Medical Examiner 12-04-2020 by Daniel Pearson

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ARE YOU?

HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS

DECEMBER 4, 2020

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We know what you’re thinking: Am I what? Good question. One clue to the answer is provided by the caricatures on this page. Do you know who they depict? His name is Groucho Marx (1890-1977), and he was considered to be one of America’s greatest comedians, with a successful career on stage, in movies, and on radio and television that began in 1905 and spanned nearly 75 years. For our purposes, we’re looking at perhaps his biggest exposure in that long career, a TV quiz show he hosted that aired on NBC from 1950 to 1961 called You Bet Your Life. With a title like that, it’s an even bet that some alert reality show producer is already working on a pilot for a new TV show by the same name. Since any new version of the show would be released in very late 2020 or early 2021, maybe it will show its up-to-the-minute relevancy by having people bet their lives by hosting huge parties or family reunions without a single mask in sight. Or maybe they’ll assemble teams of people who refuse to take the COVID vaccine once it has been fully tested and gets the stamp of approval from health agencies around the world. The teams will attend crowded events like concerts and professional sports games. The team

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with the fewest infections and deaths wins a nice prize. The losers are forcibly given the vaccine. Looking at this on paper, maybe it’s not such a hot idea after all. It’s probably never going to be green-lighted. But even if it isn’t we can watch it play out in real life all over the country and around the world on a daily basis. Ignoring health and safety guidelines is definitely a roll of the dice, but it’s one that people get away with all the time. You could drive around without wearing a seatbelt for decades and never get a scratch on either yourself or your car. You could refuse to wear a mask or get a vaccine and sail right through this pandemic with flying colors. On the other hand, some people do the right thing and still pay the price: they have never smoked, but somehow they wind up with lung cancer; they wear a mask every day and still have tested positive for coronavirus. Almost nothing is completely guaranteed to provide the same results for every person every time. Even the best and safest drugs warn, “Your results may vary.” As Groucho might put it, you bet your life every day. We all do. When the COVID vaccine becomes available, those who take it will be betting their health and potentially their very lives on it. Those who refuse will likewise be betting their life and health on the stand they take. What each of us has the obligation to do on any important decision is to weigh the risks and the quality of the information we have about that risk, and make the best decision possible. Please see ARE YOU? page 3

AUGUSTAMEDICALEXAMiNER

DECEMBER 4, 2020

THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD by David W. Proefrock, PhD

Your 10 year-old son doesn’t seem to want to do anything. He goes to school willingly and his grades are passing, but he doesn’t have friends and prefers to play alone. He stays in his room, watches TV, and plays video games. You have to make him go outside. He seems happy enough and you don’t think he’s depressed, but you’re worried about him. What do you do? A. Take him to a mental health professional as soon as possible. He might not seem depressed, but he very well may be. B. Arrange for him to go visit kids his age and make sure he goes. C. Devise a plan to get him involved in activities he’ll enjoy. D. Don’t worry. This is just a phase that many children go through. He’ll be okay. If you answered: A. This may not be necessary. Try some other things first. Get him involved in activities outside of the house. B. Forcing one-on-one activities with peers on a child who is socially withdrawn most often doesn’t work out the way we would like it to. Get him involved in structured group activities instead. C. This is the best response. One way that often works is to tell him he has to be involved in two activities with other kids. Give him some examples, but let him choose. Tell him that if he doesn’t choose, you will choose for him. D. To be this withdrawn is not “just a phase.” He’s missing out on any chance to develop important social skills. It’s your job to help him. Around ten years old is the age range when children are supposed to be developing social skills. If he’s not spending time with other kids and making friends, he’s not developing those necessary skills. One of the jobs of parents is to make sure he has the opportunity to develop all the skills he should. + Dr. Proefrock is a retired clinical and forensic child psychologist.

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ARE YOU?… from page 1

When we say it’s an obligation to make good choices, what do we mean? As the English poet John Donne wrote, “no man is an island.” We recently noted on these very pages in an article about suicide that every suicide (and deaths by any other means, we would suppose) directly affects an average of at least 135 other people: the husband or wife, children, brothers and sisters, parents, grandparents, friends, neighbors, co-workers, aunts, uncles, nieces and nephews, people they owe money to...the list goes on and on. In other words, none of us has the luxury of making decisions in a vacuum. Our decisions will affect others. Bad decisions will affect them negatively. Good decisions will have positive effects (even though they might go completely unnoticed: “Did you hear the news about Joe? He drove safely today and didn’t get in a wreck.”). Taking others within our sphere of living into account as we make decisions is part of our obligation as a good marriage mate or a good child or parent or friend or citizen. In all honesty it must be said that 2020 may enter the record books as the Worst Year for Informed Decision-Making in recorded history. Here’s a real-life example: there is an up-and-coming boxer and aspiring rapper named Jake Paul who believes that COVID is a complete hoax. He has gone on record that in his view 98% of news is fake. “So what?” you say. “I’ve never even heard of the guy.” That may be true for you and me, but he has more than 20 million followers on YouTube and another 12 million or so on TikTok. One of his rap videos has been viewed more than 275 million times. It’s one thing for a doctor or a medical research scientist to hold an opposing viewpoint. Getting a second opinion is standard procedure in medicine, and the two opinions don’t always agree. It’s another matter entirely when a boxer, rapper or social media influencer promotes medical ignorance as Jake Paul fact to tens millions of followers. Listening to the profusion of coronavirus opinions floating around the internet from soccer moms and motorcycle mechanics and insurance agents is an especially effective (but dangerous) way to bet your life. Therein lies one of the key differences between 2020 and any other year any of us has ever lived through. A year ago or a decade ago people could have their differences of opinion on a variety of topics (including many medical ones) without any serious fallout on either side of the issue. This year, the consequences of ignoring sound medical advice has been deadly. Well over 63 million people worldwide have been infected with coronavirus so far. The death toll is about a million and a half and counting worldwide, and it looks like it won’t be long before more than 275,000 of them are our neighbors in these 50 states. Many of these people no doubt took every reasonable precaution and still got it, but you have to wonder how many were doubters who ignored the simple and inexpensive recommendations and ended up paying the highest price possible. It just isn’t that difficult to take the precautions experts advise. It’s truly laughable when people unquestioningly obey the government when they tell us which side of the road we must drive on, and then allege some vague infringement of freedom when they suggest we wear masks. Come on. Seriously? You really don’t want to bet your life, do you? Groucho wants to know. +

WHAT’SYOURSTORY? Nearly all of us — even doctors and nurses — are sometimes patients. Perhaps you were recently injured playing your favorite sport, or years ago you somehow got hurt without even leaving your favorite recliner. Maybe you have a personal COVID-19 story or one involving your family. Maybe you were diagnosed with a dreaded disease, were mugged in a dark and lonely parking lot, or you stubbed your toe in the safety of your own bedroom. On the other hand, perhaps you needed medical attention 5,000 miles from home. Whatever your medical experience, we’d like to hear your story for our Medicine in the First Person feature. It can be frightening or funny, ordinary or extraordinary, just a few paragraphs long or quite a lengthy tale, bylined or anonymous. We’ll publish your medical adventures as often as we receive them. Hopefully that will be often. + Send your submissions for Medicine in the First Person to the Augusta Medical Examiner via e-mail: info@AugustaRx.com or to PO Box 397, Augusta, GA 30903-0397. (The Medical Examiner reserves the right to accept, reject, or edit any submission at its sole discretion.)

What makes “waves” during a pandemic? As much as we hear about these waves, there is not a clear consensus among epidemiologists for the reasons behind them. If you look at the chart below, it might surprise you to know that some health experts think we’re still in the first wave. Others say we’re clearly in the third wave. Why the confusion? It’s not like global pandemics occur every week. There aren’t a lot of previous cases to study. Here are a couple of working theories, however. One school of thought is that viral outbreaks begin by infecting the easiest targets. As a majority of those populations contract the disease, the beginnings of herd immunity start to take effect and case numbers drop. But then the virus mutates just enough to make additional population groups vulnerable to attack, and the numbers again rise in a “second wave.” Other experts think graphs like the one below are portraits of social impatience. A state or country imposes temporary restrictions to the annoyance of many. There are protests, but the government stands by its decision. As soon as the benefits of the restrictions begin to take effect and case numbers trend downward, the government yields to pressure and lifts the restrictions. Many epidemiologists believe restrictive periods that are too brief do nothing but prolong the pandemic and the misery. Some experts in this camp think we haven’t put a dent in this virus and we’re still in the first wave. +

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DECEMBER 4, 2020

#128 IN A SERIES

Who is this? ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com by Marcia Ribble

his doctor may not be a household name, but every one of us has benefited from or used (or both) his medical discovery. And as often as we have used it or had it used on us, many of us don’t really understand it. All of us will after reading this article. Born in the Russian city of Kursk in 1874, this man, Nikolai Sergeyevich Korotkov, entered medical school at Moscow University in 1895 and graduated with distinction in 1898. As so often happens in medical history, war offers innovative physicians the opportunity to explore and improve new theories and techniques of treatment. The prolific carnage provides a steady stream of patients as test subjects, and Korotkov was one of many physicians down through the centuries to take advantage of this unfortunate situation. Soon after graduating, the Boxer Rebellion erupted in 1900 in China, and Korotkov took a leave of absence from Moscow University’s surgical clinic to serve in a medical capacity with the Russian military. Then not long after his return, the RussoJapanese War broke out, and Korotkov spent 1904 and 1905 in Manchuria as the senior surgeon charge of a Red Cross unit. During this second deployment he developed an interest in vascular surgery, facing the daily question, “Is this limb viable?” Surgical repair of wounds is one thing, but is circulation sufficient to promote healing? Or should a surgeon just take the easy route and amputate? Korotkov wrote that operations with unpredictable outcomes “are unpleasant for the physician and even more unpleasant for the patient.” But what if there was a way to accurately measure blood flow and arterial pressure to offer some hint about the prospects for saving a limb? Today we would simply measure blood pressure, but early in the 19th century that was still undeveloped technology. Italian internist Scipione Riva-Rocci had just invented the easy-to-use blood pressure cuff and mercury sphygmomanometer in 1896, but it only measured peak (systolic) pressure, and depended on feeling the patient’s pulse, usually at the wrist. In 1905 Korotkov discovered that a stethoscope could be used to use arterial sounds for an accurate reading of blood pressure. Those sounds had previously been thought to come from the heart. How does hearing — auscultating — blood pressure work, and what do the numbers mean? Korotkov devised the method every BP taker uses to this day: inflate the cuff enough to completely cut off blood flow, then slowly release pressure while listening to the artery just below the cuff and watching pressure readings on a dial or column of mercury. The first pulse to squeeze past the restriction of the cuff represents the strongest pressure and is recorded as the upper, systolic reading. Pulsing sounds continue to throb against the restriction offered by the cuff as its pressure continues to be slowly released, but when there is no longer any resistance the sounds disappear. This point represents the low or distolic blood pressure reading. Collectively the sounds are known as Korotkov sounds (or sometimes Korotkoff sounds) in honor of their discoverer. +

Christmas is less than a month away. Many people have their decorations up and their presents at least ordered, if not already at home and wrapped. I am thinking about sending Christmas cards, but I am wondering if mail I send now will arrive at its destination before St. Patrick’s Day. While Trump did some good things, his pick to run the Post Office is not benefitting many seniors. Lots of us still write cards and letters like we always have. I use social media like Facebook and e-mail, but for some nothing can replace receiving a real live piece of mail that is not a bill. Let me tell you a few instances in which a letter or card is so much better. Little children are absolutely thrilled to receive the first piece of mail that is specifically just for them. I have seen munchkins lug that beloved piece of mail around with them until it is tattered and worn. Some hug and kiss it where a Grandma wrote their name in print they could read. They show it to everyone nearby and proclaim that they got “real mail, just for me!” Some treat it like an important treasure, put it in a box with other treasures, and keep it long past when they are grown. That card or letter is tangible proof that when they were small someone took the time and energy to make them important. Some look to see if it has money in it and quickly discard it. But even then, they often remember it years later. One of my aunts gave my young children an envelope with a single, brand new dollar in it. They still remember that fifty years later. I have people who send me a card with a

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photocopied letter detailing their lives over the past year. The best ones include the less happy events with the happier ones. Some send pictures of their children as they are growing. I treasure those pictures. And even at 77 I get excited when I receive a piece of real mail whose sender I can see even when they may be hundreds of miles away. They have sent me tactile proof of our long and lasting connection. It is real. It doesn’t disappear into the ether like social media messages tend to do. Because I love getting mail, I try to remember to send mail. There is one woman I spent time sharing a room with during a session of rehab. She is very old, but still very aware and bright. I try to hold her in my thoughts for a while at least once a month. We were together long enough for me to know that she loves the Atlanta Braves and enjoys watching their games. I can still see her exclaiming in wonder about how many people were in the stands cheering for them. This year there were far fewer people in the stands, but the Braves had a really good year anyway. Sending her a card takes little time, but I know she keeps things like that in her walker basket, so it’s time well spent. Since more than a year has passed, she may not even remember me anymore, but I remember her. Young or old, we need to have people who remember and think enough of us to send a card or letter, and the same is true for us remembering others. A few minutes of our time can bring a sense of connection to those we remember with love. The cost of postage is inexpensive in comparison with the happiness we are spreading. +

DECEMBER 4, 2020

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age BY J.B. COLLUM

game on my laptop since the cabin didn’t have The SEC Network (We were appalled. This is Georgia after all!). I could have used my phone, but we used his so we would have an excuse to give mom a break from the incessant phone calls. More on that later. He accepted the excuse

Dad called Mom minutes after he had just called her, and I told him that. He got angry and threw his iPhone. This made me angry again and I took the phone away. Fortunately, it wasn’t hurt as it hit a cushion. At this point, we had another evening, night and morning left in our trip, and we probably should have just taken him home then, but being the optimist that I am, we soldiered on. After we grilled some steaks Saturday night, we were going to build a fire out back, but again, we couldn’t get Dad to go outside. He just wanted to sit inside, watch TV, eat, and call Mom. This isn’t the father I grew up with who lived for the outdoors and fires. He also never liked using a phone, but Mom is now his security blanket. She is his forever “girlfriend,” something she can’t escape like I can when we are at home. This trip changed me. When I hear the pitch of Mom’s voice change to an exasperated cry I now understood why. I understand when she walks out of her room crying. I understand when she talks about the one thing that I thought I’d never consider: the inevitability of putting my father in a nursing home. I hate it, but I understand it. I will still do my best to keep that from happening though. If you know someone who is going through something difficult, like a chronic illness or caring for someone with one, remember to work on your empathy. Give them some extra patience and time. Keep them in your thoughts and prayers and let them talk to you about it. You don’t have to say anything, just listen, and be patient. Put yourself in their shoes, and when in doubt, “believe all things” when they tell you about their troubles as 1 Corinthians 13:7 implores us. +

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In the previous issue, I began my story about how I recently gained empathy for what my mother has been going through with my father’s Alzheimer’s. This insight was gained only after I took a trip with my father and brother. If you haven’t read the first part, go ahead and do that. I’ll wait. If you have, then please read on. As I said at the end of part one, things got worse as the weekend progressed. During both nights that we stayed at the cabin by the lake at Mistletoe State Park, Dad would scream out from his room for Mom. Since my bedroom was just across the hall, I would run into his room and tell him where we were and that mom wasn’t there. He screamed another time because that he couldn’t find the door to leave the room. Even after I opened the door to see what was wrong, he was still asking me where the door was. On Saturday after breakfast, we talked about going fishing, but he said he didn’t want to. We reminded him that he had especially been excited about fishing this weekend and he had even sent me to buy him a new rod & reel for that purpose on the morning of the trip. He said he would go fishing later, after we ate lunch and watched the football game. As we watched the game, he started talking about wanting to go fishing and we said that we would, right after the game. That satisfied him. Toward the end of the game my brother finished rigging Dad’s new rod & reel and set it beside him. He looked over at it multiple times and said that he was looking forward to fishing, but was concerned that he hadn’t bought a license. He brought this up at least 100 times during the course of the weekend. Each time we explained that he got a lifetime hunting and fishing license when he turned 65. All during the game, every five minutes or so, he looked for his phone or asked where it was since he wanted to call Mom, but I had it and we were using it as a hotspot for internet access to watch the

{

The father I knew is already gone.

about his phone each time. Once the game was over and we got up to go fishing, he looked surprised and said he didn’t want to go. We didn’t know what to do, so we just accepted it for the time being. I told my brother to go ahead and fish since he wanted to more than I did, and I’d sit with Dad. My brother did go fishing and reasoned that once he caught something, Dad would get inspired to go too. When it was just Dad and me in the cabin, he started asking about when we could go home. When I said that we were going home on Sunday, the next day, he got upset. He wanted to go home now to see his “girlfriend,” our mother. The entire time my brother was fishing, Dad kept coming back to that, or he would ask when mom would be there. It got to where the cycle was less than three minutes, and I am ashamed to say that it finally got to me and I raised my voice and asked him to stop asking that. Also, with voice still raised and emotional, I asked him why he even came if he was just going to pine for Mom constantly. I think my emotions were so raw because I realized at that moment that I had already lost my dad, at least the one I knew. Apparently all of this was loud enough for my brother to hear, because he came into the cabin and calmed me down. He did a great job of defusing the situation and I am grateful for it. But then shortly after that

J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. He may be reached at johnbcollum@gmail.com

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TRYTHISDISH DECEMBER 4, 2020

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by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb

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CREAMY AVOCADO HUMMUS Healthy eating is a gift! In other words, eating nutrient-rich foods gives the gift of health. This recipe is a wacky mashup of guacamole and hummus that gets its creamy light smoothness from the addition of Greek Yogurt. With half the calories of traditional hummus, it combines multiple nutrient-rich foods into a delicious appetizer fit for a party of one or many. Enjoy this on your holiday table and beyond. Serving options are limited only by your imagination: serve it with raw vegetables or chips for a light, healthy snack, or on sandwiches, morning toast or in a tortilla wrap. Ingredients • 1 large avocado, about 9 ounces, peeled and seeded • 1 cup canned chickpeas, rinsed and drained • 1 cup plain Greek yogurt • 1/3 cup cilantro leaves • 1/4 cup lime juice 1 large jalapeño, seeded, deveined and roughly chopped • 1/2 teaspoon sea salt Combine all ingredients in a food processor; blend until smooth. Serve as suggested above. Refrigerate in closed container.

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Yield: About 2-1/2 cups or 20 servings (serving size: 2 tablespoons) Nutrition Breakdown: Calories 36, Fat 1.5g, Sodium 79mg, Fiber 1g, Protein 2g.

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NUTRITION Sally, from Rome, Georgia, asks, “Are there any dietary or nutritional changes that help with thinning hair in normal, healthy women? I just bought hair vitamins!” Great question, Sally. The quick answer is “No.” Losing 50-100 hairs/day is considered normal and a part of the normal hair loss/regrowth cycle. This is referred to as hair shedding rather than hair loss. Hair loss occurs when more hair falls out than is replaced. Over 50% of women will experience some hair loss during their life. Many different factors can cause hair loss, some of which are complex and

poorly understood. The most common form of hair loss in women is called female-pattern hair loss or FPHL. About 30 million women in the U.S. are experiencing some form of hair loss at any given time. With so many women having hair loss, the stage is set for the deceptive advertising and marketing of ineffective nutritional and dietary products. These products can be legally sold in this county under the present food supplement laws, even though they are not FDA approved and meet few if any scientific and medical standards. We are exposed to many misleading ads about hair and nails, usually promoting the idea that if you want shinier, healthier hair or stronger, more beautiful nails, simply buy a supplement or eat a certain food, like gelatin. This is, unfortunately, misleading advertising. The products may be topical applications, like a shampoo or hair conditioner, or ones you take internally, like vitamin pills, herbs or protein supplements. My best advice: save your money. Sorry to say, there are no foods or supplements proven to prevent or reverse thinning hair, in normal, healthy women or men. Now, it is true that if you are suffering from malnutrition (undernutrition), you may have both hair loss and changes in both hair color and nail appearance. These changes are mostly reversible. When your body gets back into a state of normal

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nourishment, the changes usually disappear. I can think of a good example of this. I remember a really nice lady who was hospitalized for malnutrition. She had strikingly beautiful red hair. In fact, just about everyone passing by her commented on her hair. However, as she was fed a normal, healthy diet and her body began recovering from malnutrition, her hair started darkening. Before she was released from the hospital, her hair had turned from bright red to dark auburn. It was only then that she told us she had never had bright red hair until she became malnourished. In women, hair loss may be caused by many factors, such as hormones, your genes, or environmental factors. What are common causes of hair loss? Most people overlook or do not realize that a number of medications such as weight loss drugs and steroids, diseases including certain autoimmune diseases, and smoking can all lead to hair loss. Also, beauty hair treatments, coloring your hair or pulling your hair back into a bun or pony tail too tightly can lead to hair thinning and hair loss over time. If you have hair thinning or loss, check with your physician or dermatologist to see if minoxidil may be suitable for your specific condition. What about all those hair

products that promise to make your hair look younger and healthier? The key word in ads for these products is the word look. The fact is that if you take any oil, even an oil-soluble vitamin like A, D or E, and work it into your hair, it will make your hair look shinier. Your hair looks shinier because your hair is oilier and greasier. These vitamins and nutrients are not getting into your hair follicles and nourishing them. They are merely coating your hair with a thin layer of oil or grease. What it all means is that making your hair look shinier is not the same as making your hair healthier. Hair, like nails and other parts of your body, must get nutrients from your bloodstream, not by putting surface coatings on it. What’s the “No-Nonsense Nutrition” advice for today? Taking vitamins, supplements, using certain shampoos, cream rinses or conditioners or eating certain

foods will not prevent or stop hair loss in normal, healthy people. In addition, be aware that the causes of and treatment for thinning hair and hair loss in women are usually quite different from the common causes for thinning hair and hair loss in men. Don’t assume that male hair loss treatments and recommendations will work for women, especially if the hair loss and hair pattern baldness is hormone related. Discuss your hair loss concerns with your physician to look at the total picture and help you figure out what is going on. One closing thought about hair. If you are pulling your hair out this holiday season, between COVID and buying/ shipping your holiday gifts, don’t. Just take a deep breath, smile, relax and enjoy this unique 2020 season. It will be different, but our wishes are the same. We wish you a very happy and peaceful holiday and a healthy New Year. Stay safe. +

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. Dr. Karp The information is for educational use only; it is not meant to be used to diagnose, manage or treat any patient or client. Although Dr. Karp is a Professor Emeritus at Augusta University, the views and opinions expressed here are his and his alone and do not reflect the views and opinions of Augusta University or anyone else.

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Ask a Dietitian

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CHECK OUT THE COOL HOUSE SOMEONE ADDED ON TO THEIR GARAGE

STRESS LESS THIS HOLIDAY SEASON

by Elizabeth Keen, MS, RD, LD Clinical Dietitian at Doctors Hospital of Augusta 2020 has certainly been a wild ride, taxing mentally, physically, emotionally, and even spiritually. After nearly nine months of uncertainty navigating through a global pandemic, I know many are welcoming the most wonderful time of the year. December always seems like a light at the end of a tunnel, both literally and figuratively. Bright twinkling lights shining all around breathe a certain joy, warmth, and overall positivity into the air. But with the spirit of Christmas always comes an increasing number of possible stressors: entertaining kids on winter break or family from out of town, cooking, cleaning, buying last minute gifts, decorating, and for many, still having to work. It is exhausting just imagining it. Many people think of good health in terms

of diet and exercise, but that only skims the surface. Health includes so much more! For example, adequate sleep is a huge part of a healthy lifestyle. So are factors such as attitude, maintaining positive relationships, worklife balance, and a major key player that was hinted at before…stress management. Stress is defined as the body’s reaction to any change that requires an adjustment or response. The body’s response to these changes can come in many different forms that may cause negative effects on physical, mental, and emotional health. Although stress is a normal part of life, failure to control it can have significant effects on overall wellbeing. Here are many possible reactions one may experience from excessive amounts of stress:

BODY (PHYSICAL)

MOOD (EMOTIONAL)

BEHAVIOR (MENTAL)

• Headache • Grinding teeth/jaw clenching • Muscle tension/pain • Chest pain • Fatigue • Changes in libido • Upset stomach, diarrhea • Indigestion, heart burn • Trouble sleeping • Cold, sweaty palms

• Anxiety • Restlessness, fidgeting • Lack of motivation or focus • Feeling overwhelmed • Panic attacks • Irritability • Anger • Sadness or depression

• Overeating or undereating • Angry, violent outbursts • Alcohol, tobacco, or drug misuse • Social withdrawal • Exercise irregularity • Compulsive behavior such as gambling or shopping

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Do any of those sound familiar? Yes? Not surprising. Odds are different stressors will present themselves constantly, and the result can leave a run-down feeling. Chronic stress has a significant negative impact on the immune system, in turn increasing risk of contracting viral infections. This is of particular concern since flu season has arrived, on top of the coronavirus pandemic. Stress increases risk of developing diabetes, heart problems, and can lead to gastrointestinal issues such as peptic ulcers or ulcerative colitis. Stress also has a very strong correlation with mental illness. The CDC estimates that about 75% of all doctor visits are stress-related, and according to OSHA up to 90% of visits to primary care physicians can be attributed to stress-related complaints. Did you know that stress is a major contributing factor to the six leading causes of death in the United States: heart disease, cancer, respiratory disorders, accidental injuries, liver cirrhosis, and suicide? This just goes to show how intricately stress and health are intertwined. Here are some ways to help combat stress and reduce any negative effects that may accompany it. First, let us focus on physical tactics. There are many different relaxation methods such as meditation, yoga, tai-chi, massage, or even a hot bath or soothing music that can help the mind and body un-wind and relieve stress. Exercising regularly, whether it is walking or running, swimming, playing sports, or weightlifting releases endorphins which reduce Please see DE-STRESS page 16

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was setting directly over the interstate. In other words, any driver looking at the road was also looking straight into the sun. On this particular day, a fully loaded log truck was barreling across the river at full speed as the sun set. At the canal, the driver plowed into the stopped traffic, killing a North Augusta couple in the last car. The truck driver said he was blinded by the sun and couldn’t see the line of stopped cars until a second before impact. You or I could have been either of the unfortunate players in this tragic drama. We could have been flattened and killed, or sitting in a cell to this day as the guilty party. We aren’t, obviously, but the risk is always there. What is the solution? Is there one? Clearly there is nothing we can do about the earth’s orbit around the sun or the 23° angle of its axis. And most of us probably can’t reschedule our work hours to avoid traveling home around the same time the sun sets. But there are a couple of simple but important things we can do. When the sun hits a dirty, streaky windshield, there could be an elephant standing in the road right in front of us and we wouldn’t know it until the moment of impact. So that’s the first and most important rule this time of year: let’s keep our windshields squeaky clean, inside and out. That no-cost step will offer a massive improvement in visibility. Some older cars have so many tiny little pits in the glass from years of being struck by road grit that they’re almost like frosted glass in direct sun. Check with your insurance agent: replacing your windshield might also be a nocost fix. A workable sun visor and a good pair of quality sunglasses are two more excellent tools to protect visibility this time of year. Remember these letters: CG/MSD. They stand for Clear Glass Means Safer Driving. +

76 Circle K

Highland Ave.

o those letters — LS/MFT — look familiar or mean anything to you? During the 1950s and 60s they appeared on packages of Lucky Strike cigarettes. They stood for an ad slogan that promised “Lucky Strike Means Fine Tobacco.” We’re going to borrow those letters for this column and alter their meaning. For our discussion here, LS/MFT will mean “Low Sun Means Fateful Travels.” Not always, of course. But the potential for fateful travel goes up this time of year. Why? Many reasons, actually. In some parts of the country, roads are icy and dangerous. The sun sets early, and because of that much more driving is done in the dark, which has its own set of potential dangers But in every part of the nation, whether the temperatures are warm or cold, the sun is lower in the sky this time of year. Due to the Earth’s 23° tilt off vertical, it happens annually when we hit this particular segment of our orbit in space around the sun. The northern hemisphere is turned away from the sun by all of this, and the changed angle makes the sky smaller, which makes our days this time of year shorter. All this celestial stuff has a surprisingly significant effect on the safety of terrestrial traffic. For instance, during the long days of summer, most of us have been home for hours by the time the sun sets. Traffic isn’t particularly heavy around 9 o’clock on summer evenings. By contrast, today (that is, December 4) sunset occurs at 5:19 p.m. That means tens of thousands of drivers (millions nationally) spend their evening rush hour commute driving straight into the glare of the setting sun. As an illustration of how deadly this can be, a few years ago westbound evening rush hour traffic on I-20 entering Georgia was stopped due to an accident or construction. As drivers approached the river from the east, the sun

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The blog spot From the Bookshelf — posted by Uzma Khan, MD, on April 25, 2020

THE IMMENSE KINDNESS AND HUMANITY SURFACING FROM THE PANDEMIC It’s been a whirlwind of emotions during the last few weeks. I started in the hospital when our cases were starting to creep up. The fear. The anguish. The uncertainty. The anger. The sadness. The crazy dreams. The donning. The doffing. The decontamination process. This week, I signed three death certificates (non-COVID), and I sent two patients to ICU (one COVID). Needless to say, I came home every night feeling sad and powerless, knowing this COVID-19 beast has us pretty defenseless. We are trying some therapies, but nothing is showing dramatic or rapid improvement enough to gain FDA approval. (Editor’s note: this column was written in late April.) The patient I sent to ICU stayed there for over two weeks and was finally released. I was privileged to have a telephone follow-up appointment with her. She was extremely thankful to the rest of the hospital staff and me. She choked up and started crying, and naturally, I started crying too. Relieved she lived to tell the tale. Scared for how many will not make it. Grateful to be appreciated. As we settle into the new “normal,” I realize that I cannot control coronavirus. I cannot control what the government does or doesn’t do. I cannot control the people who want to mingle around in public or open businesses up early. What I can control is who I am during this crisis. I can control what I want to take away from this. I can figure out how to adjust my purpose, so I can continue to serve my community. Aren’t you seeing immense kindness and humanity surfacing from this crisis? I certainly am, and I cannot express the depth of my gratitude. So on the tails of an emotional few weeks, I am grateful for a somewhat “simple” life with fewer distractions. I am grateful for all the FaceTimes and Zooms with family and friends. Human connection is so incredibly important during a time of crisis. I’m grateful to serve my community. I’m grateful to the patients and community who are finally realizing that most physicians truly give their blood, sweat, and tears to our craft and our patients. I’ve never been more proud to be a member of this amazing and inspiring community. Please continue staying home and staying safe. This, too, shall pass. +

This too shall pass.

This is not a new book, but its relevance could not be greater if it had been written and published last week. Its author has a unique set of qualifications: he is both a physician and a historian. He writes that people often are struck by the differences between his two occupations, but in his mind they are nearly one and the same. As a clinician, a major part of his job is taking patient histories. “When did this symptom begin?” is the most basic start of a history, but a history can quickly evolve into how parents and grandparents (and beyond) sometimes factor into the complaints of the patient he’s currently examining. While this book purports to be (and is) a history of efforts to deal with epidemics (typhus and cholera) that struck New York City in 1892, it takes a fascinating look at the surprisingly ancient history of quarantines, extending long before even the brightest scientific minds had the slightest ideas about germs and disease transmission. Another aspect of the history of quarantines

covered by Markel that reaches far beyond the squalid Lower East Side epicenters of disease in 1892 is the unfortunate history of quarantines “as [the] medical rationale to isolate and stigmatize social groups reviled for other reasons.” While that doesn’t seem particularly relevant to the current pandemic, it is nevertheless a theme in quarantines down through history to point the finger of blame at “the poor, the alien, or the disenfranchised.” What does ring a bit of a bell in 2020 is the groundswell of support in the 1890s to quash immigration and the unrestricted flow of “undesirables” and all the

Note: This book was awarded the Arthur Viseltear Award for Outstanding Book in the History of Public Health in the Medical Care Section from the American Public Health Association. 1st edition hardcover copies are available on Amazon for $930.35, or in paperback for $28.00. Your choice.

Quarantine!: East European Jewish Immigrants and the New York City Epidemics of 1892 by Howard Markel, 280 pages, published in 1999 by Johns Hopkins University Press

BINGEREAD

Uzma Khan is a hospitalist.

NOW HEAR THIS! You can read the Examiner any time at www.AugustaRx.com (the current issue) or at www. issuu.com/medicalexaminer (for issues going back through January of 2012) .

diseases, real or perceived, that they bring across borders with them. The irony of that popular public opinion in the 1890s was that many of its proponents were recent immigrants themselves. Despite these forays into the more esoteric elements of quarantine, this book offers its history from the point of view of those involved in New York City in 1892 — the public health doctors who diagnosed and treated the victims, the newspaper reporters who covered the stories, the government officials who established and enforced policy, and, most importantly, the immigrants themselves. +

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The Examiners

DECEMBER 4, 2020

THE MYSTERY WORD

I can’t WAIT until we don’t have to wear masks anymore!

by Dan Pearson

When that day finally comes, I’m going to do something I haven’t done in almost a year. What?

Ditto times infinity!

You know, I’m kinda sorry I asked.

Trim the hair in my nostrils.

The Mystery Word for this issue: SNUGL

Simply unscramble the letters, then begin exploring our ads. When you find the correctly spelled word hidden in one of our ads — enter at AugustaRx.com

EXAMINER CROSSWORD

PUZZLE

19 23

We’ll announce the winner in our next issue!

E X A M I N E R

27 29

34 39 42 45

54 58

S U D O K 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.

QUOTATIONPUZZLE

31. Consumed 33. Band from 23-A 34. -tology prefix 35. “Female beginner” (Fr.) at a formal (informally) 36. Spider 37. Vigorous in manner (Music) 38. Didn’t need ER treatment 39. Celestial 41. They’re often removed 42. Prolonged unconsciousness 44. Sponge___ Squarepants 45. Abounded (with) 46. Jennifer from Summer of ‘42 47. Booke of The Dukes of Hazzard 48. _____ of Verailles 50. Recluse 51. Male duck 52. Edible tuber 57. Grand ___ 59. Gone by

4 7 2 9 3 5 8 1 7 E6 5 T3 9 A2 1 8 6 4

1 8 6 4 2 9 7 5 3

— Oscar Wilde (1854 — 1900)

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once. Black squares indicate spaces between words, and words may extend onto a second line. Solution on page 14.

Solution p. 14

Use the letters provided at bottom to create words to solve the puzzle above. All the listed letters following #1 are the first letters of the various words; the letters following #2 are the second letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.

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

R 1 2 3 4

W 1 2 3 4 7

’

1 2 3 4 — Bill Nye

1 2 3 4

1 . M Y W Y S K E E D 2 . V I V E N O O O O 3 . N E E E M U U L O 4 . W E LT T R R 5 . S T Y 6 . O H 7 . N I 8 . N E 9 . G

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

20 21 22 ACROSS 1. _______ sample 25 26 6. Number of freedoms listed by Roosevelt in 1941 28 10. Make tea 32 33 14. Dried plum 35 36 37 38 15. Gimpy 16. Son of Jacob and Leah 40 41 17. Opposite of 13-D 43 44 18. By mouth 19. Capital of Yemen 49 50 51 20. Choose 52 53 21. Swing around (var.) 23. B-52’s home 55 56 57 25. Walter L. _________ 60 61 27. Raises, as a question 63 64 28. Unrestrained power 29. Early breast cancer by Daniel R. Pearson © 2020 All rights reserved. detector (abbrev.) 30. Extinct flightless bird 62. Lace protector 32. Author Harper 63. Smell 33. Regret 64. Palmetto troopers (abbrev.) 34. Boulevard that becomes 65. Hard candy (Brit.) 13th St. 35. Ike’s middle name DOWN 38. Cozy room 1. Temp. regional tax 39. Twill-weave fabric 2. WInners can get one 40. Sportscaster Andrews 3. Expulsion 41. Male cat 4. Strokes in a Masters ace 42. Mongrel dog 5. Diminished 43. Catch 6. Like hands making bread 44. Type of snake 7. Paddled; rowed 45. Highest 8. Kill Bill star 49. Ascending and 9. Backslide descending body part 10. Lethargic feeling 51. Deportment 11. Savior 52. Pulsates 12. Vespers 53. Bring up 13. Opposite of 17-A 54. Before in poetry 22. Brunswick element 55. Prolific poet? 24. Lower digit 56. Mosque prayer leader 58. Monetary unit of Nigeria 26. Name still found on some old bumper stickers 60. Shine partner? 29. Round bread roll 61. Thurmond, for example

WORDS NUMBER

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, DEC. 14, 2020

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6 4 9 3 5 7 1 2 8

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DECEMBER 4, 2020

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

o the person who stole my glasses: I will find you. I have contacts.

The baby blue whale is the 2nd-largest baby in the world, right after people who are still complaining about wearing masks.

13 +

The

Advice Doctor

Moe: Have you started holiday shopping? Joe: Yeah, I got a PlayStation 5 and some games for my brother. Moe: I know your brother, and that’s not a bad trade.

Moe: As if 2020 wasn’t bad enough, I heard that orthodontists are planning a national strike in 2021. Joe: We’ll have to brace ourselves. Moe: Did you know they don’t let players wear glasses in football? Joe: No, I didn’t. How come? Moe: Because football is a contact sport.

Moe: I will never go back to that psychologist again! Never! Joe: What happened? Moe: The whole reason I went in the first place was to overcome my fear of palindromes. Joe: So? Moe: Are you still working on that crazy project Moe: So that jerk put me on Xanax! to improve fitness for insects? Joe: I don’t think it’s a crazy idea, but it’s not A mom bought her son a pet hamster after going too well. he promised he would take care of it. Mom, of Moe: So are you going to give up? course, ended up doing everything. Joe: No, I’m still trying to work out the bugs. One evening, exasperated, she asked him, “Do you know how many times that hamster would have died if I hadn’t been taking care of Moe: How do you turn a penny into a dollar? it?” Joe: I give. How? After a moment of thought, the boy replied, Joe: Cut it into four quarters. “Uh...once?” Moe: What do you call an Egyptian doctor who Patient: Doc, I think I’m addicted to Twitter. helps people with back trouble? Doctor: Sorry, I’m not following you. + Joe: Probably a Cairo-practor. Moe: You know those signs that say Falling Rocks? Joe: Sure. Moe: Well, it doesn’t.

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 boyfriend and I were watching a movie on Oxygen last weekend where this poor woman’s psycho ex-boyfriend continually harassed her for several years. She got more than one restraining order against him, but every time he violated it and she called police, they would just tell him to leave. Shouldn’t they have arrested him each time? — What Is the Rule Anyway? Dear What Is the Rule, As a physician you can rest assured I have watched many movies on oxygen as part of my training, plus hearing dozens of lectures. Without this vital substance life is not possible. Oxygen is a fascinating substance. Although the chemical element oxygen on the periodic table is simply O, you probably remember from school that it is often written as O2. Why? Oxygen comes in a number of different forms, which is no surprise considering how abundant it is: it’s the third most abundant element in the universe, after hydrogen and helium, and the second most common element in Earth’s atmosphere. Different forms of elements are known as allotropes. Oxygen, for example, is usually thought of as a gas, but liquid oxygen is one of its allotropes. When two oxygen molecules bond together, the result is the aforementioned O2, a colorless, odorless gas necessary for life. But if a third molecule bonds with the first two, the result is another allotrope: ozone (O3), a deadly, poisonous gas with an acrid, pungent smell not unlike the smell of chlorine gas (the word ozone actually comes from the Greek verb for smell). Imagine a one-ingredient recipe for something delicious and nutritious that calls for 2 cups of flour, but if you add a third cup, the mixture turns deadly. That’s the weirdness of oxygen versus ozone. Of course, another amazing thing about oxygen is the way plants produce it through photosynthesis. When we inhale it, blood rushing non-stop through our lungs instantly unloads waste gas it’s carrying (carbon dioxide) and picks up lifesustaining oxygen. It’s practically a miracle, yet it’s one that occurs in each of us some 20,000 times every day. That’s 20,000 daily reasons to protect our precious lungs. I hope I answered 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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Why read the Medical Examiner: Reason #145 BEFORE READING

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AFTER READING

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3 9

9 6 7 5

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

...cleverly hidden just below the man’s goatee in the p. 8 ad for PARKS PHARMACY

THE WINNER: AMY MAGYAR! 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 4, 2020

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED S P L O S T

T R O P H Y

O U S T E R

D A V E R I B A G C O T H R A N O R I S O D O

O L N E E S S P E A N L E I D N B L O O B N E R

F L O L U A R N Y E D T O O A N S I M L A S L

O U R B A M E L R A L A E A T H D P O S B S E R U E D E N S E M C U R T O P M D E M E A R E A R A M N A K E A G E D L O

R E D E E M E R

E V E N S O N G

W I N S

O N E I L L

S O R R E L

T R E A T Y

A T E

SEE PAGE 12

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

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

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

7 1 6 4 8 5 3 9

4 9 3 5 7 1 2 8

3 8 9 1 2 6 4 7

6 2 7 8 1 4 9 5

1 7 5 9 4 3 6 2

5 4 2 3 6 8 7 1

QuotatioN QUOTATION PUZZLE SOLUTION Cynics know the cost of everything and the value of nothing. — Oscar Wilde

WORDS BY NUMBER Everyone you will ever meet knows something you don’t.

— Bill Nye

READ EVERY ISSUE ONLINE WWW.ISSUU.COM/ MEDICALEXAMINER

DECEMBER 4, 2020

MEDICALEXAMINER HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS

DECEMBER 4, 2020

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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

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IN-HOME CARE

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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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DE-STRESS… from page 9

the body’s perception of pain and trigger a positive feeling. It is also a great way to stay healthy! Consume a diet rich in fruits, vegetables, whole grains, lean proteins, healthy fats, and adequate fluids to keep the body functioning at peak levels. Last but certainly not least, make sure to get enough sleep. This is the time the body uses to recover. The CDC & National Sleep Foundation recommend adults aged 18-60 get at least 7 or more hours of sleep per night, and adults over 65 get 7-8 hours. Life is busy, but the body will appreciate carving out sufficient sleep time every night. Next, lets discuss emotional tactics. Try to maintain a positive attitude and accept that there are things in life that cannot be controlled. Be assertive rather than aggressive, angry, or passive. Set clear boundaries and learn how to say no to requests that will only add more stress to the plate. To combat anxiety and restlessness, try organizing, planning, and learn to manage time more effectively. Making lists and budgeting are great ways to become more organized. Lastly, let us highlight some ways to manage mental stressors. Do not rely on alcohol, tobacco, or drugs to ease the mind. Instead, enjoy hobbies, nature, or draw on social support by spending time with friends and loved ones. If these methods do not provide relief, seek treatment with a psychologist or other mental health professional to learn more specific, individualized methods of dealing with stressors. The holidays are in full force, so stress less this season by channeling some of these effective stress management techniques to optimize health and happiness!

DECEMBER 4, 2020

GOLDEN MILK Health Benefits: • Powerful anti-inflammatory properties • Rich in antioxidants • Can hep relax, wind-down before bed

Ingredients: • 1 cup of full fat coconut milk (1 cup of almond milk or another type of dairy free milk can also be used, but will need to add a 1 teaspoon of fat for better absorption such as almond oil, coconut oil, or ghee) • ½ teaspoon ground turmeric powder • 1 big pinch of freshly ground black pepper • 1 big pinch ground cardamom • 1 big pinch ground cinnamon • 1 small (1/4 inch) piece of ginger root peeled & grated (optional, more or less to taste) • ¼ teaspoon raw honey added after heating (optional for sweetening) Instructions: • Mix all ingredients together, then gently warm on the stove over medium heat for about 15 minutes. Let gently simmer but do not boil. For a frothier drink, blend all ingredients together in a high-speed blender. Serving Size: • Serves two (1/2 cup per serving) Sources: https://www.mayoclinic.org/healthy-lifestyle/stress-management/ in-depth/stress-symptoms/art-20050987 https://my.clevelandclinic.org/health/articles/11874-stress https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341916/ https://www.sleepfoundation.org/articles/ https://www.cdc.gov/sleep/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/ https://www.elizabethrider.com/how-to-make-golden-milk-recipe/

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John Cook,

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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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