Medical Examiner 5-20-22 by Daniel Pearson

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MAY 20, 2022

a man who not only didn’t think she “looked” handicapped, but accused her of using her grandmother’s car, or even stealing the car. Exchanges like this happen all over the world on a daily basis, and sometimes lead to violence and criminal charges. For example, after pulling into a handicapped spot at the Evans Post Office, a lady started to reach for the handicap tag in her glove compartment. Before she could even do that, a furious man pulled in beside her and yelled, “Where is your sign?” and threatened to shoot her. The lady was accompanied by her 90-year-old husband, who had breathing issues and had just had foot surgery. In another incident related by a local resident, two young people (the driver and her front seat passenger) parked in a handicap spot and hopped out of their van, only to be accosted by an older man who said, “Two young women take up a handicap spot when others of us really need it.” Their answer: they opened the side door of the van and pushed a button, lowering a ramp at the top of which was a wheelchair in which sat the daughter of one of the ladies. The daughter had spina bifida.

hat does this sign mean to you? For many it’s a source of irritation and frustration because they often see this parking provision being abused by people who are not handicapped. But if you think that is irritating, talk to the people who legitimately park in these spaces. Unless their handicap is glaringly obvious, they will have stories (plural) of being accosted and harrassed by complete strangers who question their right to be in a handicapped spot. Just a few days ago on the NextDoor app we saw a post by someone named Samantha G. She has a legitimate handicap sticker and parked in a marked space at Augusta Mall. Despite the fact that she was accompanied by small children (including her 2-year-old daughter), she was harrassed, questioned, and screamed at by

Here is a news flash; several, in fact: Not everyone with a handicapped sticker is elderly. Not everyone with a handicapped tag uses a cane, walker, or wheelchair. Not everyone with a handicapped sticker “looks” handicapped in some way.

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In other words (going back to paragraph two), you and I have no way of knowing that someone is or is not handicapped, no matter what they look like or what we may think. It is really nobody’s business to ask a person what their handicap is or why they have a handicap tag or license plate. Nor should any of this give anyone the idea that anyone can park in a reserved spot since it’s nobody’s business. If you don’t belong in a handicapped spot, stay out. End of story. +

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THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD by David W. Proefrock, PhD

Strange as it may be, your 3-year-old son has stopped eating anything but hotdogs. He used to be a very good eater and has never given you any cause for concern before now. But now he wants hotdogs for every meal, even breakfast, and refuses to eat anything else. You are worried that he may become malnourished. What do you do? A. Don’t worry too much. This is just a phase he’s going through. He won’t starve and he will soon start eating other foods. B. You can’t let him continue to eat hotdogs and nothing else. Stop letting him have hotdogs at all. Put good food on his plate and make him eat what you serve. When he gets hungry enough, he’ll eat. C. Give him a hotdog to eat, but only when he promises to eat something else that is good for him after he eats the hotdog. D. Tell him that he can have a hotdog only after he finishes his other food. If you answered: A. Children often go through phases of eating mostly a single kind of food for awhile, but when it is only one food and goes on for longer than a few days, you should take some action. B. Always avoid big fights at meal times and this is a sure way to start big ones at every meal. Instead of using a “my way or not at all” tactic, use the hotdogs as a reward for eating other foods. C. Most parents know that this solution is backwards. First you eat the good foods, then you get a hotdog. D. This is the best response. Whenever you can, use the behavior that the child wants to reward the behavior that you want. Children’s’ eating habits are a surprisingly common source of parental concern and family conflict. You will be most effective when you have a sound strategy that avoids conflicts whenever possible and takes advantage of “builtin” reinforcers. + Dr. Proefrock is a local retired clinical and forensic child psychologist.

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MAY 20, 2022

PART V OF A 26-PART SERIES

IS FOR VARICOSE We probably all know what varicose veins are, generally speaking. But like so many other things in medicine, when we’re diagnosed we can become instant experts, reading up on cause and treatment. And like so many other things in medicine, we might say, “If I knew then what I know now, I wouldn’t be in this situation.” That’s because a number of the causes of varicose veins (but certainly not all) are very preventable. Let’s take a moment to define our topic. As the illustration to the right shows, varicose veins are bulging, twisted veins caused by faulty valves in our legs. Gravity being a force that the circulatory system has to reckon with, our veins are equipped with valves that are supposed to be one-way, thereby preventing blood flowing to the heart to slide back downhill. When the veins are compromised, blood isn’t flowing upward. It can accumulate in the veins of the leg, and if it happens often enough and in sufficient volume, veins start to sag and become distended,

showing up under the skin’s surface as ropelike squiggles. How does a person get to be in this situation? Sometimes it’s hereditary. Other times the cause in women is pregnancy, and in men, looking pregnant. The potbelly of an overweight person and a growing fetus can both exert downward pressure on blood vessels in the groin and upper legs, restricting the flow of blood back to the heart. Treatments can be as simple as avoiding standing for long periods of time, and giving the valves a break by elevating the legs. Another aid can be wearing compression socks or hosiery. Usually these stockings have tighter elastic near the feet and ankles, gradually becoming looser as they extend upward, essentially preventing blood from pooling in the lowest of the lower extremities. There are various degrees

of compression offered by different stockings; your doctor can advise the best option for you. If you stop and consider their role, it becomes obvious that compression stockings should be put on as early as possible in the morning, before blood has started to pool. Some even suggest putting them on before getting out of bed for maximum benefit. In the same way that people can adjust to life with one lung or one eye, the body can adjust if a varicose vein needs to be removed, whether for cosmetic or medical reasons, of conservative treatment isn’t successful. Other veins will take up the work of the removed vein. Regular exercise can offer the dual benefit of improving circulation and promoting weight loss, both very helpful in managing varicose veins, and better yet, preventing them in the first place. +

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MAY 20, 2022

ONE MILLION A

lmost exactly two years ago (on May 24, 2020), the New York Times published the issue shown on page 1, listing the name, age and a brief bio of all 100,000 victims of COVID-19 in the United States to that point. The human cost was described as incalculable, far greater than just the cold statistic. In the two dozen months since then, the U.S. body count has multiplied by ten. A million fatalities, noted the Associated Press on Monday, is equivalent to a Sept. 11 attack every single day for 336 days, roughly equal to how many Americans died in the Civil War and World War II combined. It’s as if everyone in both Boston and Pittsburgh were wiped out. Is the number accurate? There are no doubt many deaths that COVID has been unfairly blamed for, and perhaps as many COVID deaths that for one reason or another fell through the cracks. But even if the number is wildly exaggerated (as some claim), is 750,000 deaths a more acceptable number? Would a mere 500,000 deaths make this pandemic insignificant? No, any way you slice it, this has been a dreadful tragedy in countless ways to untold millions upon millions of people throughout this country and around the world. A 2016 study investigating the ripple effect of suicides estimated that 115 friends and relatives are affected by each such death, with about 20 percent of them describing the impact on their life as “devastating.”

By that measure, the one million U.S. COVID deaths have directly touched the lives of more than 100 million Americans, and deeply and profoundly affected some 23 million Americans in ways they would describe as “devastating.” Worldwide, the pandemic death toll is well above 6.2 million from more than half a billion confirmed cases. Late last year the federal National Center for Health Statistics reported the sharpest increase in the U.S. mortality rate (for 2020, the most recent year for which statistic have been compiled) since such statistics started being recorded. Similarly, the decrease in U.S. life expectancy from 2019 to 2020 was also one for the record books, nearly two full years. (During 2020, COVID-19 was the underlying cause of death in just over 350,000 U.S. deaths, a little more than 10% of the total number of deaths.) To put the size of the life expectancy drop in perspective, normal changes are measured in single decimal points. For example, U.S. life expectancy at birth in 2017 was 78.6 years; in 2018 it was 78.7; in 2019 it was 78.8. But the 2020 figure dropped all the way down to 77.0 years. For comparison with another momentous historical era, the U.S. life expectancy at birth for both sexes in 1917 was 50.9 years. Then in 1918, during the Spanish Flu, the last great pandemic, it plummeted by more than 10 years to 39.1 before recovering to 54.7 years in 1919. +

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BABY FORMULA 101

For a number of reasons, infant formula has been very scarce lately. The shortage is partly due to the closure of a major manufacturing plant in Michigan which failed an FDA inspection. The situation has gotten the attention of politicians all the way to the White House promising to address the matter. The problems leading to the shutdown are projected to be solved within two weeks, leading to predictions of a resumption of production and the end of the shortage. In the meantime, pediatricians on the ground have been dealing with the health and medical aspects of the shortage. For example, they’ve been advising parents not to dilute formula to make it last longer. Growing babies have an urgent need for nutrition, and watered down formula can result in such unintended consequences as electrolyte imbalances, anemia, and even acute, severe complications like seizures. Another disturbing trend pediatricians report is recipes for homemade formulas that are circulating around the internet and social media. These can have the same negative side effects as watery formula. Some parents who can’t find formula have been giving their babies regular milk, or they’ve been buying various plantbased “milks” like oat milk or soy milk. Newborns are often unable to digest the various substitutes that anxious parents are turning to during this shortage. “Why don’t these women simply breastfeed?” some might ask. “Isn’t that a free option that’s better anyway?” First, not every mother produces sufficient milk for her baby. And not every employer offers sufficient maternity leave, or provides for a safe place (or even allows) new mothers to breastfeed or to pump milk at work. Economic realities and workplace conditions make it next to impossible for many mothers to breastfeed even if they want to. The best course right now for families with infants caught in the middle of the current shortage is to get advice directly from their pediatrician on safe and nutritious alternatives to formula. It doesn’t necessarily require an appointment. Give them a call or check for information the practice may have posted on its website. +

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www.AugustaRx.com The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of salubrious news within every part of the Augusta medical community. Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397

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MAY 20, 2022

AUGUSTAMEDICALEXAMiNER

#165 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

hese two men changed the course of medical history in a good way, but by way of a bad way. In the early to mid 1800s, advances in medicine were making surgery more and more common (making knowledge of human anatomy more important than ever) while at the same time, the main source of cadavers — public hangings and other assorted executions — was drying up. In the England of the 1700s, hundreds were executed annually, but by the 1800s one source put the average at just over 50 per year. The need at medical schools was ten times that figure. Enter the two men above. They are the infamous serial killers William Burke (left) and William Hare. The circumstances of the day created a perfect opportunity for their twisted business model: together and separately they killed 17 people in the space of a year, not out of hatred or malice, but to supply the cadaver needs for anatomical study at the nearby medical college in Edinburgh, Scotland. Their final victim met her fate on October 31, 1828, and was discovered by a couple who rented a room at the lodging house where the crime occurred. Rejecting a bribe offered by Burke’s wife for their silence, they reported the crime to the police. Burke, Hare, and their wives were arrested three days later, and their trial began at 10:00 am on Christmas Eve. Apparently trials at the time proceeded non-stop until they concluded: the prosecutor’s 2-hour closing arguments began at 3:00 am on Christmas morning, followed by the defense summation at 5:00 am. The jury began their deliberations at 8:30 and returned a guilty verdict and death sentence against Burke alone before 9:30. He was hanged on January 28, 1829 in front of a crowd estimated at 25,000. Medical experts who testified during the trial suspected murder, but could not conclusively testify to that fact since the bodies had already been dissected. As a result, prosecutors turned to Hare, offering him immunity for his testimony. Since by law he could not testify against his wife, the two of them were never charged. Burke’s wife was tried but not convicted. Robert Knox, the physician and anatomist who was the willing recipient of Burke and Hare’s victims (some of them delivered still warm), testified that he had no knowledge that the bodies were murder victims. He was never charged with any crime, but public opinion cost him his career. Copycat murders arose here and there, including a group known as the London Burkers who murdered for unsuspecting medical institutions in 1831. Part of Burke and Hare’s enduring legacy is the Anatomy Act of 1832, giving bona fide medical instructors and institutions license to dissect donated bodies, putting a serious dent in the practice of grave robbing. As the judge passed sentence on Burke he aptly ruled, “Your body should be publicly dissected and anatomized. And I trust that if it is ever customary to preserve skeletons, yours will be preserved in order that posterity may keep in remembrance your atrocious crimes.” True to his decree, Burke’s skeleton is on display to this day at the University of Edinburgh Medical School. +

by Marcia Ribble

Recently, news reports have revealed that Ukraine is desperately in need of medical supplies. It occurred to me that I have a lot of medical supplies from multiple hospitalizations and recoveries, some that I will never use, but all of which are unexpired. They do no one any good taking up space in my home. My grandson helped me to bag them up and get them ready to be sent to Ukraine. I know that I am not alone in having those kinds of things available, so this is a request for you to scour your home for medical supplies you may be able to donate. I am giving mine to my nurse. But there are many other options. Wound clinics near you often collect that sort of thing for patients without funds to buy them. On TV you will see groups collecting needed items for Ukraine, and they should be glad to include your donation. Doctors Without Borders is currently involved in sending medical goods to Ukraine, so they might be able to help your donation reach the people in such dire need. Another thought is to simply Google sending medical supplies to Ukraine. I did that and got a whole list of individuals, groups, and agencies doing just that. We don’t need to reinvent the wheel. It’s already there for us to use. When I began to look into the cabinets and boxes, I was amazed by what I found! Scissors, gauze wraps and bandages, a sterile stitch removal kit, sterile plastic tubing for intravenous drips, a whole lot of Ace bandages (used but clean), unopened packages of gauze for packing wounds, and even more. Things like that may seem simple to us because of their availability, but they are potentially life-saving. Many of us older folks have similar quantities of medical supplies and other items the people in the war zone will die without. All of this reminded me of the war effort

during World War II. Our older relatives were faced with limited supplies of many things needed to fight Hitler. Gas was rationed, and so were shoes, sugar, and many other familiarly available items. Silk was being used for parachutes, so nylon stockings replaced silk used for ladies’ stockings. Copper was needed by the soldiers and those outfitting them, so for a while we had cardboard pennies, red ones. We had newspaper drives, rag drives, metal drives, anything that could possibly be used to fight that war was collected and used. Butter was rationed. Ukraine is acting as a barrier, preventing Hitler II (Putin), from dragging all of Europe, Africa, the Americas and the East into World War III. We need to view our temporary challenges as a small price to pay for freedom. My dad and others in the neighborhood took the bus or walked to work because car parts and tires were unavailable. Sacrifice now is challenging, but my folks and others their age had just barely come out of the Great Depression; they had been suffering for years, but I cannot remember ever hearing them complain or blame Roosevelt for the shortages of so many items. They had learned to make do with what they had, to add the weight of their sacrifices to what needed to be done to rid the world of Hitler and his horrors. So far, we are lucky. We have not been pulled into the war, but how long that may last is definitely not guaranteed. We need to get behind our President and thank him for fighting for us at home and abroad. And we need to get up off our butts and support the war effort here and in Europe. I am telling you from lived experience, it could get much worse. We are not yet faced with terrible lists of soldiers who have died in Europe, Africa, and Asia, and we need to do whatever we can to prevent that from happening. God bless America! +

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age

DEAR READERS

BY J.B. COLLUM

Warning: If a frank but light-hearted discussion of male erectile dysfunction while trying to help others who also face this in silent anonymity is distasteful to you or offends you, skip this column for this and the next issue and go read the numerous other salubrious offerings available in this fine publication. Okay, you have been warned. Don’t blame me later.

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wake up. That used to happen to me, but it had been a couple of years since I had experienced that. I was not aware that this is the body’s way of maintaining the health of the penis even if its sexual function isn’t being used on a regular basis, or at all. Once I thought about that, I realized something needed to be done. We started trying various approaches. The first option was drugs. I tried them all. You know the ones I’m talking about: Viagra, Cialis, etc. With each one, I started at the lowest dose and slowly moved up, but they had only limited success, and eventually, did nothing at all to help. The next step was something that had a word in it that I thought I would never use in the same sentence as “my penis.” That word is “vacuum.” Yes, a vacuum, but not one you plug in. That would be quite frightening. Instead, it is a simple device that you pump manually, while it draws the penis in and this in turn allows the penis to fill up with blood. Once it is fully erect, the man slips something that resembles a very strong rubber band off the vacuum device and onto the base of his penis so that it can hold the blood in, and then he removes the vacuum device. Once he has completed sexual intercourse, he can remove the band. An interesting side note is that the vacuum erectile therapy device was invented right here in Augusta by the late Geddings Osbon, a noted local tire businessman. The device is now even available over the counter. I’d recommend that you still see a urologist about it first though, as they may discover other solutions to your particular case of ED. It is interesting that there is such a stigma associated with ED. So much so that some men don’t get treatment and miss out on a beautiful part of life, and their spouses do too. This article and the follow ups to it that I plan on writing will hopefully help people get over that shyness about this issue and start working on fixing it. Unfortunately for me, so far the vacuum device has not been effective. The other option my urologist gave me was a shot directly into my penis right before intercourse. That got an immediate NO from me. Don’t get me wrong. I’m not at all squeamish about getting shots… In my arm or buttocks, but you want to stick a needle where!? Seriously? I have a feeling that would kill the mood. So, I have scheduled surgery to correct the issue. In the meantime, we will make a few more attempts with the vacuum device, just to be sure, before we resort to invasive surgery. In the next issue I will continue this story and tell you all about the surgical options. Until then, take good care of yourselves. +

You’re still reading this? You did see the warning above, right? If not, go back and read it. I can wait… Alrighty then, you have been warned. I will move on now. As I mentioned in my warning, this will be about male erectile dysfunction and, more specifically, my personal journey in working to resolve it. Like most bad things in life, I try to approach them with humor as an antidote for what could otherwise be a crushing blow to my ego and my happiness. I find that if I can laugh in the face of adversity, I won’t just survive; I’ll thrive. Fortunately, we live in a time when erectile dysfunction doesn’t have to mean the end of your sexual life. In my search for answers, I learned quite a lot, and some of it was very surprising. I thought I would bear the embarrassment and share it with my readers in the hope that it might help some of them. My other hope is that my mother doesn’t read this one. Well, enough build-up, let’s get on with it. When I first started having ED a few years ago, it was sporadic, and I attributed it to age, being tired, stressed out, or medications. All of those can be part of the cause, as well as injuries, prostate surgery, and some other things, but it turns out that the biggest contributing factors for me were type-2 diabetes and atherosclerosis (hardening of the arteries). Both diseases end up restricting blood flow to the extremities, and let’s face it, the part under discussion is an extremity. This limiting of the blood starves the tissues in the extremities and therefore damages them. I first started noticing damage to my extremities in my feet, because I had nerve pain, and I ignored it for far too long. It’s no excuse, but if I had known that my penis was also being damaged by these diseases, I would probably have made a beeline for the doctor’s office and would have changed my lifestyle immediately in order to avoid further damage. I also learned that having extra pounds on can be a contributing factor, so once all this knowledge coalesced in my procrastinating mind, I took immediate action to correct the issues. I got treatment for my diabetes, I took my cholesterol lowering drugs religiously, and I went on a diet. I didn’t think I could move any faster or do more regarding it until the fateful day that my doctor told me, “If you don’t use it, you lose it.” I did a double take, no, a triple take, and asked him what he meant. He explained that normally, men should get an erection during the early hours of the morning while sleeping or right at the time that they

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Don’t be shy about getting help.

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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SWEET POTATO-BANANA MICRO-MASH This is the easiest way to make sweet potatoes; simply microwave and mash. Ddelicious. In classic sweet potato recipes, brown sugar adds sweetness, but this version adds natural sweetness with banana and honey roasted nuts. Perfect for anytime of the year.

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Ingredients • 3 (9 ounce) sweet potatoes scrubbed clean, with peel • 1 medium ripe banana • 1 tablespoons butter or margarine • 2-4 tablespoons milk • ½ teaspoon Celtic sea salt (or other salt of choice) • 4 tablespoons honey roasted almonds Instructions Pierce the sweet potato skin 5-6 times with a fork. Place on a microwaveable plate and microwave for 5-8 minutes, rotating halfway through. The sweet potato is done when the thin skin puffs to a crisp finish; the inside will be tender and moist. Once cooked, allow the sweet potatoes to cool before handling. Meanwhile, mash the

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MAY 20, 2022

ARE YOU THIRSTY ENOUGH TO DRINK? by Ken Wilson Steppingstone to Recovery

I’m no equestrian but I’ve been told you can lead a horse to water but you can’t make him drink. However, you can make him thirsty enough to drink — water, that is. Others have put it this way – “you can’t feed a closed mouth,” or “he needs to take the cotton out of his ears and put it in his mouth.” That’s quite a visual. The 4th Dimension of the American Society of Addiction Medicine Criteria is assessing a person’s readiness to change. Some pretty smart people wrote this up back in the early 90s, realizing that it’s a waste of time and money to enroll an alcoholic or addict in treatment unless they are ready to change. Over the years I’ve seen families literally sponsor their child in a dozen treatment programs at great expense and the child just uses the “treatment” as a vacation

with room service and catered meals. Treatment can be fun! Outings, trips to Wal Mart, being around friends who understand you very well, no work requiring physical labor, workouts at the gym – it is possible to hide out in treatment and have minimal mental and emotional investment in the program. Maybe it’s all a ply to avoid jail or get back into the home. A credible treatment program will endeavor to not let this happen, but humans are humans and some can be very slick in getting by. To review the stages of change from addiction to being clean: Pre-Contemplation, Contemplation, Preparation, Action, Maintenance, and sometimes a 6th stage: Relapse. Obviously it is futile to enroll someone in treatment who is not even considering being clean and sober, right? For the most part, sure. The clinician’s job is to bump the individual along towards Action and Maintenance through

Why did the family tiptoe past their medicine cabinet? Because they didn’t want to wake up their

SLEEPING PILLS

talk or various exercises. But sometimes people get into legal, vocational, or family trouble and flee to treatment. Imagine that! A person can be in different stages of change for different issues in their life, ready to change their health habits — but not their drugging. So this stage of change is often an attempt to use whatever motivation a person does have for his or her greater good. For instance, I’ve seen a number of liver transplant cases where the person wanted to live, but because there seems to be a shortage of livers for transplanting these days, they had to complete treatment for alcoholism before being considered for the transplant list. Using that kind of motivation, a good clinician can appeal to the individual to be sober from alcohol and in time he or she will actually be ready to give up alcohol for good. A new liver, you see, doesn’t necessarily guarantee the person will stop drinking

after they get home from the hospital! I know, right?!!! A family once came in to see me with their 19-year-old son who had been in treatment on and off since age 15. They wanted to enroll him in our program. After being sent away in some program or another for months at a time, he’d come home and hang out with his old user buddies again. Every time. After speaking with him I realized he had no interest in stopping his use of THC, and he had nothing else he needed to change. I dismissed him but got a commitment from his parents to attend our Family Workshop (free to the public! Wednesdays 6 – 7:15 p.m.) once a week for 3 months. They came, learned how to make a contract with their son, and over time the son made a connection between using THC and loss of privileges. I mean, he was getting free rent, WiFi, food, cell phone, insurance, heat & air, and a car in exchange for just

breathing! In this case, the parents needed treatment, not the son. When his freebies started disappearing he got the drift and became very thirsty for help in stopping his addictive behavior. In 4 months he went from Pre-Contemplation to Contemplation to Preparation (he even gave up his cell phone!) and then to Action. He’s still clean today! So thirst is a good tool to use! As long as there’s some water nearby. +

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OH, HENRY Henry knew he saw things differently. But he figured Einstein did too. Some folks thought Henry was paranoid. Other said he was crazy. Nobody thought him a druggie. Clearly, he was not. Some strange things he did physically. Others, he did mentally. He had thoughts different than others. Late one night, Henry fired up his Apple computer and spliced it with an old 8-transistor radio, a Motorola pager, a junkyard guitar amplifier, a CB radio stolen from a wrecked semi, and a portable cardiac monitor. At that very moment lightning struck his power supply. When the sparks settled down and the smoke cleared, things were different. Next thing Henry knew, he was seeing decoded communications from an alien sleeper cell scouting out Planet Earth and the United States of America for a potential takeover. The information came in brief blurps and spurts intended for interpretations by superior intelligence. The data from their scouting mission went something like this:

and cannot do. Ball chunkers are paid huge sums of money and they feel a need to tell everyone else what to think about everything.

They found that humans are obsessed with throwing various sized balls through assorted holes. They call it sports, and there are all sorts of rules about what they can

The people of Earth have therapists for every mental problem imaginable. No one is ever cured of the disorder they complain of.

Humans shoot each other during parties. The unfortunate ones killed are always the best of their society: heroes, saints, pillars of their communities. These shootings never seem to kill a thug, thief, wife abuser, deadbeat, or some similar low-life. TV reports make sure everyone knows that. No country likes with their neighbors and frequently kill millions of them with bullets, mines, bombs, poison gases, or other implements of destruction. Everybody claims God is on their side. The young stay up all night. The old sleep all day and all night. The young and the old think the other is out of touch and misguided.

9 +

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The wealthy go to therapists. The poor go to church. Most humans have a car and a cell phone, even the homeless. Humans from all other countries want to come to America, even if they hate American ideals of freedom and religion. The US makes new laws almost daily and enforces all their laws strictly. Except for politicians and illegal aliens who seem to be immune to these laws. Humans are obsessed with movement. They have to be going someplace else all the time. Humans all seem to agree that it’s wrong to kill a newborn baby, but half of them Please see HENRY page 615

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Wait to merge Remember the old cloverleaf at I-20 and Bobby Jones? Drivers had no space at all to merge. That entire interchange was redesigned and rebuilt, along with most others over the decades, offering plenty of room for oncoming and off-going traffic. Case in point: getting onto I-20 westbound from westbound Washington

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Wait to brake Interstate highways are sometimes called superhighways for a good reason: they’re built for speed, for moving large numbers of vehicles rapidly and efficiently, and that is true more and more as the system has evolved. The original cloverleafs requiring a major slowdown to get onto are gradually being replaced by long, straight ramps you can jump off onto at full speed. A perfect example is Peach Orchard Road off Bobby Jones. There’s no need to decelerate while still on 520; there’s plenty of room for that on the ramp, yet people do it all the time, and not just on that ramp. It happens all over. Instead, get out of the way at the posted speed limit whenever possible and do your slowing down after you’re on the ramp.

drivers then often need to brake or merge left into the next lane. All of that unnecessary braking and lane shifting is the kind of thing that often leads to accidents. There are non-interstate examples in the area too. One is turning right onto Washington Road from Baston Road. Several years ago the lane for cars doing that was extended for a very important reason: to keep

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traffic moving in an intersection that has train tracks going right through the middle of it. Used properly, the extended merge lane prevents cars from getting stopped on the tracks. It’s not that trains go through there at 60 miles an hour, but even so, nobody wants to be stopped on those tracks with a train approaching, the gates coming down, and the car ahead stopped waiting to merge and another car right on their rear bumper. That wouldn’t be a good feeling at all. The solution is simple: keep moving. Use that long merge lane. It’s there for a reason. Use it. Flow is the name of the game. (Side note: why that right-turn lane doesn’t have one of those “Keep moving - merge later” signs is a mystery.) Well boys and girls, there’s more, but that’s all the space we have today. Drive safe, and keep the flow flowing. +

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Road. The dedicated lane for those vehicles must be a mile long. Even so, everyone who regularly travels that stretch of I-20 has had cars come off the ramp in front of them and immediately merge into their lane, ignoring the mile-long merge lane in front of them. Those

ns the te Join

ne of the bedrock principles of traffic safety is simply smooth flow. That’s it. No panic stops. No sudden and unexpected turns. No weaving in and out of traffic going 20 mph faster than everyone else. Just keep the flow of traffic moving smoothly. It sounds simple enough. And it can be. Here are a few basic ways to help make it happen as suggested by our roving crew of traffic investigators and observers. Individually they’re pretty insignificant, but together they can add up to a significant contribution to smooth traffic flow, and that means fewer accidents.

MAY 20, 2022

the blog spot — posted by Anne, a patient, on April 18, 2022

WHY IT BOTHERS ME WHEN DOCTORS ASSUME I HAVE TIME The other day I was at an appointment, and when we were trying to find a day after my bloodwork to go over the results, the doctor said, “You don’t have a job, do you?” I am a full-time student so I said no, not at the moment. Apparently, she didn’t catch the full-time student part, and then said, “Right, then you can come in this day at this time, no problem.” She had made the appointment before I had a chance to respond. This might sound silly, but that exchange played on my mind for a long time afterward. Just because I am not employed right now does not mean I am not busy. Just because I do not have a 9-5 job does not mean that I should not at least be asked about what time might suit me best. Perhaps I was taking my sick mother to her appointment that day or visiting a friend or attending a lecture or having a different appointment. The list goes on. There are a lot of reasons why this disturbed me. First of all, in my opinion being chronically ill can most definitely count as a full-time job. I have many different doctors and appointments and it’s a struggle to make it all fit, especially when they all have this similar attitude when scheduling. Secondly, in that type of rushed and dismissive interaction, the doctor demonstrates to me that they do not see my time as valuable. They don’t ask whether I have the time, or whether I am able to come at that time. Of course, I realize that with the pressure on the system, it might be the only appointment available for a long time. This brings me to my third point: that we as patients are treated in a way that forces us to be uber grateful for any appointment we are lucky enough to get. There have been other times like this one where I have said I really cannot make that time, and they kind of shrug and say, “Well then you’re going to suffer more because the next available time is three weeks off. You really should take what I’m offering.” This then leads me to panic. Should I take the appointment that I really can’t go to and thank the doctor profusely because I don’t have to wait in agony for three weeks? Then I will proceed to attempt to cancel whatever plans I already had for the time of the coveted appointment. It wouldn’t be completely out of line to say the doctor should actually be thanking me for my flexibility and/or even apologizing for the backup at the practice rather than making me feel guilty for taking up another slot in their schedule. I have seen a lot of doctors and some have made a lot of wrong assumptions about me. Some are dangerous to my health, but some, like this one, are just insensitive and make me feel like I’m not valued as a person or a patient. Assuming they know what my life looks like based on the fact that I do not or cannot work, and thus assuming that I have nothing more in my life than following the schedule of appointments that suits them best makes me feel like they are not hearing me or understanding me. I understand that healthcare systems everywhere are under extreme pressure at the moment. I know that appointment scheduling is really an art. But I would still very much appreciate the extra few seconds to confirm with me that I really can make that appointment, or even to ask what my daily life looks like, rather than make assumptions about it and in the process insult me by implying that I have an empty life. +

Should I be thanking them? Or do I have that backwards?

Anne is a patient suffering from chronic illness

11 +

AUGUSTAMEDICALEXAMiNER

From the Bookshelf What follows is from a Kirkus Reviews overview of The Gene by Siddhartha Mukherjee: A panoramic history of the gene and how genetics “resonate[s] far beyond the realms of science.” Mukherjee (Medicine/ Columbia Univ.; The Laws of Medicine, 2015, etc.), who won the Pulitzer Prize for his history of cancer, The Emperor of All Maladies (2010), begins with Mendel and his “pea-flower garden,” and he never lets readers forget the social, cultural, and ethical implications of genetics research. Indeed, he dedicates the book to his grandmother, who raised two mentally ill children, and to Carrie Buck, the Virginia woman judged “feeble-minded” and sterilized according to eugenics laws passed in the 1920s. After Mendel, Mukherjee describes Thomas Morgan’s fruit fly studies in the 1900s, and he goes on to trace the steps leading to the discovery of the double helix, the deciphering of

the genetic code, and the technological advances that have created ethical dilemmas. Early on, there was recombinant DNA, the insertion of genes from one species into another, and this led to mandates initially proscribing certain experiments. Then, there were the first disastrous attempts at gene therapy, which consisted of arrogant and sloppy science. Meanwhile, the human genome has been mapped, more and more genes have been associated with certain diseases (and even behaviors), and a

new technique has been developed that permits the removing or replacing of specific genetic defects. Are we ready to apply that to an individual patient? Should it apply to sperm and egg cells so as to affect future generations? Mukherjee ponders these issues in the final chapters and epilogue, ultimately seeing the need for more research about the information coded in the human genome, since so much of it does not consist of genes. Throughout, the author provides vivid portraits of the principal players and enough accessible scientific information to bring general readers into the process of genetic lab science. Sobering, humbling, and extraordinarily rich reading from a wise and gifted writer who sees how far we have come—but how much farther we have to go to understand our human nature and destiny. + The Gene by Siddhartha Mukherjee, M.D; 608 pages, published in May 2016 by Random House.

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The Examiners

MAY 20, 2022

THE MYSTERY WORD

That’s a cute dog you have, sir.

Thank you. As you can see, he has no legs, so he’s a rescue.

by Dan Pearson

Aw. What’s his name?

How did you come up It just came to me the first time I took him with that name? out for a drag.

Cigarette.

The Mystery Word for this issue: ELAPTA

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 ACROSS 1. Prices sometimes do this 5. Fundamental 10. NBC TV station 14. Urge 15. Noted bacteria 16. Inwardly (literary) 17. Cougar 18. Part of an airplane 19. Jeweler’s magnifier (var.) 20. _____ Club 22. Fish or dress starter 23. Leg joint 24. Enterprise follower 26. Magician or learned person (archaic or literary) 28. Cassius, earlier 32. Fenway site 36. Egg 37. It’s got tons of neon 39. Movie network 40. Demand payment 41. Christian or Doug 43. Mars’ color 44. Medical College beginning 45. Poetic or literary word for a bottomless chasm 46. ____ liner 47. Augusta historian Ed 49. Effortlessness 53. On sheltered side 55. Tibetan oxen 56. Lacerate 59. Chatter 61. One of three words repeated on every Medical Examiner front cover 65. Ardent; eager 66. Fragrance 68. Hawaiian honeycreeper 69. Basic monetary unit of Ghana 70. Male singing voice 71. Like some pockets

24 28

E X A M I N E R

32 38

39 43 46

53 56

We’ll announce the winner in our next issue!

55 60

61 67

DOWN 1. Kissers 2. Sewing case 3. Peak 4. Drug prefix 5. Poetically pacify 6. Obamacare acronym 7. Weeps 8. Hip bone 9. Vermilion 10. CSRA county 11. Soon, in poetry 12. Adhesive 13. Class 21. Outer edge 25. Mr. Sconyers 27. Element #79 28. McCormick County town 29. Throat dangler 30. Clock pointers

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

72. Family diagram 73. Swelling 74. Takes to court

S U D O K U

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

QUOTATIONPUZZLE

31. Compact 33. It’s opposite nine 34. Minds 35. Lymph structures 38. Dry red Beaujolais wine 41. Jump out of 18-A 42. Renounce or reject 48. Davis of Augusta 50. World’s largest desert 51. Tina’s partner 52. Class of drugs that includes aspirin 54. Dog follower? 56. Diplomacy 57. At any time 58. Helper 60. Skeleton part 62. Stead 63. Affectedly dainty (British) 64. Rose fruit 67. Dad’s partner

N R I B E D E W E L F R

J A S K A E S R E E C A B F P U L U W T S P R L H N R I

E T M P Y I

5 2 7 1 6 9 2 8 1L 7 4A 3 8 6 W 9 4 3S 5

— Anonymous

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.

L 1 2 3 4 C 1 2 3 4

E 2

1 5

1 1 2 3 4 T ’ 1 2 3 4 5

L 1 2 3 4 5 1 2 3 4

D 1 2

4 D 1 2 3 4

6 1

7 2

1 2 3 4

1.BIWIWIMIMLLDNT 2.EEEEETTHHHOO 3.CAAVEEESS 4.DTTEENNAS 5.RUST 6.VS 7.EE

SAMPLE:

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

8 4 3 5 6 9 2 1 7

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

WORDS NUMBER

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, MAY 30, 2022

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9 5 4 6 2 1 7 3 8

6 3 8 4 9 7 1 5 2

MAY 20, 2022

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

The

13 +

Advice Doctor

A minister asked a little girl why she should be quiet in church. “Because everyone is sleeping,” she promptly replied.

Moe: I’m addicted to seafood. Joe: You should definitely seek kelp.

n explorer making his way through an uncharted jungle was captured by native warriors and taken to their chieftain, a gigantic and ferocious-looking man with teeth filed to dagger-like points. Desperately, the explorer tried to think of a way to save himself. He pulled out his cigarette lighter, held it in front of the chief’s face and lit it, exclaiming, “Look! Magic!” The chief’s eyes widened in astonishment. “It certainly must be magic,” he said. “I have never seen a lighter light on the first try!”

A college student got a new dorm mate who was an exchange student from Australia. One day the exchange student asked, “Have you seen my cocaine?” “A few times,” said the other student, “I thought he was great in Cider House Rules.” A little boy asked, “Dad, what’s an alcoholic?” “See those four trees over there?” pointed the Dad. “An alcoholic would see eight trees.” “I only see two trees, Dad,” said the boy.

Moe: Define propaganda. Joe: When a British person gets a really good look at something. Moe: How was your trip to the zoo? Joe: They have some crazy displays, let me tell you. Moe: Like what? Joe: Like two slices of toast in a cage. Moe: I don’t get it. Joe: Bread in captivity. Moe: Well, I finally got a diagnosis. Joe: I didn’t even know you’ve been sick. What’s going on? Moe: Whenever I can’t sleep, I eat compulsively. Joe: Huh. That’s a weird condition. What’s it called? Moe: Insom-nom-nom-nom-nom-nia. Moe: Hey, you know anybody who needs a sound technician? Joe: Why? Moe: There’s a guy here in town who just escaped from Ukraine. He’s a sound tech and he’s looking for work. Joe: Thanks, but I already have a guy I use. A Czech one too. +

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, For as long as I can remember I’ve had a problem apologizing. I can be 100% in the wrong and know it, but I just can’t admit it out loud. There have been times when I’ve steeled myself to approach someone I’ve wronged, determined to walk up and apologize, and the words get stuck in my throat and I pretend like I was going to say something else. Do you have a suggestion on how I can conquer this major flaw? — Sorry, Not Sorry Dear Sorry, Thank you for openly sharing this vexing problem, one that many people would be too embarrassed to do. But it’s good that you have because anytime anything is stuck in a person’s throat, it’s potentially serious. What could happen? I don’t want to alarm you, but in extreme circumstances it could even be fatal. It’s that serious. More commonly, difficulty swallowing — officially called dysphagia — can lead to malnutrition and dehydration. Choking is a real possibility, and sometimes gasping for air results in inhaling food that “goes down the wrong pipe.” That leads to severe coughing fits to expel the invader, but sometimes the object is inhaled into the lungs, causing aspiration pneumonia and serious lung infections. Obviously dysphagia causes a number of situations that require immediate and/or long-term medical attention. Although it can affect anyone, dysphagia is a problem that affects people more and more as they age. What are the treatment options? First, anything that threatens breathing requires an immediate response. Call 9-11. Less serious dysphagia — and choking prevention — can be as simple and basic as taking smaller bites; eating more slowly; having water with meals and taking sips with each bite; sucking on hard candy to stimulate saliva production and help eliminate oral dryness that interferes with swallowing; and avoiding hard, rough, or dry foods. Anyone can have the occasional bout of dysphagia that is not grounds for great concern or the need for medical attention. But persistent trouble with swallowing definitely indicates the need for a doctor visit. Help is available and it’s important to get it. I hope this answered your question. + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will only be provided in the Examiner.

SUBSCRIBE TO THE MEDICALEXAMINER +

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!

Why read the Medical Examiner: Reason #106 BEFORE READING

NAME ADDRESS CITY STATE ZIP Choose six months for $20 ____ or one year for $36 ____. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

AFTER READING

+ 14

8 2 1

THE MYSTERY SOLVED The Mystery Word in our last issue was: VARIANT ...cleverly hidden on the foot in the p. 16 ad for AIYAN DIABETES CENTER

THE WINNER: MARK VRANICAR! 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!

MAY 20, 2022

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED L I P S

E T U I

M O D O C

U V U L A

T A C T

E V E R

A C M E

P B A H E C A C A R R A M I L L H A M M A A R N B A R D A B Y S H I N A L E E A R G A I D A R D I T E E E E D

S O B S

I L I U M

C I N N A D B E G A N A R S M E A S Y A B H O M A N O R E M A

W I L K G E O S L D

A N O N

G L U E

T Y P E

T H R E I N E K S E A L I I D E S U

O B E Y S

N O D E S

T W E E

H I P S

SEE PAGE 12

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

...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.

7 6 2 1 4 8 9 3

1 9 8 7 3 6 4 5

4 3 5 6 9 2 1 7

Love to stare at your phone? Visit issuu.com/ medicalexaminer and stare away.

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5 4 6 2 1 7 3 8

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QuotatioN QUOTATION PUZZLE SOLUTION Life was simpler when apple and blackberry were just fruits. — Anonymous

WORDS BY NUMBER Love me when I least deserve it because that’s when I need it most. — Swedish proverb

READ EVERY ISSUE ONLINE WWW.ISSUU.COM/ MEDICALEXAMINER

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AUGUSTAMEDICALEXAMiNER

MAY 20, 2022

HENRY… from page 9

think it is OK to kill a baby before it is born. But if you kill a pregnant mother, you get charged with two murders. They demand movies glorifying illegal acts, car chases, shoot-outs, blood and gore. Whatever humans have, it is never enough. They always want more. Henry told others what he had seen. His physician hung a diagnosis of paranoid schizophrenic on Henry and got paid for doing so. While it is true that the electronic scouting report described above had no physical being and existed only in Henry’s mind, was it really

imaginary? Were the observations evidence of paranoia? Or were they actually true and present in our society? Henry was treated with FDA-approved medications and he became a little less strange, according to his family and his physician. His electronic equipment was suddenly gone. So was the sleeper cell of aliens. Henry’s doctor says that his paranoid schizophrenia is “under treatment and clinically improving.” The problem is that when you and I look at our society, many of Henry’s paranoid observations seem to be astute and accurate. Does that mean all of us are a bit paranoid? Or does it mean that maybe Henry is not as crazy as everyone thought? +

Sparkle

Wash

PRESSURE PROFESSIONALS

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PROFESSIONAL DIRECTORY +

ACUPUNCTURE

DERMATOLOGY

Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Augusta 30904 706-733-3373 SKIN CANCER CENTER www.GaDerm.com

Dr. Eric Sherrell, DACM, LAC Augusta Acupuncture Clinic 4141 Columbia Road 706-888-0707 www.AcuClinicGA.com

CHIROPRACTIC Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A 706-860-4001 www.evanschiro.net

COUNSELING Resolution Counseling Professionals 3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866 www.visitrcp.com

DENTISTRY Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048

DEVELOPMENTAL PEDIATRICS Karen L. Carter, MD 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com

DRUG REHAB Steppingstones to Recovery 2610 Commons Blvd. Augusta 30909 706-733-1935

YOUR LISTING Floss ‘em or lose ‘em!

Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

Augusta Area Healthcare Provider 4321 CSRA Boulevard Augusta 30901 706-555-1234 CALL 706.860.5455 TODAY!

EMF PROTECTION

EMF Safe Homes Sheila Reavill Certified Building Biology Specialist 209-625-8382 (landline) SURVEY•ASSESSMENT•REMEDIATION

IN-HOME CARE Everyday Elder Care LLC Certified Home Health/Caregiver 706-231-7001 everydayeldercare.com Zena Home Care Personal Care|Skilled Nursing|Companion 706-426-5967 www.zenahomecare.com

YOUR LISTING HERE Your Practice And up to four additional lines of your choosing and, if desired, your logo. Keep your contact information in this convenient place seen by thousands of patients every month. Call (706) 860-5455 for all the details!

LONG TERM CARE

WOODY MERRY www.woodymerry.com Long-Term Care Planning I CAN HELP! (706) 733-3190 • 733-5525 (fax)

PHARMACY Parks Pharmacy 437 Georgia Ave. ARKS N. Augusta 29841 HARMACY 803-279-7450 www.parkspharmacy.com

SLEEP MEDICINE Sleep Institute of Augusta Bashir Chaudhary, MD 3685 Wheeler Rd, Suite 101 Augusta 30909 706-868-8555

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AUGUSTAMEDICALEXAMiNER

MAY 20, 2022

Aiyan Diabetes Center

Augusta’s Advanced Comprehensive Multi-Specialty Diabetes Center • Endocrinology • Endovascular Surgery • Retina Center • Podiatry

• Wound Care • Research • Clinical Trials • Interventional Radiology

• Ophthalmology • Interventional Cardiology • Limb Preservation Center • Obesity Clinic

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• Shooting, stabbing or burning pain in your feet • Everyday pain in your feet while walking or standing • Intense pain in your feet that can interrupt your sleep Talk to your doctor about how QUTENZA may provide up to 3 months of relief from diabetic nerve pain in your feet.

The area’s best team of Board Certified physicians exclusively dedicated to comprehensive diabetes treatment & care, prevention, and research.

Khalil Al Soutary, MD Endocrinology

Janaki Nadarajah, DPM Podiatry

Jamie Steinsapir, MD, PhD Endocrinology

Brandon Sur, MD Interventional Radiologist

Julian Nussbaum, MD Ophthalmology

Diabetes Center

Donald Brown, DO Vascular Surgery

Kaushal J. Shah, MD Vascular Surgery

462 FURYS FERRY ROAD • AUGUSTA GA 30907 AIYANDIABETES.COM • FAX: 706-868-3719

706-868-0319