This brief series is designed to offer a head start on health-related goals that many people choose to pursue this time of year. New Year’s Day is a calendar landmark that offers an easy point of reference for future progress.
On June 1, for example, it’s easy to say, “I haven’t had a cigarette for six months.”
Quitting tobacco, as you may recall, was the subject addressed in our last issue.
This time, let’s take a look at an issue considerably more common than smoking: being overweight and wanting to lose weight.
It is not an attempt at humor to say this is a growing problem; it’s a fact. In 1953, only 10% of men and
44% of women responded in the affirmative to a survey asking if they considered themselves to be overweight. 70 years later in 2023, “yes” answers came from 47% of men and 55% of women.
On any given day in the United States, about half the population is trying to lose weight. Judging by the success rates, it’s is one of the more challenging goals in the realm of health and wellness. But people lose weight all the time, and keep it off, so it is definitely a doable proposition.
What are some of the tricks and secrets that can enhance a person’s odds of success?
See page 16 for the answer.
• Call to see if there is an
•
PARENTHOOD
by Dr. Warren Umansky, PhD
You wander into your young son’s room one evening to remind him to get ready for bed. He is looking at his phone as you approach him and quickly turns it off and puts it down. You ask to look at his phone. He doesn’t want to give it to you, but ultimately you take it from him. You leave his room with the phone, go find his mom, and the two of you go through the phone history together. You find a long list of porn sites he has visited. You are horrified and frozen. What do you do?
A. Dad thinks it’s just what boys do and isn’t that concerned. Mom thinks it’s a real problem and wants to restrict access to electronics.
B. Both parents think a frank discussion with their son is needed, but they want to speak with him from a position of knowledge rather than emotion. They plan to go on social media and ask others to give them advice. They tell their son they will be talking to him about this tomorrow. Meanwhile, he needs to go to bed.
C. Parents acknowledge to each other that they are responsible for what their child does with his phone. They discuss what changes are needed.
D. The parents sit down with the child and watch the porn videos together. This way they can explain what a negative influence these are.
If you answered:
A. Boys may well have looked at “girlie” magazines when dad was younger, but access to those probably was limited for most kids and the content was not nearly as graphic. Mom understands that access to the internet is frighteningly easy and needs to be restricted. However, children can figure out ways to get access to the internet at school, from friends, etc. Guidance for the child needs to go along with the restrictions. Mom’s thinking is closer to being right.
B. Parents need to be engaged with their children’s activities. Communication is always important among family members. Had family members been talking to each other around the dinner table daily, parents might have had a better understanding of what their son was doing in his room. Information about the effects on children of viewing porn needs to come from more authoritative sources than social media. Research reveals that the negative effects of young children viewing pornography can be significant, long-lasting, and have an impact on every aspect of the child’s life.
C. Parents are accountable for their children’s responsible access to the internet and social media. That means not waiting until something terrible happens. It is important to monitor your children’s electronics regularly, not permit access to social media while they are in their bedroom, and not allow them to take phones or tablets to bed with them. Consistently good oversight and communication are so important.
D. This is not an acceptable option. Parents should be sure their children are involved in productive activities that provide enjoyment, success, and feelings of self-worth that keep them away from negative influences, not subject them to such influences from the parents. These activities can be sports, music and the arts, part-time employment, and academics.
Dr. Umansky has a child behavioral health practice in Augusta.
FICTIONAL PHARMACEUTICALS
If you aspire to a career in literature, specifically in the realm of fiction, there may be a job waiting for you in the always-exciting world of dietary supplements.
This is a thriving sector of healthcare, at least from a monetary perspective, generating more than a billion dollars a week in sales for the year 2023.
What’s more, those hardearned dollars are being spent on products that perform some amazing feats: they build muscle mass and endurance, fight wrinkles, grow hair, promote weight loss, improve sleep and “bedroom performance,” provide energy, foster better heart health and circulation, improve mood, and crush toenail fungus, among other things.
There’s just one problem. All such products carry the following advisory about their claimed benefits: ”These statements have not been evaluated by the Food and Drug Administration.”
As it turns out, in the vast majority of cases no one else has either.
A recent sampling of eight popular over-the-counter supplements reported on in MedPage Today found virtually none of the products sampled had independent clinical data to support their often heavily advertised health claims.
The eight products were Prevagen, Kidney COP, Crystal Flush, Super Beets, Nutrafol, Nugenix Total-T and Free T, SeroVital and SeroVital Advanced, and Relief Factor.
OTC supplements have al-
most no legal burden of proof under existing FDA regulations. They are essentially free to make any claim that might be believed by consumers without the need to offer proof or conduct a single test.
“But the supplement I use says ‘Clinically tested’ right on the package,” someone might say.
A statement like that may be technically true without being actually true. It works like this: let’s say a researcher publishes the results of a legitimate clinical trial showing that Agent X helps improve cardiovascular circulation. A supplement maker might add a single drop of Agent X per 1,000 gallon vat of its product and then loudly promote “Now containing clinically-proven Agent X!”
Another supplement seller tactic is to offer the results of their own internal studies. These typically suffer from poor design, small sample sizes, and a complete lack of independent oversight and verification.
Everyone wants better health, and we want, sometimes desperately, to believe what supplement makers are telling us.
The Medical Examiner agrees. Here is something they tell us that we can all believe in: “This product is not intended to diagnose, treat, cure, or prevent any disease.”
Who is this?
One look at this guy and you know he played with a chemistry set as a kid. In his case, it paid off nicely.
Let’s introduce him without delay. This is Jack Fishman, a pharmaceutical researcher (See? What did we tell you?) born in Poland in 1930. With the Nazi occupation of Poland looming, at age eight his parents fled the country, ending up in Shanghai, where Jack would spend the next ten years before emigrating to the United States at age 18. He enrolled at New York’s Yeshiva University, and followed that up with a master’s degree from Columbia and a doctorate in chemistry in 1955 from Wayne State University in Detroit.
Back in New York thereafter, he was a cancer researcher at Memorial Sloan Kettering Cancer Center when he took a parttime job at a pharmaceutical lab run by Mozes Lewenstein. Together, the two made pharmaceutical history. Countless lives have been saved because of their discovery. But even if the total number saved as of today was ten million, Jack Fishman would be sad that it wasn’t ten million and one.
The discovery he made with his colleague was a drug they named Naloxone, often called Narcan. The breakthrough arose from research they were doing back in the 1960s looking for ways to treat constipation resulting from opioid use. Along the way they happened to discover the formulation they were testing immediately reversed the effects of opioids. Opioids work by binding to and activating specific receptors in the brain. Naloxone also does that using an even stronger bond than the strongest opioid. It’s like playing musical chairs at a party. The music stops and everyone immediately takes a seat, but one person is always left standing. Pretend that person is naloxone. It’s going to go for the nearest chair and knock the person sitting on it right to the floor. At a party that would be unacceptable behavior, but when enough opioids have bonded to receptors in the brain to slow a person’s breathing almost to a complete stop, knocking those opioids off their perch is life-saving.
Drs. Fishman and Lewenstein were granted a patent for naloxone in 1961 and the drug languished more or less in obscurity for years before eventually becoming the standard treatment for opioid overdose in every ambulance and emergency room in the country. Fishman not only never benefitted financially from its popularity, but could not afford the cost of renewing the patent once it expired. The patent was snapped up by pharmaceutical companies.
Gradually, the invention of naloxone faded farther and farther back in the rearview mirror of Jack Fishman’s life. He married and divorced a few times and moved to Florida, where the great irony of his life unfolded tragically one October night in 2003.
His stepson Jonathan had been delivered to an emergency room in the throes of an overdose. A few progressive municipalities were easing prescription-only restrictions on naxolone, but at the time it was still unavailable across much of the U.S., including Florida. Fishman himself would have been unable to save his stepson’s life with his own discovery.
Jack Fishman, who died in 2013 at age 83, would be pleased to know that his invention has saved tens of thousands of lives and is available without a prescription to anyone at reduced cost or free of charge. It will continue to save lives.
Middle Age
BY J.B. COLLUM
Welcome to Part Two of our discussion of… what was it again? Oh yeah, loss. We already talked about loss of memory, night vision, and other things in the last article, but I’ve lost so much, we had to go into overtime with another article to cover it all.
The loss with the most impact is the loss of people. It is a cruel fact of nature and statistics that the older we get, the more people we know will die. Just in the past two weeks, I have lost four old friends and acquaintances. The biggest losses for me personally were the losses of my father just three years ago, my great uncle Larry four years ago, and the loss of my grandparents, now many years ago.
This past year has seen the loss of a first cousin, many dear old friends, and a man that was like an uncle to me as well as a former employer and life-long mentor. Most nights, in my prayer just before falling asleep, I thank God for all the good people I’ve had in my life that I have lost. It is a bittersweet time as I recall them, and it isn’t unusual for me to shed a tear or two as I talk about them with Him. But the sweet part of it is the memories of the many blessings those dearly departed bestowed on me during my time with them, and I come away grateful. I do believe that I will see them again, and that helps me stay strong. I’m sure you too have a list of folks you have lost who meant more to you than you can express. Keep them alive in your memory.
course, if that fall had seriously hurt me, that would not have been a good thing. Maybe it is about time I turn on the fall detector on my watch. I thought I wasn’t old enough for that yet, but that now deserves serious reconsideration. The way it works is that if it detects a fall, you have pre-loaded a list of people who will be notified that it is now time to laugh at you, and then to check on you. Oh, and by the way, the computer and tablet both survived their fall too.
{ { MY MIND WRITES CHECKS MY BODY REFUSES TO CASH
Anyone in the category of middle age remembers the energy crisis back in the 1970s. There were really two; one in 1973, and another in 1979. I remember gas going from being so cheap and available that you didn’t hesitate to take a road trip, to being so expensive and hard to find that you had to really justify an extra trip to the grocery store for that missing condiment because of the cost and the line you might have to be in for gas. We definitely had a meal or two without the tartar sauce. And let me tell you, hush puppies without tartar sauce is worse than French fries without ketchup. To me anyway.
Well, enough of that sad stuff. Back to some lighter topics. I have noticed that my balance is just not what it used to be, so there’s another loss. As a young man, I could stand on one leg with my eyes closed without any fear of falling. Don’t ask me why I know that. Now, when I am standing up for the prayer (with two feet firmly on the floor) at the beginning or ending of a Sunday meeting, I had better hold on to the chair in front of me or keep my eyes open lest I fall. And that would be more tragic than you think because my wife usually holds on to me during the prayer so she won’t fall. That’s what marriage is all about.
Just last night I fell in my office. It is currently stacked with plastic bins in preparation for moving to a new office I am building in a detached building in my yard. I was trying to get around a particularly tall stack of those bins to get a drink out of my fridge, while also trying to hold on to a computer and a tablet in my other hand. Big mistake. I got twisted around, lost my grip on the computer and the tablet, and as they fell I somehow had the stupid idea to lunge for them. The lunge was unsuccessful — they fell anyway — and my effort to save them assured my fall as well. I yelped, but fortunately with my granddaughter watching a movie at the volume of a rock concert in the next room, nobody heard me fall or yelp, so my dignity was maintained. Of
In middle age though, we face another energy crisis. This one isn’t caused by war in the middle east or anything like that. It is the energy crisis of aging. My mind makes big plans for the weekend, but an hour or two into a project on Saturday and I am trying to think of something I need to go buy at Home Depot. If I can’t think of something, I go anyway and find something to excuse my trip there. Maybe a new tool to make something easier, or some building materials I will need eventually. Of course, there is the requisite stop over at a drive-thru for a snack or a meal, and while I am out, I figure I should drop by the sporting goods store or a bookstore, just to make the gas expense worthwhile. Of course, none of this has anything to do with my body needing a break from the labor. At least that is how I try to fool myself. Or more accurately, my wife, but she is never fooled. This is why I have to factor in the side trip expenses when giving her a quote on what a project will cost. It is easy though. I calculate the material costs, add ten percent for a safety margin, and then double the total. This not only helps with all of the extras I buy, but also my forgetfulness on what it takes to build it in the first place.
Well, friends, it looks like we are out of time and space again. I look forward to sharing with you again in the next issue. About what, I do not know. But I am sure it will come to me. I hope you all had a great year and that next year is even better. I will talk to you then.
J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. He may be reached at johnbcollum@ gmail.com
Sanity or Insanity?
Hurricane Helene barreled through Georgia and other states on September 27 causing massive destruction. In Evans, the time was 4:30 A.M. By 5:00 A.M., all power was out and stayed out until October 3, when it was restored in many areas.
Trees are uprooted; fences lay on the ground; roof shingles and other debris are everywhere; trees are landing on houses; long lines of people are waiting for a business to open to buy gas or groceries; fallen electric lines threaten danger of shock; flooding destroys towns and causes death to persons.
News media broadcasts visuals and descriptions of the disaster. Insanity reigns. How do I manage to remain sane? These were my strategies.
• Pulling weeds and removing debris from the yard
• Praying for others and myself to have strength to endure the chaos
• Reading or writing on the porch in the shade where there might be a slight breeze
• Polishing the silver in the china cabinet
• Updating my 2024 medical expenses to deduct on taxes
• Having water to flush, shower and shampoo
• Staying hydrated. One day after I came inside, I drank water and 2 Popsicles from my warm freezer
• Glowing in the sweltering heat and humidity. Southern ladies do not sweat, they glow
• Enjoying the beauties of nature. I imagined seeing pictures in the clouds during the day and watching magnificent sunsets at dusk
The activities above helped me to keep my
sanity, but the most heart-warming experience was observing the interactions of caring and compassion among neighbors when we gathered on the street after the storm and exchanged information.
I saw men with chainsaws cutting tree branches and trunks which had fallen on roofs or elsewhere on properties.
Some neighbors had generators or gas stoves and brought meals to others who had no electricity.
A minister from my church brought food to me which had been donated by members. Other church members stopped by to see if I was o.k. Another neighbor drove me to the grocery store (my car was in the repair shop) and paid for the food, which was an unexpected surprise.
A family cleared my yard of shingles and other debris which, because of health issues, I was not able to do myself.
My elder daughter came twice (I had no telephone service), and my other daughter from Charlotte telephoned her sister and expressed concern for my safety.
In appreciation for the acts of kindness, I wrote thank you cards to several persons and made cookies for three families who were especially helpful. I handed out index cards and asked neighbors, if they choose, to write their name, house and telephone numbers. I gave them my information as well.
Hundreds of persons from other states came to help by removing forests of fallen trees and restoring services with electricity, telephone, internet, etc.
May love, kindness, compassion and service to others become widespread.
— Dolores Eckles Evans, Georgia
WHY DO WE GET WRINKLES?
Some of the euphemisms we give to wrinkles suggest a possible cause. “Laugh lines” and “smile lines” are two of the more common, suggesting that the wrinkles around our mouth and eyes are the result of a lifetime of smiling and laughing thousands upon thousands of times.
It’s not a bad theory, but it doesn’t hold up under scientific scrutiny. Even if smiling and laughing were the main (or sole) cause of wrinkles, that would be a good price to pay. Who would want to go through life without ever displaying joy or happiness just to avoid a harmless wrinkle or two?
A person could do just that and still become as wrinkled as a prune, so there must be another cause. If you’re thinking one of the main contributors might be dermatoheliosis, give yourself a gold star and a healthy slathering of sunscreen.
As you can parse out from looking at that 7-syllable word, it combines elements of skin (derma) and sun (helio), with a chaser of disease (osis).
There are definitely other contributors. We produce less collagen and elastin as we age, which decreases our skin’s resiliency. We also lose subdermal fat, and that loss of structural support leads to wrinkled and sagging skin.
Take a look at the face above. Both sides of the man’s face are the same age (we checked). But the two sides look very different. As it turns out, he drove a delivery truck for 28 years, exposing the left side of his face to much more sun than the right side. The results are obvious and striking. If you’re thinking unilateral dermatoheliosis, give yourself another gold star and a second application of wrinkle-reducing sunscreen. +
www.AugustaRx.com
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: Dan@AugustaRX.com
www.Facebook.com/AugustaRX
WHEN YOU GET OLDER BASED ON
When you get older, your bones and joints creak. Your bladder begins to leak. Sometime you forget the day of the week. Sometimes you think your problems get solved while you sleep. Could it be that you just forgot the problem, and a solution is not necessary?
When you get older, you see unruly children making a scene in stores. Unskilled parents act like their urchins are “cute and social.” Maybe they’re just mean like they seem. Maybe I’m just out of step, and the next generation doesn’t need older people’s help. Makes me wonder what these kids will be like when they get to where everything ain’t free.
When you get older, little cars with a loud mufflers make your ears suffer. They dart in and out of traffic like ants in a stomped-upon hill. Pretty soon, they’ll find a fender to bend or blood to spill.
A TRUE STORY
(most
of the time)
A series by Bad Billy Laveau
When you get older, alarm clocks are a waste. You wake up early, nose and eyes full of paste. Yesterday’s concerns feel like floppy shoes unlaced. Your socks have holes, but still they keep out the cold. Suspenders struggle to hold up baggy pants, doing things your belt can’t.
When you get older, calories hover a moment on your lips and forever on your hips. Dunlap disease is when your belly done-lapped over your belt. Control your fat folds, make your blessing longer, and your meals shorter. Appetites are on warpaths with funeral paths. It is best to eat less and know you are blessed.
When you get older, you hear some say: Live fast, love hard, die young, and leave a beautiful memory. That is for young fools who don’t know better or could care less. Gluttony ain’t for the best. Menu choices need a brain, not an endless calorie train.
When you get older, fat on your butt and gut are the food freed you don’t need. It got there due to overeating and repeating. And repeating. And repeating.
When you get older, your shoes get smaller, your bills get taller, and your clothes shrink around the middle. Surely it can’t be all those extra sweets you eat. Must be a communist plot to make us eat a lot on the way to a funeral plot.
When you get older, you see colleges letting children graduate with ease … with degrees you never heard of. PE or Physical Education is now Kinesiology. Sports
Communication teaches you to talk about ball games. Transgender Studies. (What does that mean or why does it exist?) Are our kids being educated or indoctrinated?
When you get older, you tend to speak bolder. But fear not. It’s old timer’s disease, not brain rot. Say what you please. Nobody listens to what older people say anyway. Not really. They just blink and your golden thoughts drift away like failing candles in a breezy night. That’s why history repeats itself. No one listened the first time.
When you get older, you know more that you did yesterday … and less than you will know tomorrow. Maybe you ought to write a book based on the mental notes you took as you ambled through the traps and snares of yesteryear. But would any youngsters get in gear and actually read you book? And if they did, would they understand a lot? Probably not. Bringing wisdom to young ones on the brink, won’t always make them think.
When you get older, vacations are less frequent and shorter. Naps and days at home alone doing nothing become more in order.
When you get older, taking “old folk’s pills” is a goal, not a chore. It ain’t so bad. Don’t make your friends sad. They aren’t glad making hospital visits to commiserate with you. Take your meds before going to bed. Take some more, whenever your doctor
said.
When you get older, obituary notices outpace wedding announcements by quite a bit. Baby shower invitations still pour in. That’s what grown children galore are for. Be glad you still get them.
When you get older, be glad for the days gone by. Be gladder for the days coming. Let your personality glow. People will ask how you are? You don’t have to say everything you know. They really don’t care about your bowels … or if you toenails itch … or if your eyebrows burn. They yearn to hear you are aging like fine wine. Older, bolder, and better. Smile and say, “Better than I deserve.” Don’t whine. Change subjects faster than a NASCAR driver changes gears when he’s behind.
I am getting older than most everybody I know. 94 were in my high school class. At our last reunion, only 20 struggled in. A couple wheel chairs battled for position and numerous medical bracelets rattled about. We smiled and spoke loudly so as to be better heard. No one cried even though one had died the week before … and that only a couple weeks after his wife had gone to meet Jesus. None of that pleased us. But crying about dying in public helps no one.
As I get older, I sleep more, eat less, and have faith tomorrow will be my best day ever. So far, it is working out just great. I would not have it any other way. And neither should you. +
by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author
PROVENCAL LENTIL SOUP
This soup proves that French fare can be light and not laden with cream. Herbs de Provence is a mixture of herbs traditionally gathered from the southeastern French country side that includes marjoram, rosemary, oregano, and thyme, with lavender sometimes thrown in. To me, thyme is the noteworthy ingredient; when dried it retains its flavor better than many herbs, and its oils are renowned for having antimicrobial and antibacterial properties. Another nutritional superstar in this recipe is the lentils, whose high fiber content is great for stabilizing blood sugar. Lentils also create a hearty taste sensation, leaving you feeling as though you’ve just eaten a nice, satiating meal.
Ingredients
• 2 tablespoons extra-virgin olive oil
• 1 yellow onion, diced small Sea salt
• 2 carrots, peeled and diced small
• 2 stalks celery, diced small
• 2 cloves garlic, minced
• 1½ teaspoons herbs de Provence (see “Cook’s Note”)
• ¼ teaspoons freshly ground black pepper
• 1 (14.5-ounce) can diced tomatoes, drained
• 1 cup dried French green lentils, rinsed well
• 6 cups Magic Mineral Broth
• Freshly squeezed lemon juice (optional)
• 3 cups tightly packed baby spinach
• 2 tablespoons Many Herb Drizzle for garnish
Directions
Heat the olive oil in a soup pot over medium heat, then add the onion and a pinch of salt and sauté until translucent, about 4 minutes.
Add the carrots, celery, and ½ teaspoon salt and sauté until all of the vegetables are tender and turning golden brown, about 8 minutes. Add the garlic and sauté for about
30 seconds, then stir in the herbes de Provence, pepper and ¼ teaspoon salt. Stir in the tomatoes and lentils, then add the broth and bay leaf. Increase the heat to high and bring to a boil. Decrease the heat to low, cover and simmer until the lentils are tender, about 25 minutes. You may want to add a spritz of lemon juice or up to ½ teaspoon salt.
To serve, divide the spinach among six bowls, ladle the soup over the spinach, and top with the drizzle. Or
store in an airtight container in the refrigerator for up to 5 days or in the freezer for up to 3 months.
Cook’s Note: If you don’t have herbs de Provence in your spice cabinet, substitute ½ teaspoon dried thyme, ¼ teaspoon dried oregano, ¼ teaspoon dried rosemary, and ½ teaspoon ground fennel seed. Recipe from and used with permission from: CLEAN SOUPS: Simple, Nourishing Recipes for Health and Vitality, by Rebecca Katz with Mat Edelson. For more information visit rebeccakatz.
ASK DR. KARP
NO NONSENSE
NUTRITION
Dan, the Medical Examiner’s publisher, asks:
“Do you have any suggestions for starting 2025 on a nutritional high note?
Also, what about the rumor that you’re going to discontinue this column?”
Hi, Dan. It has been a treat to write this column for so many years. Thank you for the great opportunity. Yes, this is my last column for The Augusta Medical Examiner, but I will continue to answer questions on my Facebook page or via email. Let me answer the first part of your question about a New Year’s Resolution for 2025; then I will comment on the second part of your question.
When it comes to one’s health and wellness, there are some things we have no control over, like our genetics, for example. However, there are other risk factors that, indeed, we can control. Present data supports that the controllable health risks in our lives can significantly overcome our genetic disease risks. That is great news and motivation to keep in mind during 2025. With cardiovascular disease, i.e., heart disease, stroke and peripheral vascular disease, such a major contributor to one’s disease and death risks, there is no doubt that a 2025 New Year’s resolution should focus on the voluntary things you can do to decrease this risk. The most important resolution may be knowing and controlling your blood cholesterol levels.
Resolution: In 2025, in partnership with my physician and other health care providers, I will get my blood cholesterol measured and under control. I will aggressively take steps to reduce my risk of cardiovascular disease. These steps include lifestyle changes and taking cholesterol-lowering medications, if necessary.
Currently, more than 70% of Americans are either overweight or obese. Most Americans have very unhealthy eating and movement habits. Because of this, most Americans have elevated blood cholesterol levels. Along with these elevated levels comes increased cardiovascular risk, especially if you also have diabetes and high blood pressure. Despite this, many people seem confused about whether they should control their blood sugar levels. All the hearsay and social media gossip does not help people make rationale
and evidenced-based decisions about their blood cholesterol levels.
Let’s review what the data shows. The latest cholesterol guidelines were updated and published in 2018. They are still current. The evolving data supports aggressive control of blood cholesterol levels, with statin drugs playing a key role. If your total cholesterol and LDL (so-called “bad” cholesterol) are too high, especially if you have other risk factors present, you need to take aggressive steps. The first step your health care provider will take if your total cholesterol is elevated is to order a total lipid profile (on a fasting sample). That way, you will know which blood cholesterol parameter is high. Increased cardiovascular risk is associated with an elevated LDL level; if your high total cholesterol is due to high HDL, that is not a problem. High HDL is protective against cardiovascular disease.
Most people’s total cholesterol is high due to high LDL. This puts you at increased risk of a cardiovascular event. Statins are effective and safe LDL-cholesterol-lowering drugs. Focus on the data, not people’s chit-chat. There are many factors influencing cardiovascular risk. So, if after you and your physician have reviewed all your risks, and she or he recommends you go on cholesterol-lowering medication, do it!
You will be comforted to know that while cholester-
ol-lowering medications do, indeed, reduce your total blood cholesterol and LDL-cholesterol levels, the drugs allow normal healthy brain cholesterol metabolism. The drugs lower your blood cholesterol to a level which is consistent with normal, healthy physiological functioning and lower cardiovascular disease risk due to excessive blood cholesterol. You will also be happy to hear that the data also shows that people who control their blood cholesterol and other cardiovascular risk factors also lower their risk for Alzheimer’s Disease. The exact mechanism for this effect is not fully understood, but what is known is that the decreased risk is related to your blood cholesterol levels, not to any reduction or direct effect on brain cholesterol metabolism. Now that I have stressed the importance of getting your blood cholesterol into the healthy range, let me add some personal testimonial information, separate from the objective data. Personally, I have been on cholesterol-lowering medication for over 40 years. My brother d ied of a heart attack at age 35, playing soccer at the Y with his young son. My father had his dorsal aorta replaced with tubing when he was 55 due to an aortic aneurysm. My uncontrolled cholesterol is 323 or thereabouts. My LDL fraction is very high. On statins, my total cholesterol is just 160 and my LDL falls dramatically. If I wash out the statins
from my system (sometimes I volunteer to be in cholesterol studies that require a washout phase) my total cholesterol (and LDL) always pop back to way above the healthy range. Taking statins is what I have done and will do for the rest of my life. At 81, I’ve already lived 2.5 times longer than my brother and much longer than my father. It is interesting that you ask your question right now, because last week I had a cardiovascular stress test. I wanted to find out how my cardiovascular system is doing. Even I was surprised when the results came back that I have less than a 1% chance of a cardiovascular event in the next year. Pretty good coming from such a high-risk family! Thank you, statins.
Now, about the second part of your question. Over the past several months, I have been thinking about having my column in this month’s Medical Examiner be my last “Ask Dr. Karp” column. ÂWhy, you ask? Yes, it has been an honor and a pleasure, but as the saying goes, “it’s time to move on.” I will be focusing on other ways of helping people discern nutrition, diet, food and lifestyle INformation from MISinformation. I am concerned that MISinformation will get worse in the future, especially with AI and the continuing expansion of social media “chit-chat.” So, my friends, Nancy and I want to wish everyone a very happy and healthy New Year and a bright and healthy future.
What is my final “No-Nonsense Nutrition” advice in this column? Keep plugging away at your health goals. Going sure and steady, not jumping on and off the latest “wellness” and supplement/ diet bandwagons, will help you achieve your preventive health goals. Follow the evidenced-based data and recommendations, not your friends’ or relatives’ testimonial experiences.
If you have questions in the future post them or private message my “Wa rren Karp” Facebook page, or email them to me at wbkarp@ gmail.com
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
Dr. Karp
CHOLESTEROL
Tasty tips from registered dietitians with the Augusta Dietetic District Association
EATING SEASONALLY DURING WINTER FOODISMEDICINE
by Lianni Maldonado, MS, RDN, CSOWM, LD
It’s easy to eat seasonally during the summer when fruits and vegetables are plentiful, but what about during the winter when farmers markets are no longer being hosted throughout our city?
These days we can access any variety of fruit or vegetables at the grocery store at any time of year, but it comes at a cost. Produce that is not in season usually must travel farther, often being imported from other countries. This increases the cost of the produce and decreases the quality by the time it arrives at our stores. Eating seasonally means fresher fruit and vegetables and luckily for us there are still a wide array of fruits and vegetables that are harvested during the winter months.
But what good is a list of seasonal fruits and vegetables when you don’t know what to do with them? So here are a couple of easy and delicious recipes to get you started.
• Place the shredded kale in a very large salad bowl. Add the lemon juice and oil. Use your hands to massage the lemon juice and oil into the greens, about a minute or
so. The greens should wilt slightly and take on a deep green color.
• Add the other shredded vegetables to the bowl as well as the chopped apple.
• Make the dressing by combining all of the dressing ingredients in a mason jar. Shake for 30 seconds and then pour over the salad. Toss well to combine.
• Add the pumpkin seeds, goat cheese, butternut squash, and pomegranate arils on top. Serve.
(Recipe adapted from the Pioneer Woman)
Roasted Winter Vegetables
Ingredients:
• 1 cup carrots, peeled and diced
• 1 cup parsnips, peeled and diced
• 1 large sweet potato, peeled and diced
• 1 cup butternut squash. Peeled and diced
• 2 cups Brussel sprouts, halved
• 1 onion, chopped in large pieces (optional)
• 3 Tablespoons Olive oil (or vegetable oil of choice)
• Place all vegetables in a single layer on a baking sheet. Drizzle with oil, salt, pepper, garlic powder, onion powder, and paprika. Toss until all vegetables are coated well. Bake for 25-30 minutes until all vegetables are fork tender.
• Once vegetables have been removed from the oven, sprinkle cheese of choice on top (optional) and serve.
Winter vegetables are abundant, delicious, and nutritious.
CRASH COURSE
More Americans have died on US roads since 2006 than in World Wars I & II combined
sleek, silver sedan races through the aisles of a shipping container storage yard, pursued by a menacing motorcycle. The sedan windows are tinted just enough that you can imagine yourself as the driver. The motorcycle is gaining ground, so you turn down an aisle currently being worked by a crane. As you blow past the crane, it lowers a shipping container, blocking the motorcycle. You’re safe. Or are you?
driver behavior when we’re sending conflicting messages?
ADS UNSAFE?
Scene change. A young, good-looking couple take off their virtual reality headsets, revealing that the chase is just part of their game. However, the sleek, silver sedan is real, it’s turbocharged, and it’s available from your local car dealer. You should take it for a test drive.
Each year in the U.S., more than 300,000 people are injured and more than 12,000 die in speed-related car crashes. These crashes occur at all hours, on all types of roads and involve all types of drivers. The simple fact is, no matter how skilled the driver, speed affects both the likelihood of a crash and the severity of crash injuries. Why are we promoting car sales by glorifying speed?
Perhaps these ads are just harmless fun. One might suppose that the viewer is aware enough to separate fantasy from reality, and we all know that speeding is dangerous. We would never try to imitate the extreme stunt driving seen in the ads. But might we be tempted to push the boundaries of speed just a bit?
A few years ago, traffic safety experts noticed a national upsurge in risky driving behavior such as speeding, driving after drinking and failing to wear seatbelts. Many U.S. cities have lately experienced a sizeable increase in deaths to pedestrians and other vulnerable road users. They have responded with traffic-calming strategies such as lane narrowing, speed humps, and lower speed limits. Ads encouraging drivers to go fast run counter to these efforts. How can we change
The content of automobile ads is essentially self-regulated in the U.S. The Federal Communications Commission (FCC) requires broadcasters to “operate in the public interest,” but there is no specific mention of depictions of unsafe driving. Broadcasters formulate their own standards, although often they’re open to interpretation.
Automakers themselves bear responsibility for their advertising content. Some choose to glorify speed to sell vehicles, even as they also tout the safety of their products and conduct safe-driving campaigns. Most vehicle manufacturers include a commitment to safety as part of their mission. When it comes to vehicle design and the adoption of safety technology, they have followed through. Year after year, these companies compete for IIHS TOP SAFETY PICK awards, continually making improvements to their vehicles as we strengthen the criteria for the accolades. Many automakers also sponsor programs to encourage safe driving for teens. We know that teens are especially susceptible to the urge to speed, so how can companies justify ads that feed that impulse?
Advertisers must treat unsafe speed the same way they would treat drunk driving or failure to use a seat belt — behaviors they wouldn’t think of showing in a positive light. The thrill of moving at extreme speeds should be confined to amusement parks and virtual reality games.
Today’s vehicles are more reliable, more efficient, more comfortable and safer than ever before. Shouldn’t that be enough of a selling point?
— An excerpt from an editorial by Chuck Farmer, Vice President of Research and Statistical Services at the Insurance Institute for Highway Safety +
THEMEDICALEXAMiNERJOKESPAGE
NARCAN:
A FEW HIGH NOTES
Most people have heard of Narcan, the brand name of the drug naloxone. See page 4 for a profile of its inventor and a simplified description of how it works so amazingly.
Hollywood’s depictions of Narcan’s fast-acting power are somewhat accelerated, but Narcan is definitely a fast-acting drug
That doesn’t mean a single intravenous injection or shot of Narcan nasal spray will work. If a victim does not respond within 2 to 3 minutes, administer another dose. Narcan is considered to be completely harmless, so there is no danger in giving multiple doses. Similarly, if a person is discovered to be unresponsive, there is no harm in administering Narcan — after calling 911 — just in case. If an overdose is the reason for the lethargy, they will respond; if not, no harm, no foul.
Naloxone and Narcan packaging comes with an expiration date that may not be too far down the road, but those in the know will tell you the drug is so stable that for all practical purposes it is good for up to 30 years from the date on the package.
Long gone are the days when a person could be arrested for overdosing. Georgia’s 911 Medical Amnesty Law protects the caller and the victim from arrest. People administering Narcan are likewise legally protected from civil and criminal liability. GeorgiaOverdosePrevention.org says “Don’t Run! Call 911!” Anyone who uses Narcan to rescue a victim can contact the organization for free replacement of the Narcan they used.
GRAPPLING WITH THE KILLING OF UNITED HEALTHCARE’S CEO
I am torn. I have the devil whispering in one ear, telling me to join with the masses hailing the murder of UnitedHealthcare CEO Brian Thompson and shouting that he had it coming to him. And I have an angel speaking in my other ear, reminding me that physicians must rise above violence and hate. A man is dead after all.
So, where do we go from here?
On the one hand, I shed no tears for Thompson. The man made millions off the suffering of others. More than $10 million last year, in fact. Likewise, every penny of the $22 billion in profit made by parent company UnitedHealth Group in 2023 was at the expense of the suffering of others.
I have no small amount of schadenfreude for what has happened to him. Sometimes, I even find myself wanting to crack jokes at his expense. Is Hell going to require a 2-night qualifying stay prior to admission? Others have had similar reactions, posting online comments like, “Unfortunately my condolences are out-of-network,” and “Prior authorization is needed for thoughts and prayers.”
As physicians, I understand how easy it is to sit back and take some pleasure in the death of a man whose leadership of an insurance company led to the untold suffering of hundreds of thousands of our patients. Patients we care for every day.
Yet, I am torn. This guy was my age (he was 50 years old, and I’m 49). He has a wife with two kids. His kids are 19 and 16 years old, near the same age as mine (in their teens). They’ve gotten bomb threats to their home. When they look on social media, they see nothing but hate directed at the man they loved, a man they called their husband and father.
I hate everything that Thompson stood for. I hate everything that his company stands for and will likely continue to stand for. I expect that the UnitedHealth Group PR and legal teams will use his death as an excuse to stifle any substantive debate or legitimate criticism about UnitedHealthcare with the mantra of, “We need to cool the temperature of the conversation,” or some similar, hollow PR statement.
And yet, I find myself troubled by jumping on the bandwagon of hate.
Thompson was a human being, and we as physicians are supposed to have compassion for all. We are to care for all -- saints or sinners, good or bad, demonic or angelic. What they do or did is irrelevant. We treat murderers, rapists, and politicians alongside charity workers, victims of crime, and the saintly. What allows us to do that is the compassion we have for people. It’s what keeps us in this profession, despite the machinations of companies like UnitedHealthcare and people like Thompson, and whatever corporate leader rises to replace him.
So, what I’m calling upon us as physicians to do is
JEWELRY REPAIR
posted by James Young, MD on December 10, 2024
Wow. 17 people died in a multi-car pileup on an icy highway.
How terrible! And right before Christmas too.
I never understand what people mean when they say that. Just that the timing makes it seem even worse. Would you feel better if 17 people died in, say, July?
ACROSS
1. Augusta mill
5. Augusta’s “The _______”
10. 2nd son of Adam and Eve
14. Potpourri
15. Hilo greetings
16. Cab
17. A version of Baal
18. Occur before something else
20. Part of a combo with feathers
21. Carry out
23. Biblical coin
25. Speed abbreviation
26. Make a mistake
27. Business matters
31. Idleness
35. And not
36. Guides
38. Famous Ukraine seaport
39. Increased
41. Rejoice
43. Capital of Ukraine
44. Iron feature
46. James, pioneer of TV cooking shows
48. Dr. of rap
49. State of having a will
51. Young girls
53. Nurse asst.
54. Stroke abbrev.
55. Greek island
59. Like a mobile, but stationary
63. McKinley’s First Lady
64. Sure
66. Joy Luck Club author
67. Reuben seller
69. Average Joe
70. Distasteful; yucky
71. Shaker contents
72. Luster
73. Mets’ former home
WORDS NUMBER
DOWN
1. NBA’s Bryant
2. Holly genus
3. West ____ Virus
4. Depart
5. Wednesday at the National
6. On sheltered side
7. Former weight for wool
8. Central African republic 9. Intense dislike
10. @
11. Nearby South Carolina town
12. Test
13. Old Italian money
18. Center of an iris
19. Type of bird?
22. Nashville awards prog.
24. Floorboard sound
27. Anguish
28. Specialty
29. Liberates
30. Sen. Chambliss
31. Religion with a billion followers
by Dan Pearson
On an icy highway? That would be curious.
The Mystery Word for this issue: SSADRITE
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
We’ll announce the winner in our next issue!
32. Glass under a microscope
33. _____-wheeler
34. Roof overhangs
37. ____ date
40. Fossil product
42. Sustained pull, as on a leg
45. Frenetically busy
47. Sofa
50. Stroke gently
52. Pat lightly
55. Children, informally
56. Notion
57. Lofty
58. Lead-in to rival
59. Identical
60. Scratch
61. Michigan or Ontario
62. New Age singer
65. Definite article
68. Type of girl Clara Bow was
70. These are dotted
DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.
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.
on page 14.
Use the letters provided at bottom to create words to solve the puzzle above. All the listed letters following #1 are the first letters of the various words; the letters following #2 are the second letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.
— Merry Browne
THEBESTMEDICINE
ha... ha...
Aminister visited a man from his congregation who hadn’t been to church for quite some time.
“Is there some reason you don’t attend more often?” the minister asked.
“It’s the music,” said the absent parishioner.
“Is there something in particular you don’t like about the music?” asked the minister.
“There sure is,” replied the man. “Every time I show up it’s the same songs over and over. Silent Night. Joy to the World. Oh Little Town of Bethlehem. Come All Ye Faithful...”
Moe: What’s the #1 Christmas wine?
Joe: Probably something about the music.
Moe: Even with all the focus on Santa Claus year after year, I’ve never heard one word about his ethnicity.
Joe: He’s North Polish.
Moe: What do you get when you cross a snowman and a dog?
Joe: Frostbite.
Moe: What do you get when you cross a
fish and an elephant?
Joe: Swimming trunks.
Moe: What do you get when you cross the Atlantic with the Titanic?
Joe: Halfway.
Moe: Why did the kid cross the playground?
Joe: To get to the other slide.
Moe: Can you give me a quick example of something that causes anaphylactic shock?
Joe: In a nutshell, sure.
Moe: Knock knock.
Joe: Who’s there?
Moe: To.
Joe: To who?
Joe: You mean to whom?
Moe: Did you hear my pet pig Bacon has cancer?
Joe: Oh no! Is there such a think as a pet oncologist?
Moe: Yes. Well, for pigs it’s actually called an oinkologist.
Joe: So how is Bacon doing?
Moe: He’s cured.
Moe: I am so annoyed right now.
Joe: You know what they say about when life hands you lemons...
Moe: Right. Isn’t there a 72-hour refund policy on car sales?
Joe: No. You go medieval on life, You make life regret the day it thought it could give you lemons and get away with it.
MEDICALEXAMINER?
Staring at my phone all day has certainly had no Effect on ME!
By popular demand we’re making at-cost subscriptions available for the convenience of our readers. If you live beyond the Aiken-Augusta area, or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house!
NAME ADDRESS
CITY STATE ZIP
Choose six months for $24 or one year for $42 . Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903- 0397
Dear Advice Doctor,
My husband is a first responder who served around the clock in the immediate aftermath of Hurricane Helene. Once things started to calm down a little bit here, an urgent call went up for help with flood victims in North Carolina. He responded again. He was up there, away from his home and his family, for a full month. What as a community - and individually - can we do to show these large-hearted, self-sacrificing people the depth of our appreciation?
Dear Responding,
I certainly share your concern, and I’m glad you took the time to write about this important matter.
The medical term for an enlarged heart is cardiomegaly. It’s too bad we aren’t talking about a common colloquial term for generous people, who are said to be “big-hearted.” Metaphorically, a large heart is a good thing. Medically, not so much.
Like any other muscle, the heart can get bigger the more it is exercised, so athletes are sometimes found to have enlarged hearts. Depending on their overall medical picture, this can be grounds for concern, or nothing to worry about.
For the average armchair athlete, however, common reasons the heart has to work overtime include high blood pressure and blockages typical of coronary artery disease. There are a number of other causes, as well as cases where doctors can’t find a cause. Sometimes cardiomegaly is a permanent condition, in other cases it’s temporary. An enlarged heart has thickened walls, so it doesn’t circulate blood as efficiently as it should.
Because of that, some indicators which suggest a prompt visit to a doctor should happen soon include shortness of breath, irregular heartbeat, and swelling in feet and ankles. On the other hand, chest pains, severe shortness of breath, loss of consciousness and pain in the neck, jaw, and arms mean that emergency medical care is the immediate next step to take. Managing cardiomegaly can prolong life and prevent a whole laundry list of side effects.
Preventive steps include not smoking, controlling blood pressure, cholesterol and diabetes, and eating a healthy diet.
I hope this answers your question.
— Responding to a responder +
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.
THE MYSTERY SOLVED
The Celebrated MYSTERY WORD CONTEST
...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.
PROFESSIONAL DIRECTORY
ACUPUNCTURE
Dr. Eric Sherrell, DACM, LAC Augusta Acupuncture Clinic 4141 Columbia Road
706-888-0707 www.AcuClinicGA.com 3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866 www.visitrcp.com
L. Carter, MD 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com
Davis Road
Augusta 30907
706-860-4048 Floss ‘em or lose ‘em!
LOSE IT OR LOSE IT
If you’re reading this, chances are you want to lose weight. Odds are all the people not reading this want to lose weight too. It’s one of the trademarks of living in an affluent country: the United States is home to some 13% of the obese people globally even though we repre sent only 5% of the world’s population. But we are far from the only country where obesity is a problem. We are not on the list of the Top 5 nations with the largest increase in obesity, nor on the list of countries where obesity in women exceeds 50%. It is truly a global problem: in 1980, an estimated 250 million people around the world were either overweight or obese. In 2022 that number was estimated to be 2.5 billion.
This plague brings with it a host of additional problems. The World Health Organization (WHO) lists the following 7 common diseases — some of them which might surprise you — that are linked to obesity: arthritis, cancer, infertility, heart disease, back pain, diabetes, and stroke.
WHO also prescribes what they call “ABC to Obesity Prevention, Simple Rules to Stay in Shape.”
As anyone knows who has tried or is trying to lose
THE BLOG SPOT from page 11
to remember that we are the adults in the room. We are the profession that has the moral high ground opposite companies like UnitedHealthcare and people like Thompson. We are supposed to be better.
We need to take this opportunity to mourn the loss of another human being, taken by violence on our streets. We need to show compassion to his family.
weight, simple really isn’t part of the equation, but just for fun, here is WHO’s ABC list:
dopt New Healthy Habits As examples, they offer habits like riding a bike to work, swimming, and eating a balanced diet. Well alrighty then.
alance Your Calorie Intake Simply put, bring calories IN more in line with calories OUT. That might require more physical activity and less eating.
Control Weight Gain Regularly monitor your weight and adjust your diet and your physical activity accordingly.
In the category of non-WHO recommendations, the Medical Examiner recommends seeking professional assistance. Talk to your doctor. Consult a registered dietitian, of which the CSRA has an abundance. Check in with the Y or a fitness center. Talk to your pharmacist. Check in with a professional weight loss expert, perhaps an organization like WeightWatchers.
Losing weight is too important and too difficult to try to accomplish alone. You might pull it off, but your odds of success will be far better with expert support on your side.
We need to say with a single voice that we condemn the actions of Thompson and UnitedHealthcare as vehemently as we condemn the actions of his assassin. We need to warn that too many people -- both patients and executives -- will continue to suffer until insurance giants put the needs of the patient above those of the shareholder. While I don’t condone more killing or violence against health insurance executives, it’s not unlikely. In fact, it’s already happening. But it needs to be made clear that it’s not rhetoric or debate about insur-
ance company malfeasance driving this action, but the companies’ own actions. We as physicians need to be vocal, engaged, and seize this moment where the public is now engaged and the media watching, to make the case for why insurance in America is broken. We must also be above the fray.
So, while I hate UnitedHealthcare and Thompson’s policies, I mourn his death as I would mourn any death, and I truly feel deeply for the loss and pain that his family must be feeling at this moment. I put them in my prayers and I hope that healing, albeit slowly, does eventually come to them. I also pray that health executives everywhere use this as a moment to not only beef up their security but also to ask, “Why?”
James Young, MD, is a family medicine physician in rural Wisconsin
