July12 19 by Daniel Pearson

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JULY 12, 2019

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CBD The ABCs of

PART III

CBD: WHAT YOU NEED TO KNOW – PART 3 of 3: HUMAN DOSING AND CBD FOR PETS

Written by Augusta pharmacists Chris and Lee Davidson • NOTE: None of the information provided here is intended to be a claim that these products do or do not work for the uses listed. It is intended only to create awareness of what the available products are being suggested for and the research that is currently being done. This is a quickly changing area of medicine so it is recommended that you do your own additional research before choosing any of the products. Once someone has made an informed decision to take CBD after closely researching which brand they would prefer and which dosage form to take, the next big question should be about dosing. How much is recommended? That is the million dollar question! Since the FDA does not currently regulate CBD dosing (except in the case of the recently approved prescription product Epidiolex for two very specific types of childhood seizures) the dose for most conditions is open to discussion and interpretation. Each manufacturer will give you a different recommended basic starting point depending on their product. For example, one manufacturer will recommend a beginning dose of 2-3 mg per day, whereas another manufacturer might recommend beginning at 20-25mg per day. One recommends titrating the dose up to the maintenance dose, and another recommends a larger “loading dose,” and then dropping to a lower maintenance

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dose. (This likely has to do with how many of the cannabinoid varieties are present and if the product does or does not contain THC.) Even factoring in for the differences between the products themselves, the dosing for each individual person may be vastly different. Although each CBD manufacturer has slightly different dosing recommendations, the general range suggestions are similar. If you have never tried CBD before, most of the companies recommend beginning with a low dose – approximately 5 mg – and increasing the dose as needed in a stepwise fashion regardless of the indication. It is recommended to try the lower dose for 3-7 days and then slowly increase by 1-2 mg at a time until the desired effect is attained. (The following suggestions are for the zero-THC products.) For allaround basic health and wellness, a dose of 3-7 mg per day should do the job. The dose for basic anxiety and minor sleep issues ranges from 7-17 mg per day. For minor to moderate chronic pain, inflammation, and moderate sleep issues, you may need to try a total of 20-40 mg/day. More severe sleep disorders, including some narcolepsy, may require doses 40mg or higher. Severe chronic pain, such as that from rheumatoid arthritis or the like, may require doses of 25-50 mg or more. Getting into more severe issues such as Parkinson’s Disease or as an adjunct to certain seizure or psychiatric conditions may require doses of 50mg or more. An interesting note about how almost all CBD products are labeled: The bottles tend to state the total amount of CBD in the container. For example, Green Roads has the oils in 100mg, 250mg, 350mg, 550mg, 1000mg, 1500mg, and 3500mg bottles. The 100mg size is in a 15ml bottle, so it is a concentration of 7mg/ml. This bottle would be good for someone just getting started with CBD, or who only needs just a small amount per dose. At the other end of the dosing spectrum would be the 3500mg size in a 60ml bottle, a concentration of approximately 58mg/ml. Obviously THIS MONTH MARKS THE the higher dosage bottle is going to 13th ANNIVERSARY OF THE cost significantly more, but it would FIRST ISSUE OF THE be good for someone who is estabMEDICAL EXAMINER, lished on their dose who can easily PUBLISHED JULY 1, 2006. adjust for the number of milligrams they need. In both cases, the “recomTHANK YOU TO ALL OUR mended dose” is ½-1ml under the LOYAL READERS & ADVERTISERS! tongue once or twice a day. Sun Med Please see CBD page 2

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THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD by David W. Proefrock, PhD

You walk in on your 5 year-old daughter painting a wall in your family room with a watercolor paint set she found somewhere. What do you do? A. After you stop yelling, spank her and take away the paint set. B. After you stop yelling, tell her that there is a time and a place for painting and that this time and place is not it. Make her help you clean the wall. Then make her help clean the other walls in the room and the floor. C. After you stop yelling, send her to her room while you clean up the mess. Stop occasionally to yell some more. D. Don’t yell at her. Stay calm and explain to her why she can’t paint on the family room walls.

If you answered: A. It’s not really that all spankings have to be bad, but most are. They also don’t teach the lesson you want to teach. In this case, a spanking would not help at all. Even at this age, she needs to learn that messes have to be cleaned up and that it is her responsibility to clean up her messes. B. This is the best response, even if you do yell some. The lesson to be learned here is that each of us is responsible for cleaning up our own messes. Doing more than cleaning up the mess she directly created is called overcorrection, and it helps ensure that the lesson is learned. It works much better than punishment. C. This is what most parents do in a situation like this, but you miss out on an opportunity to teach responsibility. She should help clean up her mess. D. Let’s be honest. This would be completely impossible for most parents. Besides, it gives her the impression that you are not upset with what she did. You also don’t want to miss the opportunity to teach an important lesson. Parents don’t have to be perfect. We are going to yell when we’re upset. What is important is that we take every opportunity to teach the lessons that we want our children to learn. Responsibility is one of the most important of these. + Dr. Proefrock is a local clinical and forensic psychologist

JULY 12, 2019

CBD… from page 1 and MedTerra both come in a tincture formulation, also for use under the tongue, and the bottles range anywhere from 250mg up to 3000mg in a 30ml bottle (in other words, in concentrations of 8mg/ml all the way up to 100mg/ml). The doses are just in a smaller amount of liquid, so the recommended dose of the 3000mg tincture would be ¼ to ½ ml twice daily. The tinctures may be easier to hold under the tongue for the necessary time due to the decreased volume of the dose, making this something to consider when choosing dosage forms. Even the topical creams and balms tend to be labeled by total amount of CBD in the whole container. Koi brand has a balm jar marked 500mg and a small tin marked 150mg. The smaller tin is not any less potent, but rather it is just a travel size or trial size of the same balm that is in the larger jar. The different dosage forms lend themselves to be better for some indications over others. The vape/inhalation options are very quick-acting and easy to carry, so they seem to be a pretty good choice for things like social anxiety or dealing with pain on the go. While you do have to check the specifics for your device, an example of dosing with the vape cartridge/pen would be a four-second puff (counting one-1000, two-1000, etc) for a 2 mg dose. It acts within just a couple of minutes and, with vaping being so mainstream now, no one would even question why you were doing it. (With vaping options, please be aware of the inactive ingredients that are in the product in addition to the active ingredients. The lungs can be easily damaged by extra solvents and chemicals in vape solutions. Be very selective when choosing this option.) The water soluble options (i.e. from Sun Med) make it easy to put a dose in a water bottle and take with you. These are also good for people who don’t necessarily like the taste of the tinctures or oils. The oils and tinctures offer the widest range of dosing and last the longest. The edibles – gummies, hard candies, CBD-infused honey sticks, etc – are easy to carry and ingest. They range anywhere from 10mg per piece up to 25-50mg. (As with any gummy or candy style supplement, we highly recommend taking great care to store these away from children and pets. They can easily ingest too much if they believe they are just eating candy.) Capsules are available from multiple

companies, usually in doses of 25-50mg per capsule. These offer easy transportation and quick dosing, but they do not offer the same ease of dose adjustment. The combination tablets/capsules have other ingredients added in a fixed dosage. For example, MedTerra has a combination CBD 25mg + melatonin 10mg in each orally dissolvable tablet. Topicals are a good option for those who only need localized dosing or as an additive to their regular maintenance regimen. In addition to using CBD for humans, CBD is now available for pets as well. Cats and dogs can have issues with anxiety, tremors, arthritis pain and inflammation and more, just like people do. Most of the larger CBD manufacturers have a line of pet medications now. These products range from sublingual oils, treats, and sprays that can be applied directly in the animal’s mouth or sprayed on their food. Depending on whether it is for a cat or for a dog, there are many different doses available. The treats may have as little as 1-2mg CBD per treat or up to 10-20-30mg per treat for larger dogs. The general rule of thumb for both dogs and cats is 0.5mg to 5mg per 10 lbs. body weight per day, or twice daily if absolutely necessary. The oils and sprays are usually mixed with a carrier oil like krill oil (contains omega 3s) or coconut oil (MCTs) that are good for them for other reasons such as coat health or treating inflammation. CBD is very helpful for animals with storm anxiety and especially for fireworks, but try to remember (if possible) to give it a little time to kick in before the animal is subjected to the fear-inducing noises. A few important things to remember about CBD in general: • Doses can be divided into two or three doses during the day or evening depending on what it is being used for. By dividing the dosage out over the day, it helps to extend the benefits over a longer time period and to minimize the potential side effects. • Use the lowest dose that will sufficiently achieve the goal. • ALWAYS let your physician (and your pharmacist) know if you are taking CBD of any variety, especially if you take other medications. There are new interactions that we are finding out about between CBD and certain medications that can be incredibly important. It is also important for your physiContinued, page 3

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CBD… from page 2 cian to know when to adjust your medications due to the addition of CBD. Please do not attempt to take yourself off any prescription medication, especially those for seizures or diabetes, without discussing it with your physician/medical provider. • As stated previously, CBD dosing is very individualized. There is no “one size fits all” dose. • Doses of THC-containing full spectrum CBD products, although not discussed

here, appear to be somewhat less than their zero-THC cousins. It is important to ask about the appropriate dosing of the product when you purchase it. • A reminder that any information given here regarding the dosing or uses of CBD is purely for information only. While we do have numerous personal accounts from people with positive experiences with CBD, it is important to note that CBD products are not approved

by the FDA for the diagnosis, cure, mitigation, treatment, or prevention of any disease. Studies are currently being done with CBD for various disease states, as well as some that have already been done, but there is still a lot to be learned about CBD, its potential uses, and correct dosing. Please feel free to contact us at cjdlpdrph@bellsouth.net if you have any questions about CBD at all.

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WHY THIS SUDDEN ALLERGY?

It is a bit weird to never have a problem with epic allergy triggers like Augusta’s legendary springtime pollen, and then suddenly one spring you’re engulfed in misery. Or someone experiences a nasty rash and intense itching after eating a dish they have enjoyed without problems for years. As it happens, such experiences are not that weird at all. In fact, a study published in the Journal of Allergy and Clinical Immunology in 2017 said that more than 40 percent of some allergies (atopic dermatitis, to be exact) are adult onset. Overall, adult onset allergies of every stripe are on the rise, according to researchers. The suspected reasons for new allergies are many. Some might be considered obvious — switching laundry detergents (or the manufacturer changes their formula); using a new perfume; moving to a different part of the country with new allergens; getting a cat when you’ve always had only dogs in the past — while others are under debate: is climate change responsible for longer or more intense pollen seasons? Are environmental pollutants and household chemicals somehow compromising our immune systems? Whatever the reason(s) may be — not that there will be an identifiable trigger in every case — suffering through the misery is not only unnecessary, it can be extremely risky: some food allergies can cause airways to close, making them literally (and quickly) life-threatening. Food allergies can also be stealth attackers. No one ever had springtime in Augusta sneak up on them unawares, but someone might order a meal at a restaurant without knowing it contains an ingredient they are severely allergic to. People with food allergies usually carry an epinephrine injector (a.k.a. an epi-pen) for just such situations. While over-the-counter antihistamines and nasal sprays can offer relief, doctors called allergists are experts at identifying the specific cause of allergies. A person can’t avoid an allergy trigger if they don’t know what it is. Armed with that knowledge an allergist can employ immunotherapy to minimize or even eliminate allergic reactions, or prescribe stronger-than-OTC medications that alleviate the symptoms. Truly, allergies are nothing to sneeze at. +

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(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net www.Facebook.com/AugustaRX Opinions expressed by the writers herein are their own and/or their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., nor its agents or employees take any responsibility for the accuracy of submitted information, which is presented for general informational purposes only. For specific medical advice, diagnosis, and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2019 PEARSON GRAPHIC 365 INC.

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AUGUSTAMEDICALEXAMiNER

#94 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 by Marcia Ribble

adies, it’s likely many of you never heard of this woman before reading this article, but if you’ve had children you’re probably about to thank her profusely. Her name was Gertie Marx, and she made the alleviation of pain during childbirth the centerpiece of her remarkable career. In fact, she is known as the mother of obstetric anesthesia for the key role she played in bringing this branch of medicine to birth. But doing so was a little like birthing an elephant — without anesthesia. To understand the obstacles she faced we have to turn on ye olde time machine. The future Dr. Marx was born in Frankfurt, Germany, in 1912. By age 24 (if we do the math...let’s see... born in ’12, add 24... so in 1936) she was a medical student at the University of Frankfurt. That very year, she went to hear a rising political leader give a speech. His name was Adolph Hitler. And did we mention Gertie was Jewish? Hearing that speech was a good thing. It convinced Gertie to persuade her family to flee Germany. Immediately. They moved to Switzerland, where Marx finished medical school in 1937, and by 1938, she was in New York City doing her postdoctoral training at Beth Israel Hospital. Whew. Problems over. Uh, not exactly. Although this makes it sound like ancient times, she was the one and only female intern at Beth Israel. Obstacles for female physicians were many. On one occasion she went to an upscale club in New York City where she was scheduled to speak to a medical group. Upon arriving she was denied entry and told to walk around to the alley and enter through the back door. Undeterred by such events, Marx eventually became the director of obstetric anesthesia at Beth Israel, a position she held until 1955, when she accepted a similar position at Albert Einstein College of Medicine. At both institutions her focus was relieving the pain of childbirth, primarily by epidural administration of anesthesia. You would think reducing the pain of childbirth would be — like trying to alleviate any acute pain — devoid of controversy. But you would be wrong. One of the most curious arguments in favor of pain (do not adjust your Medical Examiner) was the misapplication of Genesis 3:16. Yes, some people had to go all the way back to the Garden of Eden to argue that God told Eve childbirth was supposed to be painful. And anyone minimizing it was going against the will of God. Fortunately, compassion — and Dr. Marx — prevailed, and millions of mothers have benefited, not just from epidurals, but even from pre- and post-anesthetic procedures developed by Marx to increase the safety and comfort of childbirth for both mother and baby. She even developed an improved needle for epidurals known as the Gertie Marx Spinal Needle. Marx was the founding editor of the quarterly journal Obstetric Anesthesia Digest. Among her many honors was a medal from the Royal College of Anaesthetists presented to her by Queen Elizabeth II of England in 1993. Marx died in 2004 at age 91. +

Lately we’ve passed the drought conditions of earlier this year, and now we’re into the summer pattern of frequent afternoon and evening storms after hot middays! I rather like the pattern. It gives me the cooler mornings to run errands and the promise of good afternoon naps soothed by the sound of raindrops hitting my windows. My only problem occurs when there is thunder and lightning. My dog KC is afraid of thunder and will interrupt my naps by poking me with her nose until I wake up to snuggle her and protect her from the demons threatening her tranquility. While that is occasionally a bother, it does have its benefits. At least I am awake to respond to any crises the storm creates. Sleeping through storms, on the other hand, means I am totally unaware of more serious issues than a little noise and rain. I am oblivious to severe storm and even tornado warnings. If there is hail, I am unable to go out and measure it and report the dimensions online. If the electricity goes out while I am sleeping, I could wake up and won’t know if it’s day or night. There is much to be learned in stormy weather. I never know when the rain and wind will attack my trashcan and send it merrily down our street in a line of trashcans with movement, but no destination. My granddaughter Sara and I have sat on her porch watching a whole line of trashcans doing their best to escape, going full tilt until a hapless car gets in their way. If that occurs, the trashcans bump into one another, jostling for position. They look like concert goers waiting in line for ticket sales to begin. Their line isn’t well organized and bumping into others is sanctioned behavior. Because I live in a neighborhood where

we have no front yard trees large enough to cause major damage, falling trees isn’t an issue there. However, we do have big trees in our backyards that can make our homes vulnerable! Being awake if trees start falling can help in making a conscious decision about life-saving measures. Neither are there normally electrical outages here because our wires are underground. Outages occur only when part of the transmission line that is linked to our neighborhood goes down. Being in an area like ours means pretty fast recovery from electrical interruptions because no wires can be knocked down that attach to our homes. Once the main lines are up, we’re back online again. If I were younger, I would invest in a rooftop solar system, or a nice tall wind turbine, creating electricity right at home and with a battery storage system for cloudy or windless days. A century ago many farmers relied on windmills to pump water from their wells and to keep family and farm supplied with water. The solar systems and wind turbines of today function better than those old windmills did and are more reliable. I’m not sure how well either of them would handle a tornado or hurricane, though. Both kinds of storms can rip off the roofs that solar systems are usually mounted on, although information from NOAA and NORAD suggests that both systems are less likely to be destroyed than normal electrical infrastructures. The aerodynamic design of wind turbines may make them less vulnerable in storms and some reports have them surviving tornadic wind gusts up to 300 mph. We all need clean drinking water and electricity for optimal health, so you may want to consider installing them for the health benefits, not just the fact that they are environmentally friendly and cost effective. +

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JULY 12, 2019

Musings of a Distractible Mind

I’ve heard many doctors refer to themselves as “healers,” as if we have some special power to bring about healing in our patients. This idea confers some sort of a higher status and originates, to some, from the higher calling to a more noble life. Again, this is a logical term, in that we have opportunities on a regular basis to help and even save the lives of people. It’s natural to believe that somehow the healing power comes from our touch, or even from our knowledge. It doesn’t. I am not a healer. Healing is what the patient does, not the doctor. As a physician, I am certainly one who can help the patient find a faster road to healing, but I don’t heal. I help. Why am I taking the time to talk about this? Why get stressed out over whether I am a helper or a healer? I think that the belief in doctors as healers causes significant harm to both doctors and patients, and that getting a better perspective about the roles of each will greatly improve the care given. Here’s why I believe this is a topic that needs addressing:

by Augusta physician Rob Lamberts, MD, recovering physician, internet blogger extraordinaire, and TEDx Augusta 2018 speaker. Reach him via Twitter: @doc_rob or via his website: moredistractible.org

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1. DOCTORS OFTEN FAIL AT HEALING (AND WILL ALWAYS ULTIMATELY FAIL) There are many patient problems that do not get better, despite my best efforts. There are countless pains I can’t remove, and many problems I do not solve. Even when I succeed, the success is always temporary, as a new problem will eventually come back. And if healing is our ultimate goal as physicians, we all are total failures, as all of our patients eventually die. If healing is held as our goal, we fight a losing battle. We are the soldiers in the Alamo, offering impotent resistance to an overwhelming force. If I believe in myself as a healer, I will face constant disappointment and defeat. 2. WHEN HEALING OCCURS, IT IS OFTEN INDEPENDENT OF DOCTORS My patient may follow my

advice and not get better, or may disregard what I say and recover from their problem. My direction is imprecise and imperfect, based on my knowledge and experience, along with what I believe to be happening with the

HEALING IS WHAT THE PATIENT DOES, NOT THE DOCTOR patient. But my experience and knowledge may not be right, and my interpretation of what is happening with the patient may be inaccurate. Healing is something that happens in the patient’s body. It’s when they get better, whether or not I am involved in the process. Belief in myself as a healer is based on a falsely high opinion of my knowledge and abilities. 3. PATIENTS WHO SEE DOCTORS AS HEALERS WILL EXPECT TOO MUCH I’ve seen it. I’ve heard people’s frustration when I’ve told them I can’t fix their problem or remove their pain. They feel like they shouldn’t have to hurt, or that if there is something wrong it’s because I’ve missed something. These are the folks who buy the “miracle” cures pandered by Dr. Oz and other profiteers. They hear the promises of health and wellness from the media and are disappointed when we can’t offer the same. By believing I am a healer, my patients will eventually be frustrated and disappointed. 4. DOCTORS WHO TRY TO BE HEALERS DO HARM TO THEIR PATIENTS The pressure to find the “magic bullet,” or the unifying diagnosis leads many doctors to practice bad medicine. This is a pressure we all feel when faced with the powerless feeling some

patients bring. This leads to ordering unnecessary tests, performing unnecessary procedures, and prescribing medications that should not be given. I believe this is what drives many doctors to over-prescribe narcotic pain medications and other addictive drugs. We don’t want to stand helpless; we want to do something. To protect my role as a healer, I am drawn away from my training and toward the task of finding a miracle. In doing this I can cause significant harm. 5. TO PROTECT THEIR STATUS AS HEALERS, DOCTORS WILL OPPOSE ANY OTHER PERCEIVED COMPETITION Doctors in the past have been held with reverence by the general public. We possessed that “secret knowledge” that others didn’t have access to, knowledge that fueled our healing power. Now everyone has access not only to all of the knowledge we have, but also to others who offer alternatives. This causes many doctors to aggressively discourage patients to research their own problems and to attack alternative providers. In defending their turf, however, they are giving patients an ultimatum: us or them. More and more patients are choosing “them” because of this and are rejecting what we offer. By clinging to our power as healers, doctors have greatly harmed people’s trust in our profession. So what’s the alternative? Does it really make a difference what we call ourselves as long as we practice medicine? I think it does. Now that I’ve got time to choose the best way to practice, I’ve seen that there is a much better alternative to being a healer: being a helper. Yeah, that sounds all dull and boring, I know, but it is not only more realistic, it is a much better way to practice medicine. +

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AU Medical Center wins statewide award for “BreathEasy” Program At its annual Summer Meeting, the Georgia Hospital Association (GHA) presented its prestigious Community Leadership Award to Augusta University Medical Center (AUMC) in Augusta for its smoking cessation initiatives that are helping to improve the health of the community. After noting that a number of community businesses still permitted smoking indoors during business hours, the AUMC Respiratory Care team worked with other community partners to form BreathEasy Augusta. This coalition, which includes AUMC, the American Heart Association, the American Lung Association, American Cancer Society, Family Y of Greater Augusta and the Georgia Cancer Center, works to educate the community, raise awareness of the dangers of secondhand smoke and advocate for smoke-free workplaces. The coalition was originally formed in 2012 to urge local lawmakers to consider a smoke-free ordinance. This request stemmed from a 2005 statewide smoking ordinance that banned smoking in restaurants and places that serve people under age

18 yet permitted smoking in bars and similar adult establishments. The coalition dedicated countless hours to the task of producing and distributing marketing materials and advocating to lawmakers. Their hard work was rewarded with the passage of legislation that resulted in a new law that bans smoking in virtually all enclosed public spaces. The law took effect on Jan. 1, 2019 and helped make all community businesses safer for employees in the workplace. With cleaner air more available to its community, AUMC also rec-

ognized the need to assist those individuals who smoke, both with their health care and with smoking cessation. With a focus on early detection of smoking-related illnesses, AUMC, through a partnership with the Community Awareness Access Research and Education (c-CARE) at the Georgia Cancer Center, began offering free lung screenings to smokers ages 50-80 who have smoked a pack of cigarettes a day for 20 years or more. Smoking cessation assistance was also a priority for AUMC because of a Federal Housing Administration

requirement that a tobacco-free policy be in place for all public housing by mid-2018. In partnership with Augusta University’s Georgia Prevention Institute and the Georgia Cancer Center, AUMC worked with the Augusta Housing Authority to provide onsite tobacco cessation counseling and resources for public housing residents. All residents of 12 public housing communities were invited to participate in the Augusta University Tobacco Cessation Program, which uses evidence-based methods to help participants quit tobacco. “Smoking cessation programs reduce the risk of contracting smoking-related diseases for both smokers and non-smokers,” said GHA President and CEO Earl Rogers. “We applaud Augusta University Medical Center for its dedication to addressing this issue and for empowering its community to take control and be healthier. We are pleased to present Augusta University Medical Center with this esteemed award.” — article by the Georgia Hospital Association

AS WE CELEBRATE OUR 13TH ANNIVERSARY

Looking back through the years with a few photos from the Medical Examiner scrapbook

In the Medical Examiner’s early years, we employed cheerleaders to create interest in the publication and get readers excited about its message to live a healthy life (1933, above; 1954, below).

In this 1927 photograph, a stylish flapper in downtown Augusta stops traffic to read the latest issue of the Medical Examiner.

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GARDENVARIETY

The Georgia heat is upon us full force, and I am always trying to find ways to cook a nutritious meal without heating up the kitchen. Salads are a staple during this time of year, but sometimes I want something heartier. That’s when I pull out my Instant Pot and create a quick meal that does not warm up the kitchen or require me to go outside and cook over a hot grill. I decided to make my own version of bolognese. Bolognese usually is a meatbased sauce originating in Bologna, Italy. The sauce has just a bit of tomato for flavor, while the rest is meat, spices, and liquids, generally wine and milk. My recipe for Instant Pot vegan bolognese is a play on the hearty meat sauce which exchanges its meaty texture with very finely chopped cauliflower, carrots, mushrooms, and eggplant. The base is still the traditional seasonings of tomatoes, garlic, oregano, basil, and rosemary. For the liquid, milk is substituted with almond milk. The sauce is lightly sweetened with maple syrup which brings out the flavor of the tomatoes, and a little kick of heat is Instant Pot Vegan Bolgnese added with crushed red pepper flakes. Bolognese is usually simmered slowly Instructions for several hours until the ingredients Add the cauliflower florets to the food processor all marry together creating a thick sauce and pulse until the pieces are tiny, about the size perfect served over pasta. However, of couscous. Scrape out into your Instant Pot liner. using the Instant Pot creates this thick Now add the mushrooms to the food processor vegan version of sauce in only 20 and pulse until small, then add them to your minutes of cooking time. Instant Pot liner. Repeat with the carrots, and eggplants until all the vegetables are minced and Instant Pot Vegan Bolognese placed into your Instant Pot. Place stewed tomatoes into the food processor Ingredients and pulse for a few times, just to get them in small • 1/2 head cauliflower florets pieces. Pour into the Instant Pot liner. • 1 10 oz container mushrooms Mix in almond milk, tomato paste, maple syrup, • 2 cups shredded carrot balsamic vinegar, oregano, basil, salt, and rosemary. • 2 cups eggplant chunks Cook on manual with high pressure for 20 • 2 – 28 oz cans stewed tomatoes minutes. Let the pressure release naturally. • 1 cup almond milk Serve with chopped fresh basil over pasta of your • 6 cloves garlic choice. + • 3 tablespoons tomato paste by Gina Dickson. “As a mother of six who beat • 2 tablespoons maple syrup cancer, I want to share with you what I’ve • 2 tablespoons balsamic vinegar learned. Healing from cancer can take • 1-1/2 tablespoon dried oregano everything a mom has, yet you still want • 1 tablespoon dried basil to love and care for your family through the • 1-1/2 dried rosemary chopped fine treatments. My blog is a community full of • 2 teaspoons Homemade Zesty Italian encouragement for moms going through cancer Season and Dressing Mix treatments who would like to use a plant-based • 1 teaspoon pink Himalayan salt vegan diet to complement their healing journey. • 1 to 2 teaspoons crushed red peppers www.thelifegivingkitchen.com

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JULY 12, 2019

ASK DR. KARP

help people prioritize their nutrition concerns so you don’t start worrying about everything. Over-worrying about diet and nutrition usually leads to taking vitamin, mineral or herbal supplements as “insurance.” Avoid going down this path. Is magnesium deficiency a big problem in the US? The simple answer is, “no.” Generally, it is not a nutrient that you need to be concerned about if you are otherwise healthy and eating a variety of food. If you have certain diseases or conditions, like kidney disease, for example, your magnesium intake Ryleigh from Appling, becomes a medical concern GA, writes: “I am won- and then is more important to monitor. Also, some peodering if I have a mag- ple with diabetes can be at nesium deficiency. I eat risk for magnesium deficienlots of foods rich in mag- cy. On the other hand, there are people who take magnenesium, but I didn’t see sium supplements because it listed on the results of of all the pseudo-scientific “buzz” about magnesium on my annual physical social media and its relaexamination blood tionship to vague claims like work. Is it possible that “decreases inflammation,” “reduces Alzheimer’s risk,” I need a magnesium or “cuts chronic disease supplement?” risk.” Like most urban or so Great question, Ryleigh. cial media “factoids,” yes, Magnesium deficiencies are there is some published data rare because magnesium is showing that magnesium present in so many foods. I might be related to the inalways feel that one of the creased occurrence of chronmajor roles I can play is to ic disease. However, there

NO NONSENSE

NUTRITION

is not an overwhelming or decisive amount of evidence at this time. Therefore, there is presently NO recommendation that normal, healthy people take magnesium supplements to reduce or prevent the risk of chronic diseases, like heart disease, stroke or Alzheimer’s. Here is my advice about evaluating whether you need to take a magnesium supplement. If, for some reason, you are concerned about your magnesium levels, then discuss this with your physician. A blood test may be ordered to measure your blood magnesium level. Blood magnesium is not routinely measured in the usual physical examination blood workup (which is why it wasn’t listed in your results), so it has to be specifically requested. Then, if the results of the test show

below normal blood magnesium levels and this information complements what your physician is finding on clinical examination, magnesium might be a concern for you. The first advice would always be to get it from food. However, your physician might recommend magnesium supplements, as a “catch-up,” and then once your blood levels are in the normal range, simply getting the magnesium you need from the food you eat. The idea of taking magnesium just for the heck of it, i.e., to make you “healthier,” is faulty thinking and fraught with problems, including magnesium toxicity or interference of the magnesium supplement with the absorption of other nutrients. It is never a good idea to take a supplement for the general idea it will make you health-

ier. Rather, you need to be a partner with your physician and base health decisions on your personal clinical and laboratory data. Are you showing the signs and symptoms of a magnesium deficiency, like loss of appetite, nausea, vomiting, fatigue, and weakness? Are your blood magnesium levels low and do these low levels back up your physician’s clinical findings? If your physician does suggest a supplement, the soluble magnesium salts are generally more bioavailable. These magnesium salts include the aspartate, citrate, lactate, and chloride forms. These forms of magnesium may be absorbed more completely and are thought to be more bioavailable than either magnesium oxide or magnesium sulfate. What’s the “No-Nonsense Nutrition” advice for today? Don’t make personal health decisions based on general recommendations. General recommendations are guidelines, not rules to apply directly to you. What you need to do is see how those general recommendations apply to you, based on your very own, specific, clinical and laboratory findings. Personalizing recommendations is always the way to go. +

Have a question about food, diet or nutrition? Post or private message your question on Facebook (www.Facebook.com/AskDrKarp) or email your question to askdrkarp@gmail.com If your question is chosen for a column, your name will be changed to insure your privacy. Warren B. Karp, Ph.D., D.M.D., is Professor Emeritus at Augusta University. He has served as Director of the Nutrition Consult Service at the Dental College of Georgia and is past Vice Chair of the Columbia County Board of Health. You can find out more about Dr. Karp and the download site for the public domain eBook, Nutrition for Smarties, at www.wbkarp.com Dr. Karp obtains no funding for writing his columns, articles, or books, and has no financial or other interests in any food, book, nutrition product or company. His interest is only in providing freely available, evidenced-based, scientific nutrition knowledge and education. The information is for educational use only; it is not meant to be used to diagnose, manage or treat any patient or client. Although Dr. Karp is a Professor Emeritus at Augusta University, the views and opinions expressed here are his and his alone and do not reflect the views and opinions of Augusta University or anyone else.

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AUGUSTAMEDICALEXAMiNER

Ask a Dietitian LUFFA: AN EDIBLE SPONGE

by Lo Bannerman, MS, RDN, LD Entrepreneurial Dietitian, Teal Avocado Luffa (or loofah/loofa) is the genus name for a group of plants in the cucumber family. Yes, the scrubber often found in the shower is actually a gourd! Favoring warm climates, luffa grows exceptionally well in the South and has started popping up in local farmers markets and backyards. When picked at an immature stage, luffa (often under the pseudonym Chinese okra) can be eaten raw or cooked similarly to squash. It has a mild yet slightly bitter flavor and is most commonly found in Asian cooking. To be used as a sponge, luffa is grown to full maturity and allowed to dry on the vine. Once picked, the outer skin and inner seeds are removed and the luffa is ready for use! Its fibrous and durable nature makes luffa a wonderful choice for cleaning pots and pans or exfoliating your skin. Luffa can also be cleaned in a washing machine or dishwasher and reused for years! Just don’t put a luffa in the dryer; the heat causes the fibers to crumble and create quite a mess. When purchasing authentic luffa (instead of a plastic impersonator), local is key. Most luffa imported from other countries or found on store shelves is sprayed with synthetic chemicals to help the fibers become rigid.

and sustainable gift. If all this talk about gourds is making you hungry, check out this recipe for luffa’s cousin, squash:

These chemicals then find their way onto your skin or pots and pans. For the best variety, look for luffa at a local farmers market (Radiant Acres Farm is currently growing some to be available through Augusta Locally Grown’s online farmers market and Burke County’s Thursday Market) or pick up some seeds, set up a trellis, and grow your own! They make a wonderful, unique,

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The blog spot From the Bookshelf — posted by Richard Gunderman, M.D, Ph.D., and James Lynch, M.D. on July 1, 2019 (edited for space)

EHRs VERSUS HANDS-ON MEDICINE The introduction of electronic health records (EHRs) was accompanied by a great deal of fanfare. Such systems, which replaced old paper-based charts, were designed to make patient data more accurate, safer and accessible. It was also claimed that they would make it easier for doctors to monitor medical care. Doctors have realized that EHRs are no panacea. They are expensive; one study showed for a five-doctor group, the cost is $162,000 to install and $85,000 per year to maintain. These systems force doctors to follow generic templates that may not reflect the needs of a particular patient. Health professionals often find themselves spending more time and energy tending to the EHR than to their patient. Too often, the EHR seems better adapted to coding and collecting revenue than patient care. A patient’s story There is a far deeper and more pervasive problem with EHRs that was brought home to us recently by a patient we know. Mary is a frail woman in her 60s who was first diagnosed with a form of lymphoma about 20 years ago. She had been doing well until she developed abdominal pain, which was traced to diverticulitis. Surgery fixed the problem with her colon, but her recovery was quite difficult. Eventually, she was well enough to be sent home, but she was quite discouraged. At home, she developed a urinary tract infection and returned to the hospital. There she told the doctors treating her that she did not want any further treatment, and instead wanted to be referred to hospice. Plans were made to do so. Fortunately, her husband reached out to her long-time oncologist, who came and saw her. He persuaded her to accept a transfer to his hospital service, where she turned the corner. That was eight years ago. Today Mary is leading a healthy, happy life. But had her oncologist not seen her, she would have been transferred to hospice and likely died. The doctors responsible for her care all had access to the same information through the EHR, but none of them actually knew the patient. Many experienced doctors can point to such stories. Too often, sophisticated new technology interposes itself between patient and doctor, drawing the doctor’s attention away from the patient and sometimes making the electronic data in the medical record seem more reliable and even more real than patients themselves. Over time, it becomes progressively more tempting for doctors to suppose that because they have thoroughly reviewed the EHR, they have a thorough grasp of the patient’s medical situation. Yet there is a profound difference between looking at the data and actually laying eyes on the patient. This difference was dramatized in a patient presentation by one of our thirdyear medical students. He reported that his patient was “post BKA,” meaning that the patient had undergone a Below-theKnee Amputation. “Really?” said the faculty doctor, “Let’s go see the patient.” When the team walked in the room, the patient was seated on the side of the bed, two feet and 10 toes resting on the floor. What happened? Several years ago, the patient had been admitted in DKA, or diabetic ketoacidosis. The voice recognition dictation system had mistranscribed DKA as BKA, and that bit of the patient’s history had been copied and pasted from one admission note to the next over several hospitalizations. Why wasn’t it detected and corrected? As this case illustrates, patient data in an EHR should never be regarded as an adequate substitute for a doctor’s firsthand knowledge. The EHR has a role to play, but it is merely a tool, like a stethoscope or CT scanner. It is important to remember what medicine really is: an art dedicated to the care of patients, whose interests should always come first. Patients and doctors will thrive only if we keep patients front and center. + Richard Gunderman is Chancellor’s Professor, Schools of Medicine, Liberal Arts, and Philanthropy, Indiana University, Indianapolis, IN. James Lynch is dean of admissions, University of Florida College of Medicine, Gainesville, FL.

A quick glimpse at tonight’s TV programming will tell you why this is a popular book. Virtually every night of the week, reality shows and crime dramas present to us the ever-expanding frontiers of forensic medicine. It’s a wonder anyone ever gets away with murder anymore. But it hasn’t always been that way. Medical investigative writer Douglas Starr unveils the story of a serial killer who terrorized the French countryside during the 1890s. Joseph Vacher’s name may not share the same infamy as Jack the Ripper, but his crime spree was just as heinous. Vacher roamed the back roads of rural France, killing up to a dozen people, many of them shepherds — hence the book’s title. His reign of terror may have lasted longer than the three years it did had it not been for the pioneering forensic work of Dr. Alexandre Lacassagne, head of the Institute of Legal Medicine in Lyons, France. These two men, Vacher and Lacassagne, are the central characters in this book that will probably hook you from

its opening pages —if forensic medicine is of interest to you. As one reviewer noted, if Vacher was France’s Jack the Ripper, this whole book is CSI: Rural France. But if this book is a TV show, it’s definitely cable: the graphic detail of the crimes Vacher committed might be too much for some readers, but it makes the vital need for people like Dr. Lacassagne (and his modern-day counterparts) all the more apparent and their work all the more appreciated. Those Lacassagne colleagues of today are still using some of the techniques that were just beginning to

be explored in the 1890s: microscopic examination of hair and fibers; matching blood types found at crime scenes to potential suspects; identifying guns used in crimes by what we now call ballistics; analysis of wounds and blood spatter patterns; and one of the earliest cases where profiling was employed to identify general traits of the person for whom investigators were hunting. Vacher’s terrible work is also examined in detail: Starr looks into the age-old nature versus nurture question, examining whether Vacher’s psychopathic acts were the result of a genetic heritage, or the result of a violent and abusive upbringing. Starr intimately introduces readers to the victims and their families, telling the stories of the impact their untimely deaths had on the victims’ friends and family. It’s a thoroughly researched and compelling book to read. + The Killer of Little Shepherds—A True Crime Story - And The Birth of Forensic Science, by Douglas Starr, 336 pages, published in 2011 by Vintage.

Research News Broken record news We have published several stories lately about new research findings that say even minimal amounts of exercise pay handsome dividends. To be honest, we’ve been so busy with these newsbriefs that we haven’t really had time to exercise. Actually, that was a lame attempt at humor: everyone has time to exercise. It’s just that not everyone takes the time to exercise. To keep the repetitious theme going, it takes very little time to reap benefits, which is the finding of yet another research study. This one is from Oregon Health & Science University. Their report is a little different. Instead of telling us how much our heart or vascular system or muscles benefit from exercise, their study focused on brain health. At OHSU, neuroscientists discovered that even a short burst of exercise boosts function of a gene which

increases neural connections in the area of the brain associated with learning and memory. Admittedly, the Oregon study was conducted using mice. But they chose mice that are like a lot of us: sedentary. They placed these mice on running wheels and after a workout that would be the human equivalent of, say a pickup basketball game or several thousand walking steps, they found an increase in synapses in the brain’s hippocampus prompted by exercise-related surges in a gene activated by exercise. So: need to ace a big test, complete a vital report, perform rocket science or brain surgery? Take a brisk walk beforehand to prime your brain for optimal performance. What do sick kids want? With a major children’s hospital right here in Augusta, it’s a valid question. What do sick kids really want? Cool

architecture? Nifty toys? Plenty of green Jell-O? Cute nurses? Australian researchers have conducted what they say is the first study of its kind: a study about kid’s preferences that actually asked kids, not adults. The results? Very basic: Feeling safe and being able to get to sleep at night finished first and second. The Coffee Cure Speaking of repeated themes, here’s more news about good coffee. (It has to be good coffee or we wouldn’t be drinking it, right?) Scientists at the UK’s University of Nottingham say that drinking coffee can stimulate the body’s fatfighting defenses. The data could be key to tackling both obesity and diabetes, two large and growing epidemics. The benefit comes from coffee’s ability to stimulate a type of body fat which generates heat and burns calories (as opposed to other fats which store calories). +

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AUGUSTAMEDICALEXAMiNER

The Examiners

JULY 12, 2019

THE MYSTERY WORD

It’s unfair the way women are paid less than men for the same jobs!

And it’s in every field: business, law, Hollywood, even music, including my favorite genre, rap.

It’s practically criminal.

So true.

by Dan Pearson

Who’s your favorite female rapper?

The Mystery Word for this issue: RILACAN

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

We’ll announce the winner in our next issue!

E X A M4 I 1 N9 E R7

19 21 24

33 37

42 44 48

53 59

9 3 4 6 5

3 9 5

6 2 5 9

4 6

S 3 U 1 2 D O K U

3 9 6 8 3

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

QUOTATIONPUZZLE

30. Former host of Late Night 31. Deplete 33. Cookie makers? 34. Cut of meat 35. Police team 38. Defamatory 41. Move through the air 43. Campus org. 45. What a person might donate 46. Summerville library 47. Corpulent 48. _______ Creek 49. Curve 50. Muslim messiah 53. Flower holder 56. On, upon or above prefix 57. RN colleague 58. The “A” of IPA 59. Permit 60. Sick

5 1 6 7 2 4 S L 8D 2 R E 4I 3 1 9 N 9Y 5 R 3 8 7 6 — Orson Wells

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. All the listed letters following 1 are the 1st letters of each word; the letters following 2 are 2nd letters of each word, and so on. Try solving words with letter clues and entering unique and minimal choice letters. A sample is shown. Solution on page 14.

M I 1 2 3 1 2 3 4 1 2 3 4 5 6 7 8 9 F I 1 2 1 2 1 2 3 4 5 6 7 1 2 3 4

P 1 2 3 4

1 2 3

1 2 3 4 5 6

1 2 3

K 1 2 3 4

A 1 2 3 4 5 6 7

1.PHILIMMMITTTY 2.AAAEEHIMNOORS 3.KLUSOPEEFYI 4.PETPETOF 5.IWLR 6.ATEN 7.YAG 8.N 9.T

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

20 ACROSS 1. Former Augusta 23 District Attorney 26 27 28 6. Shatter 11. Fat meas. 29 30 31 32 14. River in Paris 36 15. Craze 16. Operated 39 40 41 17. Late 18th century 43 movement in arts & literature 45 46 47 19. Mel of the Giants 51 20. Fuel for some plants 21. Join metals with high heat 54 55 56 57 58 23. Pompeo’s department 61 62 24. South American country 64 65 26. Inhibitor lead-in 28. Augusta merchant by Daniel R. Pearson © 2019 All rights reserved. 29. Leader of a certain army 32. Excited; eager DOWN 33. Ernie of the PGA 1. Area abbrev. 36. Thinner 2. Speedwagon intro 37. Doctoral associate 3. Intention 39. Organ of hearing 4. Apathy in a situation that 40. 27th US President (and a calls for a response former Augusta visitor) 5. Seaport in NW Italy 42. Minor facts or details 6. Look happy 43. Steps for scaling a wall or 7. Shortened name for a fence common computer 44. Curved; crooked 8. Black bird of South America 45. Process of mountain 9. Sib range formation 10. Farmhaus offering 48. Mr. Brown 11. Main Street Augusta? 51. Concrete reinforcement 12. Passover bread 52. By mouth 13. Bury 54. Command to a horse 55. Sadness; gloom; depression 18. Make lace 22. Mr. Floyd 61. Donkey 23. Echolocation 62. Singer Fiona 24. Brain wave letters 63. Now illegal means of 25. Lara of Tomb Raider settling disputes 26. _____ nurse 64. Born 27. A of 1-D 65. Rule of _____ (in burns) 28. Dull finish 66. Plant fiber

WORDS NUMBER

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, JULY 22, 2019

8 3 9 6 7 5 4 1 2

9 4 6 5 8 2 3 7 1

3 2 1 7 9 6 8 4 5

7 8 5 4 1 3 6 2 9

JULY 12, 2019

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AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

f the person who named walkie-talkies also named other things... Stamp - licky-sticky Defibrillator - hearty-starty Bumble bee - fuzzy-buzzy Fork - stabby-grabby Socks - feety-heaties Nightmare - screamy-dreamy Tennis racket - stringy-swingy Cactus - pricky-sticky Squid - squishy-fishy Horror film - thrashy-slashy Whisky - stinky-drinky Wasp - stingy-wingy Parrot - wordie-birdie Auto-correct - writey-righty Lifejacket - boaty-coaty Moe: What’s it called when your parachute doesn’t open? Joe: Jumping to a conclusion. Moe: You know what’s even more amazing than a talking dog? Joe: A spelling bee?

The

Advice Doctor

Moe: Why was the stegosaurus the top player on his volleyball team? Joe: Maybe because he was so good at spiking the ball.

Moe: I have a fountain pen that can write underwater. Joe: A fountain pen? That’s amazing. Moe: And that’s just one of the words it can write. Joe: That’s nothing. In the past two weeks I’ve mastered Karate, Ju-Jitsu and Judo. Moe: Really? Joe: Really. And several other Japanese words too. Moe: I treat every day like I’m running a marathon tomorrow. Joe: What do you mean? Moe: I take it easy, don’t run, and load up on carbs. A nurse was questioning a new patient: “Are you on any special diets?” “Yes,” said the patient. “I drink Slim Fast twice a day, but it’s not working. In fact, I’ve gained several pounds since I started. “That happens sometimes,” the nurse said. “Do you think that skipping meals to drink a shake makes you so hungry that maybe you overeat later?” The patient looked puzzled. “Skipping meals?” Amazing but true: if all your blood vessels, arteries and capillaries were laid end to end from here to the moon, you would die. +

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, I have worked closely with an incredibly awesome human being for almost 30 years. Well, the inevitable has happened: he has announced his retirement, and later this month I am supposed to deliver a speech at his retirement party. Aside from normal (ok, extreme) nervousness about public speaking, every time I even think about saying farewell to this great man I get a lump in my throat. How can I get through this speech without losing it? — Hello goodbye Dear Hello, I’m glad you took the time to write about this important subject. Just how important it may turn out to be is still unknown at this point, but I will say this: any lump that is in the throat region needs to be checked. There is a lot of equipment in the neck and throat that is essential for life, and real estate is pretty scarce in that part of the body. Naturally, many people who feel a lump in their throat automatically think the worst: cancer. That is but one of many possibilities, some of them of very little concern medically, others that need urgent attention. Cancer certainly qualifies as something that needs prompt diagnosis and treatment, but there’s no need to make a cancer assumption and panic. For one thing, until a definitive diagnosis has been made and confirmed, there is no need to believe a lump is cancerous. For another thing, even if it is malignant, tremendous progress has been made in treating cancer and increasing the odds of long-term survival. Among many other possible reasons for a lump in one’s throat: swollen lymph nodes that may have a simple and very treatable infection; strep throat; tonsillitis; a blocked or infected salivary gland; HIV; sinus infections; mumps; thyroid disorders like goiter; and mononucleosis. And that is by no means a complete list of possibilities. You can plainly see that your symptoms need to be checked by a doctor and treated. There are possible causes that demand prompt attention if for no other reason than that throat-related functions include tasks like breathing and eating that are crucial to continuing to live. So get checked and get treated. Soon! 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 be provided only in the Examiner.

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Why read the Medical Examiner: Reason #208

By popular demand we’re making at-cost subscriptions available for the convenience of our readers. If you live beyond the Aiken-Augusta area, or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house! NAME ADDRESS CITY STATE ZIP Choose ____ six months for $20; or ____ one year for $36. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

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

...cleverly hidden on the palm tree in the p. 1 ad for INTERNATIONAL UNIFORM

THE WINNER: CHRISTINE HOLECEK! Want to find your name here next time? If it is, we’ll send you some cool swag from our goodie bag. The new Mystery Word is on page 12. Start looking!

JULY 12, 2019

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED C R A I G S E I N E R O M A N A C O S T A M A O I A R N O L L E A N E E A R T S T O R O G E R E B A R G E E M A S S A N E E N

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

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

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

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QuotatioN QUOTATION PUZZLE SOLUTION “There are only two emotions in a plane: boredom and terror.”

— Orson Wells

WORDS BY NUMBER

“The most important trip you may take in life is meeting people halfway.”

— Henry Boye

READ EVERY ISSUE ONLINE WWW.ISSUU.COM/ MEDICALEXAMINER

JULY 12, 2019 C. You have very limited availability to help. D. You have just become reacquainted with your parents after estrangement and are only willing to do the minimum.

IT’S A QUESTION OF CARE How do I decide which type of care best caters to Mom or Dad’s needs? Determining if/when your parent(s) needs additional assistance in their home can be difficult and emotionally draining. Don’t know where to begin? This quiz may help. • How committed are they to staying in their own home? A. There’s no way they will leave. B. They prefer the belongings and memories of their own home. C. They’re open to change, if it’s for the better. D. As long as they have friends and family nearby, it doesn’t matter where they are. • How committed are you to helping them stay in their own home? A. You will work tirelessly to make it happen and have the time to do so. B. You’re able to check on them regularly- at least 3 times per week.

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• What is their financial situation? A. They saved every penny that they ever earned/inherited, and it’s buried in the backyard. B. They enjoy splurging once in awhile, but they also invested wisely. C. They have some money in the bank, but spoil themselves periodically and therefore are not positioned well financially. D. They spent money like it grows on trees and now are in a bind. • What level of care or assistance do they need? A. They need almost 24/7 care or supervision for safety reasons due physical or cognitive decline. B. They need help with the affairs of daily living, and ensuring they take their medications correctly. They also need a second set of eyes and ears at medical appointments, but they can be left alone for long periods of time (up to 12 hours). C. They can still prepare simple meals and drive their familiar routes. They are self-sufficient enough to write checks and make doctor appointments, but they need someone to oversee the details of money management and medical care. They also need limited help with bathing and dressing, as well as support to ensure medication compliance. They may only require help on the days that their needs must be addressed (i.e.

only bathe 3 days/week). D. They are fairly independent, although someone checking in on them to visit and help, even if only two days a week, would be priceless. More importantly, you know they need companionship and routine. Decision Time! Based upon your answers, consider these options: In-Home Care This costs approximately $20/hour if you use a licensed and insured agency. A private caregiver is approximately $12/ hour. Therefore, 24/7 care is between $8,500 and $14,500 per month. The assigned caregivers can handle all of your loved one’s needs and it’s a one on one care situation. Assisted Living In this geographic market, the cost is approximately $4,500/month based upon

the amount of care and supervision needed. There is also Memory Care Assisted Living which specializes in care for those with significant cognitive impairment. Some communities have both regular Assisted Living and Memory Care options. Assisted Living provides 24/7 care and supervision, meals, medication management, personal care, socialization, and transportation for shopping and medical appointments. Adult Daycare/Senior Center The cost for Adult daycare is approximately $100/day (8-10 hours), which would amount to about $3,000/month. Another option is half-day daycare. Activities, meals, and socialization are offered. Some facilities offer personal care such as bathing and in house physical or occupational therapy. Nursing Home The cost of a nursing home

in this geographic market is $7500/month. All personal care needs are met, meals, activities, nursing and physician services, and transportation to specialty medical appointments The bottom line is whether there is enough money to provide the level of care needed. If not, how much care can or will family and friends provide? Make sure to factor in income, Long Term Care Insurance, savings and other assets, VA benefits, Department of Labor benefits for those who worked at Savannah River Site and qualify, and Medicaid. + 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.

Do you struggle with moderate to severe unsalubriousness?

Doctors recommend twice-monthly

MEDICALEXAMINER

Safe • Effective • Convenient • Available Without a Prescription

For external use only. May be habit-forming. Take regularly; do not discontinue reading unless advised by a physician. Product not child resistant. Do not chew or crush. Not to be taken by mouth. May be taken (read) on an empty stomach, or with food. May be taken one hour before or after meals. And at any other time. Product may not be gargled. Do not drive a motor vehicle or operate heavy machinery while reading. Use in conditions of adequate light. Store in a cool dry place. Not to be used as a personal flotation device. Dispose of properly. Overeating, poor diet, cigarette smoking and excessive drinking may alter the effectiveness of this product. Do not use near spark or flame. Not dishwasher safe.

READ ONLINE If you become too salubrious, please read fewer articles.

THE

MEDICALEXAMINER VISIT AUGUSTARX.COM FOR EVERY NEW ISSUE, AND ISSUU.COM/MEDICALEXAMINER, WHERE MORE THAN 180 PAST ISSUES OF THE EXAMINER AWAIT YOUR READING PLEASURE.

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AUGUSTAMEDICALEXAMiNER

JULY 12, 2019

You are cordially invited to the

Grand Opening of

Thrive at Augusta Senior Living Thursday, July 25th • 4:00 pm - 6:00 pm. Ribbon Cutting • Live Entertainment • Fine Foods & Beverage RSVP Is Appreciated: Hello@ThriveAtAugusta.com or 706.955.2275 On-Site Parking Will Be Available

Thrive at Augusta 309 Furys Ferry Road | Martinez, GA 30907 | 706.955.2275 Hello@ThriveAtAugusta.com | ThriveSL.com/Augusta

PROFESSIONAL DIRECTORY +

ACUPUNCTURE

DENTISTRY

DRUG REHAB

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

Dr. Judson S. Hickey 2315-B Central Ave Augusta 30904 PRACTICE CLOSED 706-739-0071

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

ALLERGY Tesneem K. Chaudhary, MD Allergy & Asthma Center 3685 Wheeler Road, Suite 101 Augusta 30909 706-868-8555

AMBULANCE SERVICE

Floss ‘em or lose ‘em!

Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048 Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

DERMATOLOGY AMBULANCE • STRETCHER • WHEELCHAIR

706-863-9800

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

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

LONG TERM CARE

Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) WOODY MERRY www.woodymerry.com Augusta 30904 Long-Term Care Planning 706-733-3373 SKIN CANCER CENTER I CAN HELP! www.GaDerm.com (706) 733-3190 • 733-5525 (fax)

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

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

PHARMACY

Medical Center West Pharmacy 465 North Belair Road Evans 30809 706-854-2424 www.medicalcenterwestpharmacy.com Parks Pharmacy 437 Georgia Ave. ARKS HARMACY N. Augusta 29841 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

VEIN CARE Vein Specialists of Augusta G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 501 Blackburn Dr, Martinez 30907 706-854-8340 www.VeinsAugusta.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!