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DECEMBER 20, 2019
AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006
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Who is this?
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hat is your vision for 2020? Let’s hope it’s 20/20, but what about your vision for the coming year in non-vision-related matters? Some people call them New Year’s resolutions, but all too often they’ve gone down in flames by mid-January (if not the 2nd or 3rd of the month). Maybe it’s better to simply call them goals for the coming year. True, that might give the weak among us all the room we need to procrastinate — “I know it’s late November 2020, but my goal was for the year, and there are still four weeks left in the year. So calm down!” — but the flip side of the coin is that a long-term goal takes into account the realities of life: there will be delays. There will be setbacks. One step forward, two — correction — one pound lost, two pounds gained. Unfortunately, setbacks are often the reason well-intentioned resolutions come off the rails. We all need to expect setbacks and remember that in the long run, they are completely unimportant as long as we stay on track. For example, let’s say someone’s goal is to lose 20 pounds by this time next year. If they reach their goal, who cares if there was that one week in May when the scale went back up by three pounds? Answer: nobody. It’s 100% irrelevant. Like a come-from-behind win, overcoming the obstacles and hiccups makes the victory that much sweeter. Want some ideas for salubrious 2020 goals? Flip this paper over and see the back page. +
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by guest columnist Wayne Thigpen
he humble mosquito is a summer nuisance driving us out of our gardens and off our porches. Pesky, we say of them. As many of you know, that’s far from all, however. Through two members of its roughly 3,500 species — Anopheles and Aedes, respectively — the mosquito is a carrier of malaria and yellow fever organisms, making it the biggest killer of humans in history, more so than all wars or any other mechanism. (We’ll have to wait and see if global warming surpasses the mosquito’s deadly record.) Our profiled physician, U.S. Army Col. William C. Gorgas, earned a magnificent reputation battling mosquitoes and their dread diseases. He saved thousands of lives in Cuba and Panama, beginning in about 1901, and untold millions since. Plus, he had a street named in his honor at the U.S. Army’s Augusta Arsenal, now Augusta University. Perhaps some of you have seen the sign off Arsenal Avenue. Born Please see WHO IS THIS? page 4
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DECEMBER 20, 2019
SLEEP
THE FIRST 40 YEARS ARE ALWAYS THE HARDEST
JEWELRY SURGEON
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• MODERN & ESTATE PIECES •
PARENTHOOD by David W. Proefrock, PhD
This edition of Parenthood is a holiday card to my readers. The regular Parenthood will return next year. May the Joy of the Season be with you and your family and may your New Year be filled with goodness. A CHRISTMAS TREE IS A TREE OF HOPE. A CHILD IS A TREE OF HOPE. A CHILD WILL GROW AS A TREE WILL GROW, SWEET AND STRONG AND SKYWARD, IF THE CLIMATE WILL HAVE IT SO. WITH LIGHT TO BECKON AND LOVE TO NOURISH A TREE WILL FLOURISH, A CHILD WILL FLOURISH. IF ROOTS MAY FEED ON THE NURTURE OF LOVE, IF THE LIGHT OF HOPE DRAWS FROM ABOVE. A CHILD WILL GROW AS A TREE WILL GROW: SKYWARD — Author unknown + Dr. Proefrock is a retired clinical and forensic child psychologist. Headquarters for the well dressed man since 1963
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AUGUSTAMEDICALEXAMiNER
DECEMBER 20, 2019 PART 3 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 in the picture: he’s real.
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hen my alarm rang on day 3 of my prison nurse journey, I couldn’t have imagined the world I was going to walk into that day. The drive to the prison was uneventful, the groping and scanning of security was becoming less shocking, and the multicolored little ants roaming the yard didn’t seem to notice me. I again found myself pounding on the door of the little concrete bunker known only as “Medical.” The familiar guard from the day before was on duty and quickly let me in. Just like yesterday, I was greeted by around 50 frowning faces and a barrage of insults. I stiffened my spine, squared my shoulders and with my best John Wayne impression nodded to the disgruntled patients and walked to my office. As a former police officer, the most unnatural thing is to turn your back on a threat and casually stroll away. Every alarm bell in your head screams that you are about to be stabbed or beaten. Rule #1 of prison life is just the opposite: show no fear. I made the turn into my of-
in the first epiSHOCKING TRUE TALES! mentioned sode, Max is a dreadful place
I Was a
Prison Nurse !
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that seems to emanate darkness. The building is securely locked away from the rest of the yard and is barely visible in its secure corner. I watch as the director gathers up a small tool box and a helmet with a clear face shield and together we set off for the dark tower. The first thing you notice after moving through roughly a dozen secure doors is the oppressive miasma, severely reducing your enthusiasm for breathing. I also noted the building was utterly falling apart. The director told me this was the most secure area of the prison and finding workers that could obtain clearance in this part of the building was challenging and costly. We arrived at a point where the director pointed to huge body armor suits and told me to sling one on. All staff shared the same few suits (except the warden of course). They were damp with sweat and reeked to high heaven. They were stained with only God knows what and the thought of wearing it makes me shiver to this day.
fice, closed the door and collapsed with a sigh. I stare at my computer as I contemplate the choices that brought me to this surreal situation: not long ago I was putting people into prison; now I’m caring for them. A knock at the door jars me from my musings and the director enters and plops into my patient chair with a grin. “Ready for Max?” The answer to that question isn’t one you, me, or anyone else is ever actually capable of giving without first experiencing the horror that is maximum security. As I Please see PRISON NURSE page 6
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DO PET OWNERS LIVE LONGER, HEALTHIER LIVES? That is the rumor. But is it true? Try some searches using a Googler machine and it’s as easy as pie to get lots of hits that say yes! pet owners are heppier, healthier, and live longer lives compared to non-pet owners. What stands out, however, is how many of them say something like, “Studies show that...” without ever referencing or linking to a single study. The CDC, the American Heart Association, and Harvard Medical School are among the healthcare heavyweights who have online articles about the specific benefits of pet ownership which vaguely refer to unnamed “studies.” Undoubtedly there are many studies supporting the benefits of owning a pet conducted by reputable researchers doing scholarly work. But they aren’t always easy to find. On the other hand, there are studies which say the opposite. A large and ongoing California study involving more than 42,000 participants found no evidence (or very shaky evidence at best) that pet ownership has significant and measurable health benefits. Unexpectedly, dog owners in the study had a higher body mass index (BMI) compared with non-pet owners. And perhaps not unexpectedly, study participants with asthma were 20 percent more likely to own a dog or a cat than those without asthma. The scholarly journal PLOS One published an extensively researched study (using the California data) examining the difficulties in accurately mea Studies or no studies (or flawed and inaccurate studies) aside, it seems highly likely that there are various benefits to owning certain kinds of pets. Dogs like to be walked, and that can be good for their human companions. Cats don’t, but like dogs they can offer affection and companionship. Canaries and guppies aren’t the kinds of pets that offer warmth and love or excuses to exercise, but they can still offer much to their owners. Even if every nameless “study” was debunked as false tomorrow, it’s hard to imagine they would be replaced by studies saying pet ownership is harmful. That’s not happening. Got pets? Enjoy them. You don’t need a study to do that. +
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DECEMBER 20, 2019
WHO IS THIS?… from page 1 and raised in the Mobile, Alabama, area, Dr. Gorgas was a humble person, saying once to group of prominent physicians, “I am not much of a doctor; that is, I am not experienced in the care of the sick; and I am not much of a military man, although I have been in the Army service practically all my professional life.” He had great intelligence, focus and determination, however. Initially, Dr. Gorgas had to battle ignorance, including his own. Like nearly all scientists of his day, Gorgas believed in the miasma theory as the source of germs and disease, which held that bad air (Latin: “mal-aria”) caused fevers and death. Augusta’s Bon Air (“good air”) Hotel was built on the Hill to get away from downtown’s supposedly bad air, which the theory said came from foul, swampy, wet, low-lying areas full of gases from decaying plants, dead animals and who knew what. Against that backdrop, when mosquitoes were first reported to be the source of a yellow fever outbreak rather than miasma, Gorgas was not initially convinced. However, when the U.S. occupied Cuba after the Spanish-American War, he fully adopted the finding of the Army’s Yellow Fever Commission that in fact disease-carrying mosquitoes, not evil gases, killed people. In his historic Havana campaign of 1901, Gorgas led teams door-to-door, emptying all water containers and other breeding grounds for larvae. The results: in 1900 in Havana, 1,400 people had contracted yellow fever; in 1901 the number dropped to 37; and after October, 1901, none; and in all of 1902, none. As for malaria, coincidentally being fought via the same eradication effort, in 1900 Havana had 325 deaths; but in 1902, only 77. Further, Gorgas learned things in Cuba: that Aedes mosquitoes symbiotically survive by proximity to humans. Only the female bites; she needs blood to mature her eggs and strongly prefers human blood. She is very particular about depositing her eggs in or near buildings occupied by humans, only in clean water and only in water in artificial containers, like the jars used indoors to hold drinking water or rain barrels then used outside to catch runoff. Based on his tremendous success in Cuba, in 1904 Dr. Gorgas was named to lead sanitation efforts in Panama in support of construction of the Canal. Workers there were especially terrified of yellow fever — the high death rate, the suffering, the rapidity of death, the black vomit — so that when even a single case presented itself, employees literally ran and would not return. Progress on the huge project was nearly impossible. When people saw, though, that Gorgas’s techniques were effective, they calmed; deaths were prevented and work could be done. It is generally agreed that but for William Gorgas, the Panama Canal could not have been built. His work lives on. While yellow fever has now been largely controlled worldwide, about half the world’s billions remain at risk for malaria, and in fact, in 2016 some 216 million new cases of malaria were reported resulting in nearly 450,000 deaths, mostly in Africa. Much suffering occurs through high, recurrent fever and extreme chills. People are drained of energy and health. The social and economic costs are staggering. Issues of standing water where Anopheles mosquitoes can breed must continue to be addressed. Today in the U.S., what Gorgas learned and accomplished helps us fight our latest outbreak of the mosquito-borne EEE virus (Eastern Equine Encephalitis). This year, however, the Centers for Disease Control, reports 37 EEE cases nationwide (as of Dec. 3), with 15 resulting deaths, an extremely high mortality rate. As tragic as even 15 deaths are, they pale into insignificance when compared to the disease outbreaks of the past. Yes, the discoveries by William Gorgas about prevention techniques and mosquito breeding habits continue to protect us. +
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 veggies I can just toss in the microwave. I don’t lose my appetite. I still enjoy eating. It’s the Depression comes in many forms to many cooking and the doing dishes I find difficult to people and it often increases during the fall and manage. On bright, sunny days I try to cook a winter, when less sunlight creates a darkness of big dinner with a roast beef, potatoes, carrots spirit as well. I have Seasonal Affective Disorder and onions, something I can eat for several (SAD) and it affects me with a non-sunny days, or a big pot of kind of bone-numbing sense of or a big pot of chili. Today, I have tears in my eyes soup, the blahs and makes it hard to which is lovely with sunshine, as I write this. carry out life’s normal functions. my goal is to take the chicken Unfortunately SAD arrives just as bones and make soup from them. the wonderful holiday season does. Dumplings would make the soup a real treat. For me that means shifting thought into We’ll see if I can translate this delicious thought action is challenging. My mind is willing, but into an actual pot of soup and dumplings. I’m my body doesn’t want to participate. My body crossing my fingers on that one, but at least I wants to go into hibernation and stay there have enough energy today to write this column. until spring. It affects everything I would like I have found that talking about SAD is to or should do. The brain says, “You need to do helpful. For years I didn’t say it out loud the laundry.” I agree with that wholeheartedly, and just accused myself of being lazy, but what I actually do is nothing. The laundry irresponsible, a bad person. But last week I piles up until I run out of clean underwear, at had an appointment for physical therapy and which point I am forced to put some clothes in that morning was cold, damp, and foggy after the washing machine. The problematic nature several days of being socked in with dark of this dysphoria is increased because I have clouds. I felt bone-deep weariness and fatigue. enough underwear to last at least a month. So, unlike in the old days when I would have Right now my dirty laundry fills a mounded made up some ridiculous and untrue excuse, laundry basket and spreads out onto the floor. I simply told the scheduler, “I have SAD and I can actually see this as kind of funny in a I just can’t move this morning.” She was strange way. “Eaten by dirty laundry” comes to wonderful. “Oh, honey, I hope you feel better mind as the title of a short story. I make lists. soon,” she said. I felt heard. I told her, “Thank Do the laundry is item #1 at the top of the list. I you for your compassion.” ignore the list and read the newspaper. I have tears in my eyes as I write this because Eating is another issue. Thank God for Meals her words made it OK to be me, struggling with on Wheels! Those meals make sure I have at this nasty trick my body pulls on me when least one nutritious meal a day on days when sunlight is lacking. + cooking is just too much for me. On those days Editor’s note: This column previously breakfast might be peanut butter on whole appeared in a 2017 issue of the Medical wheat bread and dinner might be hummus and Examiner. crackers, with some fruit thrown in and some by Marcia Ribble
The Medical Examiner is what is known as a
GOLDILOCKS PUBLICATION At 16 pages every issue, we’re just right.
DECEMBER 20, 2019
I
Musings of a Distractible Mind
by Augusta physician Rob Lamberts, MD, recovering physician, internet blogger extraordinaire, and TEDx Augusta 2018 speaker. Reach him via Twitter: @doc_rob or via his website: moredistractible.org
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DECEMBER 20, 2019
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have good days and bad. Some days I am content, connected, focused, and motivated. On those days I enjoy my job, I enjoy the people I’m with, I am willing to be inconvenienced by interruptions. On other days…not so much. I wake up as grumpy Rob and (despite multiple cups of coffee) the old codger doesn’t leave me alone. I keep score of all the ways in which life has conspired to make the day difficult. Too many red lights. Too windy. Clearly terrible things going on. I am not patient with people, and am distracted by little things. I do my best to not let these things stand in the way of the care I give. I try to hide my emotions from my patients. It’s part of the job. But there are still days I’m better at it than others. Yesterday a patient came to the office to pick up prescriptions. He spotted me in my office and asked if he could have a few minutes of my time. Yesterday was a grumpy day, so I immediately felt a little miffed at this interruption, but I quickly stuffed that down and told him to come on in. “Are you OK, doc?” He asked as he sat on the couch. “Yeah I’m fine,” I replied, obviously not hiding grumpy Rob as well as I thought. “I’m just tired.” He proceeded to ask me several questions: one about guitars (we both play) and one about medications related to a certain problem. I banished grumpy Rob and did my best to answer his questions. He stood up to leave and then grew serious. “I really appreciate you and your office.” “Thanks,” I said.
“I’m serious, doc. I don’t know what I’d do without you. You saved my life twice, you know.” “Twice?” I asked. “I remember when you were on death’s door with diverticulitis and didn’t want to go to the hospital.” He came very close to developing peritonitis, so it wasn’t an exaggeration that I saved him that time. “What was the other time?” He made a gun with his fingers and pointed into his mouth. “Back when things were so bad a few years ago, I was ready to end it all. I even bought a rope. It was you who saved me. Things you said gave me hope.” He teared up as he spoke. I remembered. His life was falling apart: his wife abandoned him, he lost his job, he didn’t have a place to live, and he had a very painful orthopedic condition. I recall getting him on medication, helping him find a place to live, pointed him toward agencies that could help him, and just gave him moral support. I also remember that we didn’t pay much attention to whether or not he could pay us. “Thanks,” I said again, recovering the ability to speak. “It’s nice to hear I make a difference. I’m just doing my job, but it means a lot to hear that.” I walked over to him and gave him a hug. “I really appreciate you and your staff. You mean so much to me. I love you, doc.” He wiped at his eyes and nose as he walked out. As I sat back at my desk, the weight of what he said crashed down on me. Recognizing someone who is critically ill with diverticulitis is easy. I take minimal pride diagnosing the obvious, even if it is life
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threatening. Even if grumpy Rob is in the room. But this... This isn’t about diagnostic skill. This isn’t about intelligence, problem-solving, or clinical experience. This is about caring. And caring can vary based on attitude. What if I was tired and didn’t pay as much attention? What if I said to myself, “I’ll deal with that next time?” What if I didn’t take the time, look him in the eye, try to do the extra thing? I don’t feel pride about this; I feel gratitude. I am grateful I have a job in which I can make a difference. I am grateful to have Jenn and Jamie, who are willing to go the extra distance for people. I’m grateful to have a practice in which I can take extra time with people (and to discount the care if I want). I am grateful grumpy Rob was on vacation when I saw this patient. But I am also sobered by this. It’s not just in the exam room where words make such a difference. It could be a text from a friend or an email from family members. It could be on a good or a bad day. I have to be ready to help when the next opportunity arises, regardless of how I feel. I’m fortunate to have incredible role models in my parents, who have always lived their lives with the intent to leave people in their wake who are better off than the would’ve been. I can only strive to do so as well as they have. There’s a lot of crappy stuff in this world. There are a lot of things pushing people down as they struggle to survive. While I can’t fix what’s wrong in the world, I’ve always got opportunities to put good in the balance and tip the scales back up. Even grumpy Rob can do that. +
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Money Doctor Health Savings Accounts - Should you use one? Health Savings Accounts (HSAs) are becoming a common term in many American households today. We continue to see more and more companies offering high deductible health plans (HDHP) with an HSA account option. For healthy adults, if you have minimal medical visits, a HDHP with HSA can save you money given the lower premiums and tax deduction for the HSA contributions. To qualify for an HSA account you must have an HDHP. You also cannot be enrolled in Medicare, be claimed as a dependent on someone else’s tax return, or have other health coverage unless permitted by IRS rules. Given the complexity of the rules, we recommended you confirm with your CPA that you are eligible to use an HSA. If you qualify to use an HSA account, it is important to understand the tax benefits of using the account. This account is the only account available today that offers a “triple” tax advantage, which is one of the main reasons these accounts have become so popular. You get an income tax deduction when you contribute funds, the earnings grow tax-free, and the withdrawals are tax-free if you withdraw funds for “qualified” medical expenses. What are qualified medical expenses? These are medical expenses that generally qualify for the medical and dental expense deduction based on IRS rules for Schedule A (itemized deductions) on your personal tax return. The list is extensive and worth looking up. A few of the larger items are long-term care insurance premiums (subject to limits based on age) and Medicare premiums. A few smaller items that surprise people are first aid kits, hot/cold packs, sunscreen (SPF-15 or higher), thermometers, and prenatal vitamins. The most common are copayments, coinsurance, and deductibles for health, dental, or vision. Make sure you save your receipts to document these expenses. What happens if you withdraw funds for “non-qualified” expenses? It depends on how old you are. If you are under 65, you will be subject to income tax and a 20% tax penalty. If you are over 65, you will no longer be subject to the 20% penalty but will still need to pay income taxes. What happens to the funds if you pass away? You can name a beneficiary just like you can for life insurance or retirement accounts. If you name your spouse, the account will be treated as your spouse’s HSA after you pass away, preserving the tax benefits. If your beneficiary is a non-spouse, the account becomes taxable to the beneficiary in the year you pass away. If you do not name a beneficiary, the account value will be included in your gross income for the year you pass away. Once you understand the tax benefits and rules for taking funds out of the account, you will be in a much better position to decide how much to put in the account. The IRS does have contribution limits. For 2020 families can contribute up to $7,100, and individuals can contribute up to $3,550. There are catch-up contributions for age 55 an older and specific calculations for people that start or end an HDHP in the middle of a year. It is best to confirm with a CPA the amount you can contribute each year. There are many other options to consider: some employers offer employees the ability to make contributions through payroll deductions, which can provide additional tax benefits if part of a cafeteria plan. Most HSAs now offer investment options as well. HSAs also offer unique withdrawal strategies that your financial planner can discuss with you. + by Clayton Quamme, CFP® a financial planner with AP Wealth Management, LLC (www.apwealth.com). AP Wealth is a financial planning and investment advisory firm with offices in Augusta.
AUGUSTAMEDICALEXAMiNER
DECEMBER 20, 2019
PRISON NURSE… from page 3
The director explained that no one goes into Max without body armor and a face shield. Reluctantly I donned the wretched equipment and followed as two officers escorted us into B Pod. Picture a two story concrete room roughly 100 feet x 100 feet. Every 10 feet or so a metal door with a tiny window breaks the monotony of bare concrete. There is a chain link fence instead of railing on the second floor. At the back of the room a small alcove of showers stands in clear view of the entire room. Together our little band of foul smelling turtles wearing helmets moved to the first cell door where the officer opened the tiny window and a hand reached out palm up. The director reached into her toolbox, grabbed a small jewelers envelope containing medicine, and poured it into a small medicine cup full of water. She then placed the cup in the inmate’s hand and the officers quickly closed the window. We followed this routine all through B Pod, providing medication for roughly 50 inmates. We repeated this process through A, C, and D Pods before finally reaching death row. For those of you counting, especially you nurses, the director distributed medications to approximately 200 inmates using only a small toolbox she was carrying and a bunch of jewelry envelopes. She did it while inmates screamed, pounded, urinated, ejaculated, defecated, and provided nearly every other distraction you can imagine. At nearly every window
we passed, there was an inmate pleasuring or relieving himself to the sight of the director (at least I chose to believe the focus of their attention was her). Combine all these horrors with the constantly fogging face shield, the 40 pounds or so of stab-proof body armor, the foul odors assaulting your sinuses, and we have the worst pill pass known to man. After nearly two and a half hours of seeing and smelling the most unspeakable things, we walked into the cool fresh coastal Carolina air and I never felt so relieved. Even today, years later, I find it challenging to truly articulate the horrors of that building. Worse yet, I’m unable to fathom the healthcare workers who had gradually accepted the bizarre world of Max as normal, just another day at the office. Cage men and treat them like animals, and that’s just what you’ll get. If I had known what was yet to come, I would have never gone back.
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DECEMBER 20, 2019
GARDENVARIETY
Ingredients • 1 cup of dates, pitted • 1/2 cup raisins • 1/4 cup coconut protein powder (or your favorite protein vanilla protein powder) • 1/2 cup pecans • 1 tablespoon freshsqueezed orange juice • 1/2 teaspoon cinnamon • 1/4 teaspoon allspice • 1 teaspoon fresh orange zest • 1 tablespoon cocoa powder • 1/4 cup vegan white melting chocolate • 16 nice shaped pumpkin seeds for leaves
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Christmas Pudding Protein Balls • 10 naturally sweetened dried cranberries cut into thirds, rolled in your fingers to form balls for berry decorations Instructions Blend together all of the ingredients in a food processor for 2-3 minutes or until a smooth consistency is obtained. Use a small cookie scoop to form dough into approximately 12 evensized balls. Roll the ball in the palm of your hand to pack the mixture tightly. Place on a parchment-lined cookie sheet and chill for 30 minutes in the refrigerator. Melt the white chocolate in a double boiler. Remove balls from refrigerator and top with a dollop of
chocolate encouraging slight drips down the side of the ball. Place two cranberry pieces and 2 pumpkin seeds on each Christmas pudding protein ball to decorate. Place cookie sheet in the refrigerator to allow the protein balls to harden for about 20 minutes. Store in refrigerator until you are ready to eat. Enjoy! + by Gina Dickson, an Augusta mom to six and Gigi to ten. Her web site, intentionalhospitality. com, celebrates gathering with friends, cooking great healthy meals and sharing life together around the table. Also on Instagram @ intentionalhospitality
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Whipping up special recipes for Christmas time snacking is one of my favorite traditions. Sometimes it can get a little out of hand with all the sugary treats, so I wanted to create a healthy vegan treat that was also pretty enough to serve when guests were in our home. These Christmas pudding protein balls are filled with warm spices such as cinnamon, allspice, a touch of orange and sweetened with dates and raisins. A hint of cocoa and coconut protein powder makes them the perfect sweet Christmas snack to share, or a treat for yourself after a busy day of shopping. They are simple to make. Just blend all the ingredients in a food processor, then roll into even-sized balls. Top with a dollop of white melting chocolate and decorate with cranberries and pumpkin seeds to give them a festive look. Once you make them, they store well in the refrigerator for a quick anytime healthy snack.
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DECEMBER 20, 2019
FAITH & RECOVERY by Ken Wilson Steppingstones to Recovery
This is Part 2 of FAITH AND RECOVERY: Fiction or Fact? Be truthful: What were your feelings when you read this title? It was probably somewhere between “YES!” or “Bunk!” Your feelings about the subject were probably formed years ago and are probably enmeshed with your religious ideations – positive or negative. The largest self-reported study done on the subject of faith and recovery, presented to the American Psychological Association in the year 2000* found that higher levels of religious faith and spirituality were associated with more positive outcomes of recovery from substance abuse. The study reported increased coping skills and greater resilience to stress and overall life satisfaction among those who possessed higher levels of religious faith and spirituality c.f. those without such faith and spiritual fitness. Of course the study was admittedly vague re the difference between religion and spirituality but the point was well made. Then again, we’re probably confused about the difference! Shortly, religion can be seen as worshiping a superhuman power and adherence to an organized system of beliefs, rules, and ceremonies whereas spirituality might be seen as achieving peace of mind with God or higher powers, self, and others. Religion often has an agenda for someone else; spirituality does not. Humbug? What’s the bottom line here? People in self-help groups over 75 years ago summarized it by saying something like “sometimes the only factor that keeps us from relapsing is our spiritual condition at the moment.” At the moment! A saved up storage tank of past religiosity and spirituality just doesn’t work. If that’s hard to believe, listen to the news for a few days to see how even high and mighty men in law and fame fall to the ground on what seems like the spur of the moment! Because this disease is non-discriminatory in every way. Our spiritual condition “at the moment” bleeds over into life itself, whether it involves alcohol or drugs! Ever notice your reaction to crazy drivers when you’re stressed to the max, maybe running late to work? Compared with your reaction on a nice sunny day when you’re relaxed and feeling serene?!!! We are in the busy and stressful season. Holidays (from “holy days”) can tax even
THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional the elite in every way. If you are in recovery or want to be in recovery, and if all else has failed, try improving your spiritual condition this year. For starters, slow down your racing mind! An ancient writer said “Be still and know…” Those words are the embodiment of the art of meditation, or “slowing the mind down.” Meaning to literally try not to think about anything! Anything! Close to when you’re laying in bed about to drift off to sleep…only don’t quite let yourself go to sleep! There are abundant materials out there to teach you this spiritual practice – whether you are religious in beliefs or not. Millions attest to the healing, serene bliss that lasts for hours after even 30 minutes of slowing down their brain waves. This condition is the opposite of anxiety, a “racing mind.” The early 12-steppers found success in recovery that has surpassed most other programs by their 11th step. (research this one… you don’t expect me to do all the work do you?!!! That’s what internet search engines are for!) Particularly note the fourth and fifth words in the step when you “google” it. These programs are not a “secret society!” They’re for everybody who has the desire to use them. And that’s a fact. Not fiction! + * “Religious Denomination Affiliation and Psychological Health: Results From a Substance Abuse Population,” Thomas G. Plante, PhD, Santa Clara University and Dustin A. Pardini, MS, University of Alabama
DECEMBER 20, 2019
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AUGUSTAMEDICALEXAMiNER
DON’T LICK THE BEATERS Useful food facts from dietetic interns with the Augusta University MS-Dietetic Internship Program
Are Sweet Potatoes Sweet on Health? by Laura Martin, MS-Dietetic Intern The holiday season means it’s time for one of everyone’s favorite comfort foods, sweet potato casserole. This powerful orange root vegetable has tons of nutrients and bioactive compounds (on the other hand, it is typically prepared with layers of butter and sugar). Sweet potatoes are a rich source of antioxidants, fiber, vitamin C and vitamin B6, potassium, and some minerals. These nutrients are helpful with promoting gut health, digestion, supporting healthy vision, and the immune system. Antioxidants are compounds that help defend the body against free radicals which can cause DNA damage and increase inflammation. Free radical damage is linked to many chronic diseases such as cancer and heart disease. The antioxidant beta-carotene gives sweet potatoes its orange color. The body converts beta-carotene to vitamin A, which is a fat-soluble vitamin also known as retinol. It is essential for growth, cell development, vision, immune function, gut integrity, and healthy skin and hair. Sweet potatoes with the skin included is one of the best natural sources of beta-carotene. Vitamin A, as a fat-soluble vitamin, is best absorbed by the body when prepared with a fat. Use a healthy fat such as olive oil to maximize health benefits. The fat must be used sparingly to avoid excessive calorie intake. Sweet potatoes are an excellent source of fiber. One medium sweet potato provides approximately 25% of the recommended daily fiber intake of 25-30 grams. These potatoes provide soluble and insoluble fiber. Both are important and carry out different essential body functions to maintain health. Soluble fiber helps lower the risk of
heart disease and improve blood glucose control, while insoluble fiber supports normal digestive health. Both types are beneficial in achieving and maintaining healthy weight. Vitamin C supports the immune system, heart, and healthy skin and gums. Sweet potatoes are also rich in magnesium, which helps with anxiety. Vitamin C and magnesium together may also help reduce inflammation. Sweet potatoes will provide about 15% of the vitamin C recommended daily requirement and 25% for vitamin B6. Vitamin B6 is needed to regulate glucose storage to glycogen. Glycogen is the energy stored in the liver and muscles throughout the body. Sweet potatoes are also high in potassium at 15% of the daily need. Potassium helps to maintain healthy blood pressure. Choline and manganese are also found in sweet potatoes, both of which help improve brain function. It’s time to get back to the roots of this vegetable and let it be the healthy food it always has been. Instead of loading them with butter and sugar, those sweet potato casseroles could be lightened up by mashing them with orange essence. This provides all the warm holiday flavors but with no added sugar or excessive fats, while getting in all the benefits of this powerful spud. Try adding toasted pecans or walnuts to the top for some extra crunch and some omega-3 fatty acids. For additional health and nutrition information, visit the Academy of Nutrition and Dietetics website at www.eatright.org. The Academy is the largest group of trained professionals in the science of nutrition and credentialed Registered Dietitian Nutritionists (RDN). +
MASHED SWEET POTATOES WITH ORANGE ESSENCE
Skill level: Easy Prep time: 20 minutes Cook time: 8 minutes Total time: 28 minutes Ingredients: • 4 medium sweet potatoes (about 8 oz. each) peeled and cut into a large dice • 1/4 cup buttermilk, warmed slightly • 1/4 cup orange juice • 2 teaspoons orange zest • 1/2 teaspoon salt • 1/4 teaspoon ground nutmeg • 1 tablespoon butter, optional Instructions: 1. Steam the potatoes in a large covered pan fitted with a steamer basket until tender, about 8 minutes 2. In a large bowl, mash the potatoes with the buttermilk and orange juice. Stir in the zest, salt, and nutmeg, Serve potatoes topped with butter, if desired. Yields: 4 servings, ¾ cup serving size Nutrition facts (per serving) Calories: 210 Total fat: 0 grams Saturated fat: 0 grams Cholesterol: 0.5 grams Sodium: 98 milligrams Carbohydrates: 48 grams Dietary fiber: 7 grams Protein: 4 grams + Recipe from Ellie Krieger with The Food Network https://www.foodnetwork.com/recipes/ellie-krieger/mashed-sweet-potatoes-with-orange-essence-recipe-1949852#/
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More Americans have died on US roads since 2000 than in World Wars I & II combined REPLY TO “I AM A ‘BAD’ DRIVER,” PART 2
“I text. I drive.” If you’re going to text and drive, you might as well drink and drive. Some studies say its effect on driving safely is actually worse than drunk driving. Unlike driving under the influence, which is often a nighttime vice, using a phone while driving goes on 24/7. Take a spin around the highways and byways of the Aiken-Augusta area and it’s no problem to see people using their phones left and right. You would never know it’s illegal — and with all due respect, cops don’t seem to know either. Enforcement is low enough that people are not concerned with trying to conceal their unlawful and hazardous habit. As the first installment of this series noted last summer, it’s the wild wild west out there. “I don’t use blinkers” Granted, there are bigger fish to fry in the world of driving safety than blinker use. 98% of the time, turn signals are a simple courtesy you extend to other drivers. Someone is waiting to pull out from a side street or parking lot, and they can if you let them know you’re turning in. 98% of the time you’re exhibiting good manners, not preventing a 14-car pileup. Blinkers help keep traffic flowing smoothly; they keep tempers down. What about the other 2%? Some people pay a steep price for failure to signal. How many episodes of COPS or Live PD have you seen where an epic traffic stop began with the officer saying, “I notice you failed to signal your turn back there.” The driver broke the law; they gave the cop probable cause, and it went severely downhill from there. +
In our Nov. 15 issue, Bad You sail through and instinctively look in the rear-view Driver gave us 7 reasons why mirror, expecting to see blue his bad driving isn’t so bad lights. Instead you see someafter all. In our last issue one else follow you through! we addressed his first three And you thought your ofpoints: his justification for fense was flagrant! speeding and driving in the left lane, and his excuses for tailgating. Here is our pointby-point rebuttal to the rest of his flawed reasoning: “I cheat on yellows” This is the new normal. It isn’t just Bad Driver; it seems like half the population completely ignores what used to be the message delivered by the yellow light: prepare to stop; red comes next. Apparently dyslexia is rampant because “I drink. I drive” This is most people have it exactly the very definition of the backwards: they speed up person who does not dewhen they see yellow (if serve the privilege of driving. they don’t ignore the caution Aside from being illegal, it’s light altogether). As we have thumbing your nose at the noted before in this space, very lives and well-being there is no better evidence of every infant or child or of the rampant disregard for grandmother or parent in yellow lights than personal every other car you pass. It experience. It goes like this: also shows flagrant disregard for whatever reason you fail for your wallet, your job, to see the lights change. It your family, and your entire happens to the best of us. At future. There is a reason why the very moment you notice impaired drivers believe their the yellow for the first time, judgment is not impaired. it goes red. You haven’t even It’s because their judgment is entered the intersection yet, impaired. and it’s far too late to stop. In summary, there are usually plenty of excuses to ignore traffic laws, but there are always at least two good reasons why traffic laws should be obeyed. First, because it’s the law. Secondly, because it’s the right thing to do, even if it’s not necessarily convenient, or if there isn’t a police car within fifty miles. Bad Driver, are you listening?
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DECEMBER 20, 2019
HUMAN BEHAVIOR
How neuroscience works in everyday life
PAIN IS SUCH A PAIN
My pain often makes it difficult to concentrate — sometimes I stare at my email for hours trying to make sense of by Jeremy Hertza, Psy.D. the words. My pain makes it difficult to do little things, or to enjoy anything. I cannot tell you how many days I’ve spent lying down, or nights I’ve spent wide awake, unable to sleep. When the pain is bad enough, I cannot cook. I cannot eat. I cannot clean, and I cannot bear to sit or stand. And that pain? The pain of knowing I am living half a life? Of knowing I am missing out? That pain is far greater than what I feel in my back. That is the toughest pill to swallow. –Ashley Jane, excerpted from the Scary Mommy blog, www.scarymommy.com Thirty years ago, pharmaceutical companies promised relief to the nearly 25% of Americans who live with chronic pain: opioids. While these same companies were riding high on a golden balloon, families were destroyed. Pills clearly aren’t always the answer. Doctors still prescribe opioids, and patients in pain still benefit from them. But these medications were originally designed to treat the worst pain, 10 out of 10. They’re designed to give immediate relief. They were never meant to be used on a daily basis. So with the medical profession now much more cautious, what can patients and families do to help manage pain that’s 5 out of 10? Or higher? More Pain We’re living longer today. But our bodies aren’t necessarily staying in peak condition. Our backs weaken, our knees are creaking, and arthritis curls our fingers and hands. With chronic pain, experts in physical therapy and rehabilitation often say, “Motion is lotion.” The more you move and stretch, the less pain you tend to have. We say, move and stretch as you are able. That could mean walking, exercise in a pool, gentle yoga or stretches—whatever you are comfortable with. I can’t repeat this enough: Physical activity is important. This is different from acute pain, like from a sprained ankle or broken arm, which needs to stay immobile. While people may be a little skeptical about alternative therapies—they are called “alternative,” after all—studies have shown that acupuncture, biofeedback, chiropractic services, even massage can help knock pain down by about 20%. Stress and anxiety can make pain symptoms worse, so stress reduction is pain reduction. The important thing is to have several tools you can use to help manage your pain before you reach for a prescription pain pill. What About CBD? Derived from the marijuana plant, CBD oil, whether or not it contains THC, is everywhere these days. There is no current research that has found CBD has any harmful effects. As for THC, most studies show no longer-term effects, although that varies depending on how you use it. People using THC through a vape pen have experienced lung problems, even death. Smoking anything can be harmful to your lungs. There’s also very little evidence that it’s chemically addicting, although it could be emotionally addicting. Like anything, use moderation if you choose to explore CBD oil. The Final Word My personal approach is to advise patients to consider a variety of techniques before taking an opioid. By design, opioids are not a first-line treatment; they should be a last-line treatment. Whether that’s exercise and CBD oil or nerve blocks and antiinflammatories, all of those are going to be safer at managing pain. 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. +
DECEMBER 20, 2019
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AUGUSTAMEDICALEXAMiNER
The blog spot From the Bookshelf — posted by Edwin Leap, MD, on December 10, 2019 (edited for space)
TAKING FOOD AND DRINK AWAY FROM DOCTORS AND NURSES IS JUST CRUEL It’s hard to explain what we do in the emergency department. And so maybe it’s hard for others to sympathize with our situations, and this lack of understanding is what leads some hospital administrations to do one of the stupidest things imaginable. What is that thing? Banning food and drink from our work-spaces. This isn’t the case in my current job. But it is the case in all too many facilities. I talk to people. I hear things. And it’s usually justified with some unholy combination of infection control, Joint Commission and public health clap-trap, then circulated as a cruel policy. When it’s enacted, clinical staff have their water bottles taken away. Nobody is allowed to eat where they work. Dedicated, compassionate staff members grow tired and dehydrated and hungry. (Maybe it’s a good thing. They often don’t have time to urinate anyway, and water just makes that happen more often.) All you have to do is take your break and go to the cafeteria or to the break room, right? Those who come up with these rules don’t understand that a scheduled break is a great idea that never happens. It’s an emergency department. It isn’t (technically) a production line; however, we try to impose time restrictions and through-put metrics. It isn’t “raw material in/product out.” A single patient can take anywhere from, oh, 20 minutes to 12 hours. During which time, it’s pretty hard to leave the critical patient, in the understaffed department, with the “five minute door to doctor” guarantee and the limitless capacity for new tragedy rolling through the door. As such, it’s nothing short of cruel and unusual for anyone to say to the staff of a modern emergency department, “you can’t have food or drink.” Especially when it’s typically uttered by people who have food and drink in their offices and at their desks. People who have lunch meetings or who have time to walk to the cafeteria or drive off-campus. And who feel so very good about protecting the staff from their deadly water bottles. The argument, of course, is that the clinical staff work in a ‘”patient care area.” They are afraid we’ll catch something. That it’s unsafe for us to eat or drink where we work. Of course, this is while we positively roll around in MRSA and breathe in the fine, particulate sputum of septic pneumonia patients. This is while staff clean up infectious diarrhea and wear the same scrubs all day. This is after we intubate poor immigrants who may well have tuberculosis and start central lines on HIV patients. This is after we wrestle with meth-addicts who have hepatitis C. And this concern for our “safety” occurs in places where physical security, actual security against potential violent attack, is a joke. As for our patients, our food and drink are no danger to them. They and their families fill the exam rooms with the aroma of fried chicken, fries, and burgers, eaten at the bedside (often by the patient with abdominal pain). Their infants drag pacifiers across floors that would make an infectious disease specialist wake from bacterial nightmares in a sweat-soaked panic. In short, our food or drink are no threat to them and no threat to us. But a ban on our food and drink? That’s a problem. Because the ED is an endless maelstrom of uncontrollable events and tragedies, of things beyond our control for which we are responsible. It is a place of physical, emotional and spiritual exhaustion where we daily rise to the challenge. In the midst of all that, a bottle of water, a cup of coffee, a bottle of Diet Coke, a styrofoam cup of iced tea is an oasis in the desert. And that sandwich, slice of pizza, cupcake or salad is the fuel that helps make it happen. Depriving staff of food and drink proximate to where they work is of no health value and strikes me as just one more way of exerting control over the people actually engaged in the hard, grinding work of saving lives. And worse than that, it’s just mean. +
“Just take your break. Simple.”
Edwin Leap is an emergency physician.
Publisher review: If the conscious mind--the part you consider to be you--is just the tip of the iceberg, what is the rest doing? In this sparkling and provocative book, renowned neuroscientist David Eagleman navigates the depths of the subconscious brain to illuminate its surprising mysteries. Why can your foot move halfway to the brake pedal before you become consciously aware of danger ahead? Is there a true Mel Gibson? How is your brain like a conflicted democracy engaged in civil war? What do Odysseus and the subprime mortgage meltdown have in common? Why are people whose names begin with J more like to marry other people whose names begin with J? And why is it so difficult to keep a secret? Taking in brain damage, plane spotting, dating, drugs, beauty, infidelity, synesthesia, criminal law, artificial intelligence, and visual illusions, Incognito is a thrilling subsurface exploration of the mind and all its contradictions.” “Written in clear, precise language, the book is sure
Eagleman’s book are wellarticulated and entertaining, elucidated with the intelligent, casual tone of an enthusiastic university lecturer.” —TheMillions.com
to appeal to readers with an interest in psychology and the human mind, but it will also please people who just want to know, with a little more clarity, what is going on inside their own skulls.” —Booklist “Incognito is popular science at its best . . . beautifully synthesized.” —Boston Globe Best of 2011 “Eagleman presents difficult neuroscience concepts in an energetic, casual voice with plenty of analogies and examples to ensure that what could easily be an overwhelming catalog of facts remains engaging and accessible. . . . The ideas in
“After you read Eagleman’s breezy treatment of the brain, you will marvel at how much is illusory that we think is real, and how we sometimes function out autopilot without consciously knowing what is happening. . . . This is a fascinating book.” —The Advocate “A fascinating, dynamic, faceted look under the hood of the conscious mind. . . . Equal parts entertaining and illuminating, the case studies, examples and insights in Incognito are more than mere talking points to impressed at the next dinner party, poised instead to radically shift your understanding of the world, other people, and your own mind.” —Brain Pickings Incognito — The Secet Lives of the Brain by David Eagleman, 304 pages, published in 2012 by Vintage +
Research News Take these two tablets – away This week the results of scholastic research from around the world was released, as and has been the case in previous years, American students scored lower than their peers in other industrialized countries. Coincidentally (or perhaps not), a study published last week claimed to have discovered a significant reason why some children score poorly in reading skills. Exploring the results of previous studies more deeply, the new research found again that reading using electronic devices is associated with poor reading scores. Forth graders who reported tablet use in “all or almost all” of their classes scored the equivalent of a full grade level lower on reading exams compared with students who primarily used paper. “Reading on
screens doesn’t offer the same experience as reading on paper. It’s difficult to say exactly why but studies have suggested that the missing tactile experience can cause deficits in comprehension. These differences may be even more keenly felt with young students who don’t yet have a wealth of reading experience.” The new study and the earlier research it built upon does not recommend the abolition of electronic devices in learning. Instead they recommend caution about overuse of any one type of device, paper or electronic, advocating a mixture based on facts showing how and where students learn most effectively. The strangest paradox in healthcare? A paper by University of North Carolina at Chapel Hill researchers published Dec. 16 in The Lancet reports on
a growing trend in low and middle income countries that is also seen in low income domestic populations: people who are simultaneously obese and undernourished. In years past those were two separate public health issues. No longer. Worldwide, some 2.3 billion children and adults are overweight and malnourished, says the study. Often referred to as the “double burden” of malnutrition, the problem is caused in part by the modern food system. Specifically, many areas around the globe (and in Augusta) are in what are called food deserts, areas where fresh food is not readily or conveniently available. Locally, the closing of major supermarkets in lowincome areas leads to local residents shopping for food in convenience and dollar stores, buying low cost items high on sodium and short on nutrition. +
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AUGUSTAMEDICALEXAMiNER
The Examiners
DECEMBER 20, 2019
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by Dan Pearson
I’m trying to lose weight, Every time I see you you’re Why the long face? but I’ve gained 5 pounds eating cookies. No wonder I’m 100% sure the How can you say that? this week alone. you’re gaining weight. cookies are not the It makes no sense. They’re Thin Mints. problem. Duh.
The Mystery Word for this issue: EPSEL
© 2019 Daniel Pearson All rights reserved.
EXAMINER CROSSWORD
PUZZLE
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14 17
6
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19 23
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26 31
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38 42
43 47
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48 52
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Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, JAN. 6, 2020
We’ll announce the winner in our next issue!
E X A M I N E R
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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
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by Daniel R. Pearson © 2019 All rights reserved.
S U 2 D 1 O K 5 U
DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.
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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
Solution p. 14
QUOTATIONPUZZLE P T O D L E O O O R I
R K T C O R V S H H C N S O A I I E D E O O S E W E T T O C N N D
by Daniel R. Pearson © 2019 All rights reserved
2 8 9 1 4 5 6 3 8M7 5 E4 1 6 N 7 9 3 2
— Merry Browne
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. 7655 (US president) ____
6. 5462656 (US president) _______
2. 8238 (US president) ____
7. 6234766 (US president) _______
3. 89537 (US president) _____
8. 5366339 (US president) _______
4. 23267 (US president) _____
9. 42734353 (US president) ________
5. 743723 (US president) ______
10. 3473646937 (US president) __________
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.
by Daniel R. Pearson © 2019 All rights reserved
ME
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21 22 ACROSS 1. Augusta mill 25 5. Augusta’s “The _______” 27 28 29 30 10. 2nd son of Adam and Eve 35 36 37 14. Potpourri 15. Hilo greetings 39 40 41 16. Cab 44 45 46 17. A version of Baal 18. Occur before something 49 50 else 53 20. Part of a combo with feathers 55 56 57 58 21. Carry out 63 64 65 23. Biblical coin 25. Speed abbreviation 67 68 69 26. Make a mistake 71 72 27. Business matters 31. Idleness by Daniel R. Pearson © 2019 All rights reserved. 35. And not 36. Guides 38. Famous Ukraine seaport DOWN 1. NBA’s Bryant 39. Increased 2. Holly genus 41. Rejoice 3. West ____ Virus 43. Capital of Ukraine 4. Depart 44. Iron feature 5. Wednesday at the National 46. James, pioneer of TV 6. On sheltered side cooking shows 7. Former weight for wool 48. Dr. of rap 8. Central African republic 49. State of having a will 9. Intense dislike 51. Young girls 10. @ 53. Nurse asst. 11. Nearby South Carolina town 54. Stroke abbrev. 12. Test 55. Greek island 13. Old Italian money 59. Like a mobile, but 18. Center of an iris stationary 19. Type of bird? 63. McKinley’s First Lady 22. Nashville awards prog. 64. Sure 24. Floorboard sound 66. Joy Luck Club author 27. Anguish 67. Reuben seller 28. Specialty 69. Average Joe 29. Liberates 70. Distasteful; yucky 30. Sen. Chambliss 71. Shaker contents 31. Religion with a billion 72. Luster followers 73. Mets’ former home
TEXT
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DECEMBER 20, 2019
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AUGUSTAMEDICALEXAMiNER
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The
Advice Doctor
Moe: Where could I find a turtle with no legs? Joe: Probably right where you left it.
©
Woman in a museum: Are we allowed to take pictures in here? Man: No, I think they better stay right where they are on the wall.
A
n Army drill sergeant calls his troops together and tells them, “I’ve got a mole in my garden. The first one of you that gets rid of it will be rewarded handsomely.” One of the soldiers quickly succeeds in catching it. “What do I do with it now, sir?” asks the soldier. “That mole made a hell of a mess in my garden, soldier,” said the drill sergeant, “So give that miserable varmint the worst send-off you can think of. Kill him good, and be creative.” After about an hour the soldier comes back. “Did you obey my orders?” asked the commander. “Yes sir! I did the most horrible thing ever! Try to guess!” “Did you shoot him?” “Too unimaginative, sir.” “Did you unleash the dogs on him?” “Much worse!” “Did you cut it in pieces while it was still alive?” “Even worse than that!” “Good God, what did you do to the poor creature?” “I buried it alive, sir!”
A man finds a magic lamp, and when he rubs it a genie emerges, eager to show his gratitude for being freed from the bottle after centuries of confinement. Genie: I will grant you one wish, anything on earth you desire. Man: I wish your name was “Burger King.” Genie: That is your wish? Why? Man: It’s for a good joke, trust me. Genie: You’d waste a perfectly good wish, something with life-changing power, for a joke? Man: Yes. Burger King: Have it your way. Moe: Is there such a thing as a male equivalent of mermaid? Joe: Yes, merbutler. Moe: This dish I’m making requires cutting a lot of onions. Isn’t there some secret to not crying when you cut onions? Joe: The trick is to not form an emotional bond with them. Moe: Christmas is exactly like my job. Joe: How do you figure that? Moe: I do all the work, but the fat guy in the suit gets all the credit. +
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 neighbor is a real busy-body, and I would like your advice about how to deal with him. As soon as we put our Christmas light up, he came over and reminded us that we shouldn’t leave them up too long after Christmas. How is that any business of his? I agree they shouldn’t be left up until July, but if somebody does that, it’s no skin off my back. There are bigger fish to fry, am I right? How can I respond to him in a civilized manner (when I really want to bite his head off)? — Deal with it? That’s my challenge. Dear Deal With It, Where to start? Your situation presents so many potential topics to address. One of the most important aspects of your dilemma — and there are several — is your reference to the “skin off your back.” Many people don’t realize how important skin grafts are in medical care, and how often they are used. This is relevant to what you describe because the back is often the source of donor skin for grafting. In fact, the related idiom people sometimes use is, “it’s no skin off my nose.” Ironically enough, the nose is one of the places where skin sometimes is off. And therefore where skin from the back might be grafted on. Generally speaking, skin grafts are used to replace skin lost because of fire or chemical burns, trauma (car accidents, for example) or illness (such as infections, skin cancer or ulcers). Grafts can use full thickness skin, meaning both the epidermis and dermis, for smaller areas, or very thin grafts, called splitthickness grafts. In such cases the donor site (perhaps the back, abdomen or thighs) is shaved, as it were, and the thin layer of healthy skin is transplanted to the damaged area. Before application, however, split-thickness skin is often perforated to make it more open and mesh-like. That permits a small amount of donor skin to be stretched to cover a larger area, since new cells will grow in the open areas. Keeping the donor site as small as possible also helps reduce pain and the potential for infection. Grafting is often a lengthy and complex process. Best wishes! I hope this answers your question. Thanks for writing. + Do you have a question for The Advice Doctor about health, life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.
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THE MYSTERY SOLVED The Mystery Word in our last issue was: GENETICS
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THE WINNER: ANGIE BROWN! 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!
DECEMBER 20, 2019
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QuotatioN QUOTATION PUZZLE SOLUTION “Preconceived notions are the locks on the door to wisdom.” — Merry Browne
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OVERHEAD DOOR COMPANY OF AUGUSTA/AIKEN (706) 736-8478 / (803) 642-7269 WWW.OHDAUGUSTA.COM
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ACUPUNCTURE
Dr. Eric Sherrell, DACM, LAC Augusta Acupuncture Clinic 4141 Columbia Road 706-888-0707 www.AcuClinicGA.com
ALLERGY Tesneem K. Chaudhary, MD Allergy & Asthma Center 3685 Wheeler Road, Suite 101 Augusta 30909 706-868-8555
CHIROPRACTIC Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A 706-860-4001 www.evanschiro.net
COUNSELING Resolution Counseling Professionals 3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866 www.visitrcp.com
DENTISTRY
Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048
IN-HOME CARE
Floss ‘em or lose ‘em!
Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445
DERMATOLOGY
Everyday Elder Care LLC Certified Home Health/Caregiver 706-231-7001 everydayeldercare.com Zena Home Care Personal Care|Skilled Nursing|Companion 706-426-5967 www.zenahomecare.com
LONG TERM CARE
Georgia Dermatology & WOODY MERRY www.woodymerry.com Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Long-Term Care Planning I CAN HELP! Augusta 30904 (706) 733-3190 • 733-5525 (fax) 706-733-3373 SKIN CANCER CENTER www.GaDerm.com
DEVELOPMENTAL PEDIATRICS
PHARMACY
SLEEP MEDICINE
Sleep Institute of Augusta Bashir Chaudhary, MD 3685 Wheeler Rd, Suite 101 Augusta 30909 706-868-8555
TRANSPORTATION AMBULANCE • STRETCHER • WHEELCHAIR
706-863-9800
VEIN CARE Vein Specialists of Augusta G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 501 Blackburn Dr, Martinez 30907 706-854-8340 www.VeinsAugusta.com
Karen L. Carter, MD Medical Center West Pharmacy 1303 D’Antignac St, Suite 2100 465 North Belair Road Augusta 30901 Evans 30809 706-396-0600 Your Practice 706-854-2424 www.augustadevelopmentalspecialists.com www.medicalcenterwestpharmacy.com And up to four additional lines of your choosing and, if desired, your logo. Parks Pharmacy Keep your contact information in this 437 Georgia Ave. ARKS convenient place seen by thousands of HARMACY N. Augusta 29841 patients every month. Steppingstones to Recovery 803-279-7450 Call (706) 860-5455 for all the details! 2610 Commons Blvd. www.parkspharmacy.com Augusta 30909 706-733-1935
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DECEMBER 20, 2019
VISION What is your vision for improving your life and well-being over the coming year? It’s essential to recognize that not all health-related goals need to be directly health-related. Here are some examples. Some people experience a fair amount of stress and anxiety because they’re disorganized, constantly losing their keys and other items, or they’re always running late. A goal that would make their life much happier (and therefore healthier) would be to get organized. Someone else might worry constantly about financial issues. Paying their bills is always a struggle. In the past year, their gas, water, electricity and cable have all been shut off at various times for non-payment. The car is always about to be repossessed. That is a terrible way to live. An important goal would be to fix that situation. Can you get a raise at work? Can you get a part-time job to add additional income? An even better goal: can you reduce expenses to make your present income work? There are easy ways and hard ways to make that happen. Cable is not a necessity for life. Neither is eating out multiple times per week. Cell phone plans can be cut back to save money. An older car with no (or low) car payments might be a tough pill to swallow, but the reduced stress and anxiety can make it well worth the sacrifice. Of course, there are all of the standard year end/new year goals, many of them directly related to more healthful living: lose weight, get more exercise, watch less TV, meditate more, read more, quit smoking, reduce excessive drinking, reduce debt, and many more. The keys to success in reaching any goal are simple (even if the goal itself might not be): Be realistic. Don’t set goals so high that they’re doomed to failure. Take baby steps. Be specific. Instead of “get organized” or “lose weight,” try “buy desk organizer” or “lose two pounds by [date].” Make it measurable. Set a goal whose progress you can track, like “walk around the block 3 times a week.” Keep it fluid. While the ultimate goal may not change, the next steps you take to reach it after the current steps might. Adjust accordingly. Be kind to yourself. You wouldn’t trip on a flight of stairs and then just lie there. You would get up, dust yourself off and continue on your way. Do the same when you have setbacks in reaching your goal. Pick yourself up. Keep climbing. +
IT’S NOT TOO LATE!
Proudly affiliated with Dr. John Cook of Southern Dermatology in Aiken
M.D. John Cook,
Still V
Pictured above (from left to right), John Cook, MD; Lauren Ploch, MD; Jason Arnold, MD; Caroline Wells, PA-C; Chris Thompson, PA-C
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