virus (the estimate for what is needed to achieve herd immunity in the population - which means that enough people have immunity to protect those who are not immune), then over 300,000 more people would die. These are not insignificant numbers, and they could be brought close to zero with the vaccine. But the most significant factor to me is the desire to get back to “normal.” I don’t want to wear masks. I don’t want to stay away from friends. I don’t want to have sporting events with empty stadiums, have restaurants going out of business, and miss out on spending time with friends and family. The only way out of this is for enough people to get the vaccine. Let me repeat (with emphasis): THE ONLY WAY OUT OF THIS IS IF ENOUGH PEOPLE GET THE VACCINE. Some states have lifted their ban on masks and large gatherings, as if doing so will make the virus less real (see the above data and Myths 1 & 2 if you forgot that this is real). To do this when there is a safe, effective solution that has already been paid for (that means it’s free!) is absolutely irresponsible and foolhardy. We all want those bans lifted. We all want “normal.” But wait until it’s actually safe to do so! Have I ever mentioned how much I hate the politics of COVID-19??
MYTH #3
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AUGUSTAMEDICALEXAMiNER
THE FIRST 40 YEARS ARE ALWAYS THE HARDEST
THE MONEY DOCTOR
PARENTHOOD by David W. Proefrock, PhD
Your 14 year-old daughter, like most adolescents, spends way too much time on her phone. You have already limited her time on the phone to one hour after her homework is completed and taken her phone when she goes to bed at night. However, you recently discovered her with her phone very late at night when everyone else had gone to bed. You don’t know who she might be texting or otherwise in contact with. What do you do? A. Have a talk with her about responsibility and trust. B. Most kids spend too much time on their phones. There’s not much you can do about it. C. Take her phone away completely for a few days and give it back a little at a time to give her a chance to prove that she can abide by the rules. D. Put her on complete restriction for lying and being sneaky. If you answered: A. You are already past the point of having a talk. There need to be consequences for breaking the rules. B. Time with her phone is a privilege, not a right. There should be consequences when she does not obey your rules. C. This is the best response in this situation. The consequences follow logically from the offense and provide the opportunity to get the phone back with appropriate behavior. D. Punishments work best when they are directly related to the offense and provide an opportunity to correct the unacceptable behavior. Her phone should be taken away briefly with an opportunity to earn it back. There is no real reason to restrict her completely. Adolescents need structure and reasonable consequences for misbehavior. Your job as a parent is to teach life skills. Obeying rules is one of those life skills. Teaching, not punishment, should be the purpose of consequences for misbehavior. +
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APRIL 16, 2021
WHAT IS FINANCIAL PLANNING? The reason financial planning is important is the same reason teams or performers need to plan, rehearse and practice before playing a game or performing. The planning process helps prepare you for success as your family makes financial decisions every day. Unlike playing a game or performing, your family cannot choose to cancel a game or performance if you are not prepared. As the old saying goes – “Those who fail to plan, plan to fail.” We often hear that the reason people never do financial planning is that they do not know what the financial planning process is or covers. The good news is that the CFP Board has established standards that all Certified Financial Planner™ professionals are expected to follow. These standards outline what financial planning is and covers. The CFP board defines financial planning as “the process of determining whether and how an individual can meet life goals through the proper management of financial resources.” Plans are customized to ad-
dress the areas of importance for your family. The CFP board does not identify a minimum number of subject areas required for financial plans, so a financial plan may cover one or multiple subject areas. The following subject areas are typically included in financial plans: • Financial statement preparation and analysis • Insurance planning and risk management • Employee benefits planning • Investment planning • Income tax planning • Retirement planning • Estate planning Once you identify the subject areas for your financial plan, a Certified Financial Planner™ can help you work through the planning process. The steps in the planning process are also outlined by the CFP Board. It involves six steps: 1 • Establishing and defining the client-planner relationship 2 • Gathering client data including goals 3 • Analyzing and evaluating the client’s current
financial status 4 • Developing and presenting recommendations and/or alternatives 5 • Implementing the recommendations 6 • Monitoring the recommendations The hardest steps are often five and six, the implementing and monitoring. A good financial planner will check in with you on a regular basis and hold you accountable to make sure you stay on track. The planning process is ongoing and life events will change the inputs or assumptions that you make in the original plan. When that happens, it is important to re-visit the steps in the planning process and update your plan. This ongoing planning process is the reason most families look to form a longterm relationship with their financial planner. A good planner will clearly explain how they’re paid and why their help is worth the cost to you. Almost anyone can call themselves a financial planner, so be sure to do your homework and make sure they know what they’re talking about. A good starting place is looking for a Certified Financial Planner™ that is held to the CFP Board code of ethics & standards of conduct found on www.cfp. net. + by Clayton Quamme, a Certified Financial Planner (CFP®) with AP Wealth Management, LLC (www.apwealth.com). AP Wealth is a financial planning and investment advisory firm with offices in Augusta, GA.
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APRIL 16, 2021
MORGUE… from page 1
questions. Moments later when all the students were facing away from the body looking at something else, I got a shock. Did I just see that? I blink my eyes. That lady on the slab moved! I knew I was not going anywhere now. She moved again. I thought rigor mortis is not what’s happening. This is about to be funny. She blinked her eyes. I am trying to not make a sound because I can lose my job for being stupid. She turned her head, sat up a little and said, ”what is going on here?” The professor was the first hand on the door and his students followed. They took off like rodents at a carnival. I am laughing so hard, tears are rolling down my cheeks. A different doctor came in, saw me and said, ”how in the hell did you get in here?” I repeated his question back. Obviously they had to reverse the lady’s autopsy report. Apparently a rushed and overworked physician pronounced her as DOA, but she had some kind of breathing syncope (there is a medical term I can’t think of at the moment). The MD that was on the shift when she came in after her loved ones called for an ambulance thought she had passed away. Not the case! I was called in for a meeting with the director of the hospital and was reprimanded for being in a secured area. I was a good girl afterwards because I was put in the ER where there was nothing but action. I stayed out of trouble. I didn’t have time for misbehavior. But every time I saw the professor or the doctor, I snickered to myself. It was one of the funniest things of my 17 year medical professional career. + Submitted by Eurcyla Roberson Formerly of Augusta, Georgia
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I got the vaccine and had ZERO side effects. Am I still protected? There are people who have scheduled their vaccine appointments, and for the second one in particular, have also scheduled absolutely nothing for the following day — unless you count working down their anticipatory stash of chicken soup, saltines, ginger ale and pain relievers. But nothing like any activities outside the home, including going to work. They have heard all the horror stories from co-workers, family members, the media, neighbors, etc.; fever, chills, nausea, pain, swelling, and redness at the injection site, fatigue, headache, muscle pain and more. It has also been reported than many older people have reduced vaccine side effects because as we age our immune system is not quite the vigorous guardian it once was. Younger people with more robust immune systems typically experience greater side effects because they mount a stronger defense against the triggers delivered by the vaccine. With all of that in mind, virtually everyone expects some vaccine side effects. But the fact that, generally speaking, the weaker someone’s immune system the weaker the side effects might lead someone to worry if they have none. Rest assured, say medical professionals, that is not the case. Recall that a sizable percentage of people did experience side effects during vaccine trials: for the Pfizer vaccine the number was 77.4%; slightly more people felt systemic reactions after a second Moderna shot—81.9%. In other words, nearly 20% of Moderna recipients and well over 20% of Pfizer recipients did not experience side effects. The participants in the vaccine trials are being carefully followed at every stage, from their first dose to the present. Researchers are able to follow up and track the effectiveness of the vaccine among those with no side effects just as they are doing with those who had major side effects. The verdict: the level of side effects experienced has no bearing on the vaccine’s effectiveness. We all experience this virus and the vaccine to protect us from it differently and independently. But side effects have no bearing on vaccine efficacy (or the lack thereof). +
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APRIL 16, 2021
AUGUSTAMEDICALEXAMiNER
#137 IN A SERIES
Who is this? ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com
H
ere we have a man who is the very definition of the forgotten healthcare hero, invisible on the pages of history despite saving untold thousands of lives. No less a medical luminary than Lord Joseph Lister, the great British bacteriologist and pioneer of antiseptic surgery called this man “the saviour of mankind.” And he wasn’t even a doctor. Yet the medical advancements he made more than a century ago (and his setbacks) are quite relevant in the context of the current pandemic. Born in 1860 in Odessa, Russia (now Ukraine), Walldemar Haffkine later emigrated to Switzerland, employing his degree in zoology in a position at the University of Geneva. On the recommendation of an old friend from Odessa (noted biologist Ilya Mechnikov), Haffkine joined Mechnikov and Louis Pasteur in 1889 at the newly established Pasteur Institute in Paris as assistant librarian. In his free time, Haffkine either played the violin or experimented in the Institute’s bacteriology lab. His tinkerings in the lab were productive, and by the summer of 1892, he had developed a cholera vaccine. He also discovered a perfect guinea pig for his vaccine: Walldemar Haffkine. Risking his life, he performed the first human test on himself and reported his encouraging findings to the Biological Society. His discovery was not widely accepted by his senior colleagues, including both Mechnikov and Pasteur, nor by the European medical establishment. Fortunately (or unfortunately) India was at the time in the midst of a raging cholera epidemic, offering a perfect place to further demonstrate the effectiveness of his vaccine. With help from the British ambassador to India, who happened to be in Paris at the time, Haffkine moved to India and set up mass inoculations, protecting more than 40,000 people before he contracted malaria in 1895 and was forced to return to Europe. Soon after recuperating he was called back into the fray to battle a bubonic plague outbreak in India. By January of 1897 he had developed a vaccine that, after bravely testing first on himself and then a group of prisoners with good results, was eventually administered to half a million people. By 1901 he was knighted by Queen Victoria in recognition of his efforts. And by 1902 he was an outcast from the medical establishment. Disaster struck in October of 1902 when, out of 107 people inoculated in the Indian village of Mulkowal, 19 died, all from the same single vial of tainted vaccine. Haffkine was immediately fired. It took 5 years for him to be exonerated by independent investigations, but the damage had been done. The episode permanently stained his reputation. His vaccine still worked, though: between 1897 and 1925, 26 million doses of Haffkine’s anti-plague vaccine were sent out from Bombay. Medical historians say the number of lives he saved is uncountable but “enormous.” For Haffkine’s place in medical history, however, the 19 who died in Mulkowal canceled out the millions he saved. +
by Marcia Ribble
As the days of solitude pass one after another, I find myself giving thanks for all those family members and friends who remain connected via phone and Facebook. No matter what time of the day or night it is, I can always find someone to talk with. In a lot of ways I am reminded of my years at home with my four sisters in our growing up days. Those days and their conversations left a warm spot in my heart, kind of like how it feels to eat freshly baked chocolate chip cookies cooled just enough to not scald my mouth and throat. And it didn’t matter too much if we agreed or disagreed, as long as that underlying companionship existed. Those sisters, still important parts of my life, form bonds that cannot be torn apart. Now in addition to my sisters there are my adult children, their children, and my wonderful nieces and nephews. I have great-grandchildren too. Since we can’t see one another face-toface these days, we have the wonders of technology as our connectors. When I was a child and young adult, using the phone to make long-distance calls was reserved for emergencies or great news such as the birth of a baby. Now it’s my handy way to play with my great-granddaughter. Luna and I can play hide-and-seek and I guess where she is, even though she is over twenty miles away in another city. We had a great giggling time until she finally told me where she was. Another game we play on the phone is “What is that sound?” We usually tell one another what the sound is, but that doesn’t seem to matter to either of us. Our latest conversation was about the huge number of frogs determined to make a home in her family’s swimming pool. Luna, her mom and grandma took the frogs out and put them into the pond, only to have
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them and their strings of eggs return to the pool while Luna and her folks slept that night. The frogs seem to prefer the cleaner pool to the dirtier pond for courtship, mating, and egg laying. Big frogs, little frogs, medium frogs all head for the pool on warm spring evenings. There are pictures on Facebook to go with the phone calls. Luna can be heard giggling. I am giggling, too, as I watch her. She knows and loves her great-grandma even if we can’t hug in person, and I love her back. There was a plan for when I was feeling up to it after rehab, to go with Viv to see her new house in Charlotte North Carolina. I was looking forward to seeing it and she was looking forward to showing it to me. She’s proud of her new home and I’m proud of her. So today on Facebook she sent me a bunch of photos of her various rooms and furnishings. It’s beautiful and looks just like her homes have looked, with the same loving care she put into designing them. Seeing a photo isn’t the same thing as being in her home, smelling her coffee, her cooking, her perfume. But it will do until stay in place orders are lifted and we can touch one another again. I am writing letters again, too. I mailed one yesterday to the woman who shared my room at Amara. She may not remember who I am, but I know she loves cats and the card I wrote on had a picture of cats. She can’t have company, but she can carry the card around in the basket of her walker and know that someone cares that she is alive. Tomorrow I will write more All I need to do is remember how we stayed in touch in the days before technology. Writing letters was one important way we reached out and touched one another’s hands from across a city, a state, or a country. A letter was a pledge of mutual connection and love. Works just as well today. +
APRIL 16, 2021
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AUGUSTAMEDICALEXAMiNER
ADVENTURES IN
Middle Age BY J.B. COLLUM
you with it as they turn up the juice each time and cackle maniacally as you writhe in pain. I’m only partly joking. It isn’t a taser, and they don’t actually laugh (out loud anyway), but they do connect electrodes to you and shock you. It isn’t pleasant. Before I went, I mentioned
toolkit wrapped up in leather in order to break me. Trust me, if this had been actual torture, I would have spilled the beans. I would have told all I knew, and if I didn’t know anything to tell, I’d have made stuff up. Weeks went by before I could get to my regular doctor to find out all the results. That’s when I found out that it wasn’t MS, but neuropathy and carpal tunnel syndrome. By this time, we were dealing with some other more pressing health issues, but they had given me some medicine for the nerve pain already and it was finally helping me manage it. So things are leveling out now and we seem to be on the right path to getting me fully functional again. I still have to go to the neurologist though, because they did see something in the MRI that concerns them. They saw a black spot that could be brain damage from some old trauma or perhaps even a stroke in the past, so there is still that. Of course, I have been taking advantage of that with my wife. Every time I screw up in some way now I say, “Hey, I have brain damage. I can’t help it.” When it is a particularly bad screw-up, I call it “dain bramage.” Either way, she’s not buying it. I investigated what behavioral effects can come from brain damage in that particular area of my brain and it said that, among other things, it could cause impulsiveness, risk-taking, and inability to focus. Believe it or not, that actually made my wife and I feel relieved. She put it best when she said, “you’ve been that way as long as I’ve known you. That brain damage probably happened when you were a kid.” Leave it to my wife to tell it like it is and to take away my excuse for bad behavior. +
THE
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I’ve heard that lots of people experience more pain when they get into middle age, but for the past few months, I’ve been having much more than the usual aches and pains that come with age. I have been getting tests done to try to determine why I sometimes have severe pain in my hands and feet, pain that alternately feels like I’m being electrocuted or being stabbed with needles. My wife and I will be sitting there watching TV and I shout or grunt out loud and maybe even come up out of my recliner. I’ve gotten fairly good at hiding it lately though. On the other hand, she has gotten better at detecting it too. Now I just make a quiet grunt, scrunch up my face and grip the arms of my recliner like I’m holding on for dear life until it passes. For a while, the leading contender for my diagnosis was MS (multiple sclerosis). This really put a scare into me. As it turned out, it was not MS. Instead, it was a combination of neuropathy from my diabetes and carpal tunnel syndrome. To get to the bottom of the mystery, I had an MRI of my head. It went surprisingly well, considering how bad my last one went. Perhaps you remember my trauma from the previous one since I was too big for the MRI machine and felt like a trapped sardine that time. Or maybe more like a trapped whale inside a sardine can. Only prayer got me through it. This time however, I had a bigger MRI machine and a much more skilled operator. He knew all the tricks. For one, he let me pick my favorite music to play while the test was being done. On top of that, he put something over my eyes so that I couldn’t see during the procedure. I was hesitant about this part, but he swore this would help, and he was right. The next test was new for me. It was an EMG (Electromyography). For this test, they essentially connect a taser to different parts of your body and then slowly shock
{
A co-worker told me it would be excruciating.
it to a co-worker and he said, “oh yeah, a friend of mine had that. He said that it was excruciating.” Please, never do that to anyone. I think that almost made my anxiety worse than the actual test. Almost. I can’t agree that it was excruciating, but at times it was close to my limit. In some of the tests, they are testing nerves for pain reception, and in others they are testing nerves that control muscles. On the muscle tests, depending on where they connected the electrodes, my hands, arms, feet, or some other part, would twitch or even move dramatically. On one spot in particular, my arm smacked the person doing the test. Hard. I promise I didn’t do it on purpose. No really, it wasn’t my fault. Once the first part was over, they brought in a doctor to carry out the next stage of the testing. I thought the first part would be worse, but the technician told me that most people say the second part is. Oh, great, I thought. More fun to look forward to as I lay there on the little bed. The doctor showed up, and then proceeded to stick needles into my hands, feet, legs, arms, etc. and let me tell you, it was worse. Especially the feet. It was sort of like the first part was me being tortured by a regular KGB agent. I made it through without telling my secrets, so now they had to bring in Boris with his scary
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
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GET SHOT!… from page 1 Final Thoughts There have been many questions thrown at me about the vaccines, so let me try to answer those. Q: Which one should I get? The Pfizer and Moderna vaccines are equally effective in preventing infection (around 95%) and have very comparable side effect profiles. Get whichever one you can! I got Moderna and did just fine with minimal effects afterward. Some people report getting sick on the day after the 2nd dose, but this is not the majority, and presents far, far fewer problems than the virus. Q: What about the new vaccine from Johnson & Johnson? This vaccine has one big advantage: it is a single dose, and does not require a booster. It is not an RNA vaccine like the other two, but uses DNA encased in a virus shell from one of the “common cold” viruses. It is less effective than the other two. In clinical trials, all three vaccines were 100% effective at preventing death, and are effective at preventing severe illness from COVID-19, which health experts say is their most important attribute. The J & J vaccine was 85% effective at preventing moderate to severe illness in trials. It is 66% effective in preventing symptomatic illness 28 days after vaccination, compared to about 95% for the Pfizer and Moderna vaccines. But it’s important to remember that 66% is still a high number. The standard flu vaccine reduces the risk of illness by between 40% and 60%.
Q: What about kids under 18? The Pfizer vaccine is indicated for people down to 16 years of age. All of the current vaccines are being studied in children, and should be safe. I will recommend them to my patients, my friends, and my family members who have children. We need enough people vaccinated to prevent this disease from spreading (especially those scary new mutant strains). It will take vaccinated children to make this happen. Q. How did these vaccines get developed so fast? There are several factors that sped it up way beyond what the most optimistic people were saying last year: This is 2021. We have all of the science that has ever been done to build upon. We’ve already made lots of vaccine, and several messenger RNA vaccines. We had the genetic code for COVID-19 very early. That was a huge help. The government subsidized the vaccine like never before. Drug companies developing the vaccine didn’t have to fight to be first. They were already paid. Because of this, the vaccine manufacturers actually worked together and shared information. And the data of the trials was open in a way that does not normally happen. We got lucky. Even most optimistic guesses would never have put the vaccine efficacies in the 95% range, much less 65%. Apparently coronavirus vaccines are easier than most. And that’s all I have to say….except: get your damn vaccine! (Sorry for using the “D-word,” Mom). +
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TRYTHISDISH APRIL 16, 2021
AUGUSTAMEDICALEXAMiNER
by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb
SCRAMBLED TOFU
EARN POINTS!
This is a delicious rendition of scrambled eggs, complete with protein, flavor and fiber! Ingredients • 2 teaspoons extra virgin olive oil (divided) • 1/2 cup onion finely chopped • 1/4 red bell pepper, finely chopped • 1 small tomato, diced • 1 clove garlic, minced • 1 teaspoon fresh parsley, chopped • 14 oz extra firm tofu (one block), drained • 1 tablespoon nutritional yeast flakes (optional) • 1 tablespoon Mrs. Dash seasoning or any other chicken style seasoning • 1/8 teaspoon turmeric • ½ teaspoon kosher salt Instructions Place a teaspoon of oil in a nonstick skillet and once hot, add the onion, and bell pepper. Sauté the mixture over medium-high heat until the vegetables are soft approximately 2-3 minutes. Next add the garlic and tomato; sauté for about 30 seconds. Remove the veggies from the pan and set aside Add another teaspoon of olive oil to the nonstick skil-
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let and place over medium to medium-high heat. Once the oil is hot, add the tofu, break up with a wooden spoon, then allow to get lightly browned. Mix in the seasonings and add the veggies back to the pan. Serve with whole wheat tortillas and salsa, or serve on toasted whole bread. Yield: 4 servings Nutrition Breakdown: Calories 140, Fat 8g (1g saturat-
ed), Cholesterol 0mg, Sodium 250mg, Carbohydrate 7g, Fiber 3g, Protein 12g, Potassium 175mg. Percent Daily Value: 10% Vitamin A, 30% Vitamin C, 10% Iron, 8% Calcium Carbohydrate Choice: ½ Carbohydrates Diabetes Exchanges: 1 Vegetable, 1 ½ Lean meat, 1 Fat Optional: Add ½ cup of spinach or chopped mushrooms to the onion and bell pepper mixture. +
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So, Pre-Contemplation is over, Contemplation has been conquered, and now the third stage of change, Preparation, is the next frontier to hike. And what a frontier it is! It is personal jeopardy to try to skip a stage and go to the next one. Preparation is so necessary to go through: failure to do so could cause big time misery due to not planning or researching the next move adequately. If you fail to plan, plan to fail. The preparation stage is for someone hoping to make a change within 30 days or so. In the Preparation stage an individual might even start making small changes in the total landscape, such as switching from liquor to beer, drinking on weekends only, going on the Marijuana Maintenance Program as an alternative to drugs, or perhaps even ceasing to drink/drug entirely while making plans to undergo treatment for substance abuse. In this stage, some might even go to individual one-onone counseling as an effort to address alcohol dependence although this method is not nearly as successful as group therapy in a licensed and accredited substance abuse treatment program. Three things are important for recovery: desire, accountability, and support. The last two are more available in a group treatment program and help spell success quicker and easier.
A person in this stage will be researching other sources of professional help in most cases, but let it be known: substance abuse treatment is the Wild, Wild West of recovery options! That’s the way an insurance customer service rep put it to me once upon a time anyway. And he’s right. Because “I’ve been to rehab” could mean any of the following: • Went for detox in a hospital – 3-5 days maybe • Stayed a week or two at some place for addicts • Finished 6 months in prison RSAT (Residential Substance Abuse Treatment) • Went to a work farm and to AA some while there • Stayed a year in a recovery residence but had no actual counseling • Saw a counselor once or twice for an hour each time • Attended AA or NA a few times but did not get a Sponsor (no charge!) • Went to a church-sponsored Bible study for addiction • A teen month-long camping survival program out west • Am in a medication-assisted-treatment program only with no counseling and don’t want to be entirely drug-free but be on prescribed meds indefinitely • Satisfactorily completed a licensed/accredited inpatient or outpatient treatment program and followed up with all discharge recommendations If you’re looking for help, please do call a professional and ask for guidance and
THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional
direction in finding a program that meets your particular situation! It often takes weeks to find such a place due to the widely varied options out there and based on your ability to pay or not pay. It’s all part of the Preparation stage of change and one of the most important stages to use the “ready, aim, fire” plan instead of the “ready, fire, aim” plan. It is not uncommon to try several programs before succeeding, since treatment is not a one-size-fits-all. This stage of change addresses the barriers to change, including getting time off work if necessary, getting an FMLA (research that one!), arranging for someone to cut the grass, get the mail, watch the dog, pay the bills, and cover the bases while occupied with recovery. Without doing the work of assessing what’s involved in changing, you will be open to a painful fall. If your loved one is in this stage of change, it’s not a good time to take his beer. +
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AUGUSTAMEDICALEXAMiNER
DON’T LICK THE BEATERS Useful food facts from dietetic interns with the Augusta University MS-Dietetic Internship Program
What about omega 3s and 6s? by Lauren Horvat Augusta University Dietetic Intern
We’re all constantly hearing that we should eat omegas, but what are they? Omega-3 polyunsaturated fatty acids (omega-3s) and omega-6 polyunsaturated fatty acids (omega-6s) are two essential fatty acids. Essential means that our bodies cannot produce them on their own, so we must get them through food. Omega-3s and omega-6s are healthy fats that play vital roles in human health. Although both are important, intake of omega-3s should be greater than intake of omega-6s. They are deemed healthy fats because their chemical structure is polyunsaturated. Saturated fats, by contrast, are a type of unhealthy fat that can easily build up in the body and lead to damage. Saturated fats are commonly found in red meat, processed meats, baked goods, and fried foods. The typical American diet is notoriously low in providing omega-3s. The Dietary Guidelines for Americans recommends at least eight ounces of seafood each week, which would provide about 250mg of omega-3s. An easy way to know how many ounces you are eating is to compare it to the size of a deck of cards. One deck of cards is equivalent to 3 oz. of meat. Omega 3s are found in both meat and nonmeat sources. Oily fish, such as sardines, salmon, mackerel, and herring, contain high amounts of omega-3s; while algae, crustaceans, and mollusks also serve as sources of omega-3s. Non-meat sources can be found in seeds and nuts such as flaxseed, pumpkin seeds, and walnuts. However, nonmeat sources contain much lower amounts of omega-3s than that provided by marine sources. Both women who are pregnant and small children should be careful about the types of fish they consume
BAKED SALMON Ingredients: • 1-1/2 pound salmon filet • 2 tablespoons fresh parsley, chopped • 2 tablespoons olive oil • 2 tablespoons fresh lemon juice • 3 garlic cloves, pressed • 1/2 tablespoon Dijon mustard • 1/2 teaspoon salt • 1/8 teaspoon black pepper • lemon slices (for serving) Directions: • Preheat oven to 450˚F and line a rimmed baking sheet with foil. Slice salmon into 4 portions and arrange them on a lined baking sheet, skin-side-down. • In a small bowl, combine: parsley, garlic cloves, olive oil, lemon juice, Dijon, salt, and pepper. • Generously spread the marinade over the top and sides of the salmon, then top each piece with a slice of lemon. • Bake at 450°F for 12-15 minutes or until just cooked through and flaky. Be careful not to over-cook. because some types contain higher levels of mercury, which can harm susceptible individuals. Large predatory fish, such as swordfish, tuna, and marlin, are examples of types of fish
that may contain higher levels of mercury, and thus should be consumed in moderation. Omega-3s are highly important in the diet and help to perform an array of functions. Proper dietary intake helps to prevent chronic diseases such as cardiovascular diseases, arthritis, and cancers. Due to the metabolite produced from breakdown of omega-3s, the anti-inflammatory effect helps to lessen stress in the body. Omega-3s are extremely beneficial for the cardiovascular system, as they help to lower blood pressure, lower risk of blood clots, and improve heart function and health. Omega-3s are highly supportive of the central nervous system by contributing to maintenance and development physiologically, cognitively, and behaviorally. This helps to prevent the formation of neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease. Omega-3s support eye health and help with glucose tolerance. Research studies are showing beneficial effects of omega-3s on the health of the kidneys and slowing of renal disease progression. Overall, dietary consumption of omega-3s lowers risk of mortality and morbidity. Omega-6s are also important in the diet. Omega-6s can be found in foods such as nuts, seeds, and types of vegetable oils. However, the dietary ratio between omega-3s and 6s is believed to play a role in overall health and disease formation. This is because both omega-3s and omega-6s compete for the same enzymes in the body during metabolism. The breakdown of omega-3s yields anti-inflammatory effects, while the breakdown of omega-6s can yield inflammatory effects. The American diet is commonly high in omega-6s and low in omega-3s, which contributes to the deficit of omega-3s because of the competition of the two fatty acids during metabolism. Therefore, though both omega-3s and omega-6s are important, people should focus more on inclusion of omega-3s in their diet. To achieve this, aim for higher intakes of foods that rich in omega-3s, such as fatty fish like sardines, salmon, mackerel, and herring. Aim for two servings weekly. Like omega-3s, omega-6s have diverse roles in maintaining our health. In the body, omega-6s help to lower harmPlease see OMEGAS page 10
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COURSE
More Americans have died on US roads since 2000 than in World Wars I & II combined
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Thankfully this scenario doesn’t happen often: 51 times in the entire country in 2019; 24 times last year. But even one is one too many, and every single hot car death is preventable. Even though you don’t think it could ever happen to you, here’s how to make sure it doesn’t. • If you have a child in daycare, pre-school, etc., put it in their records that you want to be contacted immediately any time he or she is absent or even tardy. • Always keep your car locked, even in your garage, and keep the keys out of the reach of your children. Sometimes kids get in a car to play or as part of a game, like hide & seek. Maybe they end up falling asleep, then a little while later someone gets in the car and drives off. When they get to the store or mall they lock it up and go about their business. The oven, child inside, has been turned on. • Develop the look before you lock habit, even if you don’t have kids, but especially if you do. It only takes a few seconds, but you never know when the unexpected might happen and a life might be saved. • Always be on the alert to prevent hot car heatstroke, not just in the summertime: in the 80s or even the 70s, the interior of a closed car can be well above 100°. • Everyone can and should be part of the rescue team. That doesn’t mean inspecting parked cars every time you go to the store, but anyone who happens to see a child in a closed car should take immediate action. Two things need to happen right away: get that child out of that car, and call 9-1-1. With a bystanders help, both can happen simultaneously. In such a situation there is no legal liability in breaking a window to get into a car. Good Samaritan laws protect you. Start cooling efforts immediately using cool air and cool (not icy) water. Heatstroke is one of the leading causes of non-crash-related fatalities among children, and it’s certainly the most preventable. +
{
KIDS & CARS Part 1
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ful LDL cholesterol and raise beneficial HDL cholesterol. They are vital in brain development and function of memory, cognition, and behavior. Omega-6s are also necessary for metabolic regulation, normal cellular growth, and maintenance. They support hair and skin growth and bone health. A deficit of omega-6 intake may cause reproductive malfunction. Omega-6s are vital to health, and sufficient dietary intake is needed. The ratios of omega-3s to omega-6s should be taken into account when meal planning. Aim to include at least two servings of fatty fish per week. To help increase intake of the highly beneficial omega-3s, a recipe for baked salmon is on page 9. Pair the salmon with roasted broccoli and a sweet potato. Serve with lemon and enjoy! + Sources: • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357022/ • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1780156/ • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591664/ • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030645/ • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721310/#:~:text=Weekly%20consumption%20of%20high%20Hg,swordfish%2C%20mackerel%2C%20or%20tilefish. • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213446/
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OMEGAS… from page 9
ns he te
F
or a segment of the population that doesn’t even drive, children have an unexpectedly high number of automotive risks specific to their age group. Let’s talk about a few of these in the next edition or two of Crash Course. Most of us realize that a traffic accident is a possibility every time we’re on the road. We don’t expect anything to happen, but we understand that anything is possible. There is another type of vehicular accident, however, that no one thinks could ever happen to them. That would be the dreaded and dreadful child-left-in-a-hot-car accident. It can happen to anyone, including the most loving, caring and conscientious parent. And when it does, especially for exactly that kind of parent, it can be the catalyst for a lifetime of grief and guilt, sometimes even suicide. Entire extended family groups can be shattered How can something so tragic be prevented? It must be said, prevention is challenging precisely because no one ever thinks this could happen to them. You would be about as likely to prepare for a volcano in Augusta. What’s the point? Another complicating factor is that hot car incidents often occur when there has been some disruption in a family’s ordinary daily routine. Mom usually takes the child to daycare, but on this one day for the very first time dad has to. For mom it’s as automatic as the sun coming up, but for dad it’s a radical departure from the norm. He straps the toddler into the car seat and drives off, and within two blocks he’s on autopilot, heading to work as always. His backseat passenger has fallen asleep. The very next thing that happens is someone leaves for lunch who happens to be parked next to dad in the company parking lot. Just by chance they see what they think is a doll in the backseat. They do a double take and then a triple take, and then the awful realization hits.
APRIL 16, 2021
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AUGUSTAMEDICALEXAMiNER
The blog spot From the Bookshelf — posted by Tiffany Chenneville, PhD, on April 10, 2021 (edited for space)
MORE THAN JUST A HEADACHE Sometimes I’m warned. There might be little flecks of light that distract my attention and signal the pain to come. Other times, there is no premonition. Out of nowhere, I am struck by pounding inside my skull and unrelenting nausea. Even then, my partner will say he knew it was coming. He has come to interpret a certain look in my eyes and a distinct mood, which suggests I soon will require an ice pack and a cool, dark room, entirely free of sound. I could spend days in that place. He also knows that a trip to the emergency room for a cocktail infusion may be in order if the medications do not work, which has happened more times than either of us care to remember. For those of you who have ever suffered from this ailment, you will know I am talking about migraines. For those of you who have not, you might question how bad a headache could possibly be. “It’s a headache. Take some Tylenol and get back to work. It can’t be that bad.” In my experience Tylenol does absolutely nothing for a migraine, nor does any other over-the-counter remedy, including those specifically designed to relieve the pain of migraines. Believe me, I have tried them all. Considered the third most prevalent and sixth most disabling illness in the world, migraines affect 39 million people in the U.S. and one billion people across the globe. There has been a surge in migraines since the onset of the coronavirus pandemic. Women are disproportionately affected by migraines. In the U.S., three times as many women as men are migraine sufferers. Among those with chronic migraines, 85 percent are women. The fact that migraines disproportionately affect women likely contributes to the fact that migraine research is underfunded. Gender bias affects the headache field in other ways as well. Women are underrepresented as migraine experts, which means men are driving the conversations about this illness. Indeed, a migraine is more than just a headache. Migraine is extreme pain and suffering, disability, loss of productivity, and loss of income. Migraine is stigma, an illness that is minimized and often disregarded. We must first acknowledge all of the ways in which migraine is more than just a headache before we can truly begin to address this debilitating disease that affects so many. Until then, I will continue to experiment with treatments, adding to the long list of things I have tried. These include multiple prophylactic medications to prevent migraines — none of which I could tolerate due to reactions ranging from mental confusion and poor word recall to hallucinations and out-of-body experiences, and the prescription drugs that sometimes work for me but not without serious side effects. I used to spend 20 minutes every morning wearing a device that generated an electrical current designed to stimulate the trigeminal nerve within the brain. I got used to the discomfort, but ultimately I did not see the promised benefit. I have tried acupuncture and massage, both of which were costly and neither of which yielded a migrainefree existence. I have tried biofeedback and peppermint as well as other essential oils with virtually no effect. The only thing I have tried that has really worked is the keto diet. Trust me, only the pain of a migraine would keep me from carbs and sugar. But, many people cannot adhere to the keto diet, so its utility as a widespread treatment for migraines is probably not realistic. Migraine is more than just a headache and should be treated as such. +
How bad can it be? Very bad.
Tiffany Chenneville is a psychologist
It’s probably fitting that the cover of The Butchering Art is dark. The subject of surgery in centuries past can be a bit dark and ghastly, enough so that the book’s title is perfectly appropriate. But it’s the sub-title that makes this book worth reading: “Joseph Lister’s Quest to Transform the Grisly World of Victorian Medicine.” No one likes to experience the truth of an old maxim first-hand, the one that says we learn from our mistakes. But perhaps nowhere is this more evident than in medicine. After all, in the days of our grandparents and great-grandparents, you didn’t usually go to a hospital to get better. A hospital stay was a bit like a stay on death row. Maybe there would be a last-minute pardon, but it wasn’t likely. The vastly improved state of healthcare today, imperfect though it still is, is the work of a handful of giants in medical history, and one of them — Joseph Lister — is a central character in this book. As its author, Dr. Lindsey
Fitzharris, writes, the world of surgery in the 1840s was a filthy business. Literally. The floor of an operating theater — accurately named for its ascending rows of seats crowded with medical voyeurs surrounding the wooden table upon which the unfortunate would lay — was ankle deep in sawdust to soak up the blood. Surgeon’s hands and aprons would be further saturated with blood from previous operations. As if it all wasn’t terrifying enough visually, the agonized screams of patients in the era just before the advent of anesthesia filled the air.
We’ve come a long way, haven’t we? Medical history may not always be pretty, but it is usually interesting. In the case of this well-researched book, it’s fascinating. The changes between then and now are amazing, as any reader of this book will see, but they were also extremely hard-won. Lister’s advocacy of sterile methods was one he doggedly pursued, but he had to do so because he was opposed at every turn by people just as dogmatic in their ignorance. In the end, sterile methods won out, and we are all the beneficiaries. It makes you wonder what routine practices of today’s healthcare landscape might someday be viewed as steeped in ignorance? If you like well-written history that keeps you turning pages, you’re probably going to like this book. + The Butchering Art: Joseph Lister’s Quest to Transform the Grisly World of Victorian Medicine by Lindsey Fitzharris, 284 pages, published in October 2017 by Farrar, Straus and Giroux
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APRIL 16, 2021
THE MYSTERY WORD
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This new diet I’m on is great!
Details please.
by Dan Pearson
It is literally an all-you-can-eat diet. And I mean literally. But I’m still losing!
Possibly. Oh, and the other question you asked I wonder if it’s a me a minute ago: no, side effect from my I don’ t want to split an gastric bypass surgery. M&M with you.
How is that even possible?
The Mystery Word for this issue: GONSIRN
© 2021 Daniel Pearson All rights reserved.
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
EXAMINER CROSSWORD
PUZZLE
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E X A M I N E R
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We’ll announce the winner in our next issue!
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by Daniel R. Pearson © 2021 All rights reserved.
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DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.
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QUOTATIONPUZZLE
28. Knee injury ltrs. 30. Brandon ________ 31. Kettering’s partner 32. Meadow 33. Augusta’s ____ Park 34. Canoe power 35. High tennis shot 37. Dwight’s better half 38. What you do with 34 & 46-D 41. Noted lexicographer 42. 30 Rock creator 45. Liquids 46. Scull implement 47. Popular magazine 49. Road division 50. Type of cavity 51. Peruse 52. Be _____ someone; leery 54. European mountain range 55. _____ flash 56. Unit of force 57. Self-esteem 59. Natal beginning 60. Flightless bird
S S T P T E S N R T A W L E N I F S C I M B L I A A I Y L I I E L O O P U M C L T N I M K E E by Daniel R. Pearson © 2021 All rights reserved
1 9 2 8 5 4 4 3 8 7 9G6 6I2 7D5 3 1
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— Confucius
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.
Solution p. 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
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1 2 3 4
1 2 3
1 2 3
P K 1 2 3 4 5
U 1 2 3 4 5 6 7 8
K 1 2 3 4
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1.AWWSSTTTTMMPN 2.PHEEEHHAHIROO 3.KRILEEONANOOO 4.AUSPEEEN 5.SLENK 6.ATE 7.N 8.D
SAMPLE:
1. ILB 2. SLO 3. VI 4. NE 5. D =
L 1
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E 4
I 1
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B 1
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I 3
N 4
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by Daniel R. Pearson © 2021 All rights reserved
BY
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ACROSS 24 25 1. Of the ear 5. Frau’s partner 26 27 28 9. Incline 32 33 13. Calypso music from 36 37 Trinidad 14. Hip bone 40 41 42 16. Islamic chieftain 44 45 17. Some are said to be white 18. Slant 48 49 19. Aquatic bird 51 52 20. Dated 57 58 59 22. Chemical (atomic #53) 24. Wedding words 62 63 25. Blue Goose, in brief 65 66 26. Blvd. in medical district 28. Sigh of pleasure by Daniel R. Pearson © 2021 All rights reserved. 29. Type of hound 32. Biopsy destination 64. Type of chair 33. AU, not long ago 65. Scent 34. Nobel Prize winner in 66. Downtown Bar Literature (1936) 67. Otherwise 36. Cleckley/Thigpen title woman DOWN 37. Grand ___ 1. Scandinavian capital 38. Mr. Floyd 2. Labor 39. British can 3. Chilled 40. A of ABC 4. Late Augusta historian Ed 42. In place of 5. Prefix relating to tissue 43. Small amount 6. Building add-on, sometimes 44. Brain ____ 7. Cap. of Brazil (until 1960) 45. Not many 8. Indonesian currency 46. Type of fracture 9. Former employee? 48. Type of club 10. Corner of note 50. No in Scotland 11. Muck 51. Capital of Dominica 12. “As needed” in med. 53. About 15. Catcall 57. Medical specialist (abbrev) 21. Large CSRA employer 58. Rule of ______ (in burns) 23. Famous Thomas 61. Animal hunted for food 25. ______ reflex 62. Swinging barrier 26. Jefferson of note 63. Swelling 27. Famous film critic
WORDS NUMBER
8
Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, MAY 3, 2021
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APRIL 16, 2021
AUGUSTAMEDICALEXAMiNER
THEBESTMEDICINE ha... ha...
The
13 +
Advice Doctor
Moe: What is Sisyphus’ least favorite band? Joe: I give. What? Moe: The Rolling Stones.
©
Moe: I’m reading a book about an immortal dog. Joe: I bet that’s interesting. Moe: It was impossible to put down.
A
lizard mother is pushing her little newborn lizard down the sidewalk in a stroller when she passes one of her neighbors, who admires the little baby. “How adorable!” she says. “What’s his name?” “We named him Miniscule,” the proud mother says. “Interesting,” says the neighbor. “How did you decide on that name?” “It just seemed to fit,” the lizard mother said proudly, looking down at her baby. “He’s my newt.”
Moe: My wife and I have discovered the secret to enjoying marriage. Twice a week we go to a nice restaurant and have a little wine and good food. Joe: Sounds great. Tell me more. Moe: She goes on Tuesdays, I go on Fridays. Moe: Mercury has an extremely harsh climate. The daytime temperature is 800°F. Then at night it goes down to almost 300° below zero. Joe: Eh. First world problems.
Moe: They say that a short nap can help prevent aging. Joe: Yes, especially whle driving. Here is a chart that demonstrates the process the Internal Revenue Service uses to collect funds: The IRS The IRs The Irs The irs Theirs Moe: My friend Jay and his wife were expecting twins and hoping for boys. They wanted to name them after him. Joe: What happened? Moe: They ended up having twin girls, so naming them after him wasn’t really an option then. Joe: What about Kaye and Elle? Moe: Hedgehogs, man. I just don’t get them. Joe: What’s not to get? Moe: Why can’t they just share the hedge?” Moe: What did the Japanese janitor say when he jumped out of the closet? Joe: Supplies! +
Why subscribe to theMEDICALEXAMINER? What do you mean?
Staring at my phone all day has had no Effect on ME!
Because try as they might, no one can stare at their phone all day.
Dear Advice Doctor, Two weeks ago I was halfway through an ordinary day at work, feeling perfectly fine, when suddenly I started to feel light-headed. I did the exact wrong thing: I stood up, and when I did I almost fainted. My boss insisted I take the rest of the day off, but by the end of the day I was notified that I needed a doctor’s release to return to work. It took me three days to get in to see my doctor, and before that could happen I was terminated. Should I sue?
— Felt Faint; Felt Fired
Dear Felt, This is an unfortunate situation, indeed, and it’s far more common than it should be. In fact, discrimination against people who are light-headed is rampant, and all too often there is not even the barest attempt to conceal the bias. As we all know, being light-headed (usually called “blonde”) is constantly equated with being dumb. A 2012 survey found more than two dozen joke books on Amazon that included blondes in the title, but just two for brunettes and only one for red heads. But is the “dumb blonde” stereotype based in fact? It is not. A study published by The Ohio State University in 2016 examined decades of data sourced from the National Longitudinal Survey of Youth 1979 (NLSY79). The study has followed, studied, and repeatedly surveyed the same huge pool of participants on a wide variety of topics since 1979 when the enrollees ranged from age 14 to 21. One of the questions added in 1985 was “what is your natural hair color?” NLSY79 also includes IQ test results. Data from more than 10,000 people found the average IQ for women with blonde hair was 103.2. For women with brown hair the IQ figure was 102.7; for red hair, 101.2; and for women with black hair, 100.5. (Among men, blondes came in second to brunettes, 103.9 to 104.4.) Yes, blonde women sported the highest IQs of the four major hair color groups. My advice —and last time I checked, I am The Advice Doctor — if you were terminated solely for being light-headed, you may have grounds for legal action. Victorious legal action at that. Thanks for writing, and I hope I answered your question. + 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.
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IT’S A QUESTION OF CARE How can I get my loved one to eat?
AUGUSTAMEDICALEXAMiNER As people age and/or are battling illness, their appetite is affected – typically negatively. Often, age itself, a slower metabolism, and illness cause someone to not be as interested in eating. Medications used to treat illnesses or treatment, such as chemotherapy or radiation, can make people feel sick, nauseated, or almost too tired to eat. One way we show love in our society is by feeding those we love and participating and sharing time with them while we eat. As someone struggles with not
having enough appetite due to sickness or the effects of aging, they need to be supplemented in some form or fashion. • You can buy basic supplements, like Ensure or Boost. There are many varieties and flavors, and ones that are particularly better for people with diabetes that do not raise their blood sugar. The idea is to supplement the diet with more protein, calories and vitamins, while being careful not to substitute these shakes for food. Perhaps you offer a half of a shake with a small meal?
Michael Sharkey, MD Lauren Ploch, MD Caroline Wells, PA-C Chris Thompson, PA-C John Cook, MD, Emeritus GENERAL, SURGICAL & COSMETIC DERMATOLOGY
APRIL 16, 2021 • Another way to get more calories into our loved ones is to mix in ice cream, which is calorie dense, but also provides some additional calcium from the milk, with something like Boost or Ensure to make a milkshake. Creating an even denser milkshake can be done by putting peanut butter or almond butter in to provide more protein and calories. • You can also sprinkle some slivered almonds, raisins, dried cherries or anything that might be considered an “extra” on top of yogurt, cottage cheese, soups
or ice cream. Creamier foods are often easier to get down when someone is just taking little nibbles, as they do not require a lot of chewing, and to add calorie-dense items as a topping can be very helpful. Yes, we do want our loved one to eat what is served to them, but sometimes, we need a little assistance to make it more appealing. + by Amy Hane, a licensed Master Social Worker in South Carolina and Georgia, an Advanced Professional Aging Life Care Manager and also a Certified Advanced Social Work Case Manager.
PRINT IS DEAD WELL, A LOT OF IT IS.
Augusta Office: 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 just be a temporary COVID situation. And many people say The Augusta Chronicle is a mere shadow of its former self.
Aiken Office:
GADERM.COM
YOU ARE ESSENTIAL DON'T DELAY. GET THE CARE YOU NEED.
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:
MEDICALEXAMINER
SNORING