Medical Examiner by Daniel Pearson

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orry to have to tell you this, but that hostage to the right? That’s you. I know, it might not look exactly like you, but trust me, that is definitely you in the picture.

Here’s the situation. You have been kidnapped. You are being held hostage. The ransom demands are a little unusual, but they seem doable. Your captors are clear about one thing, however: if their demands are not met you will die. They explain what they want. They’re not interested in money. There will be no appeal to an outsider to come to your rescue; whether you live or die is entirely in your hands. Here’s where it gets weird. They say all you have to do to earn your freedom is bang on a drum. Are they serious? That’s it? They assure you they are quite serious: bang on the drum and live. Stop, and death will come swiftly. One of them roughly takes off your gag. “Any questions?” he asks. “Yes,” you say. “You’ve kidnapped me just to let me go after I bang on a drum? That makes no sense. What is... What’s the catch?” “Ah, the catch,” says your captor with a sinister grin. “There is always a catch, isn’t there?” He replaces the gag over your mouth. “The catch,” he says as he retightens it with a sudden jerk, “is that you have to beat the drum without letup. If you want to live you cannot stop, not even once.” He slides in front of you a drum you hadn’t even noticed was in the room. He unties one of your arm restraints and hands you a drumstick. “It’s really very simple,” he says. “Just beat this drum, and at this time tomorrow you can go free.” He leans down right in front of your face. “Do you understand what I just said? You have to beat the drum continuously for 24 hours... starting,” he makes an exaggerated show of looking at a large clock on the wall. “Starting right now.” INTERNATIONAL UNIFORM

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This is no joke Everything goes okay for the first hour, but your arm soon begins to tire. You try to tell the kidnappers you need a break, but they can’t understand you. You cannot convey the message that you need the gag removed so you can ask for a break, or simply the chance to switch to your other arm. Gradually you begin to realize the ridiculousness of the situation and the insanity of their demand. You’re being mistreated, yet you’re doing what they want? Why? Finally you decide to protest. You simply stop. Your expectation is that there will be some angry words, but they will lead to negotiations and your freedom. That’s not what happens. Two of the strongest men immediately rush you with menace on their faces. One brutally knocks you to the floor, the other chokes you until you start to black out. You’re shocked to see how malicious they are. Obviously they fully intend to kill you. Your hand frantically gropes for and finds the drumstick and you again begin beating the drum, which fell over when you were knocked to the ground. As soon as they hear the drum beat start again they back off. Slowly you begin to recover from their attack and keep the beat with renewed determination. Even so, the prospect of doing this simple task throughout the day and on into the

FEBRUARY 15, 2013

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Editor’s note: Healthcare is a whole new ballgame with the passage of the Patient Protection and Affordable Care Act (PPACA). How will healthcare providers be affected? What about patients? And how about employers who provide health coverage as an employee benefit? How will Medicare and Medicaid recipients be affected? Look to this column for the answers.

HEALTHCARE REFORM & YOU by Russell T. Head, CBC, CSA

VOTE

ho is the best doctor in our area? We hereby announce a search for that person, and a perpetual quest at that. Our invitation to vote is not one of those once-a-year propositions; it’s a never-ending poll beginning today. We have no ballot. We’re not looking for the man or woman who gets the most votes. The winner might get just one vote, because here’s what we’re looking for: not just that Dr. J. Doe is the best, but exactly why J. Doe, M.D. is, in your view, the best doctor in this corner of the world. We’re looking for a doctor who went (or goes) above and beyond the call of duty in service to patients. So we’re not looking for your votes in dozens of categories: Best Female Pediatrican, Best Male Pediatrician, Best Left-Handed Veterinarian, Best Bespectacled Ophthalmologist, Dentist With the Best Smile, and so on. We simply want to know who you say is great — and why. We have no idea what kind of response we’ll get from readers on this, but we would like to recognize these outstanding physicians often, perhaps quarterly. This program will evolve as we go along, but we’ll do our best here at Medical Examiner world headquarters to make this something area physicians can be proud of, that their patients will be aware of, and that will also bring some rewards to the patients who bring this all to light for us. Just drop me a line via mail or e-mail. Those addresses are in the box that’s on page 3. Be sure I have the information to contact you in return. Thanks in advance! + — Dan Pearson Publisher

THE MONTHLY Q & A

change has been made at the Federal level that I want to make note of. On January 24, the Department of Labor (DOL) announced that employers will not be required to notify their current and future employees with a written notice regarding the Affordable Care Act (ACA) by March 1, 2013. The DOL expects that the compliance date will be in the late summer or fall of 2013. This time frame will coordinate better with open enrollment dates for group plans. Any future announcements regarding the new date will be shared Russell Head in this column. In the last issue Private Healthcare Exchanges were summarized. The following Questions and Answers will further explain some of the ins and outs of this outlet for employee benefits and individual coverage. Q: What is a Private Healthcare Exchange? A: Private Healthcare Exchange is a private business that is typically operated by an insurance company or an insurance brokerage firm. It sells insurance products such as health, life, dental, supplemental coverage and vision through an online website. A consumer can shop within the exchange from a wide variety of insurance carriers offering a full complement of benefits. Think of it as a store where you shop for health insurance all in one location. Q: Why would I choose a Private Exchange over the Public Exchange? A: Because the Private Exchange offers much more than just health insurance, a consumer who wants to purchase additional coverage such as dental or disability can do this in the Private Exchange environment. The Public Exchanges will initially only be

offering medical plans. Employees may also be able to take advantage of purchasing a plan through the individual health insurance market but still have it partially funded by their employer with pre-tax dollars. As stated in the previous Q & A, Private Exchanges are run by private industry where Public Exchanges are run by a state or the federal government. Georgia & South Carolina Public Exchanges will be run at the federal level. Q: Are the health plans the same in both the Public and the Private Exchanges? A: Since Private exchanges offer so many plans underwritten by so many carriers, it is likely that the same plans will be available on both purchase platforms. A Private Exchange may also offer plans at a lower cost than the same plan elsewhere. Q: When will Private Exchanges be available for small business? A: Many Private Exchanges are online now. Generally speaking, large employers such as Sears and Darden Restaurants have been accessing them. As small employer’s health plans are renewing, carriers are presenting them with large rate increases, many are looking at the Private Exchange as a very attractive option to implement significant savings for their checkbook and the employee’s costs as well as the opportunity to allow employees to buy what they need. + Russell T. Head is a Partner and Chief Visionary Architect with Group & Benefits Consultants, Inc., Augusta’s largest, privately held employee benefits consulting firm. He can be reached at 706733-3459 or rthead@gandbc. com. Visit Group & Benefits Consultants at www. groupandbenefits.com.

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FEBRUARY 15, 2013

FUTURE DOCTORS ASK CURRENT DOCTORS

How do you know if someone is faking? from Madison M., 4th Grade, Martinez Elementary

ou know, this is a question a lot of parents ask themselves when their children seem to get mysteriously sick on the same day they have a big test at school. I’m sure you have never done this, and are just asking an innocent question. (Do you have a big math test coming up next week???) The body is a wonderfully tuned machine with a variety of ways to make sure it can react to all sorts of events. One key way that the body fights illnesses is by developing a fever. This means that the body is going into high gear to mobilize its full array of defenses to fight off infection. Whenever the body gets an infection there are elements in your blood that are specifically designed to fight it, to stop it from getting worse and making you even sicker. This defense mechanism is often associated with fever – and fever is one pretty good sign that you really are sick, not just trying to get out of that math test. Another way to tell if someone is really sick is to look at the color of their skin. If you have an infection and have a fever, your skin will feel hot. It will also look like it feels – it will look flushed. This is due to your blood travelling to the surface of your skin in an attempt to reduce your fever.

You may also be sweating due to your fever. This is another way the body works to try and get your temperature down. You may also have a rapid heart rate – again, this is another sign that your body is working harder to fight off the infection. When you come to your doctor, they will look for all of these signs. They will take your temperature, measure your heart rate and examine you very carefully. They may take some swabs from your throat (yes, these do make almost everyone gag) or a sample of your urine. They may draw some blood or take some X-rays as they look for signs of infection. They will ask if anyone else in your family is sick. And they will help make you well again. + Written by the physicians of Pediatric Partners, with offices in Evans and Augusta. They can be reached at 706.854.2500 and at www.pedpartners.com. TEACHERS! PARENTS! Send us your kids’ questions, whether they’re in high school, kindergarten, or somewhere in between. Mail them to Dan@AugustaRx.com or to Ask the Doctor, Medical Examiner, PO Box 397, Augusta, GA 30903-0397

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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 were diagnosed with a dreaded disease, 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 encounters with the medical profession as often as we receive them. + 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.)

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www.AugustaRx.com The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of news within every part of the Augusta medical community. Submit editorial content to graphicadv@knology.net Direct editorial and advertising inquiries to:

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Opinions expressed by the writers herein are their own and their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., or its agents or employees take any responsibility for the accuracy of submitted information, which is presented for informational purposes only. For specific medical advice, diagnosis, and treatment consult your doctor.

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Hope IS Possible

Haters: 21st century adult bullies

Helen Blocker-Adams

ullying has become more prevalent today than ever before. Unfortunately, deadly violence associated with bullying is the norm. Back in the day, a punch in the face or a kick in the shin while fighting in the schoolyard was the extent of violence and bullying. Today juvenile courts are filled with youth who have brought weapons - guns and knives - to school... and those are kids who simply are trying to protect themselves. Bullying means “to use superior strength or influence to intimidate (someone), typically to force him or her to do what he wants.” Another definition is “intentional aggressive behavior. It can take the form of physical or verbal harassment.” There is another term that’s become well known over the years and can be heard during

arguments, read on Facebook pages, or heard over the radio airwaves: Haters. Also known as 21st Century adult bullies. One can define hate as “to feel hostility or animosity toward,” “a feeling of dislike so strong that it demands action.” A hater might be someone “having anger towards everyone reaching success.” Notice the similarities between the two words, bullying and haters. Adults are bullied and experience haters today. The late Rodney King was famous for asking, “Can’t we all just get along?” But how does one deal with a hater? How do you stop it? Where does it come from? How can someone hate when they don’t even know the person? I believe the modern day form of adult bullying is from “haters.” Have you been a victim of someone who harbored such disdain for you that nothing good came out of their mouth toward you? Or what about name-calling by people who have never met you or had a conversation with you? Why do people hate? There are so many reasons. Discrimination, prejudice, jealousy, because you are different, you don’t think like the other person, and the list goes on and on. To hate is ugly. Very, very ugly. Haters and those who bully

are cruel; there’s no other way to say it. No one is too old or exempt from being bullied or experiencing a hater. I’ve experienced it and you probably have too. Personally I do not think it will go away. Human imperfection and our sinful nature is the reason. The word hate can be found in the book of Genesis – the beginning of time. God knew there would be haters. Jesus experienced haters in the cruelest sense of the word. Jesus demonstrated to us clearly and vividly how to deal with the haters and bullies too. There are examples of that throughout the Bible. How we deal with haters and bullying will determine how it can be overcome. Last week I watched, for the first time, a show on USA Network called “NFL Characters Unite.” It focused on four NFL superstars who experienced haters and bullying first hand. The program was riveting, honest, inspiring and made me proud. It shared how these football players rose above prejudice and discrimination. Baltimore Ravens player Jameel McClain as a kid was homeless and lived at The Salvation Army. He sometimes wore dirty shoes and clothes to school and was ridiculed. The program matched him up with a young boy named Jessie who is experiencing the same thing in his life. Jameel told Jessie that “if you are on the ground, if you can look up, you can get up.” The New York Giants’ Justin Tuck is from a small town in Alabama where he said there were more cows than people. He was bullied, called ugly names, was called a goodie two shoes – all because he chose to excel in school more

than most kids his age. It was not “cool” for a black kid from Alabama to want to pursue an education. As he talked with a young man named Sebastian who wrote an essay to Justin’s foundation (The RUSH Foundation) on the bullying he experienced, Justin was touched by the young man’s words. Justin introduced Sebastian’s favorite author, Jason A. Spencer Edwards, to him and he was ecstatic. He read his essay to the entire school body and received a standing ovation. You see, other boys were also experiencing bullying but they were afraid to tell. Justin said “haters focus on people who are doing something right.” Pittsburgh Steeler Troy Polamalu was adopted in the 4th grade in Southern California. Kids made fun of his funny name. On the USA program he was matched up with a family of girls who experienced similar situations. They felt unimportant because they were different. Troy taught them that different is good and should be cherished. He showed them that music can help people cope with bullying. He also let the girls know that they are not alone and do not have to feel alone. Philadelphia Eagles player Larry Fitzgerald’s mother had cancer and died in 2003. He experienced people being cruel to his mother because of how she looked. He told a young girl named Natalie, who had brain cancer, that people would wipe the handle on the door if they walked behind his mother. Natalie was discriminated against because she looked different. Larry uses photography as a way to cope and express

himself and showed Natalie how to do the same thing. I really hope this particular issue of NFL Characters Unite comes on again because it’s a must see. The common theme on how these NFL players dealt with haters and bullying was that they focused on something positive, productive and satisfying. They didn’t try to retaliate or use anger toward people who were ugly toward them. They focused on finding their passion and winning despite the odds, no matter what. They didn’t focus on what other people had to say about them. All of them are using their experiences, along with their sports celebrity status and money to help others who have been or are victims of haters and bullying. Wow, that’s powerful. A Facebook friend of mine sent me a video the other day about how someone addressed the subject of haters. Katt Williams, a stand-up comedian with a rather crude mouth, I would say, said this: “You need haters – that’s their job. What do you think they wake up for?” Now that is one way to look at it, isn’t it? There are several websites that address bullying and here are three of them: www.stopbullying.gov, www.thebullyproject.com., and www.childworks.com. + Helen Blocker-Adams is Executive Producer/Host of “The Helen Blocker Adams Show with Co-Host Sammy Lilly”, which airs Monday through Thursday 1 p.m. – 3 p.m. on 103.7 FM/1600 AM WKZK The Spirit. She is also Founder of Unlikely Allies Emerging Leaders Conference. You can contact her at hba@hbagroup-intl.com or visit her at www.helenblockeradams.com

If you don’t know something’s impossible, it’s easier to do .

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FEBRUARY 15, 2013

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW ABOUT WHAT WE MIGHT KNOW

ifteen hundred years ago, everybody knew Earth was the center of the universe. 1,000 years ago, everybody knew the Earth was flat. 500 years ago, everybody knew man would never fly. 200 years ago, everybody knew man would never go to the moon. 100 years ago, everybody knew that if you got pneumonia and were fat, you had a 90% chance of dying within the month. 100 years ago, everybody knew that if you had “sugar” (country shorthand for sugar diabetes) you would die within a few years. 50 years ago, everybody knew that if a middle aged woman had pain in all four body quadrants and no other physical signs, she was a “crock” who just wanted attention.

But now we know science has changed all that. The sun is the center of our solar system, which is only a minor part of the universe. Earth is round so you can’t sail off the end of the Earth. Man has walked on the moon. We even have pictures of Earth from the moon. Nowadays if you get pneumonia, most likely you will be treated at home with antibiotics and various inhalants. If you develop diabetes mellitus, you can eat healthy, take various pills and insulin shots, and expect to live for decades. Fibromyalgia is medically recognized and has 17 various points of pain scattered over all four quadrants of the body. It is more common in middle aged women and difficult to manage. All those things that were known to be true were not true. Just think how many things we know today that ain’t so. Think how time and research changes things. Some still cling to the poor thought that we should not have gone to the moon in the first place. They say it cost too much just to find out the moon was barren and dry and not made of cream cheese like the childhood fairy tales

GOT A STORY?

Best said. But had we not gone to the moon, we might not have computers, fiber optics, flat screen TVs, cell phones, microwave ovens, GPS in our cars and boats, arthroscopic surgery, cardiac caths, cardiac pacemakers, gamma knife surgery, cardiac defibrillators, laparoscopic surgery, birthday cards that sing, or laser light halftime shows at the Super Bowl. But all that progress comes with a heavy price. Our world population has ballooned to about 7,000,000,000 worldwide. That means we need much more food, water, medicine, buildings, clothing, transportation, and energy. It means populations become desirous of property and resources of others and try to get those resources however they can. That means more war, death, and famine. In the U.S. we set up a Social Security system to assist our seniors in their retirement. It was designed for a population

e n i c i d ME

to work until age 65, retire, and die with a few years. It was designed when the life expectancy was in the low 60s. Now the US life expectancy is in the mid 70s and quickly inching toward the 80s. The Social Security trust fund no longer exists. Instead, social security payments are a general obligation of the US Treasury. All that is well and good, as long as our workers pay in more than retirees take out. But with the ever increasing longevity in the US, that will lead to a short fall. That is another way of saying we will run out of money. So what can we do? We can’t take away the medical technology we have and cause life expectancy to decrease. No, we must depend upon science to produce new knowledge that will produce a healthier society who can and will continue working past age 65. We must develop new energy resources that can and will support a greater

production of food and goods at cheaper prices. Right now everybody knows that can’t be done. Let’s hope and pray that “fact” ain’t so, just like the seven bits of “common knowledge that everybody knows” listed at the beginning of this column. As one of my medical professors used to say, it is best to not so know so much, than to know so much that ain’t so. He also said that 80% of all inventions occurred in the past century. What we need is another century that exceeds the past century. I can’t wait to hear some of the things we know today turn out to be not true. Just remember, they once designed elegant city districts so that horses were only allowed on alternate streets because ladies did not like to step in or smell horse manure. But they never had to do that. Oil and cars made that not so. + Bad Billy Laveau is a retired MD with a pointed sense of humor. Bad Billy speaks and entertains at public and private events for audiences not subject to cardiac seizure secondary to overwhelming laughter and glee BadBilly@knology.net or 706306-9397

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Medicine in the First Person

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Adventures in Administration

HOSTAGE!… from page 1 night — all night — fills you with dread. Even so, you somehow manage to beat the drum non-stop on into the night. It was extremely difficult, but with about three hours left in your sentence of 24, you got a burst of energy as you realized you were going to make it. You had already been beating the drum for 21 hours. What was three more? With a half hour to go, your captors began to glance at the clock, then in your direction. You realize they never thought you’d make it either. With ten minutes left they gather around you. It’s the home stretch. Finally, one of the captors raises his hand and begins staring at the watch on his wrist. The final minute is counting down. Despite everything, a huge smile breaks out across your face. The captor with the watch, who seems to be in charge, kneels down before you. He looks at last from his watch to your face and a wide smile is splashed across his face too. “You did it!” he says. “Twenty-four straight hours. I never thought you could do it.” He seems almost proud. You stop hitting the drum and rub your arm and its throbbing muscles. The prospect of freedom is thrilling. You appreciate it as never before; you’ve been thinking about it more and more as the 24 hours have wound down. “Will you please untie me now?” you ask. “No,” the man says, standing up, the smile suddenly gone from his face. “Do another twenty four hours. Start now. Right now.” “What?” you cry. “I did what you asked. We had a deal.” “I will tell you now what I told you

yesterday: beat that drum like your life depends upon it.” He bends down until his face is right in front of yours. He slowly says, ”Because it does.” What is going on? All right, this charade has gone on long enough. We have a confession to make: the hostage pictured on page one isn’t really you after all. Sorry about that. But it is someone (or something) very near and dear to your heart. In fact, it is your heart. We went down this garden path together to make us all stop and think about what our hearts are doing right now — all day, every day; all night, every night, beating 100,000 times a day, give or take. And you thought it was tough beating a drum for one day? Ok, two days? If you’re 50, your heart has been doing this for 18,250 days. Right? Wrong! It started in the womb four months after you were conceived, not the day you were born. You’re getting close to 2 billion beats by age 50. Are you there yet? Or far beyond? There has never been a break for your heart, never a vacation day, not even a lunch break. Not one! Can we show the heart a little respect for keeping us alive to this point? It has earned everything we can do to help it do its job. See below (and page 7) for a few simple things that will help our hearts — and us at the same time. Oh, and if you’re wondering, the heart is like you in the story: it’s not getting a reprieve. It’s going to keep beating. That, after all, is the whole point. +

Looking for 10 steps you can Likes in all take to lower your the right heart disease risk places.

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FEBRUARY 15, 2013

AUGUSTA MEDiCAL EXAMINER

1. Quit using tobacco — period. No ifs, ands, or butts. 2. Avoid second-hand smoke by not allowing tobacco use in your home 3. Know your blood pressure. Have it regularly checked, and ask for specific recommendations from your healthcare provider based on your readings. If you check your blood pressure at home (it’s easy to learn how to do it), keep a record of it and bring it with you to doctor appointments. 4. With your doctor’s blessing, do aerobic exercises to strengthen your heart, not sporadically, but on a regular, scheduled basis. Walk briskly, ride a bicycle, swim, whatever works for you. Work up to 60 minutes a day, even if comes in little batches of five minutes here, ten minutes there. 5. Lose excess weight. Even a modest reduction in weight will reduce the workload on your heart and therefore your heart disease risk. 6. Manage stress. Learn to relax. Learn to control your anger and frustration. 7. Follow the DASH Eating Plan (get more information at www. nhlbi.nih.gov). Banish trans fats from your diet. 8. Ask your doctor if you should be screened for diabetes. If you have already been diagnosed as a diabetic, be a compliant patient and religiously follow your treatment plan. 9. Communicate with your doctor honestly if you have not taken your prescribed medications to control your diabetes, cholesterol, or blood pressure. 10. Nurture your heart with healthy emotions and positive, beneficial friendships. +

You’re fired! D

by Bill Atkinson

uring my 17-year tenure as CEO of St. Joseph Hospital I had three men work as my top assistant. They were Peter Monge, Philip Fontana and Vince Caponi. Their applications were similar in several ways. All were recommended for the job by the University of Michigan faculty. All came from mid-level positions in other hospitals. All were young and eager. All wanted a job in a Catholic hospital. All were seemingly good fits for the job. During their interviews I told each of them that they could grow in responsibility as they were capable. I promised to help them build a resume to further their career. One of my greatest satisfactions as CEO was the opportunity to prepare subordinates for bigger positions. Over the 17 years, eight members of my staff went on to become organizational CEOs. Peter was the first. I saw Peter recently. We reminisced about his time at St. Joseph. He was bright and eager, always wanting more authority. Peter would tell you about a time going through the food line where he got the inspiration to ask me if he could manage the kitchen. When I casually responded positively, I think he was stunned. One day when I must have been in a teaching mood I suggested to Peter that maybe he would like the experience of applying for a job. Ha! Once the world found Peter he was gone, much to my dismay and that of his parents who had moved to Augusta to be near him and his young family. Vince Caponi also was bright and eager. He stayed on after I left St. Joseph to become CEO. Then the Daughters of Charity found him and now he is the CEO for the Daughter’s presence in the state of Indiana. Vince is still working with the Daughters. He has a big job. Two of my best decisions during my career were to hire Peter and to hire Vince. One of my worst decision was to hire Philip. That decision is high on my list of career failures. Philip was a pharmacist before going to Michigan. After graduation he went to a major hospital in Chattanooga as one of its many assistants. His credentials looked strong and his boss gave him high marks. I hired him. He started off just like Peter and Vince but somehow what I was telling him was not sinking in. On top of that I could sense unrest among his staff. Bless them, for none of them complained. They just toughed it out. After about four months, during which time Philip and I had several private discussions, I decided something had to be done. The difference between how he wanted to do things and how I wanted them done was just too great. I talked to some of my colleagues about how I could have made such a bad decision. I remember what Hulett Sumlin, then president of Piedmont Hospital (Atlanta) said, “I would be happy with a 70% batting average in picking people.” After just four months I fired Philip. Consistent with my philosophy of placing the responsibility for failure on management, I recognized that something had gone awry with my selection process. I had failed. Firing a person was never pleasant. As usual for me, the decision was non-negotiable. I saw no value in discussing details. I simply called Philip in and told him that we were philosophically different and despite efforts to bridge the gap, it was not working. I told him to clear his desk. I remember him saying that my method was like the movies, i.e. “you’re out of here.” I guess so. I told him that he was not doing what I wanted yesterday, so why should I think it would be different tomorrow? Yes, he was gone. My understanding is that Philip went back to pharmacy. I have hurt many people as a direct result of some of my decisions and hurt myself for what I have done. I was not immune to being fired and experienced it three or four times. I apologize to Philip Fontana and pray, like me, he ended his career pleasurably. + Bill Atkinson is the former CEO of Trinity Hospital (then St. Joseph Hospital), and the author of the comprehensive 2009 Medical Examiner series on the founding of the Augusta area’s major healthcare providers.

FEBRUARY 15, 2013

Don’t Lick the Beaters

doctor on a regular basis. 10. Have a support system – family/friends/support groups.

and other interesting food facts

by dietetic interns with University Hospital’s Augusta Area Dietetic Internship Program

THE FIX FOR THE 7 DEADLY SINS

t’s that time of year again! February is National Heart Health month! Yay! A yearly reminder that we need to take care of our heart so our heart can take care of us! Unfortunately, it’s also a reminder that we, as a nation, are not yet getting the message. Heart disease is still reigning champion as this country’s number one killer, claiming a life every 40 seconds. That’s just unacceptable! We must do better! We can do better! With that, it’s time for a refresher course in heart health behaviors and nutrition. I know what you may be thinking, “Geez, haven’t we already covered this information, over and over again?” No doubt we have. However, over my years working with heart patients I have found that this information needs to be reviewed, refreshed, and renewed at least once a year in order to initiate or maintain heart healthy behaviors. As the saying goes, “Practice makes …. permanent.” That’s right. Permanent. As in, the more you practice healthy behaviors, the more permanent those behaviors will become. Let’s begin. Topic: Risk Factors for Heart Disease and How to Fix Them #1: Smoking The fix: Stop smoking. Now. Not next month. Not next Christmas. Now. There are plenty of methods out there: cold turkey, nicotine replacement therapy, meditation, hypnosis, behavior therapy, and smoking cessation programs. Find what best suits your needs and lifestyle and don’t give up. Quitting smoking is HARD, but it is not impossible, and the health rewards of quitting start immediately. #2: Lack of physical activity The fix: Do something…

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anything! Get off your buttocks and M-O-V-E! That goes for your kids too! Aim for at least 30 minutes of moderate activity per day. Moderate activity means a brisk walk (3.0 mph or greater), water aerobics, bicycling, gardening, doubles tennis, ballroom dancing, whatever you enjoy and can and will do. Do more exercise for added benefits. If you have never exercised before, be sure to check with your physician before beginning an exercise program. As an added benefit, physical activity will help with many of the other heart disease risk factors: weight control, diabetes, high blood pressure, cholesterol, stress. Exercise is medicine! #3: Overweight/Obesity The fix: Common sense weight loss: eat less, exercise more. What goes in must not be more than what goes out. Simple rule. Try it. If your Body Mass Index (BMI) is greater than 25, you may need to lose some weight. To calculate BMI, divide your weight in pounds by height in inches squared (56” x 56,” for instance) and multiply by 703 (the easy way: go to the BMI calculator at the cdc.gov site). Sensible weight loss of 1 to 2 lbs per week is recommended. No fad diets or crazy supplements are needed here. Visit a registered dietitian for an individualized plan or go to MyPlate.org to get basic information. Online apps such as MyFitnessPal (it’s free!) can help keep you motivated to maintain weight loss programs.

If you don’t have diabetes, don’t get it. Maintain a healthy weight (BMI < 25), exercise, and eat healthy.

#5: High blood pressure The fix: Follow these 10 commandments. 1. Lose excess weight 2. Exercise regularly 3. Eat healthy – more fruits and vegetables, whole grains, lean proteins 4. Reduce the sodium (salt) in your diet. Your limit is 2,300 mg per day unless you’re over 51 years of age, are African American, have high blood pressure, diabetes, or chronic kidney disease. If you fit in any of those categories, you should have no more than 1,500 mg of dietary sodium per day. 5. Limit alcohol consumption: no more than 1 drink per day for women of all ages and men over 65 years of age and no more than 2 drinks per day for men under 65 years. One drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor. 6. Do. Not. Smoke. 7. Decrease caffeine intake. 8. Manage stress levels. 9. Monitor blood pressure levels at home and visit your

#6: High cholesterol levels The fix: Proper diet, proper exercise, stop smoking. Let’s take these one at a time. 1) Proper Diet – Choose foods with healthier fats like those found in olive, peanut, vegetable oils. Limit saturated fats like those found in fatty meats and high fat dairy products. Eliminate trans fat found in fried foods, storebought cookies, pastries, crackers, snack cakes. If you see the words “partially hydrogenated oil” in the ingredient listing, it has trans fat. Drop it and run! Limit dietary cholesterol to less than 300 mg per day. Organ meats, egg yolk, and high fat dairy are sources of concentrated cholesterol. Eat more high fiber whole grains and increase your fruit and vegetable intake. The fiber found in whole grains, fruits, and vegetables can help lower cholesterol by absorbing cholesterol and removing it from the body. Additionally, fruits and vegetables have many heart protective properties and may actually “turn off” the gene that predisposes one to heart disease. Eating foods that contain omega-3 fatty acids (salmon, herring, sardines, anchovies, trout, mackerel, walnuts, almonds, ground flaxseeds) can help lower your LDL (“bad”) cholesterol. Lastly, foods that contain plant sterols or stanols can help block the absorption of cholesterol and may decrease LDL cholesterol by at least 10%. Look for added plant sterols/ stanols in fortified margarines, orange juice, and yogurt drinks. 2) Proper Exercise – Regular physical activity has shown to improve blood cholesterol levels by increasing HDL cholesterol (your “good” cholesterol).

3) Smoking cessation – Quitting smoking may help increase your HDL cholesterol. #7: Poorly managed stress levels. The fix: Healthy coping skills. Stress hormones constrict blood vessels, cause the heart to beat faster, and increase inflammation that is part of the atherosclerosis (plaque building up in arteries) process. Avoid drugs and alcohol to alleviate stress. Seek support from family, friends, counselors, clergymen, or anyone that can lend a sympathetic ear. Be sure to stay socially connected and don’t isolate yourself from the outside world. Be altruistic. Doing something for someone else can help take your mind off of your stressors and can put things into perspective. Lastly, take care of yourself: exercise, eat right, sleep right, treat yourself to a massage, find quiet time, and maintain a normal routine. That concludes our yearly refresher course in Heart Healthy Living. Hopefully, you will have learned something new. Maybe this information has given you the motivation to change any unhealthy behaviors. Or, perhaps, this refresher course left you saying, “Yes, I am on the right track to heart healthy behaviors. I am doing it!” Put these suggestions to use and practice them so that they may become permanent in your everyday living. “Practice makes permanent.” May your heart be healthy. Class dismissed. + by Susan Fanning, University Hospital Dietetic Intern References: Centers for Disease Control and Prevention; American Heart Association; NIH Heart Lung, and Blood Institute

#4: Diabetes. The fix: If you have diabetes, keep your blood sugar in control by following your diet, taking your medications, and exercising.

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Around town: • Barney’s Pharmacy, 2604 Peach Orchard Rd. • Birth Control Source, 1944 Walton Way • ASU Student Bookstore • Blue Sky Kitchen, 990 Broad Street • Columbia County Library, main branch lobby, Ronald Reagan Drive, Evans • Enterprise Mill (North Tower), 1450 Greene Street, Augusta • Daniel Village Barber Shop, Wrightsboro Road at Ohio Ave. • Hartley’s Uniforms, 1010 Druid Park Ave, Augusta • International Uniforms, 1216 Broad Street, Augusta • Marshall Family Y, Belair Rd, Evans • Mellow Mushroom, 12th and Broad Streets, Augusta • Southside Family Y, Tobacco Road, Augusta • Surrey Center, Surrey Center Pharmacy, Highland Avenue, Augusta • Top-Notch Car Wash, 512 N. Belair Road, Evans • Wild Wing Cafe, 3035 Washington Road, Augusta

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FEBRUARY 15, 2013

AUGUSTA MEDiCAL EXAMINER

Very little if anything about healthcare is inexpensive, and that includes medicine. Tiny pills can command large prices. Over-the-counter medications may be less expensive, but are they also less effective? Find the answers to lots of your drug store questions in this column written by Augusta pharmacists Chris and Lee Davidson exclusively for the Medical Examiner.

LET’S SOLVE THOSE NASAL SINUS ALLERGIES

iving in the southeast can be daunting for those with allergies, but rest easy. There is help out there. Many natural remedies for allergies as well as some medications are available to help with allergies and the sinus congestion that accompanies them. So let’s look at what causes sinus congestion from common allergies and then go over a few remedies, some proven, some controversial. Everyone has sinuses behind your nose as well as in your cheeks and forehead. These are air-filled pockets lined with a thin film of mucus. Tiny hairs constantly move the mucus and other particles that have found their way into your sinuses. When a particle to which you are allergic finds its way into your nose, a reaction occurs causing the mucous membranes in your nose to swell and block the sinuses from draining. This causes a backup of mucus resulting in sinus pressure and pain. Avoidance of common allergy triggers can be an important first step in reducing nasal and sinus problems. Common triggers include pet dander, dust mites and pollen. A simple way to avoid some of these allergens is a dust and allergy mask when cleaning or when outdoors in pollen or dust if you think you might be allergic to the pollen that is in the air. Maintaining a smoke-free environment is also important to good nasal and sinus function. The easiest natural remedies for sinus problem are to keep the air you breathe moist and warm. Pick up a humidifier at your local drugstore and use it at night so that your bedroom air stays moist. Moist air reduces the irritation caused by dry air. Another helpful tip is to breathe in steam two to four times a day. This can be accomplished by sitting in the shower and breathing deeply the steam from a good hot shower. The other way to do this is to use a vaporizer instead of a humidifier and get the good steam at bedtime. When treating a cold or congestion, a vaporizer can be used with inhaled medication to help open sinuses and relieve congestion. Nasal irrigation is another good way to naturally relieve congestion by flushing out thickened mucus and allergens. The technique is to lean over a sink and force a sterile saline solution into one nostril (the top nostril), through the sinuses and out the

other nostril. Devices can be purchased at your pharmacy to irrigate your sinuses. These include saline bottles, bulb syringes, and a device called a neti-pot. The irrigation solution can be purchased pre-made or in packets to be made at home with sterile water. A solution can also be made at home with sterile water, salt and baking soda. The formula is a pint of lukewarm sterile water mixed with a teaspoonful of salt and an optional one-half teaspoonful of baking soda. The baking soda takes the sting of the salt out of the equation. Remember to keep your mouth open and do not breathe thru your nose when irrigating your sinuses. Hydration helps to keep muses thin so always keep your water or other noncaffeinated beverage intake at an adequate level. Beverages include juice or caffeine-free tea. Caffeine can lead to dehydration, which is the opposite effect of what is desired. Local honey (honey obtained from local bee hives) is a commonly touted natural remedy for allergy symptoms. The theory is that the bees incorporate small amounts of common local allergens into their honey and therefore consumption of the honey can have a therapeutic effect by providing a level of immunity to local allergens. While this is a popular thory, experts say it is not true and that the bees bring back flower pollen and not the pollen of common allergens. Either way, honey has enough good value for the average person that I feel it falls into the “it can’t hurt to try” category. Medications include antihistamines, decongestants, and a product called Nasalcrom, which stabilizes the cells that end up bursting and continuing the allergic reaction cascade in your body. When these cells are stabilized they stay intact and the allergic reaction is stopped. Check with your pharmacist or physician about which of these over-the-counter remedies would be appropriate for you. And stay tuned to next issue’s article where we will review cold and cough medications. + Questions about this article or suggestions for future columns can be sent to us at cjdlpdrph@bellsouth.net Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson (cjdlpdrph@bellsouth.net )

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FEBRUARY 15, 2013

LET’S CTRL+ALT+DEL OUR MEDICAL RECORD SYSTEMS

n the U.S. healthcare system, “I.T.” still really only stands for “imagined technology.” At least that’s the indication from research published in last month’s issue of Health Affairs. The article, presented by researchers for the RAND Corporation, served as a followup to a 2005 publication in which researchers for the same company projected that wide adoption of Electronic Medical Records (EMR) and other forms of Health Information Technology could save the U.S. more than $81 billion each year. Yet, seven years later, those savings have not remotely been realized. Still, the researchers insist that the technology is there and that the only things holding us back are shortcomings in their design, implementation, and use. Numerous factors contribute to this great disparity between what is possible and what has been realized. For starters, it’s

easy to point out that while EMR has grown significantly since its inception in the 1960s, the majority of providers have resisted the transition. The researchers identified that only 40% of physicians and 27% of hospitals use EMR. Of the providers that do, many choose a system, not out of true satisfaction with the concept, but to take advantage of shortterm advantages such as the $44,000 offered to healthcare providers to make “meaningful use” of EMR by 2014 under the American Recovery and Reinvestment Act of 2009. It’s hard to blame the others who continue to resist. Choosing a car to buy may very well be an easier decision than which service of EMR to go with. Countless systems exist, each with different methods of operation that require physicians and staff to attend classes or spend some serious time with a

manual. Additionally, these systems can cost several tens of thousands of dollars for a private physician to set up. Even more, after that money is spent, there is no guarantee that a new system will not leave this one obsolete, or that future government regulations may designate it worthless. Perhaps even more alarming, though, is that even where EMR practices have been enacted, the quality and efficiency of patient care has improved only marginally. These results and others have led this particular writer to believe that the only answer is a single system. A single system solves each of the problems mentioned in the preceding paragraph, and others. There would certainly be dissidents, and providers would take issues with some features. That’s inevitable with any system. However, a single system would serve patients and providers optimal benefits through compatibility and, hopefully, better patient engagement. One of the biggest existing problems is that records are not compatible from provider to provider. For example, even providers who do make effective use of EMR within large medical organizations—such as the Department of Veteran Affairs or Kaiser Permanente—possess seemingly useless information Please see EMR page 10

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if a patient seeks care outside of their network. Just imagine, as a patient, what unified records could do for you. No more need for providing ame, address, emergency contact, allergies, immunizations, medications, past medical history and more at every single stop of the healthcare transit route. Providers, imagine the usefulness of having a complete medical history at your fingertips as soon as the patient enters your doors. Systems such as these exist in other countries with far better healthcare systems than the US, and have for years. One such example is France. Not only is their system universal, but the same system also controls billing for the providers, with no administrative assistance necessary. The concept isn’t a new one to the French, either. This cutting-edge arrangement was established in 1998. Another necessity for this system is patient involvement. For starters, patients have to see them. Polls have shown that over 90% of patients believe that their records should be fully accessible to them. Yet, few take the time to review them when offered. One study claimed that when such an opportunity was presented to patients, only 42% of them chose to access the records and more than half of those only accessed them once. Much of this is due to the perception that records aren’t easily navigable for patients. Imagine if the one system had sections that were easy to understand, user-friendly and aesthetically pleasing to the patient. Imagine a health page that operated as easily as Facebook. It’s very possible that patients might be more compliant and more aware of their health with such a system. The system could allow them to update information as well. After all, one could readily see that many patients might prefer to enter sensitive information, such as drug use or sexual history, into their private and secure portfolio rather than bring it up in a personal conversation with their physician. The possibilities are nearly endless. Many of the potential benefits remain unimagined. But the technology is there. Hopefully, seven years from now, we’ll have learned to use it a little better. + Ross Everett is a 2nd year medical student at the Medical College of Georgia. He grew up in Buford, Georgia and graduated from the University of Georgia in 2011. In addition to his coursework, he is very interested in health policy, health systems and health management. Please contact him at wideeyedwhitecoat@gmail. com and “Like” him on Facebook at Wide-Eyed White Coat.

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The blog spot — Posted Feb. 9, 2013 at head-nurse.blogspot.com. (Edited)

LOUD CHEERS! (FOR SEVERAL REASONS) Doctor Annoyance is going away. I don’t care where or when, though I know when it will be, and believe me, it’s not soon enough: he’s going away. Doctor A has been a thorn in my side now for longer than I care to consider. He’s one of those doctors--you know, the ones who can’t find a phone number on their own, or who ask you stupid, unimportant questions in the middle of a crisis, or who think they’re being cute when what they’re really being is totally off the chain and for God’s sake will you just TAKE IT DOWN A NOTCH ohmygawd how many times do I have to tell you. . . .Anyhow, he’s going. And with him goes another colleague--one so toxic (as the kids say) that I didn’t know how much my work life was being affected. I wrote a piece t’other day for Scrubs about toxic workplaces and nasty, poisonous coworkers. I hadn’t connected that bit of writing with anything that was going on in my own precious unit until now. Turns out I was speaking more truth than I had ever imagined. For the last two years, my daily life’s been made unpleasant by somebody who can’t see the good in anything. Swear to Frog, if this person won the lottery, patented a device to reverse global warming and remove pollution from the air, and cured cancer, all in one afternoon, there would still be bitching. Some people are never happy, and this is one of those folks. And they’re leaving. Cue my happy-dance. They’re leaving, and they’re taking Doctor Annoying with ‘em, and for the next week, I am going to be blissed out and just smiling like a fool.

“ Some people are never happy. ”

In other Hooray news, I have a confession to make: a sexist, horrible, awful confession: There is some serious eye-candy happening in my unit these days. We got a new crop of residents in as part of the half-year switcheroo, and although I know most of them, there are a few lovely strangers to gaze upon. (Yes, yes, I know. They’re all young enough to be my children and they’re professionals and so on and so forth, but dayum.) HR has also given the go-ahead to hiring what seems to be America’s/Australia’s/Canada’s/ Backobeyondistan’s Top Model candidates for the night shifts, and all of ‘em are orienting, in succession, to the NCCU. Aside from a I-will-always-say-something-stupid moment when I tried to guess where one of the newbies was from (I guessed Ireland; turns out the correct answer was New Zealand), things have been going swimmingly. Not only are these guys--because they’re all male, and what’s up with that?--easy on the eyes, they all came in knowing what three-percent saline is for and how to do an NIH stroke scale exam. They’re all experienced.They’re all certified. All I’ve had to do the last three weeks is show ‘em where the coffee machine is, tell ‘em how to access the computers, and turn ‘em loose. This is in contrast with what I’ve been doing lately, which involves equal parts babysitting, computer training, and hand-holding. Is there an asteroid due to hit soon? Because, if there is, I want to open my mouth as wide as possible and show it my tonsils before I get blown to cinders. And therein lies the last Hooray bit of news: my two-and-some year’s checkup was clean as a whistle. I’m tempted to deck out an IV pole with streamers and fake flowers and ride it around the unit, waving like Queen Bess at everyone. +

From THE Bookshelf If you’ve read the blog spot in this issue, you’ve seen the comment made about people who are so steeped in pessimism and negativity that nothing seems to penetrate their bitter shell. Enter The Antidote. Oliver Burkeman’s book says it is, well, the antidote for people like that. As you can see, it’s subtitled, “Happiness for people who can’t stand positive thinking.” In fact, earlier versions of this book included these words on the cover: “... detox for the self-help junkie.” Yes, if you have to fight your gag reflex every time you see a smiley face or hear some syrupy maxim that dismisses one of the world’s thorniest problems in six words or less, this could be your book. Burkeman argues that our relentless “pursuit of happiness” — where have we heard that phrase before? — lies at the very root of the unhappiness problem. He takes the counterintuitive approach: happiness may well come from acknowledging insecurity, pessimism, failure, and uncertainty, to name a few things. Care to debate him on that?

Before you sign up for that, let us take stock of what we have been looking to for happiness: stuff. Material possessions. Excessive recreation; living for the weekend. Autonomy; loosing the bounds of Victorian — or even 1950s — morals. Plunging into careers to the exclusion of family. Severely scaling back work to focus on family. None of it has worked for millions of people who still chase after happiness like the elusive carrot dangling just out of their reach. But again, is seeking happiness so overtly actually

acting — here comes that word again — counterintuitively? Stare at someone and tell them not to smile. You’ll get a smile within seconds every time. Tell someone they will be happy if they buy the latest gadget, move to the current trendy neighborhood, lose ten pounds, date (or marry) some luscious eye candy, sire 2-point-3 lovely children and buy a vacation time share and, well, they just might not wind up being very happy. Then again, they might be deliriously happy. It’s all about attitude. It’s hard to imagine our ancestors of one or two hundred years ago being overly concerned with happiness as a destination. They simply focused on living, and if they managed to do things reasonably well, happiness was a pleasant byproduct. Today we seem to think happiness itself is the ultimate goal. That, in the words of Teddy Roosevelt, is like trying to nail jelly to the wall. +

The Antidote by Oliver Burkeman, 257 pages, published November 2012 by Faber & Faber/Macmillan

the

Clipping File Not just what. It’s also when. The claims by some that eating late in the day is a factor in weight gain are nothing new — the closer to bedtime one eats, the more grave the dietary sin, goes the conventional wisdom — but many researchers have long said that a calorie is a calorie is a calorie, no matter what time of day. Better wait before we carve that in stone. In a study just published in The International Journal of Obesity, researchers from Harvard and elsewhere report on their study of 420 overweight men and women in Spain over the course of a 20week weight loss program. Split into two groups, each group followed a similar diet with similar caloric intakes and expenditures, got roughly the same amount of sleep, and were confirmed as equal in two key hormones (leptin and ghrelin) that play a key role in appetite. The one significant

difference, reports The New York Times, was when they ate their main meal of the day, lunch. In European fashion, one group ate lunch before 3:00 pm each day, the other group after 3:00. Twenty weeks later, the late eaters had loss considerably less weight than their early counterparts. They also showed lower insulin sensitivity, a risk factor for diabetes. While timing may not mean a lot, says the Times, it does appear to be a factor. What are you looking for? A more appropriate question is, exactly what are you looking for? (Strict grammarians, please send hate mail to the address on page 3.) Exactly is a key word, because in many situations we’re likely to find only what we’re looking for. Like the Beatles’ song Nowhere Man: “He’s as blind as he can be, just sees what he wants to see.” Have you ever been searching for something in a cupboard

that you thought had a red label? Because it actually had a blue label, you couldn’t find it, even though it was right in front of your eyes. Turns out some physicians have experienced the same problem. You’ve heard of people who can’t see the 800-pound gorilla in the room? Well, researchers superimposed an image of a gorilla onto images that radiologists were told to examine for the presence of cancerous nodules. (See the same image they saw on the Medical Examiner blog: www. AugustaRx.com/news). If you know anything about radiology, reading images is tricky. They can see things you and I can’t, just in the slightest variation of color. Well, 83 percent of the radiologists in the study missed the gorilla, reported NPR. The implications for researchers are enormous: what is not seen that’s sitting there in plain sight because we’re looking for something else? +

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THE EXAMiNERS +

Man, I’m so sore.

FEBRUARY 15, 2013

AUGUSTA MEDiCAL EXAMINER

by Dan Pearson

I got mugged. Guy punched me right in the solar plexus. When was this?

What’s wrong?

Last night So wouldn’t that have about midnight. been your lunar plexus?

EXAMINER CROSSWORD

PUZZLE

19 20 21 ACROSS 1. First name of 42-A 22 23 24 6. Triangular sail 25 26 27 28 29 30 9. Post-mortem instructions? 13. Entertain 31 32 33 34 35 14. Method 36 37 38 15. Great Lake 16. Easy on the ears 39 40 41 18. Sea eagle 42 43 44 19. Endure (Scottish) 20. Donkeys 45 46 47 21. Competed 48 49 50 51 52 53 54 55 22. Little devils 24. Vital follower 56 57 58 25. Baby’s sock 59 60 61 28. Ancient Jewish tradition (var.) 62 63 64 31. Avril in England by Daniel R. Pearson © 2013 All rights reserved. Built in part with software from www.crauswords.com 32. Dish of raw vegetables 33. Mr. Turner 34. “Within” prefix DOWN 36. Tulip planting areas 35. University department 1. Hairless 37. Cavalry sword head 2. Giant of Nordic mythology 38. Cone source 37. DOD site 3. Trick 39. Black bird of South 38. Monogamy’s extreme 4. Inflammation of bone America opposite 5. Born 40. Banks of Chicago 40. Nightmare street 6. Creator of 52-A 41. Two-toned bearlike 41. National standard 7. Doing nothing mammal 43. WJBF’s George 8. The Secret Life of ____ 42. Last name of 1-A 44. Two-masted sailboat 9. Cotton archenemy 44. Capital of Burma 45. Seaweed; algae 10. Hydrating/rinsing 45. Tic 46. Former Alaska governor 11. Cloth woven from fl ax 47. Do no... 47. Moves like most birds 12. City in northern England 48. Songbird 49. Heroic poem 14. Type of production? 49. Equip; fund 50. Emperor of Rome 54-68 17. Neck back 52. Nano player 51. IV 23. Gibson or Brooks 56. Potpourri 53. Baby ICU 57. Bewilderment, confusion 24. Unhappy 54. Of the ear 25. Ali’s last name 59. Joy starter, sometimes 55. Unit of force 26. Fracture type 60. Ring-shaped optic 58. Trauma pt. destinations 27. Most of the time membrane 61. Toxic castor oil derivative 28. Mamie’s _____ 29. On sheltered side 62. New Age singer 30. Ingot 63. Policeman 32. Monte’s follower 64. Gravy; or insolence Solution p. 14

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 All Mystery Word finders will be eligible to win by random drawing. We’ll announce the winner in our next issue!

VISIT WWW.AUGUSTARX.COM TO ENTER!

Click on “Reader Contests”

QUOTATION PUZZLE C W T I

O E K D

N E W W A N G L A N E V E O H K

H O I I

H R I S S R A E E S T T S T R T O S H

— José Bergamin

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 only be used once. Black squares indicate spaces between words, and words may extend onto a second line. Solution on page 14.

6 7

X A M I N E R

5 3 1

4 5

3 1 8 7

7 1

4 6

6 3 2 3 5 6 2 1 4 7

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.

Use the letters provided — one per dash — to create words to solve the puzzle. All the listed letters following 1 are the 1st letters of each word; the letters following 2 are 2nd letters of each word, and so on. Try solving short words and entering unique and minimal choice letters (such as 5 thru 10 in this puzzle). A sample is shown. Solution on page 10.

1 2 3 O 1 2 1

1 2

A 2 3

’ 3 4

4 1

2 3

4 A 1

5 2

U 1 1 2 3 4 5 6 7 8 9 10 I 1 2 1 2 1 2 3 4 5

1.WGOBARACDTYY 2.HURANEOOOOO 3.IPIAUUNE 4.LUTTN 5.TGD 6.A 7.T

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

8.I

S 2

9.O

B 1

10.N

L 2

I 3

N 4

D 5

WORDS NUMBER

The Mystery Word for this issue: ARCHYPAM

THE MYSTERY WORD

FEBRUARY 15, 2013

13 +

AUGUSTA MEDiCAL EXAMINER

THE BEST MEDICINE ha... ha...

young boy, about eight years old, was at the corner Mom & Pop grocery picking out a pretty good size box of laundry detergent. The grocer walked over, and, trying to be friendly, asked the boy if he had a lot of laundry to do. “Oh, it’s not for laundry,” the boy said, “I’m going to wash my dog.” “You shouldn’t use this to wash your dog. It’s very powerful and if you wash your dog in this, he’ll get sick. In fact, it might even kill him.” But the boy was not to be stopped and carried the detergent to the counter and paid for it, even as the grocer still tried to talk him out of washing his dog. About a week later the boy was back in the store to buy some candy. The grocer asked the boy how his dog was doing. “Oh, he died,” the boy said. The grocer said he was sorry but added, “I

tried to tell you not to use that detergent on your dog.” “Well,” the boy replied, “I don’t think it was the detergent that killed him.” “Oh? What was it then?” “I think it was the spin cycle.” A history professor and an anatomy professor were sitting on a deck at a nudist colony. The history professor asked the anatomy professor, “Have you read Marx?” The anatomy professor replied, “Yes, I think they’re from the wicker chairs.” Patient: It’s been a month since my last visit and I still feel miserable. Doctor: Have you followed the instructions on the medicine I gave you? Patient: I sure have. The bottle says “keep tightly closed.” A woman was rushed to the hospital unexpectedly, and called to tell her husband. She asked him to bring her some items from home including “comfortable underwear.” Worried he’d make the wrong choice, he asked, “How will I know which ones are comfortable?” She answered, “Hold them up and imagine me in them. If you smile, put ‘em back.” +

OUR NEXT ISSUE: MARCH 1

Why subscribe to the Medical Examiner? Because no one should have to make a trip to the doctor or the hospital just to read Augusta’s Most Salubrious Newspaper.

The Patient’s Perspective by Marcia Ribble

eek Six post-knee. Since September 5th my life has been lived, primarily, within the walls of my little house. I get time out to go to rehab and to the doctor’s office. Wheee! Talk about excitement! Part of me is heading for all-out rebellion and the urge to drive the still forbidden car. Another part is urging me to be patient and not push the boundaries beyond what is safe for me and for others. Thank goodness the wild part of me is squelched by visions of my car careening insanely out of control on a busy local street. This vision is enhanced by an actual experience that occurred years ago in Salt Lake City after an ice storm left the roads down from the 5000 ft. tall sides of surrounding mountains to the valley at sea level below slick and dangerous. Ahead of me a much heavier car’s driver realized that he was losing control and slammed on the brakes. The kids and I watched as his car followed the rules of gravity and plummeted those 5000 ft. hitting every car, tree, stop sign and garbage can along the way. When it’s not happening to you, it’s kind of interesting to watch as every surface of his car hit every other surface and dented and crumbled and some parts like the rearview mirrors even fell off. Fortunately, the movement was occurring at an inexorably slow speed, so the man was in no trouble personally, but his car was fatally damaged beyond any hope of repair. I watched until he finally

Talk is cheap. Not talking can be deadly.

came to a stop at the bottom of the hill, put my Ford Escort into second gear and gingerly followed him, but not his path of destruction. I used to know the number of cars he smashed into, but that was over twenty-five years ago; however, think about a nearly five mile long and very steep hill with parking on both sides of the street, and you can imagine it with me. It made me really grateful for learning to drive a stick shift car on the hills of Grand Rapids, Michigan, and my instructor’s advice, “If you lose control on a hill, head for the snow bank.” Given that I no longer drive a stick shift car, and that I doubt very much that I’ll encounter any snow banks in Georgia, it makes sense to wait until the doctor clears me to drive, no matter how much I am suffering from cabin fever. + Marcia Ribble received her PhD in English at Michigan State and recently retired from the University of Cincinnati where she taught composition. She taught writing at the college level and loves giving voice to people who have been silenced. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.

+ +

SUBSCRIBE TO THE MEDICAL EXAMINER By popular demand we’re making at-cost subscriptions available for the convenience of our readers. If you live beyond the Aiken-Augusta area or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house! NAME ADDRESS CITY

STATE

ZIP

Choose ____ six months for $16; or ____ one year for $32. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

GRAPHIC ADVERTISING

Publisher of the Medical Examiner Proudly celebrating our 25th year in Augusta publishing, 1988 — 2013

+ 14

FEBRUARY 15, 2013

AUGUSTA MEDiCAL EXAMINER

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

...cleverly hidden (in the eyelashes) in the page 15 ad for ROGER M. SMITH, M.D. Congratulations to Ruth Wesbey, who scores a $20 Wild Wing Cafe gift certificate, two free movie passes courtesy of Health Center Credit Union, a free Top Notch Car Wash gift card, and for coffee drinkers, a jar of Drug of Choice gourmet coffee. Win this stuff! The new Mystery Word is on p. 12. Start looking!

The Celebrated MYSTERY WORD CONTEST ...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then be the first to 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: gift certificates from Wild Wing Cafe, Top Notch Car Wash, and movie passes from Health Center Credit Union! 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. 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.

The new scrambled Mystery Word is found on page 12

SENDING US A CLASSIFIED? USE THE FORM BELOW AND MAIL IT IN, OR GO TO WWW.AUGUSTARX.COM AND PLACE & PAY CONVENIENTLY AND SAFELY ONLINE. THANKS!

EXAMINER CLASSIFIEDS townhome. 2 master suites, like new, end unit with extra parking, single garage, covered patio, $125,000. 706-799-0394

HOMES, APARTMENTS, ROOMMATES, LAND, ETC. FOR SALE Brand new contemporary townhome/end unit in The Vista on Hwy 1, minutes from MCG. 1450 sqft. Two bdrm, two baths, office. Walk-in closets, lots of upgrades. Hardwood throughout, custom tiled kitchen/bathrooms. Floor to ceiling windows, pristine condition. Ready today. $125K - OBO. 803-5078991.

SERVICES FULL-SERVICE MOVER Anthony’s Professional Moving, 28 years serving the CSRA moving hospital equipment, offices, homes, apartments, etc. Estimates are FREE. Call 706.860.3726 or 706.814.8141

WEST AUGUSTA Two bedroom townhome, quiet & clean units close to ASU, GHSU and hospitals. $645/mo. Call 706951-3598.

CAREGIVER Let me help you with your loved one. 24 hour care, very reasonable. Call 706-738-0851

HOMESBYOWNER.COM Buy • Sell • Rent Apartments available 706-564-5885

CNA IN-HOME CARE I assist with daily activities, prepare meals, light housekeeping, grocery shopping, doctor’s appts. I will meet you to discuss your specific needs. Call 706-833-9787

LAWN SERVICE Commercial, residential. Call Vince: (704) 490-1005

11112

1.1.13

TOWNHOME Great location, everything new, 2 master suites, sunroom, all appliances. $98,000 (706) 504-4023 WEST AUGUSTA Luxury 3 BR / 2 BA Townhouse, 1-car attached garage located off Pleasant Home Road $725 /mo 706-228-4655 TOWNHOME 3 bedroom, 3 full bath

BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673) SPARKLING CLEAN Looking for offices to clean. No contract req. Husband & wife team have years experience and give FREE on-request estimates. Call 706.831.8552 or 706.831.8553

MISCELLANEOUS MATTRESS We have a Queen Pillowtop Set that is new and still in the wrapping $150 Call or Text 762-444-7615. CAREGIVER/COMPANION Need a ride to the doctor, store, etc. or someone to come in to visit and help you. Great References, reasonable rates. Call (706) 589-1698 or email msmagic4@yahoo.com.

GOT A CLASSIFIED? SEND IT IN TODAY! THE PUZZLE SOLVED

WHAT’S YOUR DRUG OF CHOICE? (OURS IS COFFEE)

Augusta Medical Examiner Classifieds

NOTICE! ATTENTION! If any current or past employer has failed to pay you min. wage or time and a half overtime pay, you may be entitled to an order from US Federal Court awarding you twice the amount of your unpaid wages plus atty. fees. For info, call Arthur H. Shealy, Attorney at Law, 803-278-5149, 1010 Plantation Rd, North Augusta SC 29841. You may be entitled to a similar award for unpaid wages if your employer required you to perform duties during your lunch hour, before clocking in, or after clocking out.

B A L D

Y M I R

R U S E

O S T E I B O O T A P R I B E D S A N I N E S P A S L A R K O L I O K I L L E N Y A

.75

1.00

1.25

1.50

1.75

2.00

2.25

2.50

2.75

3.00

3.25

3.50

3.75

4.00

4.25

4.50

4.75

5.00

5.25

5.50

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6.00

6.25

6.50

6.75

7.00

7.25

7.50

7.75

8.00

8.25

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8.75

9.00

(Copy this form or continue on additional sheet if more space needed.)

Send this form with payment to:

AUGUSTA MEDICAL EXAMINER, PO BOX 397, AUGUSTA, GA 30903-0397 Total ad cost by number of words as shown above: $

I R R I G A T P I A N N G M I P X I I C A U

L I N E N

L E E D S

E N D O

D E A N

O T I C

D Y N E

QUOTATION PUZZLE SOLUTION: Page 12: “In love it is the weak who strike and the strong who caress.” — José Bergamin

AD COPY (one word per line; phone numbers MUST include the area code): .50

W E E V I L

QUOTATION

In case we need to contact you. These numbers will not appear in the ad.

.25

J I B M O D E A B L E S S E S S S C A B A S A L A D A B E R N I E P O N Y A H A R N D O W E R P L E R I S R O P S

SEE PAGE 12

CLASSIFIED ADVERTISING FORM Name Address Work number (if applicable) ( ) Home phone ( ) Category of ad (leave blank if unsure):

N E E N A M P E E L S E R L S M E P I C

The Sudoku Solution

COFFEE IS GOOD MEDICINE VISIT DRUGOFCHOICECOFFEE.COM FOR YOUR REFILLS TODAY

Multiply by number of times ad to run: x

6 5 4 8 2 9 1 7 3

7 9 2 5 1 3 8 4 6

8 3 1 4 7 6 5 2 9

5 4 9 6 8 1 7 3 2

2 1 7 9 3 4 6 5 8

3 8 6 7 5 2 4 9 1

4 2 8 1 9 7 3 6 5

1 7 3 2 6 5 9 8 4

9 6 5 3 4 8 2 1 7

WORDS BY NUMBER “You can’t build a reputation on what you are going to do.” — Henry Ford

Total submitted: $

The Augusta Medical Examiner publishes on the 1st and 3rd Friday of every month. Your ad should reach us no later than 5 days prior to our publication date.

Thanks for reading!

www.AugustaRx.com

FEBRUARY 15, 2013

15 +

AUGUSTA MEDiCAL EXAMINER

The Money Doctor

Keep Your Tax Dollars Local and Impact the Life of a Child

icture yourself as a single parent; your child is in a classroom with more than 25 other students; you are working as hard as you can for your family but you have limited income, and your child is not excelling in the public school system. Up until several years ago, there were virtually no options for your child, and the dropout rate is hard to comprehend in this day and age (Georgia has a graduation rate a little over 65%). To make matters worse, the unemployment rate was over 13% for individuals 25 years and older without a high school diploma as of late 2011, according to calculatedriskblog. com. This compares to an unemployment rate just over 4% for those with a bachelors degree and higher. The process of getting a quality education and good study habits starts when a child is very young. We are fortunate in this area to have good schools. For most, public schools are a good environment to get a quality education. For some students though, they are not getting the specialized attention and instruction they need and experience shows they can perform at a higher level in a private school environment. It has been interesting to see the evolution of the Qualified Education Expense tax credit. Several years ago, the state of Georgia passed HB 1133. The

VOTE

intent of this law is to provide lower income families with the opportunity of giving their children a private school education if they are not reaching their full potential in public school. For making a contribution to a qualified student scholarship organization, Georgia taxpayers can receive a state income tax credit for up to $2,500 per couple and $1,000 for individuals. No amount is too small to contribute. The law also allows C corporations to contribute significantly more than this. Donors also receive a federal income tax deduction as a charitable contribution. In 2008, many individuals were skeptical. It sounded too good to be true. But in 2011 the full $50 million the law allocated was claimed by early November, and in 2012 the cap was reached in mid-August. It is clear that citizens want to direct a portion of their taxes to help educate children. If you would like this tax credit, make your contribution early in the year as some think the 2013 cap will be reached as early as May. The Georgia GOAL Scholarship Program is the leading qualified Student Scholarship Organization that administers the program. You can view their website at www.goalscholarship.org for a list of local schools, taxpayer filing guidance, and general information on the program. I just completed the “GOAL Paperless Process” on their

Today and every day we’re on a quest to find the Augusta area’s best doctors. Write us! E-mail us! Tell us who did what that was above and beyond the call of duty.

website, which takes less than a minute to complete. Heritage Academy is one of the schools in our area that is using this program to make a significant difference for our young people. According to Darlene Walters in the school’s development office, the average household income for students on GOAL scholarships is $18,500. 85% of students qualify for free or reduced lunch and over 60% are in single parent homes. With the annual tuition rate at Heritage at $6,000 per year, it is obvious many of these students would not have the opportunity to attend this great school if not for the GOAL scholarships and private contributions from our community. If you do not have the funds readily available, consider making an adjustment to your state income tax withholding in your paycheck so that you do not have to wait until you file your return. This is a great topic to discuss with your CPA over the next several months. As always, please consult with your CPA or advisor prior to doing this. If you are as skeptical as I initially was, that this all sounds a little too good to be true, I encourage you to do more research on the GOAL scholarship at their website noted above. Curious to know more? Arrange for a tour at one of the schools like Heritage Academy and see firsthand the impact these

scholarships are making (you can contact Darlene Walters at ha.augusta@gmail.com). I understand that this tax credit may be a little confusing to some, so please ask your CPA or email me at bwc@preston-cleveland.com. While I can’t give you specific tax advice, I will be glad to answer any general questions. Because only $51.5 million is allocated for this program (less than 1/2 of one percent of the state education budget), it is up to the local Augusta community to make sure we get behind this program for our local schools. If we do not, the funds will easily be claimed by many other schools and communities who have the advantage of a large alumni base. There is not much else I can think of that is better in life than having an impact on a child and providing them with the environment they need to learn and excel. Many of these students stand at the crossroads of two different paths in life. We now have the opportunity and ability to make a difference. + by Bill Cleveland, a Certified Financial Planner (CFP®) and CPA with Preston & Cleveland Wealth Management, LLC (www. preston-cleveland.com) in Augusta and Atlanta, GA.

OPHTHALMOLOGY

706.724.3339 820 St. Sebastian Way • Suite 5A • Augusta, GA • • Medical & Surgical Treatment • • Cataract Surgery •

+ I

M.E.

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ANNOUNCING THE MEDICAL EXAMINER

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+ 16

AUGUSTA MEDiCAL EXAMINER

FEBRUARY 15, 2013

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