Medical Examiner 11-15-19 by Daniel Pearson

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NOVEMBER 15, 2019

AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

PART 1 OF A SERIES BY JONATHAN MURDICK

Editor’s note: Our correctional nurse isn’t quite as fetching as the nurse on the cover of the pulp novel shown. Ours isn’t even a female. But our nurse has at least one exceptional advantage over the nurse at right: he’s real.

hen I first stepped into the maximum security prison I was unsure of what to expect. Flashes of The Green Mile, Shawshank Redemption, and Cool Hand Luke came to mind, but they couldn’t have been further from the truth. I was greeted by some expected sights like cold cinder block walls, iron bars, metal detectors, and forceful gloved hands groping my body. Yes, nurses get forcefully frisked coming in and going out of the prison. I was no stranger to dangerous situations: I spent over eight years working as an EMT and then in law enforcement as a deputy in a local county. I assumed being a prison nurse should be easy by comparison. You know what they say about assuming? I cleared the secure entrance and was escorted through the administration facility into the “yard.” For any who might not know, the yard is the large open common area between all the housing dorms. I will never forget my first glimpse of the tiny metropolis that stretched out in the yard before me. Male inmates dressed in pink or tan (yes, I said pink) traveled in organized lines here and there like industrious ants. Housing units stretched all over the campus, and off to my left, loomed the dark tower known as “Max.”

You can only glimpse the dorm known as Max because it’s locked behind rows of chain link fence, concrete walls and barbed wire. It has no yard, no outdoor recreation, and a darkness that seems to seep out like a noxious gas. The guard who was escorting me quickly brought me back to reality when I realized he had walked off and left me standing in the open yard surrounded by inmates. I rushed to catch up and was escorted to a building that resembled a pillbox turret. Windows into the block building were only 3-4 inches wide and the door was solid steel with a hazy Plexiglas window covered in iron, spit, and possibly a few other fluids. The guard pounded and after an agonizing wait I caught my first glimpse of scrubs. Inside this locked-down little building was a fully functioning medical unit complete with a prompt care clinic, pharmacy, emergency room, hospice ward, and long term care unit. Although I longed for a tour of this miraculous miniature medical ecosystem, I was immediately greeted by the director shouting for me to grab a jump kit and follow her. A bag similar to the a medical kit EMTs carry was thrust into my chest and we quickly sprinted across the open yard. I remember the fear and hesitation

“I was soaked from chest to toes in blood and sweat.”

Please see PRISON NURSE page 6

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NEW SERI ES!

AUGUSTAMEDICALEXAMiNER

NOVEMBER 15, 2019

THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD by David W. Proefrock, PhD Your 18 year-old son is a senior in high school and will be going to college next year. You have just realized that he doesn’t know how to cook, do his own laundry, or balance a checkbook. What do you do? A. Don’t worry about him. He’ll learn to do those things as he needs them. B. Stop doing the cooking, laundry, and other things for him now so he will be forced

to learn to do them on his own. C. Begin now to systematically teach him to do all these things so he will know how to do them before he goes to school. D. Have a talk with him and tell him he needs to begin learning to do these things on his own. Let him do it at his own pace. If you answered: A. These are not the kinds of

things you learn on your own with no help without making some serious mistakes along the way. You’re going to have to teach him to do them. B. There is no need to cut him off without any kind of lifeline. He will probably learn to do these things on his own, but not without making a lot of mistakes. You should teach him to do them. C. This is the best response. These are not skills best learned on your own and they don’t come naturally. D. Unless he is a very unusual teenager, he’s going to need more structure than this. Most kids aren’t going to start doing their own laundry just because they might need to some day. You have three primary jobs as a parent: Keep your kids safe, educate them, and teach them the skills they need to live in the world successfully as an adult. These things fall under the third and it’s your job to make sure he knows them. + Dr. Proefrock is a retired clinical and forensic child psychologist.

BE A QUITTER! THE GREAT AMERICAN SMOKEOUT IS ON NOV. 21

TELL A FRIEND ABOUT THE EXAMINER!

More than 34 million Americans still smoke cigarettes, and smoking remains the single largest preventable cause of death and illness in the world. Smoking causes an estimated 480,000 deaths every year, or about 1 in 5 deaths. More than 16 million Americans live with a smoking-related disease. Smoking cigarettes kills more Americans than alcohol, car accidents, HIV, guns, and illegal drugs combined. Smoking shortens male smokers’ lives by an average of about 12 years and female smokers’ lives by about 11 years. Smoking accounts for about 30% of all cancer deaths in the United

States, including about 80% of all lung cancer deaths. Lung cancer is the leading cause of cancer death in both men and women, and is one of the hardest cancers to treat. There are a multitude of excellent reasons to quit smoking. Doing so improves health immediately and over the long term at any age. The Great American Smokeout on Nov. 21 is a great opportunity for smokers to quit, or a great day to make a plan to quit or help a smoker quit. Visit cancer.org/healthy for tips, tools and suggestions to help you make a success of quitting. For more help right now, see “the Psychology of Quitting” on page 10. +

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NOVEMBER 15, 2019

VACCINE INGREDIENT

FUNFACTS

PART TWO

WHY DOES MY DOCTOR TAP MY KNEE?

There is a constant stream of misinformation about vaccines and their safety swirling around in the online world. Vaccines contain poisonous heavy metals. They contain cells of aborted babies, along with antifreeze, weedkiller, and virus germs of the very disease they’re supposed to protect us from. What’s the real truth? We asked our resident pediatrician, Dr. Caroline, to sort through it all just for us. Part One addressed questions about formaledehyde, aluminum, and live viruses in vaccines. Here is Part Two of her two-part series. Egg protein (ovalbumin) can be found in extremely trace amounts in the flu and yellow fever vaccines. This is because the production of these vaccines involves cultures growth in fertilized hen eggs. Based on careful research, the Joint Commission says patients with a history of egg allergy can still safely receive these vaccines however, including those with history of severe allergic shock ( called anaphylaxis). They simply need to be monitored in the doctors office after vaccine administration. The dangers of full-blown influenza are higher and scarier than the dangers of egg allergy. But if you have an egg alergy, feel free to talk to your doctor before getting the flu shot. Thimerosal, whose metabolic by-product is ethyl mercury, gets a lot of unwarranted attention from vaccine critics since it has not been in childhood vaccines since 2001. Formerly used as a preservative to prevent bacterial and fungal growth and contamination of vaccines, thimerosal was removed out of excess precaution based on studies demonstrating methyl mercury (not ethyl mercury, the kind found in thimerosal) could cause neurological damage, especially since methyl mercury takes 50+ days to clear from the system. The FDA, EPA, and Agency for Toxic Substances Disease Registry have deemed annual 1-time administration safe, since ethyl mercury is cleared from the body within 7 days. The thimerosal exception is in multi-dose flu vaccine vials (as opposed to single, one-time-use vials) which do still use thimerosal as a preservative. So, in general, pediatricians are NOT injecting children with mercury. There’s no mercury in vaccines! If you have any question, ask your doctor or pharmacist if your vaccine is coming from a single-use and therefore thimerosal-free vial. One final note to take home: many of the

possible ingredients used in manufacture of vaccines are not in the final product. Vaccines undergo a rigorous purification process that occurs in multiple steps, so that the final product (those few small drops in the syringe which we established in the previous article is almost entirely water) does not contain many of the substances used in initial creation. Key among these are the cell lines used to grow the viruses and bacteria necessary to isolate for an effective vaccine. Human fetal lung cell lines, as well as kidney cell lines of the African green monkey, are used as culture mediums for various specific vaccines, but the cells themselves are not in the final product. It must be understood that bacteria and viruses cannot be grown in a garden or plucked from a tree. Living cell lines are necessary to their culture and growth. Regarding the fetal cell lines used (which are the same ones originally cultured in the 1960s), the mothers involved were consulted on their use to manufacture vaccines, and fully understood what they were consenting to. But again, pediatricians are not injecting aborted babies or monkeys into children. In the end, please simply remember the reasons why vaccination is so important. No vaccine or drug, not even aspirin, is completely without risk, but when you weigh all of the risks and benefits, it’s important to understand why people like me care so much. The threat to the health and safety and the very lives of unvaccinated children is real. Educate yourself and do real research. The conflicting information out there is overwhelming and confusing. Talk to your pediatrician about vaccines if you have questions or concerns. I promise that he/she cares and wants to have a discussion. Really! +

by Dr. Caroline, an MCG-trained, board-certified pediatrician. This article is not intended to substitute medical advice and is merely to be used as a tool of education. If questions arise or you have concerns about your child, please consult a medical care provider accordingly and avoid any delay in treatment, as all children deserve treatment on an individual basis.

We’ve all had this simple test during a physical examination. The doctor asks us to sit a certain way so our legs hang freely and then taps a ligament below the knee with a small rubber hammer or mallet. The response is usually a small involuntary kick, which might be exactly the same in both legs or different in each leg. In common parlance it’s known as a knee-jerk reaction, but for an extra 25 cents it can be called the patellar reflex, since the kneecap is officially called the patella. But for just a dollar more the term Westphal’s sign sometimes comes into play, and when it does it may not always be a good thing. Westphal’s sign describes a knee that has been struck without a corresponding knee-jerk reaction. In some people that (or only a very slight reaction) can be normal; in most, however, it’s grounds for concern, or at least some additional testing. What is it about this test that’s so significant that it is a mainstay of physical examinations? The patellar reflex is one of dozens of reflexes our bodies use to protect us: the gag reflex, cough reflex, pupillary reflex and many more. Doctors discovered in the mid 1800s that, unlike many reflexes, the patellar reflex does not involve the brain. Striking the patellar tendon causes the quadriceps muscle in the thigh to contract, resulting in the classic reaction. The motor signals involved go no higher in the spinal cord than the lumbar spine. An exaggerated kick, or the absence of a reaction — in other words, Westphal’s sign — was eventually discovered to be evidence of possible damage to the spinal cord, peripheral nerves, or the central nervous system. Doctors sometimes test this reflex as a matter of routine, but at other times to explore possible causes for specific neurological symptoms. Testing the knee-jerk response can also be helpful in recognizing thyroid disease. Who knew such a simple test could have so many important diagnostic applications! +

MEDICALEXAMINER

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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

(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.

AUGUSTAMEDICALEXAMiNER

NOVEMBER 15, 2019

#103 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 We see that kind of neighborliness in action today in the aftermath of the recent When health professionals are storms. We see perfect strangers reaching attempting to find out what my social life is out to help one another with no thought of like and what support systems I have in place, being paid for help offered and given. There they ask about family members and friends. have been drives for food, water, cleaning They rarely ask about neighbors. supplies, and other necessities That is a mistake. I have like diapers. People with little wonderful, caring neighbors. “It didn’t matter then and means give more than they We’re not “pals.” We don’t go afford. Some people pack it doesn’t matter today.” can out and do things together. We up and head for storm zones don’t have coffee or tea at one to do whatever needs to be another’s homes. But when a done. Some can do little but need comes up, we do things for one another. pray, and they bend God’s ear a lot with their When I was a toddler, my mother pleas for his love to be poured out to save emphasized that I must not go about lives. screaming, as it might disturb the naps of A couple years ago across the whole our aging next-door neighbors. She wasn’t metro area during Hurricane Irma, places afraid of “what the neighbors might think.” were set up to receive evacuees, and many She was genuinely concerned for their came. Then, and next time, we will obey welfare. Because she respected them all, we Jesus’ command to “do unto others as respected them, too. And as a result, they all we would want someone to do for us” if liked us. Mrs. Clements gave us honeycombs the tides had gone a different way. Some from her beehive. Mrs. Morris and Mrs. Fox Augustans will prepare meals. Some will shared their delicious Queen Anne cherries hold evacuees’ hands and listen to people’s that Mom canned and we ate all winter as a fears and concerns. Some will help sort special treat. through clean garmets to find clothes for In a time when children were to be the naked, medicine for the sick, relief for seen but not heard, I paid all of the old the weary, diapers for the babies. Some will lady neighbors on my street occasional supply an extra eye to look out for the little social calls when none of my friends were children. available. I liked and respected all of them, Thinking about the huge need and the regardless of any demographics that might powerful responses to those needs, I am have otherwise intervened. I didn’t care if reminded of the person who asked Jesus, they were of a religion which was not mine, “But who is my neighbor?” And the answer so I learned that we can love folks no matter was everyone. In times of great trouble, what religion they might profess. I didn’t we seem to be able to remember this care if they were tall, short, thin, fat, with instinctively and act on it. Blessings to all wrinkles or without them. None of that who struggle and to all who answer the call mattered then and none of it matters now. for help in any way. + by Marcia Ribble

epending on whom you ask, this physician is either the victim of a tragic mistake or a vile criminal in a murder plot who got away with his crime. He claimed his only crime was keeping his oath as a physician, treating a total stranger who called at his home late one night. Federal investigators say he was an active participant in perhaps the most infamous criminal conspiracy in American history. If his name — Samuel Mudd — doesn’t ring a bell, maybe the name of the man he treated will: John Wilkes Booth. The opening chapters of the story are well known. After mortally wounding President Abraham Lincoln in Washington’s Ford Theatre on the night of April 14, 1865, Booth jumped from the President’s box to the stage, breaking the fibula in his left leg in the process. He made it out of the city and arrived at the Maryland home of Mudd in the early morning hours of April 15. Mudd waited 24 hours to notify authorities that he had treated Booth, a man he told investigators on April 18 that he had never seen before. Upon further questioning, Mudd admitted on April 22 that he recalled meeting Booth in Maryland in November, 1864. Later he admitted to yet another meeting with Booth “by chance” while Christmas shopping in Washington in December, 1864. The conflicting stories eventually led to Mudd’s arrest as a co-conspirator in the plot against Lincoln. Both Mudd and Booth were ardent supporters of slavery; Mudd believed that slavery was divinely ordained. Mudd and all eight of his co-conspirators (not including Booth, who was shot and killed in Virginia on April 26) were convicted by a military tribunal. Mudd escaped the death penalty by a single vote and was instead sentenced to life imprisonment. He was initially sent to Fort Jefferson, a penal installation in the Dry Tortugas, in the Gulf of Mexico about 70 miles from Key West. He was part of a failed escape attempt in September of 1865 and as a result spent 12 hours a day in “the box” and wore leg irons 24/7. Thanks to a letter his wife wrote to President Johnson on December 22, Mudd was relieved of the leg irons and freed from the dungeon. In the fall of 1867 there was an outbreak of yellow fever at the fort, and Mudd was instrumental in saving many lives and quelling the outbreak, earning him a measure of goodwill. No fewer than three U.S. presidents have been in Mudd’s corner since his conviction: Andrew Johnson pardoned Mudd in February, 1869. More recently, Presidents Jimmy Carter and Ronald Reagan both believed in Mudd’s innocence, but their and the Mudd family’s attempts to have his conviction overturned have failed. The apparently final nail in Mudd’s coffin was the U.S. Supreme Court’s refusal to hear an appeal of the case in 2003. As Lincoln historian Edward Steers asserted in the title of one of his books, His Name Is Still Mudd. Samuel Mudd, M.D., died of pneumonia in 1883 at age 49. +

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NOVEMBER 15, 2019

Musings of a Distractible Mind

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he consultant’s note in the patient’s file read:

Weight 250 lb. BMI 40.3. Patient is morbidly obese. Counseled on the dangers of excess weight. Counseled to increase exercise and decrease calories.

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

NOVEMBER 15, 2019

5 +

AUGUSTAMEDICALEXAMiNER

I walked into her room. She smiled at me as I walked in, a lovely smile that reached her eyes. I scanned her record. She was in my office for an ankle injury. Blood pressure normal. Weight 248 lbs, BMI 40. When I looked back at her, she was still smiling. “I lost another ten pounds,” she said proudly. I looked back in her records, noting steady weight loss over the past two years. She started at... “Goodness. You have lost over 100 pounds! Amazing!” Her grin persisted as we started talking about her ankle injury. Numbers. We obsess over numbers. Is BMI over 30? Obesity. Is it over 40? Morbid obesity. No doubt these numbers are important, but in reality they are just points on the timeline. People come for care with an entire lifetime of narrative in tow. Yet most of the care that is given is ignorant, sometimes intentional and sometimes not, to the whole story of what is going on. My patient went to the specialist and was labelled as being “morbidly obese,” and given counseling on the obvious (although I suspect the specialist just checked the box to avoid censure...and financial penalty). Yet this woman knew far more than anyone

who could have counselled her. She had lost a quarter of her body mass and was continuing to lose. She was a hero, yet to anyone who didn’t look back on her timeline, she was simply another data point proving the failures of our society. The irony is that the way that she accomplished her

She did it by trying to win a small victory each day weight loss was to focus on each day separately, ignoring her past history and trying to have a small victory each day. I’ve often used the analogy of a baseball player who does what he should do: get a hit. A single is no big deal, but if that player gets hits in every game for a week, for a month, his season (and that of his team) can be significantly altered. But each game, each at bat, is a single data point where he’s only asked to do something unspectacular. But do something unspectacular for enough days, you have something transformative. We live in a world where patience is a diminishing commodity. We want each day to wrap up neatly like an episode of a TV show. We want to figure out the solution to our problems, meet our soul-mate, elect the perfect candidate, and live the rest of our lives happy and contented. But every story has many pages, every timeline has many data points, and every life is made up of many days, many decisions.

As a human, I do best when I understand that I live in a timeline, and that my solutions take a series of decisions, not just one. Yet I also do best when I try to win only the day’s battle, not the whole war. Today matters only as a piece of something much bigger, yet today is the place where my pen is writing, and where the story is created. As a doctor, I also do best to consider both things. We want to criticize people for where they are without considering where they’ve been. I am constantly frustrated by ER and Hospitalist providers who ignore the care I’ve been giving for years (and sometimes decades), viewing only what is now in front of them. Our job is to recognize that everyone comes to us with a narrative, to enter that narrative, and to direct it in the best way possible. It’s their narrative, not ours. But we can have a huge impact on people if we listen, understand who it is we are seeing, and help them write today’s narrative in a better way. I know this sounds a little ethereal or overly philosophical. But this woman will get discouraged if nobody sees where she’s been and what she’s accomplished, only to criticize today’s number. Her exhilaration at my recognition of her incredible accomplishment will likely give her much more motivation and help than if I had lectured her on “eating less” and “getting more exercise.” We do our best work when we appreciate the fact that we are simply a point in the timeline. +

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PRISON NURSE… from page 1

NOVEMBER 15, 2019

as we rushed past inmates and into the closest dorm. An officer waved us in as inmates shuffled aside. We found a man lying on the floor with copious amounts of blood oozing from his side. We began applying pressure as I assessed the patient and found that his lung was punctured. An occlusive dressing was applied and more staff arrived with a gurney. With no time for further care we grabbed the man up and loaded him on the stretcher and made a mad dash to the clinic. The nurse riding on top of the stretcher with the man managed to place an IV during the transport and when we returned to the medical unit, a team that would have made MCG’s ER proud was waiting. Within seconds these nurses had stripped and washed the inmate while the nurse practitioner was rapidly doing all she could to help this man cling to life. Moments later I heard shouting that EMS was arriving and this tiny emergency room shifted gears. The patient was packaged up and again we started sprinting to another building. As we burst out of the medical building I again found myself surrounded by inmates as they shouted encouragements and prayers for their fallen comrade. We passed through gate after gate, nurses riding on the stretcher providing life-saving care. When we finally made it to the secure loading dock, EMTs took over and the nurse practitioner climbed into the ambulance to provide assistance.

PRISON NURSE

They left with lights on and sirens blaring and only then did I survey the aftermath. I was soaked from chest to toes in blood and sweat. My arm was bleeding from who knows what, my breath was coming in ragged pants and gasps. Our motley crew all looked similar, and together we slowly trudged back to the medical unit. On our way back I was met with the most bizarre of happenings. Inmates slapped us on the back, clapped our shoulders, and shouted their thanks and gratitude. Murderers, rapists, and people who I assumed were the vilest of all creatures wept with gratitude for this little band of heroes. We walked into the tiny medical unit only to be greeted by the disaster of torn packages, bloody gauze, and the chaos that had unfolded moments ago. The director grabbed my shoulder and shook my bloody hand. Welcome to prison nursing....It’s going to be a wild ride.

IT’SYOURTURN! Your turn for what? To tell the tale of your medical experiences for Medicine in the First Person. With your help, we’d like to make this a feature in every issue of the Medical Examiner. After all, everybody has a story of something health- or medicine-related, and lots of people have many stories. Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx.com. See our “No Rules Rules” below. Thanks!

“My leg was broken in three places.”

“This was on my third day in Afghanistan.” “I lost 23 pounds.” “We had triplets.” “He was just two when he died.” “The smoke detector woke me up.” “It took “She saved 48 stitches.” my life.” “I sure learned my lesson.” “The cause was a mystery for a long time.” “The nearest hospital “They took me to the hospital by helicopter. ” “I retired from medicine was 30 miles away.” “I thought, ‘Well, this is it’.” seven years ago.”

“Now THAT hurt!” “OUCH!”

“Turned out it was only indigestion.”

“He doesn’t remember a thing.” “I’m not supposed to be alive.” “It was a terrible tragedy.” “And that’s when I fell.” NOTHING SEEMED “The ambulance crashed.” “It was my first year “At first I thought it was something I ate.” TO HELP, UNTIL... “It seemed like a miracle.” of medical school.”

Everybody has a story. Tell us yours.

Here’s our “No Rules Rules.” We’ll publish your name and city, or keep you anonymous. Your choice. Length? Up to you. Subject? It can be a monumental medical event or just a stubbed toe. It can make us laugh or make us cry. One thing we’re not interested in, however: please, no tirades against a certain doctor or hospital. Ain’t nobody got time for that.

NOVEMBER 15, 2019

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Instant Pot Applesauce Instructions Wash apples, peel and core. I simply peel then quarter the apples and cut the core out with a knife. Place apples in the Instant Pot with 1/2 cup water and 2 teaspoons lemon juice. Close the lid and pressure valve, then put on high pressure for 12 minutes. When finished do a quick release of the pressure valve. Remove the apples to a bowl and mash with a fork or potato masher. You can slightly mash for a chunky sauce or more for a fine thinner sauce. For variations on this basic start you can add a 1/2 teaspoon of cinnamon, pumpkin pie spice, or 1/2 cup of other fruits such as raspberries, pears, rhubarb, strawberries, or whatever your favorites are. Let your imagination go and enjoy easy homemade apple sauce. +

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Filling your kitchen with the sweet festive smell of homemade applesauce is easier than you can imagine when you use an Instant Pot. This recipe can be made in less than 20 minutes. I can get a little excited when we go to the mountains to pick apples. Just the experience of harvesting apples creates in me the longing for a simpler time growing up on my family farm. Walking from tree to tree, enjoying the smells of nature and the fellowship of fellow harvesters creates the perfect way to spend a fall day. However, before I know it, I have picked a bushel of apples to bring home. This is all fine and good, but how many apples can one person consume before they go bad? To preserve the just-picked flavor of fresh apples, I have found a great way to quickly prepare homemade applesauce using my Instant Pot. I then freeze pint-size containers. First, choose several varieties of apples for a well-rounded flavor. I like combining Granny Smith and Honey Crisp, but any sweet and tart apples pair well together. Just peel and core your apples, toss them in your Instant Pot with water and a dash of lemon juice. Pressure cook the apples on high pressure for 12 minutes and then do a quick release. Remove apples to a bowl and mash lightly for a chunky sauce, or more for a thinner sauce. That’s it! This recipe can have endless variations of fun flavors. You can add cinnamon, pumpkin pie spice, or other fruits such as raspberries, pears, or even rhubarb. Let your imagination go and enjoy easy homemade apple sauce. Your family will love it, and (shhh!) it’s good for them too! Instant Pot Applesauce

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FAITH & RECOVERY FACT OR FICTION? Having reread my biography on our website got me thinking. I’m often asked “Do you do Christian counseling?” I’m not taken aback by the question, but often ask back, “What do you mean by Christian counseling?” 99% of the time I get the response, “Do you use the Bible in your sessions?” I usually answer, “Yes, and No.” As a (former) Certified Fellow in the College of Chaplains and former church pastor of 14 years with a Masters degree in Divinity, it is incumbent upon me to not abuse my counseling chair as a platform for proselytizing or even “sharing my faith,” but rather to utilize and honor the individual’s personal belief system, whether Christian (and that includes scores of belief systems in and of itself doesn’t it?), atheist, agnostic, or some other world religion) to help them resolve their troubling issues. One of my first questions to new clients is, “How does your faith or belief system inform you about this topic?” Not having one makes things more difficult. Sometimes I am compelled to help them adopt a system to live up to if they are open to the idea, whether it is simply the “law of the land,” their parents’ religion taught to them as a child, or their conscience (hopefully, not a seared one!). Most people, most of the time,

THIS IS YOUR BRAIN

A monthly series by an Augusta drug treatment professional do have such a framework to work with. You see, recovery is not just cessation of drinking and drugging. It is achieving the peace of mind which occurs when one lives up to his/ her belief system whether a religious one or not. Recovery is not just sobriety, then, but is restoration to sanity when the frontal lobe in the brain (where conscience and reason operates) heals by re-establishing a good balance of brain chemicals which in turn happens through not putting foreign chemicals into the body, by sleeping well, eating well, exercising well, living in accordance with the norms of society and family, etc. This takes time…lots of time. Don’t ask me how long. If you insist on a timeframe I’ll say “God knows and He’s not telling.”

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Many people think “Christian counseling” equals “Biblical advice,” but nothing could be further from the truth. A counselor is not an advisor unless the building is on fire and he/she tells you to get out quickly! Rather, a counselor helps you come up with your own solutions, perhaps giving different scenarios of action/outcomes after listening intently to you for awhile, then allowing you to decide which avenue to take while being informed as to possible outcomes; being willing to do the work and accept the end results of your decisions. Faith comes best with personal work and processing, not being told what to do or being advised from a book of church order or from holy writings, no matter what the religious reference is. So which is best? “Christian rehab/counseling” or traditional problem-identification-and-treatment-plan-covered-by-insurance recovery programs? I am not one to say. I have seen addicts complete a half dozen traditional treatment programs and relapse on the way home each time, then go to a faith-based rehab program and maintain sobriety for years. I have also seen the exact opposite. Much depends on the willingness to change, which is why the 3rd tradition of self help groups is “The only requirement for membership is the desire to stop drinking, or using.” I wrote this thinking I could summarize the subject in one article. I now realize this might start a chain of articles…especially if you write the Examiner about your opinions on the subject! We may even have to agree to disagree. And that’s a fact! +

NOVEMBER 15, 2019

DON’T LICK THE BEATERS Useful food facts from dietetic interns with the Augusta University MS-Dietetic Internship Program

Ditch the Holiday Guilt Trip by Melanie Abron, MS-Dietetic Intern The holiday season is here again! Food is the constant at holiday celebrations and gatherings. Most people find having or sticking to a balanced diet very difficult. Holiday foods are often calorie dense, and mindless eating may cause overindulgence. A general rule for any time of year (but especially during the holidays) is to avoid fad diets. These usually promote a lot of weight loss within a few days or weeks. Healthy weight loss is about a pound a week. Also, pay close attention to serving sizes, and limit drinking excess amounts of calories. Below are some tips on how to dodge the guilt by avoiding excessive intake of calories.

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Tip #1 for social events Never skip breakfast and lunch because you’ll later be attending a work social event or having a big dinner. Skipping meals can cause excessive hunger and binging later. Having a light breakfast and lunch is recommended, with a snack like a banana, apple, or grapes before your dinner to control hunger and appetite. At the event, select smaller portion sizes including appetizers and desserts. Chew slowly and intentionally taste your food to reduce the amount of food you eat. Share appetizers and desserts and use small plates. Even with the main course choose small portions. Wait 10-15 minutes before deciding whether to have seconds. That time will allow you to

determine if you are full. If you’re thee host, consider replacing bread baskets with vegetable platters, and serve fruits for dessert. Vegetables and fruits are low calorie and are packed with vitamins, minerals, fiber and other health promoting bioactive compounds. Tip #2 for drinking calories Drinking calories can exponentially increase the caloric intake of a meal. It’s very easy to forget that drinks add calories. Depending on the beverage and amount consumed, it can add 500 calories more to a meal. Replacing a sugar-based beverage with water, or even infused water can dramatically decrease sugar intake content and total calories for the day. Water is an excellent choice because it is calorie-free and refreshing. It can be flavored with fruits or spices that can be beneficial for digestive health. Recent studies have linked excessive added sugar intake with chronic conditions like cancer and heart diseases. The American Heart Association recommends that adult men have only 9 teaspoons of added sugar daily and women 6 teaspoons. Added sugars are those added and not found naturally found Please see HOLIDAY page 15

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CRASH

COURSE

More Americans have died on US roads since 2000 than in World Wars I & II combined I AM A “BAD” DRIVER Well, according to you I am. And a few traffic cops have thought so too. I disagree. And the Medical Examiner is nice enough to offer me the chance to submit this guest column to defend myself (anonymously). Here is my point-by-point reasoning: I drive fast I think I read somewhere that speed limits are designed for drivers with the lowest skill level. Like an interstate off-ramp with a 30mph speed limit is perfect for granny, but someone like me can easily take it at 45mph — and I do. Did you know that in Germany they don’t even have speed limits? Works for them just fine. Works for me too. I tailgate It’s a great way to remind all these slow pokes that some of us have important places to go. You should try it sometime. You tortoises: get out of the way! The hares run the world!

I stay in the left lane And don’t you dare tailgate me when I do. If you don’t like it, pass me! I don’t care how many cars are stacked up behind me. I have a right to drive in any lane I choose. Last time I checked, this was still America, the Land of the Free. And if I’m already speeding in the fast lane — which 9 times out of 10 I am — then why do you want me to get out of your way? I could see it if I’m in the left lane doing 45 in a 55. But if I’m driving 70 in a 55 in the left lane, go around me if you don’t like it. I am not moving for you, pal. Get over it. I cheat on yellows Look, it’s perfectly legal in Georgia to enter an intersection on a yellow light. Is it my fault if I’m going too fast to stop when the yellow unexpectedly turns red? How am I supposed to know how long the yellow is going to last?

I drink. I drive. Yeah, I know all about the statistics. I am not a statistic. Hell, I can barely pronounce the word half the time. But here’s the deal: I know my own limits. I know when I’ve had too much. I trust my own judgment 100 percent. I know myself better than some machine you blow into. Who knows if that thing works, or what drunk blew into it right before I did? I have better judgment than most people even when my judgment is impaired. I text. I drive. So what? Look around you. I also talk on the phone while driving. So do half the drivers you see. Cops don’t enforce the law because they know it’s a joke. If it was really true that texting and driving caused wrecks there would be wrecks all the time. And there aren’t. I don’t use blinkers What a stupid law! Are you telling me that if my bright red 3-ton pickup truck with 500watt halogen running lights is in the left-turn lane, you can’t tell that I’m turning left unless a little bitty light bulb on the corner of my truck is blinking on and off? Are you insane? Are you blind? + Coming up in our next issue: a response to Bad Driver’s arguments

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HUMAN BEHAVIOR

How neuroscience works in everyday life

THE PSYCHOLOGY OF QUITTING

If you’ve ever smoked and have tried unsuccessfully to quit, you get it. You’ve done cold turkey. You’ve done by Jeremy Hertza, Psy.D. the ritual of tearing up your cigarettes the night before. You’ve tried the patch and other replacement therapies. All of that is great. But nothing ever really seems to stick. I hear this all the time from patients, and I always tell them the same thing. The most important thing when it comes to smoking cessation (or vaping or dipping or whatever it is) is this: Don’t try…until you have a plan. Your Quit Plan Here’s the first step: Ask yourself, what does the physical act of smoking/vaping/dipping do for me? Then, get a piece of paper and write it all down, every single thing that your habit does for you. Be as detailed and as lengthy as you can. For example: • I get to go outside for a 10-minute break at work. • I like having my cigarette or e-cig with my coffee in the morning. • I like the feeling when I inhale. • I enjoy holding the cigarette or the feel of the dip in my mouth. • It helps me de-stress after a long day. • At home, it gives me a break from the kids. Next to that, create a column that lists other ways you can meet these needs without your addiction of choice. For example, maybe it’s getting up from your desk at work to grab a coffee or water; taking a walk in morning with your coffee; holding a stress ball; or finding an activity the kids enjoy on their own. Do all of that before you quit—and even more importantly, go ahead and practice the plan even before you quit. Deal with the Addiction Those are all the physiological reasons you depend on smoking, etc. But then there’s the real, physical addiction. Nicotine creates an addiction because it replaces two important nerve transmitters, acetylcholine, which controls muscle control and memory, and dopamine, which plays a role in how we feel pleasure and is a big part of how we think and plan. When we flood our body with nicotine from tobacco products or e-cigs, our body says, “Whoa, I don’t need to make as much of these neurotransmitters,” and the parts of our body that absorb these neurotransmitters also stop absorbing as much. It’s a double whammy that creates tolerance. So we end up using more nicotine products to get the same feeling and to avoid feeling bad due to withdrawal. This is why, along with a plan, it’s important for anyone who’s quitting to work with a doctor to use some sort of nicotine replacement therapy. That helps step down off the addiction and can keep symptoms like irritability, weight gain, lack of focus, sweats and more from becoming a problem. Adding in exercise can also boost dopamine levels while you’re quitting. Your Other Option Want to do it old school? Just remember: quitting cold turkey without a plan is like ripping a band-aid off a fresh wound. Suddenly, our body has to deal with less acetylcholine and dopamine, leaving us feeling sad, anxious and snappy with everyone around us. We can’t focus on our work or what we need to handle at home. We eat to try to replicate the feeling of holding something in our hand or mouth. We’re even more grumpy because coffee in the morning isn’t as fun without a cigarette or we’re really missing having that 10-minute work break. If you’re serious about quitting, who wants that? +

Jeremy Hertza, Psy.D., is a neuropsychologist and the executive director of NeuroBehavioral Associates, LLC, in Augusta. Contact him at 706-823-5250 or info@nbageorgia.com.

NOVEMBER 15, 2019

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The blog spot From the Bookshelf — posted by Michael Kirsch, MD, on July 15, 2019

A COLON CANCER DIAGNOSIS IS A BAD DAY FOR THE GASTROENTEROLOGIST TOO Exercising good judgment can mean the difference between life or death. Life can be unforgiving of the choices we make. Consider some of the choices listed below that many folks make every day. Are any of them familiar to you? • Texting while driving. • Riding a motorcycle. • Riding a motorcycle without a helmet. • Getting into a car when the driver has had one too many. • Driving a car when we have had one too many. • Giving your social security number to a caller who is promising you a tax refund. • Responding to an email from Nigeria alerting you to a wad of cash waiting for you. • Rushing through a yellow light so we won’t be late for a movie. • Skipping a flu shot and other recommended vaccines. • Getting chest pain for the first time after shoveling snow and decided it was just heartburn. Get the point? All of the above choices can end tragically. But they can easily end well for us. Every day, we confront forks in the road. Sometimes, we choose the wrong road. Sometimes, we make no choice at all. But we have a choice. I see this issue in my gastroenterology practice. I’ve done about 30,000 colonoscopies in my career, a number so large that I can barely believe it myself. Fortunately, the results of nearly all of them are normal or show benign findings. Telling a patient and their family that all is well after the procedure is a pleasure that hasn’t changed over the years. But as you might imagine, I have confronted a lot of colon cancer in my career. When I discover one, I am aware that life for that person and his loved ones is about to change profoundly. While colon cancer affects the patient and his family most deeply, it’s a heavy day for the gastroenterologist also. We are human beings. What makes the day even darker for us is when the patient had faced a fork in the road, but made the wrong choice. Consider the following examples which I have seen repeatedly in my practice. • A patient turns 50 but chooses not to have a colonoscopy, against the advice of his doctor. • A patient has rectal bleeding and ignores it. • A patient was told of hemorrhoids years ago. Rectal bleeding develops and he assumes that his hemorrhoids are active again. He does not consult his physician. • A patient’s bowel changes, but he decides that this must be a side-effect of new medication. • A patient has a large colon polyp removed by his gastroenterologist. He is advised to return in a year for another colonoscopy, but he does not do so. He is too busy. Colon cancer, unlike so many other cancers, is a preventable disease. I am not suggesting that modern medicine can prevent every case of colon cancer. It can’t. I am stating that the majority of colon cancers that I have discovered were in people who did not choose wisely when they should have. They ignored. They denied. They delayed. Time after time, I have seen intelligent people who have had rectal bleeding for months before they decided to see me. Every expert will attest that the earlier colon cancer is diagnosed, the better the prognosis will be. But more importantly, timely colonoscopy can prevent the disease altogether. I haven’t made perfect choices at every fork in the road that I’ve faced. But, when I turned 50, I did the right thing. +

“I have performed about 30,000 colonoscopies.”

Michael Kirsch is a gastroenterologist

The Jazz Age was an interesting time. Best-selling author Bill Bryson wrote a fascinating book about just one season in one year of the Roaring Twenties: One Summer, America 1927. Although it isn’t a book that falls into our standard categories for this space (health, medicine, etc), we highly recommend it. But more was going on in 1927 and the rest of the era than notables like Babe Ruth and Charles Lindbergh. As it turns out, 100 years ago also saw the birth of forensic science, and this is the central theme of Pulitzer Prize-winning science writer (and UGA grad) Deborah Blum’s book. The new science was born, at least in the U.S., with the 1918 hiring of Charles Norris as the first scientifically trained medical examiner in New York City’s history. Also hired by NYC that year: Alexander Gettler, the first forensic chemist ever employed by a U.S. city. Together they made for a formidable team in the fight against crime at a time when poisonings in The Big Apple were as common as gun deaths in Chicago are today. Poison was the murder weapon of choice because without a way to trace the

untraceable, poisoning was practically the perfect crime. As chronicled by Blum, Norris and Gettler invented much of their detection techniques out of thin air (and scientific knowledge). They devised innovative and creative tests and experiments that were revolutionary in their day, a period of American history that has been called “a remarkably deadly time.” After all, not only were poison-wielding murderers lurking, but Prohibition also launched untold numbers of kitchen chemists, churning out drink by the jug or by the barrelful, virtually every drop of

it of unknown quality. In fact, this book’s chapters are chemicals: chapter 1 is entitled Chloroform; chapter 2, Wood Alcohol (see previous paragraph); chapter 3, Cyanides; and so forth, through arsenic, carbon monoxide (a weapon borne of the brand-new automobile age), mercury, etc. Each chapter links the spotlighted chemical with a corresponding crime, some of them subtle and ingenious, slow and methodical, others quick and dirty and painfully brutal. In an 1896 case from the book, a New York physician killed his wife with a morphine overdose, then used belladonna drops in her eyes to counter the telltale contraction of her pupils morphine caused. In the showmanship often characteristic of the day, the doctor was convicted when a chemist demonstrated the process for the jury by killing a cat right there in the courtroom. History is facinating, and so is this book. + The Poisoner’s Handbook — Murder and the Birth of Forensic Medicine in Jazz Age New York by Deborah Blum, 336 pages, published January 2011 by Penguin Books.

Research News Run as much as you can Did you notice the word you is italicized? That is meant to underscore a point that is probably true for the majority of us: we couldn’t run very far unless, as the saying goes, our life depended on it. And even then...still not very far. On a positive note, however, according to all available evidence, any amount of running is linked to a significantly lower risk of death from any cause. A team of health data analysts searched the world over for any and all studies they could find which examined the link between running or jogging and the risk of death from all causes, including cancer and cardiovascular disease. They came up with 14 suitable studies involving more than 232,000 participants tracked for as long as 35 years. When the data from all the studies was pooled, any amount of running — any

distance, any speed, any regular frequency — was associated with a 27 percent lower risk of death from all causes, a 30 percent lower risk of dying from cardiovascular disease, and a 23 percent reduction in the risk of death from cancer. In addition, the analysis did not show a marked lowering of risk associated with “upping the dose,” that is, by running faster, longer, and more often. In short, any amount of running is better than none at all. Get started! Start slow. Start brief. Start seldom. You can even start by asking your doctor about it first. The analysis was published Nov. 4 in the British Journal of Sports Medicine. How to enjoy more snacking Evening or bedtime snacks did not cause weight gain or disturb overnight belly fat metabolism, according to new research led by Florida State University.

The study participants were women, and the snacks were protein-rich shakes. Oh, one more detail: the study participants were all weight lifters. And the snacks came half an hour after an evening workout and half an hour before bed. There are significant nontakeaways from this study: 1. We can’t eat a bag of leftover Halloween candy as our evening or bedtime snack and expect to avoid weight gain. 2. We can’t be a couch potato and enjoy a guilt-free, weight-gain-free bedtime snack either. On the other hand, there are significant takeaways from this study: 1. The right snack can be enjoyed after supper or before bed. 2. If a person is physically active and is burning the calories and fat they consume, that snack won’t have health consequences. +

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The Examiners

NOVEMBER 15, 2019

by Dan Pearson

Why do I have to keep repeating everything Something is wrong I say to you? with my ears.

What are your symptoms?

Sounds like tinnitus. You should call the I did. It wouldn’t Tinnitus hotline for help. stop ringing.

Constant ringing.

The Mystery Word for this issue: YIDEEL

EXAMINER CROSSWORD

PUZZLE

19 ACROSS 1. Drain, as a waterlogged or 21 22 23 24 25 26 flooded area 29 30 8. Matured 35 36 37 15. An ophthalmologists’s job 16. Make eggs naturally 40 41 42 43 17. Mosquito protection 45 46 18. Architectural column in 49 50 51 the form of a man 19. A golf ball’s resting place 54 55 20. Used up 58 59 60 21. Yard invaders 25. Curtain calls 63 64 65 29. Glass ornament 71 30. A puff, especially from 73 a joint 31. Ovum by Daniel R. Pearson © 2019 All rights reserved. 35. Nerve involved in 15-A 37. Speech defect DOWN 39. Swiss mountain 1. An extra bedroom 40. Long-tailed rodent could be one of these 41. Abundantly supplied 2. Hurricanes have one 44. Contend 3. Like rainy weather 45. Entirely 4. Behave 46. School founded in 1701 5. Follow closely 47. Commerce 6. Banks of Chicago 49. Deceptions 7. University governor 51. Garment of 57-A 8. Decay 53. Old 9. Got A Secret beginning 54. Like some hairdos 10. Beat 57. Notorius Roman emperor 11. Pass by 58. Prefix denoting tissue 12. Title 61. Non-medical doc 13. English public school 63. Of the eye 14. Body blemish 66. Weirdest; creepiest 21. Away from the mouth (Zool.) 71. Place for docking a boat 22. Someone from Kathmandu 72. Severe intellectual 23. ______-tale disability 24. Military “Star Wars” abbrev. 73. Went in 26. First word of the city that’s 74. Reigning home to Texas A&M 27. Character in a Steinbeck classic

28 31 38

39 44

47 52

61 66

48 53

57 62 67

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, DEC. 2, 2019

We’ll announce the winner in our next issue!

E 56 X A M2 I N E 1 R

20 27

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

72 74

4 3 1

7 6

S U 3 D O 8 K 1 U 9

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

28. Repose 32. Forced feeding (of an animal) 33. Unpowered aircraft 34. Tight & brief swimsuit 36. Shed tears 38. Favorite, as a theory or student 42. Consumes 43. Deere implement 48. Operated 50. Stitch 52. Become visible 55. Freezing cold 56. Type of park 58. Nursing add-on 59. Symbol 60. ____-free 62. Wine sediment (usu. plural) 64. It often goes with ice 65. Blood is this 67. Traveler’s stop 68. Bush Field abbrev. 69. Wrongdoing 70. Make lace Solution p. 14

5 6 8 3 2A 4I 9K 1 7

2 4 3 1 7 9 8 6 5

1 7 9 5 8 6 2 3 4

— Plato

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.

1. 2284 (area town) _____

6. 622326 (area town) ______

2. 97367 (area town) _____

7. 5225766 (area town) _______

3. 38267 (area town) _____

8. 8466766 (area town) _______

4. 24536 (area town) _____

9. 3366275 (area town) _______

5. 427536 (area town) ______

10. 2848782 (area town) _______

Use keypad letters to convert numbers into the words suggested by the definitions provided. The is often a theme linking all answers. Sample: 742 (body part) = RIB. Answers on page 14. EDITOR’S NOTE: The first issue of each month will contain a “Words by Number” puzzle in this space; the second issue will contain a “Text Me” puzzle.

TEXT

THE MYSTERY WORD

9 3 1 2 4 7 6 5 8

7 8 2 9 6 5 1 4 3

6 5 4 8 1 3 7 9 2

NOVEMBER 15, 2019

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THEBESTMEDICINE ha... ha...

s guests invited to a wedding file into the church, the painfully shy priest awkwardly greets each person who enters the chapel. He’s extremely nervous and ill at ease and doesn’t say much to anyone. At last the couple approaches the altar and the ceremony begins. The priest steps up and gives the best sermon about love anyone has ever heard. He’s full of confidence, incredibly expressive and has everyone in fits of laughter. No one wants it to end, but all too soon it’s time for the vows and the ceremony is over. After the vows, the priest is once again extremely shy and withdrawn and stands by himself, barely saying a word to anyone. The groom approaches the him and asks, “Why are you so shy? You seemed like a different person up there giving that speech!” “I know,” says the priest shyly, “That’s my altar ego.” A state trooper pulls over a driver who was weaving a little. Walking up to the car he discovers the driver is a priest, and as soon as the priest rolls down the window the trooper smells alcohol. The next thing he notices is an

The

Advice Doctor

empty wine bottle lying on the passenger seat. “Have you been drinking?” the officer asks. “Just water,” says the priest. “Then why do I smell wine?” The priest looks at the bottle and shouts, “Praise the Lord! He’s done it again!”

Boy: Dad, my new shoes don’t fit anymore! Dad: That’s because you’re wearing them on the wrong feet. Boy: But these are the only feet I have! A student pilot in training has his first day in a real cockpit, and he is astounded by all the dials, gauges, switches and buttons. “How do you remember what they all do?” he asks the pilot. “I don’t,” answers the pilot. “And for the love of God, don’t touch the dusty ones.” Moe: I got stopped for speeding last weekend on my way to that 10k. Joe: I hate that for you. Were you able to talk your way out of it? Moe: I sure tried. Joe: What did you say? Moe: I told the cop the run started in ten minutes and I was late. Joe: Did he let you off with a warning? Moe: No. In fact, he accused me of playing the race card. Moe: My friend and I dressed as Peruvian owls for Halloween. Joe: Sounds like you were Inca hoots. +

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, My husband and I recently signed up for one of those websites where you can research your family tree. It has a monthly fee that’s not terribly expensive, but costs can definitely start adding up with more in-depth research and DNA testing. We discovered some really interesting facts already, but my husband wants to pull the plug even though we’ve barely scratched the surface. It’s not that expensive. We can definitely afford it. How can I convince him to keep paying for this? — History Buff Dear Buff, There is a very common misconception about this sort of thing. People think if all they’ve done is scratch the surface that it’s a minor wound. That may be true at first, but even a minor wound, a little scratch, can become a major wound and a gateway to serious infection if not cared for properly. There are a number of misconceptions about treating cuts and scrapes. One of the biggest is that people think it’s a good idea to let the wound “breathe.” Skip the bandage and just let fresh air do its thing. Maybe this belief comes from the weird way skin sometimes looks underneath a bandage. “That can’t be healthy,” someone might think. Actually, though, it’s very healthy. An open cut, scratch or scrape exposed to every passing microbe has infection written all over it. It’s noteworthy that when a dermatologist freezes precancerous spots or performs a shave biopsy, their instructions are often to dress the wound(s) with a petroleum jelly product like Vaseline and keep them covered. That tells us something: skin care experts recommend covering a wound, not only with a band-aid, but with a dressing that prevents the site from being exposed to any air at all. The expensive ointment at the drug store in the first aid section is usually not on the wound care shopping list you’ll get from your dermatologist. Products like Vaseline keep the wound from drying out (unlike exposure to air), and the American Academy of Dermatology says doing that, in turn “prevents...forming a scab; wounds with scabs take longer to heal.” I hope this answers your question. Thanks for writing! + 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 Examiner issues.

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THE MYSTERY SOLVED The Mystery Word in our last issue was: FRACTURE ...cleverly hidden on the files in the p. 16 ad for MY SOPHI

THE WINNER: RAVEEN BRICE! 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!

NOVEMBER 15, 2019

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

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...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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HOLIDAY… from page 9 in the food. A 12 oz can of cola contains about 10 teaspoon of added sugars; the same amount of sweet tea contains 9 teaspoons. For homemade beverages consider using less sugar. Tip # 3 for exercise To maintain a healthy weight physical activity and a balanced diet are important. The Department of Health and Human Services (HHS) recommends to be active all days and accumulate a minimum of 150 minutes of physical activity weekly. There are several places to get those minutes in outside of a gym. How about taking a walk in your neighborhood, a near-by park or using the stairs? Get the family involved, before dinner, get a pair of comfortable shoes on and go for a brisk walk. The holidays are for fun. Or at least they should be. However, it is important to pay close attention to your health at all times, including during the holidays. Get medical checks as needed and adopt a healthy lifestyle that includes physical activity and a healthy diet. + For trustworthy nutrition and health information, visit the Academy of Nutrition and Dietetics website, www.eatright.org. The Academy of Nutrition and Dietetics is the largest professional group of trained and credentialed nutrition practitioners.

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