Medical Examiner 2-3-23

Page 1

MEDICALEXAMINER

THE BEAT GOES ON

It’s American Heart Month, so for the next several weeks we’ll be reading stories about heart health and heart disease statistics and prevention and all other things heart-related. All month long our hearts will be beating, tallying an average of 100,000 beats a day for each and every one of us.

In fact, even when a heart is cut out of someone’s chest for a heart transplant operation (or an Aztec sacrifice, for that matter) it will continue to beat sitting in a pan awaiting placement in its new home.

Why? How? What makes the heart go lub-dub, lub-dub, lubdub all day every day — and all night every night?

It’s a hearty topic for our intermittent series called Body Parts.

Visit this handsome but unassuming building on Belair Road and you may experience the most unusual approach to medicine you have ever encountered.

As far as anyone at the Perfect Health Urgent Care Clinic knows, says Chris Woods, a PA at the office, it’s the only facility of its kind anywhere in the world. It wasn’t copied or borrowed from a concept already being used elsewhere.

Here’s how it works: patients drive up to the window at the right end of the building. They’re greeted at the window, somewhat fast food style, and that’s where the check-in process starts. A patient is handed either a clipboard to fill out their information, or a digital version can be sent instantly to their cellphone. They ease into a parking space and complete the digital or paper paperwork. Once it’s returned to the window, the patient is told to go to Door #5, for example. On the other side of that door is a regular exam room into which the nurse, PA or doctor will enter to provide treatment. When everything is taken care of, the patient walks back out to their car through Door #5 and goes their merry way.

What are the advantages? For both patients and a medical practice, they are numerous. Anyone who has spent an hour or two (or more) in a crowded waiting room in the company of perhaps dozens of sick, coughing, sneezing and wheezing people can appreciate the value of completely eliminating that part of a doctor visit experience. Nobody wants to get even sicker precisely because they went to a doctor to get better.

Another key benefit for patients is simple privacy.

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BODY PARTS: THE SERIES

PARENTHOOD

Your 8 year-old daughter has recently been falling asleep in school. Her teacher reports that she will usually nod off once or twice a day. You have already made sure she is getting enough sleep at night. What do you do?

A. Make her go to bed earlier even though she seems to be getting enough sleep now.

B. Take her to her pediatrician for a physical exam. Make sure the doctor knows what has been happening at school.

C. She may just be bored at school. Ask her teacher to give her more challenging work.

D. Have the teacher report to you each day, and take away some of your daughter’s privileges if she falls asleep at school.

If you answered:

A. If you have already monitored the situation and she is getting good sleep, it is unlikely that this will be the solution.

B. This is the best response. Falling asleep during the day when you are getting appropriate sleep at night could be a symptom of several disorders that would need to be addressed.

C. It is very unlikely that this would be the case. Not only is lack of challenge in school far less common than is thought, but bored children are more likely to get in trouble than to fall asleep.

D. Punishment is not going to help this situation. She is not misbehaving, she is falling asleep. That is almost the opposite. She needs to be seen by her doctor.

Many symptoms of disease are not immediately obvious as is a fever, a cough, or a rash. However, they are just as significant and potentially serious and need to be addressed.

Dr. Proefrock is a retired local clinical and forensic child psychologist.

MEDICAL MYTHOLOGY

THE ANTIBIOTIC MYTH

Antibiotics are one of the greatest innovations in the history of medicine, making cures possible for many of mankind’s worst and most long-lasting enemies.

Contrary to popular opinion, however, they can’t do everything, and the differences between what they can and cannot do are sometimes confusing.

Here’s a classic example: antibiotics cannot treat a sore throat, but they’re the perfect choice for strep throat.

What’s the difference?

Antibiotics work only against bacteria (germs), not viruses. A simple sore throat is caused by a virus, while strep is caused by a bacterial infection.

For the same reason, antibiotics are completely ineffective against COVID-19, which is caused by a virus. Having said that, a patient with COVID might receive antibiotics if they have some kind of bacterial infection on the side.

The magical reputation of antibiotics is such that their misuse and the resulting antibiotic resistance is a big

problem in medicine.

Let’s say someone has a bacterial infection and they are prescribed an antibiotic and told to take all of the pills as prescribed. That might be a 7-day course of treatment. But after three days or so, they feel great and decide to save the pills for their next infection, saving the cost of a doctor visit and another prescription (or so they think).

What happens instead is that they have not killed off the infection by cutting short their treatment. The surviving bacteria are now antibiotic-resistant (the old “whatever doesn’t kill me makes me stronger” syndrome). The next time the patient uses that very medication, its effectiveness will be mysteriously educed.

In another common scenario, the person who took the 3-day regimen instead of the 7-day course generously offers his leftover pills to a friend or family member who has a cold, the flu, or a runny nose, all common viral infections. In other words, antibiotics will be completely ineffective against them.

Meanwhile, antibiotics can actually kill perfectly harmless or even beneficial bacteria. Curiously, harmful bacteria can, in effect, “learn” survival techniques from harmless bacteria that survives an antibiotic treatment and passes along its drug-resistant properties.

The key to the curative magic of antibiotics is simple: take them exactly as prescribed and only as prescribed. Good health to you.

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privacy is a major benefit. Not only does no one hear your conversation with the medical receptionist — which can sometimes be full of private details about the reason for your visit — but you don’t have to hear the same details from other patients either, or their conversations while they wait, whether on their cell or with other waiting patients.

From the standpoint of a medical practice, notes Woods, the absence of a traditional waiting room removes a germ incubator that staff members don’t have to be exposed to either. Keeping patients from having to spend time in such a room helps keep them healthier too.

“It’s a major space that we don’t have to build, furnish, heat and cool all year round, or clean and sanitize throughout the day,” says Woods. “It means a smaller building can be just as efficient, so a smaller lot can be suitable and construction costs can be lower.”

The concept may seem to be a logical response to pandemic-era infection control, but it was actually conceived well before anyone had ever heard of COVID-19, the brainchild of Dr. Troy Coon, one of Perfect Health’s founding physicians.

The office has only been open for a few months, and time will tell if the concept catches on elsewhere, but Perfect Health staffers say the feedback from patients so far has been overwhelmingly positive.

The only problem is, it’s so new that an accurate description of it hasn’t yet been hatched. What would you call this method of healthcare delivery?

Drive-thru medicine isn’t quite accurate, and drive-up is not exactly a good description either. So what is it? Room Service Medicine?

WHAT’S THE DIFFERENCE BETWEEN URGENT CARE AND THE EMERGENCY ROOM?

There are major differences that sometimes confuse patients, especially in those hectic moments after an injury occurs.

Urgent care might be considered the middle ground between a family doctor and the ER. Their hours might be longer, offering treatment on weekends or evenings. Sometimes they’re staffed by nurses, nurse practitioners and physician’s assistants. Some specialize in specifics like sports medicine, but most offer a limited but still extensive menu of treatment options. They are not a fullfledged emergency department, but they can be a great option for minor cuts and burns, sprains and simple fractures, flu symptoms, rashes, etc.

An ER, by comparison, is open 24/7. Wait times and costs will likely be greatly increased, but the level of treatment is heightened too, and is exactly what is needed for serious conditions like compound fractures, seizures, major lacerations, uncontrolled bleeding and more.

There are situations like chest pain, stroke, heart attack, and shortness of breath where the ER is definitely the place to go but you don’t want to drive yourself or the patient there. Call 911, which offers the advantage of emergency care on the way to the ER. +

Suite Spot Healthcare? Private Prompt Care or Private Access Health? Personal Space Medicine?

If you come up with something accurate yet concise and catchy, let them know at Perfect Health.

Maybe they’ll give you a free appendectomy or something.

SHORTSTORIES

LAST WORDS I was working in a long term care facility in the 90s. We had a patient named John who came in with a terminal disease. The staff all loved this man. He was so kind and his wife of over 60 years attended to his every need. We quickly became close to this family. I wasn’t working his hall the evening he died, but all the nurses were aware it was going to be on our shift and were checking on him and helping his nurse as much as we could. During night med pass,

another nurse and I walked into his room where his nurse was by his bedside. He was obviously taking his last breaths and his sobbing wife was crying, “John, come back, don’t leave me!” Time and again he would visibly pull himself back, trying to live. His silent lips were forming the word “love” as he tried to tell her one more time he loved her. We nurses stood there with tears streaming down our faces. It’s one of the few times I have cried in a patient’s room. After he died,

IS FOOD DELIVERY SAFE?

Food delivery has gone from non-existence to a huge industry that is offered locally and nationally. Food can be ordered from around the corner or around the world, but all of it needs to arrive safely.

It not usually a issue with non-perishable items (unless mice got into a box during shipment or something), but it can be a big deal with food kits or restaurant meals. Ideally, local orders should be made for a delivery time when someone will be home. When placing orders, confirm delivery time, and don’t be shy about inquiring about their food safety practices during delivery. For instance, do drivers make multiple deliveries on each run? If so, some orders could be in someone’s hot car for an hour or more. Hot foods should arrive hot; cold food should arrive cold. If you can’t be home when a delivery is scheduled, find out if a neighbor can refrigerate your food until you return, or arrange for the delivery to made at your place of work. If you’re ordering from someplace you haven’t used before, the above questions are especially important, and maybe even their guarantee or return policy might be good to know. Speaking of returns, no matter how much something may have cost, if a return or a refund isn’t possible, throwing food away that doesn’t look or smell good, or has been sitting unrefrigerated for more than an hour or two (depending on ambient temps) is way cheaper than food poisoning or diarrhea.

The other big dog in food delivery these days are food kits from national suppliers. Presumably, national firms have their food safety and packaging act together, including dry ice to keep frozen things frozen as they should be.

his wife sobbed harder than I thought humanly possible while we tried to get our act together and do what needed to be done. Thank God it was close to the end of the shift. Professionalism is attending to other patients without any sign that someone died, let alone that your heart was broken.

The next day we realized each one of us had to pull over at least once on the way home because we were crying too hard to drive.

Anytime I think of the power of love, I think of John and his wife. The memory is bittersweet and haunts me to th is day.

Instead of problems upon arrival, the potential snags with food kits can start when the box is opened. Keep frozen things frozen until it’s time to cook them. Once food prep begins, like a good chef, start by washing your hands and making sure food prep surfaces are clean. Avoid cross-contamination: don’t cut up raw chicken or seafood on the same surface you’re using to slice carrots for salad, Follow recipes carefully, not cutting corners on time or temperature. Buy a good quality food thermometer to ensure foods are cooked to a safe temperature. They come in handy for the backyard grill too.

AUGUSTAMEDICALEXAMiNER 3 FEBRUARY 3, 2023 + + PERFECT… from page 1 Opinions expressed by the writers herein are their own and/or their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., nor its agents or employees take any responsibility for the accuracy of submitted information, which is presented for general informational purposes only. For specific medical advice, diagnosis, and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2023 PEARSON GRAPHIC 365 INC. www.AugustaRx.com The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of salubrious news within every part of the Augusta medical community. AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397 (706) 860-5455 www.AugustaRx.com • E-mail: Dan@AugustaRX.com TMMEDICALEXAMINER www.Facebook.com/AugustaRX 461 Greene Street at 5th • www.gregleopardlaw.com • 706-724-7511 GREG LEOPARD PC ATTORNEY AT LAW CRIMINAL DEFENSE • FAMILY LAW • PERSONAL INJURY He just looks friendly. Your fierce defender +
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Who is this?

THE BEAT from page 1

Keeping the beat

Like just about everything else in the human body (and the natural world as a whole), the heart is extremely complex and sophisticated, and its mechanism of pumping is involved and elaborate. A simple lub-dub it is not.

Probably everyone reading this article has benefited from the medical advancements for which this man is responsible. After all, he devoted his career to studying the upper GI (gastrointestinal) tract, significant because surveys and research reveal 74 percent of Americans are living with unpleasant digestive symptoms of some kind: abdominal pain, gas, bloating, diarrhea, ulcers, constipation, acid reflux, hemorrhoids, hernias, diverticular disease, gallstones, et cetera, et cetera, et cetera. Where does it end?

Clearly, this doctor chose a career path with plenty of potential for patients, and an abundance of potential for relieving human discomfort and suffering

Born in South Africa in 1925, Dr. Basil Hirschowitz earned the American equivalents of M.D. and Ph.D. degrees in Johannesburg before leaving South Africa in 1950 to work in London. By 1953 he was a member of the Royal College of Physicians at Edinburgh. All of which makes it somewhat unexpected that the final decades of his career were spent in Birmingham.

Alabama. Not England.

Dr. Hirschowitz moved to the United States in 1953, where he enjoyed a gastroenterology fellowship at the University of Michigan and became a faculty member there in 1954. Five years later he accepted a position at the University of Alabama at Birmingham (UAB) as the founding faculty member of its Division of Gastroenterology.

While at Michigan in 1957 he and his colleagues invented a super-flexible hair-thin optical fiber of coated glass that permitted viewing internally and remotely, even around corners. The medical implications were enormous: unobstructed and illuminated views of hollow organs like the stomach, colon and esophagus were now possible. The endoscope was born, used for the first time at UAB in 1959. Minimally invasive surgery thereby took a huge step forward. Hirschowitz tested the prototype (which is in the permanent collection of the Smithsonian) by putting the optic fibers down his own throat.

As one of his colleagues observed upon Dr. Hirschowitz’ death in Birmingham in January 2013, he essentially built what gastroenterology is today, and along the way created a tool that has saved and improved countless lives all over the world in numerous medical disciplines, changing the way physicians diagnose and treat patients. The endoscope is considered by many to be one of the most important medical developments of the 20th century.

But there were even more advancements Dr. Hirschowitz was responsible for that are much more everyday than an endoscopic procedure: the research he did into ordinary gastric functions paved the way for the widespread use of medicines like Pepcid, Prilosec, and Nexium.

Yes, many of us benefit from Dr. Basil Hirschowitz’ research virtually every day. +

As suggested by the illustration on the front page, the heart has an electrical system. After all, it’s getting an EKG, the E of which stands for “electro.” (EKG stands for electrocardiogram.) That’s where the beat comes from, the regular pulse, the constant rhythm of our hearts: it’s a reaction to a mild electric shock that originates within the heart itself.

The mini-jolt is generated in the sinoatrial (SA) node located in the right atrium of the heart. The jolt is triggered when the right and left atria, the top chambers of the heart, fill with blood. “Full” activates the SA node, which zaps both atria, causing them to contract or squeeze their contents through one-way valves (the tricuspid valve on the heart’s right side, the mitral valve on the left) down into the right and left ventricles.

While the ventricles are filling with blood, the SA node’s electrical signal reaches a relay switch of sorts known as the atrioventricular (AV) node. The AV node interrupts the signal for an instant, just long enough for the ventricles to fill with blood. The momentarily delayed electrical signal arrives just as the ventricles complete their fill-up. At that instant the jolt of voltage reaches them, causing contractions that send the blood in the left ventricle through the aortic valve and off to the rest of the body, and a split-second later from the right ventricle through the pulmonary valve and into the lungs to be oxygenated.

As highly choreographed as it all sounds, what you have just read is like learning A, B and C compared with all the words in an entire encyclopedia.

WHAT DOES AN EKG MEASURE?

The “P wave” marks the contraction of the heart’s atria, pumping blood into the ventricles. The “Q wave” denotes the moment they’re full and the electrical current enters the Bundle of His. The “R wave” marks the contraction of Purkinje fibers around the left ventricle, the “S wave” the right ventricle. The “T wave” signifies the relaxation of the ventricles as they await the next signal.

How, for instance, does heart tissue that looks under a microscope like the dessert some people call Heavenly Hash create electricity? Alas, that is an incredibly complex recipe that defies simple description. Although this is an insult to the sophistication of the system, the best way to describe it simply is to say that tissue in the SA node is charged and then discharged chemically, and does it so quickly and efficiently that a healthy heart can often beat more than 100 times a minute. The entire system monitors demand continuously and adjusts automatically, speeding up if you hit a flight of stairs, slowing down for the night when you snuggle down under the covers.

Of course, creating the voltage is of little value if it can’t be delivered to the appliance where it is needed. In the heart, an elaborate network of nerves designed specifically to carry electrical impulses takes care of that. When each burst of current leaves the SA node, it first travels to the AV node, stopping briefly there as described above.

Leaving the AV node, the current has a big job ahead of it. No disrespect to the atria intended, but all they have to do is fill up and then open their trap doors to let the ventricles fill with blood. Gravity is their best friend. The ventricles, by contrast, have to pump with enough force to provide circulation for the entire body. They can’t simply be “poked” by an electrical current; they need to be squeezed.

To accomplish this, the heart’s wiring after it leaves the AV node has two branches to serve the large and powerful ventricles. They’re called the Bundle of His after the German cardiologist (Wilhelm His) who discovered them. The left and right branches of the Bundle of His travel down through the septum that separates the left and right ventricles, and then branches out in smaller nerves to almost encircle the ventricles. These smaller nerves are called Purkinje (purr-KIN-jee) fibers, and when the current shocks them, the ventricles squeeze their contents out for general circulation to the lungs and entire body. Then they can rela x before going to work when another jolt of electricity zaps them - in about half a second.

Editor’s note: this article appeared in the Medical Examiner six years ago today, on Feb. 3, 2017. It’s okay to steal an article if we wrote the original, right?

AUGUSTAMEDICALEXAMiNER FEBRUARY 3, 2023 4 + #182 IN A SERIES
+

Middle Age

I’ve discussed hobbies in this column before, but I am looking at it from another angle now. When we talked about them before, it was mostly the negative aspects about my approach to them, namely I have too many of them. I collect them. Collecting is also another hobby I overdo, so I suppose collecting too many hobbies is a double whammy. At any rate, we have only spoken of the negative before, so I’d like to flip the script today and talk about the upside of hobbies. I did some web searches and found some interesting things about hobbies in regard to those of us middle-aged and older. Here is my take on what that revealed about how hobbies can improve mental health and even help us keep our faculties.

Notice that I said earlier that I did a web search. I’m not like some who claim to have done research (consisting of watching a video or two on YouTube) while postulating some hair-brained idea. I wanted to do some actual research with human guinea pigs, uh, I mean, test subjects, but I couldn’t find any volunteers. I don’t get why they were hesitant. I was just going to take up about half of their time having them take on difficult but rewarding hobbies and then subject them to rigorous mental testing before and after, all without charging them one penny. Alas, no one took me up on it. Oh, well. We will have to settle for what I found on the web.

It turns out that having a hobby can be a vital part of our brain health as we age. It is especially so if the hobby is a goal-oriented one. Something that has an easily measurable outcome. Things like learning to play a musical instrument, learning a new language and using it in some way, such as expanding your ministry to a foreign field or even areas nearby that have people who only speak their native tongue well. Learning to do something outside your comfort zone, like welding. Yes, welding. That was specifically mentioned in one of the articles I read. Interesting, because I recently started in on that hobby. I think that brings me up to about 752 hobbies now, which may seem a little high, but at one time the number was much higher. Just ask my wife. On second thought, please don’t.

It is important to schedule time for your hobby too. Set aside time dedicated to that hobby. Work at getting into the flow of it. Get lost in it and the stresses of your life will go away. It takes time to develop a habit, so set an alarm each day to remind yourself to do it. After a while, you won’t need that alarm.

If you aren’t retired yet — and who can afford to retire right now anyway? I mean, if you want to eat eggs, you need a good job. Anyway, as I was saying, if you aren’t retired yet, pick up a hobby that is in no way related to your job. The point of a hobby is to get your mind off of the stressful part of your life, and if your job isn’t stressful, you probably

don’t even need a hobby. But if that is the case, we all hate you. Not really, but secretly, yes. Yes, we do.

Another important aspect about having a hobby as an older person is that it gives you something to talk about. I mean, something to talk about other than your health issues. As much as this pains us all to learn, nobody, and I do mean nobody, wants to hear all about what ails you, what medicines you take for it, how the doctor visit went, blah, blah, blah. Even if they ask! They are just being polite! If you don’t like talking to people, you can use that kind of conversation to have all the solitude you want. When I hear about some old person in the news who had been dead in their house for weeks or even months before anybody noticed, first I think about how sad that is, and then I think that they probably droned on and on about their health when anyone dropped by or called. And that’s what happens. So if you don’t want to die in your home and have nobody notice for weeks, get a hobby and have something fun to talk about.

My best friend recently said that he thinks my working at home, plus so much isolation during these Covid years, has made me anti-social. He’s wrong, but he isn’t too far off the mark. I am less social, but I will get out and do things with people. I have just gotten more picky about what, when, where, and with who. Aging is part of that. I don’t like driving at night if it can be avoided. Especially in busy traffic. I also like to be home and in bed well before midnight. Actually, I want to be home and in my pajamas, lying back in my recliner by eight at the latest, but I can stay out later for special occasions. However, this brings us to another benefit of some hobbies. You can do many hobbies with others, which gets you out there making friends or renewing friendships. At the very least, you can join an online community of people who share the hobby and discuss it at length with people who actually want to talk about it. And at best, you can meet up with real live people to share your hobbies, teach others about them, or just join a group that gets together periodically to celebrate those hobbies.

Hobbies can be a great way to build friendships, keep our minds active, take our minds off the stresses of life, including our health issues, and help us keep friends from drifting away. I’d say that is a win-win situation, or maybe a win-win-win for folks who don’t have to hear about our slipped disc or our bunion for the umpteenth time.

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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IT’S STILL EARLY ENOUGH

It is still early enough in 2023 and close enough to 2022 to evaluate how we lived last year and figure out how to make this year better. We tend to do this every year with varying success.

We call them New Year’s Resolutions.

With the end of one year and the birth of another, here are a few things that I ponder:

• I should have worked harder on lowering my cholesterol and lipid level by eating better. But I didn’t do too badly. I’m actually 6 pounds lighter now than I was this time last year. I did it the old-fashioned way: I ate anything I wanted to, but not much of it.

• With tongue only partly in cheek, I told a patient not too long ago that the perfect diet for weight reduction was not eating anything white: potatoes, ice cream, cake,

BASED ON A TRUE STORY

(most of the time)

A series by Bad Billy Laveau

sugar, cream, etc.

The next month when he came in and had lost an astonishing 8 pounds, I was shocked and pleasantly surprised. He informed me that he followed the “Don’t Eat Anything White Diet,” but was not going to do it anymore because it was too hard.

• I listened carefully to politicians make beautiful speeches. I actually believe some of them. We can only hope those elected will do what is best for our country and us. Those kinds of decisions are far above

my pay grade and in their position I would be miserable. That does not mean I do not have opinions. I do. But they are mine to keep.

• Sometimes I go to church and do not listen to the pastor. This is hypocritical. I have wasted his time and mine. Next year I will do better.

• Our Yorkie lives inside and got a sweater for Christmas from my granddaughter. She put it on the Yorkie immediately. Two days later I foolishly decided to remove the sweater without the Yorkie’s permission. I got snapped at. Fortunately my tetanus is up-to-date. Next time I will seek permissionrelevant forgiveness. It hurts less.

• I will continue to wear the clothes each day that my wife hangs out for me. Her taste is better than mine.

And there’s a lot less static if I do not make changes. She watches the weather consistently on TV from various channels, and has never sent me out ill-prepared for the weather conditions. I must be more thankful and appreciative.

• Over my many years of writing this column, I’ve received many emails and phone calls: from Las Vegas; New York City (where my column is used to teach college level creative writing); Nashville, Tennessee; the Middle East (from a deployed soldier who says I can make him laugh in a war zone. I thank him for his service to our country. You should too); New Orleans; and even Willacoochee, Georgia. (No, I do not kin in any of those places.)

About 90% of comments are positive. The other 10% think I might need a mental examination. I do not know if that is good or bad. In the industry I am told you should get 20% negative responses. Therefore I have failed by about 10%. Never said I was perfect or even near that.

• I like to think of creative ways to give a compliment. Here are a couple that I use frequently. In the past year I have made a habit at least once each day in a restaurant or store to walk up to a lady that I do not know and say, “Excuse me, Ma’am. You are a beautiful lady.” I walk away without a follow up.

If the checkout line is slow and the lady working the cash register is young and not wearing a wedding ring, I might say, “Excuse me, ma’am. Are you married?” She says, “No.” I say, “Can you cook really good?” She usually looks thoughtful and says, “Yes.” Then I say, “As beautiful as you are — and you can cook, too — you must know a lot of really stupid men for not being married to you.”

This delights her (and the people in the line who think an old codger is hitting on a young girl until they realize I am giving a creative compliment.)

• I will not make a specific list what I will or will not do in 2023. I will increase the good things I do and decreased the not-so-good things I do, and hope my family will keep me one more year whether I deserve it or not.

SHORTSTORIES

OUT OF THE MOUTHS OF BABES My second-born is a charmer and has been practically since birth. People gravitate toward him and always have. When he was eight, though, for no apparent reason, a classmate pushed him down on the playground at school and stomped on his leg. A teacher’s aide on playground duty saw the whole thing. I got a call from the school nurse, who thought his leg was broken. The mother of the “stomper” also got a call to come pick him up and was told that he was suspended for three days.

The nurse’s fear about my son’s leg being broken was unfounded, fortunately, but my son returned to school the next day on crutches for soft tissue injuries. At the end of that first day, his teacher called to tell me something she thought I should know. My son had asked her if he could say something to the class. She agreed and tears welled up in her eyes as she listened to what he had to say. He told the class that he believed only very unhappy people are cruel to others, and asked them to be “extra nice” to the stomper when he returned to school. “Let’s give him a ‘do-over’ and help him become a happier kid,” he urged the class.

At the end of the school year, the teacher (herself the mother of four adult sons) told me that she believed the certain development of a bully had been nipped in the bud by the persuasive speech and example of one little boy.

AUGUSTAMEDICALEXAMiNER FEBRUARY 3, 2023 6 + +
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NOBODY OUT-SALUBRIOUSNESSES THE MEDICAL EXAMINER

TRYTHISDISH

GOOD MORNING CINNAMON OATS

Using the slow cooker is a great way to get many things on your table including breakfast. This recipe is modified from a recipe on Pinterest. Using the “dishin-crock” method is the best way I have seen to make these without drying them out or burning them.

Ingredients

• 2 apples, cut up (skin on) or pears

• 1 teaspoon cinnamon

• 2 tablespoons maple syrup

• 2 cups old fashioned rolled oats

• 2-½ cups milk

• 2 cups water

Directions

Spray a 5-quart oven-safe dish with vegetable oil cooking spray (The dish should be of a size and shape to fit into the crock of your slow cooker). Add the oats, apples, cinnamon, milk and water to the dish and stir to combine. Drizzle the maple syrup over the top of the oat mixture.

Add a cup of water to the crock of the slow cooker and place the oven-safe dish into

the slow cooker, cover and cook on low for 7-8 hours. Breakfast cooks while you get your beauty rest.

Yield: 6 Servings (serving size: 1 cup)

Nutrition Breakdown: Calories 190, Fat 3g (1g saturated fat), Cholesterol 5mg, Sodium 55mg, Carbohydrate 34g, Fiber 4g, Protein 7g.

Percent Daily Value: 4% Vitamin A and C, 8% Iron, 15% Calcium

Diabetes Exchange Value: 1 Starch, ½ Fruit, ½ Milk

AUGUSTAMEDICALEXAMiNER FEBRUARY 3, 2023 7 + +
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Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb

ASK DR. KARP

Thanks for your question, Petra. In fact, collagen peptides and other collagen supplements are also being extensively promoted in the United States and worldwide. What’s the idea behind them, and do these nutritional supplements do what is claimed they do?

NO NONSENSE

NUTRITION

Petra, a Facebook friend from Europe, asks:

“I am considering taking collagen peptides for my hair and skin. They are all the rage right now in Europe. What do you think?”

It is true that, as we age, the collagens in our skin, joints, and elsewhere in the body change, resulting in some of the common physical signs and symptoms of aging. I am referring to changes like wrinkles, sagging skin, hair changes and aching joints. The idea is that you might be able to slow down, prevent, or even reverse these common changes that occur during aging by eating collagen or small collagen precursors, such as collagen peptides.

Ah, if only that were true. What a simple way it would be to stop or reverse some of the effects of aging.

As with many ideas in what I call “armchair medicine,” this is more wishful thinking than fact. To determine if an idea is worthwhile scientific information rather than “mental gas,” you have to get out of your armchair, conduct experiments and get data to support your idea. Are there publications

in peer-reviewed scientific journals studying the effect of collagen peptides on the human body’s collagen metabolism? Yes, there are. Are the studies conclusive? No, they are not. Is there presently sufficient scientific data to support taking collagen peptides? No. Collagen is the body, accounting for about 30% of our protein. One un usual fact about collagen is that, unlike other proteins in the body, it contains large amounts of the specific ami no acids, proline, hydroxy proline and glycine. However, these amino acids are found in the proteins we consume every day. For example, glycine is found in animal and vegetable proteins such as turkey, chicken and peanuts. Proline is common in fish, egg whites, meats, asparagus, peanuts and other veggies. And the human body naturally produces hydroxyproline from proline. Before spending money and taking an unproven protein or peptide supplement which

claims to be “essential” to your body, first consider if you are already making that compound biologically in your very own body. If the answer is “yes,” then there is no need to search out and include that protein or its derivatives in your diet. Molecules that you can synthesize in your own body

be eaten, digested, absorbed, transported and used directly. That is simply not how the human body works.

The body’s biochemical and biological synthetic ability is awesome.

humans,

tissues and used for different purposes. Specific types of collagens are biosynthesized in our joints, in our skin, in our eyes and elsewhere.

When you eat collagen protein or small collagen molecules, such as peptides, they are digested, similar to any other proteins in the diet. It is true that some smaller molecules, like peptides, may be directly absorbed by a non-digestive process called micropinocytosis. This type of absorption, although important from an immunological and allergy viewpoint, is so small that it does not adequately supply the raw materials necessary for protein synthesis. In addition, protein molecules — such as collagen — are made from amino acids at the point-of-need in the organ or tissue. They cannot

Worried about protecting your collagen? Then do not smoke, limit your exposure to UV radiation, and make sure your blood glucose is under control. Those three factors degrade your collagen big time. For diabetics, getting your diabetes under control and adopting a Mediterranean-styled way of eating are important ways to avoid spikes in your blood sugar. Elevated sugar in your blood can attach to collagen and change its properties. So, it’s far better and more effective to control all these factors rather than gobbling down collagen peptide supplements.

What is the “No-Nonsense Nutrition” advice for today? During digestion, protein molecules and peptides are broken down to their constituent amino acids and re-assembled into proteins at the site of need, a process called “in situ” synthesis. The amino acids needed for collagen synthesis are found in abundance in all the proteins that you eat every day. Eating extra collagen or collagen precursors will not improve your collagen or slow collagen breakdown. Finally, if you sit in an armchair and come up with an idea, then get out of that armchair and get the data needed to support your idea. Don’t make your important health decisions based on someone else’s wishful thinking.

Have a question about food, diet or nutrition? Post or private message your question on Facebook (www.Facebook.com/ AskDrKarp) or email your question to askdrkarp@gmail.com If your question is chosen for a column, your name will be changed to insure your privacy. Warren B. Karp, Ph.D., D.M.D., is Professor Emeritus at Augusta University. He has served as Director of the Nutrition Consult Service at the Dental College of Georgia and is past Vice Chair of the Columbia County Board of Health. You can find out more about Dr. Karp and the download site for the public domain eBook, Nutrition for Smarties, at www.wbkarp.com Dr. Karp obtains no funding for writing his columns, articles, or books, and has no financial or other interests in any food, book, nutrition product or company. His interest is only in providing freely available, evidenced-based, scientific nutrition knowledge and education. The information is for educational use only; it is not meant to be used to diagnose, manage or treat any patient or client. Although Dr. Karp is a Professor Emeritus at Augusta University, the views and opinions expressed here are his and his alone and do not reflect the views and opinions of Augusta University or anyone else.

AUGUSTAMEDICALEXAMiNER FEBRUARY 3, 2023 8 + + READ THE EXAMINER ONLINE www.issuu.com/medicalexaminer FREE CANCER SCREENING! Need a breast or cervical check-up? but you can’t afford it, or have no insurance? The Georgia Breast and Cervical Cancer Screening Program (BCCP) is a comprehensive Public Health Program that provides uninsured/underinsured women with FREE breast and cervical cancer screening services. If you are a Georgia resident, 21-64 years of age, uninsured or underinsured, and your household income is no more than 200% of the Federal Poverty Level, our services to you may be FREE! SCREENING SERVICES OFFERED: For more information, please call LisaAnn Wheeler BCCP Patient Navigator: (706) 513-1033 Prevention and early detection saves lives! • Clinical Breast and Pelvic Exams • Mammogram Referrals
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And much more!
Dr. Karp

FOODISMEDICINE

Tasty tips from registered dietitians with the Augusta Dietetic District Association

Staying Heart Healthy

The beginning of the year brings new goals. In February, we celebrate Heart Health month. The number one leading cause of death is heart disease. In order to reduce your risk there are some tips you can start to incorporate today to keep your heart healthy.

ADD FIBER: Think about your last meal. Did it include any fruits or vegetables? The average American falls short of consuming the recommended goal of 25-30 grams of fiber per day. One way to obtain more fiber can be to rethink your snacks: add a fruit, vegetable or whole grain to your snack. Pairing it with a protein like tuna fish, refried beans or a piece of jerky can also make it more satisfying and filling. Other examples: an apple with peanut butter, a bowl of air popped popcorn, or using whole wheat bread for a sandwich or avocado toast.

HYDRATE: How many ounces of water do you drink daily? All fluids count, but aim for things that are naturally unsweetened such as herbal tea or infused water (mixed with fruit or herbs). While 100% fruit juice is another way to increase your fruit and vegetable intake, it does contain natural sugars, so try to keep your fruit juice intake to 8 oz. or 1 cup per day.

TRY A NEW SPICE: Take away the salt shaker. Most of our sodium intake comes from salt and eating foods flavored with salt. Incorporate other spices when cooking, using salt sparingly to enhance those flavors. Herbs and spices such as basil, garlic powder, cumin, smoked paprika, onion powder or black pepper are salt-free ways to enhance the flavor of your food. Sautéing onion and garlic in the pan before

HERBS DE PROVENCE BLEND

(Recipe from Academy of Nutrition and Dietetics Association)

you cook your foods can provide another layer of flavor.

STAY ACTIVE: The recommendation for activity is 150 minutes of moderate activity or 75 minutes of vigorous activity week per week. Movement can look different for everyone. It can be dancing around the house, going to the pool, gardening, doing some chair exercises or walking the dogs. Think about what movement brings you joy and incorporate it into your week. Even a little bit of activity can help boost your mood and make you feel good!

WATCH THE CONDIMENTS: Sodium can be lurking in your cabinet. The American Heart Association recommends consuming less than 2300 mg of sodium per day. That’s less than one teaspoon. Swapping out condiments for things without added sugar and sodium can drastically reduce your sodium intake. Look for canned goods that are low in sodium, or rinse them before use. Opt for control over where your salt and sodium intake come from. Choices that are low in sodium give you the opportunity to flavor things in other ways, and allows you to add flavor as you choose.

For additional reading:

• “Added Sugars.” Www.heart.org, 22 July 2022, https://www.heart. org/en/healthy-living/healthy-eating/eat-smart/sugar/added-sugars.

• “How Much Physical Activity Do Adults Need?” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 June 2022, https://www. cdc.gov/physicalactivity/basics/ adults/index.htm.

“How to Add Flavor Using Herbs and Spices Video.” Www. heart.org, 15 Jan. 2021, https:// www.heart.org/en/healthy-living/ healthy-eating/cooking-skills/preparing/how-to-add-flavor-usingherbs-and-spices-video.

Ingredients

¼ cup dried rosemary

1 teaspoon celery seeds

1 teaspoon fennel seeds

¼ cup dried chives

¼ cup dried oregano leaves

2 tablespoons dried basil leaves

2 tablespoons dried Italian parsley

½ teaspoon dried thyme leaves

½ teaspoon dried lavender buds

Directions

Wash your hands before you begin.

• Grind rosemary, celery seeds and fennel seeds in a spice grinder or choose

already ground spices. Place in a small bowl.

• Add chives, oregano, basil, parsley, thyme and lavender buds. Blend well.

• Store in an airtight container, in a dark place, until ready use. Use within a year for maximum flavor.

Serving size: 1 tablespoon; makes 16 portions

Preparation Notes

In food preparation, dried herbs need moisture to bring out their flavors. When substituting dried for fresh herbs, 1 teaspoon of dried herbs equals 1 tablespoon of fresh herbs.

• Quagliani, Diane, and Patricia Felt-Gunderson. “Closing America’s Fiber Intake Gap: Communication Strategies from a Food and Fiber Summit.” American Journal of Lifestyle Medicine, U.S. National Library of Medicine, 7 July 2016, https://www.ncbi.nlm.nih. gov/pmc/articles/PMC6124841/.

• Quagliani, Diane, and Patricia Felt-Gunderson. “Closing America’s Fiber Intake Gap: Communication Strategies from a Food and Fiber Summit.” American Journal of Lifestyle Medicine, U.S. National Library of Medicine, 7 July 2016, https://www.ncbi.nlm.nih. gov/pmc/articles/PMC6124841/.

• “Shaking the Salt Habit to Lower High Blood Pressure.” Www. heart.org, 2 Dec. 2022, https:// www.heart.org/en/health-topics/ high-blood-pressure/changes-youcan-make-to-manage-high-bloodpressure/shaking-the-salt-habit-tolower-high-blood-pressure.

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THANKS ALSO TO OUR CONTEST CO-SPONSOR: LOOK FOR THE MYSTERY WORD IN EVERY ISSUE!

The Advice Doctor

Will he ever get one right?

Probably not.

Questions. And answers. On page 13.

FEBRUARY 17 2023 OUR NEXT ISSUE DATE

More Americans have died on US roads since 2006 than in World Wars I & II combined

POINTS?

WHAT ARE POINTS?

People who don’t drive safely have more than just traffic tickets to worry about. There can be jail time for serious offenses. Depending on how poorly someone drives, the total ramifications of bad driving can be extremely expensive. Citations and fines alone can add up to thousands of dollars in direct costs. Added to those can be towing and impound fees, court costs, and attorney fees. And there can be massive indirect costs too: lost wages while someone is in jail or attending court, car rental costs that may not be covered by insurance, and speaking of insurance, there can be huge increases in insurance premiums — and it’s illegal to drive without it.

How do insurance rate increases work?

The corporate policies of individual insurance companies vary from provider to provider, but one of the factors are the point systems maintained by state motor vehicle departments. In South Carolina, a driver’s license will be suspended if he accrues 12 points or more on his driving record. No time limit is specified. Georgia suspends the licenses of drivers if they accrue 15 points or more over the course of 24 months.

How does one earn points? Not by doing anything good.

In the Palmetto State, here are a few common offenses from the point schedule for regular motor vehicle drivers:

• Speeding over the posted limit by: No more than 10 MPH: 2 points. Over 10 MPH but under 25 MPH: 3 points. 25 MPH or faster: 6 points.

• Failure to yield right of way: 4 points.

• Making an illegal turn: 4 points.

• Following another vehicle too closely: 4 points.

• Reckless driving: 6 points.

• Leaving the scene of an accident resulting in property damage: 6 points.

“Regular” drivers are mentioned above because those with a CDL (commercial driver’s license) may receive higher points for the same offenses as car drivers, and they’re subject to automatic suspension of their license.

In Georgia, here are some common offenses and their corresponding points:

• Speeding 15 through 18 MPH over the posted speed limit—2 points.

• Having an open alcohol container in the car—2 points.

• Speeding 19 through 23 MPH over the posted limit—3 points.

• Not obeying a police officer—3 points.

• Speeding 24 through 33 MPH over the posted speed limit—4 points.

• Reckless driving—4 points.

• Speeding 34 MPH or faster over the posted limit—6 points.

• Aggressive driving—6 points.

There are ways to get around the severe penalties of exceeding the point limits. Both Georgia and South Carolina may allow a driver to have his or her license reinstated by successfully completing a defensive driving course. But it’s not something that can be employed at will. In fact, although Georgia will reduce an offender’s point totals by as many as 7 points for completing a defensive driving class, the class option is only available once every five years.

A good driver can go through a lifetime of driving without ever accruing a single point. That should be every driver’s goal.

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the blog spot From the Bookshelf

GUN CRISIS IN AMERICA: YOUTH FATALITIES ON THE RISE

In 2020, firearm fatalities displaced motor vehicle accidents as the leading cause of death for American youth (ages 1 to 19). We long ago dramatically reduced infectious deaths (although vaccine hesitancy threatens to upend this victory), and the traditional “big five” have been auto accidents, firearms, cancer, suffocation, and drug overdose – accidental among the youngest and either intentional or accidental in teens.

THE DEATH RATE HAS DOUBLED

Between 2000 and 2015, firearm deaths remained steady at about 10 percent of all youth deaths, but this has grown dramatically since then: guns caused nearly 20 percent of young people’s deaths in 2021. Children, of course, are not the only ones to suffer. Between 1990 and 2021, a total of 1,110,421 Americans of all ages died due to gunshots: homicidal, suicidal, or accidental. The death rate has roughly doubled between 2014 and 2021. Deaths disproportionately affect males: 86 percent of the 1.1 million deaths were men. When looking at deaths among young people, black boys are much more likely to be killed than non-Hispanic white youth. When we look at suicides, older white males are the victims more than any other group.

Comparison with similar countries emphasizes how much of an outlier we are in the U.S. An American is 30 times more likely to die by firearm than a French citizen. There are 15-20 privately-owned firearms per 100 population in France, while in the U.S. there are 120 per 100 people. Multiple studies have shown a tight correlation of between gun deaths and numbers of guns in circulation. Within the U.S., states with tougher gun laws have significantly lower firearm mortality.

Social factors – mental health issues, including depression, poverty, lack of social supports – certainly play a role, but these are not unique to Americans. Every country has its share of sociopaths, depressed people, and people angry at the world, but only in America is it so easy for these people to obtain a gun.

If someone tries to kill themselves with an overdose, there is a high likelihood they will be saved and then given help. Very few such people die by suicide. But the “success” rate is nearly 100 percent when the method chosen is a gunshot. A fanatic can kill innocents with a knife (or their bare hands), but mass killings are almost always done with firearms. Public opinion surveys consistently show that most Americans support tougher gun laws, but our federal legislators seem to be under the gun lobby’s control. We must convince our legislature that the people’s will is for sensible gun control.

Unless we prefer to remain the world champions in deaths by firearms.

Edward Hoffer is an internal medicine physician and author

IF YOU CAN READ THIS please thank MEDICALEXAMiNER advertisers +

This is a book that reminds us before we even open the cover that cold case crimes can be solved, that silent victims can still testify, even from the grave. People have a curious fascination with the often gruesome science of forensics. After all, the number of CSI-type shows on television is practically without counting. There are even entire networks, like ID (Investigation Discovery) that are devoted to crime and punishment 24/7/365 (not counting commercials). As you might surmise if you are a bit of a detective, having an author whose name is Nigel indicates the book might have a bit of a British slant. True, not that that’s a bad thing. Actually, pretty much the whole world of forensics is examined in all its fascinating detail in this book, including Britain, France, and even right here in the US of A. Nigel McCrery takes us to the scene whenever and wherever there was a fascinating case or a

breakthrough in forensic methods.

He breaks it down into a handful of categories, areas like ballistics, blood, trace evidence, poisons, DNA, and so on.

Looking back on the history of the science and its present state, it’s a wonder they managed to catch and convict the right perp even half the time back in the day. And it’s equally amazing that anybody gets away with anything these days with the forensic tools available today.

The sad truth when it comes to forensic science is that the cost of each and every advancement was paid over the centuries with rivers of shed blood and untold lives cut short by acts of violence and mayhem. Blood spatter experts, for instance, unknown to detective work in the not too distant past, hone their craft when blood is spattered and splattered.

But thankfully, people have been willing to work in and gradually refine, expand and improve the art and craft of forensic science to the point where, today, it provides the basis for many, many TV shows. Plus it helps solve (and no doubt prevent) countless crimes. If the often gruesome but always fascinating history of forensic science appeals to you, this is a book you’ll definitely enjoy.

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Doing anything exciting this weekend?

I want to see that new Tom Hanks movie, the one with Meg Ryan.

New? You’ve Got Mail came out 25 years ago. No, I’m talking about the remake they did for blind people.

THE MYSTERY WORD

That’s news to me. What’s this one called?

You’ve Got Braille

The Mystery Word for this issue: LIPL

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

ACROSS

1. Bush transports

5. “Social” diseases, in brief

9. Pipe type

14. Of the ear

15. Askew

16. Banish

17. Pertaining to the noted Greek mathemetician

19. Transmits

20. Enjoyed on Facebook

21. Disney destination

23. Acquire 24. 66, for one 26. Philadelphia skaters 28. Pacify 31. Greek T 32. Wrath 33. Legal rights grp. 37. He lost to Pence in 2016 41. Hamlin’s team 44. WACG network

Word on many doors 46. Contradict; disguise 47. Kendrick of Pitch Perfect

Nashville awards show 50. National standard 52. Anticlimax (literary) 55. Rhino’s tail?

58. More pleasant

60. How a cabin can begin

61. Israeli prime minister, 1977-1983

External

1. Minor book of the Bible

2. Sewing case

3. Lyme disease transmitter

4. White of the eye

5. Unhappy

6. Emulate Trump?

7. Cover with cloth

9. Exclusive area neighborhood

10. Chopping tool

11. Shade

12. _____ care

13. Takes a break

18. Image of a deity

22. Many times (to a poet)

25. Kill Bill star

27. Dynasty before the Ming dynasty

28. Macon county

29. Lake fed by the Detroit River

30. Terrorist group

34. Assistant to 35-D (abbrev.)

WORDS

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

35. Nursing abbreviation

36. Vase for storing ashes

38. Scratch

39. Character voiced by Alexander Gould in a 2003 film

40. Periods of history

42. They can be sealed

43. Restraint device

48. WJBF affiliation 51. _____ Patch (in Aiken) 53. Long period of time (British spelling) 54. Reliable inmate

Factory

Bring down

Wide open

Rule of_____ (in burns)

Mural start, sometimes

Insult; mock

Trunk contents

Lasting prefix

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.

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.

The Examiners
AUGUSTAMEDICALEXAMiNER FEBRUARY 3, 2023 12
We’ll announce the winner in our next issue! Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, FEB. 12, 2023 + +
by Daniel R. Pearson © 2023 All rights reserved
by Dan Pearson
NUMBER BY SAMPLE: 1 2 3 4 1 2 1 2 3 4 5 LOVE BLIND IS 1. ILB 2. SLO 3. VI 4. NE 5. D = Solution p. 14
by Daniel R. Pearson © 2023 All rights reserved. E X A M I N E R S U D O K U
QUOTATIONPUZZLE
EXAMINER CROSSWORD by Daniel R. Pearson © 2023 All rights reserved W PUZZLE EXAMINER CROSSWORD by Daniel R. Pearson © 2023 All rights reserved. © 2023 Daniel Pearson All rights reserved.
6 1 3 7 2 3 1 4 9 1 7 6 2 1 8 2 6 8 5 6 4 1 9 9 1 7 6 7 4 2 6 1 7 4 2 2 8 3 5 9 4 3 9 1 8 6 9 4 6 2 1 5 8 1 5 4 3 7 2 7 3 9 6 8 6 5 2 8 7 4 3 9 4 5 2 1 1 8 7 6 9 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
DOWN
8. In (or out of) _____
56.
57.
58.
62.
64.
65.
66.
68.
70.
55.
59.
Stink
Fled
Ostrich relative
45.
49.
V A T E W E H T A S H A C L R O E E R S O S S W A S A F ’ I T T ’ L N I O N F I S G E P D A L — Garrison Keillor E 1 1 2 3 4 5 I 1.
2.
3.
4.
5.
6. YL 7. E 8. S 9. S 1 2 1 2 3 1 2 3 4 5 6 1 2 1 1 2 3 4 5 6 7 8 9 1 2 3 4 5
63.
67. Alert to 69. Care start sometimes 71. Kathmandu’s country 72. Embankment 73. Family plant? 74. Mr. Reznor of NIN 75. Son of Isaac and Rebekah 76. Strike with a stick (Scot.)
WHHAFITIA
ONESHAA
RAVEM
LEIR
NDLT
— Christopher Lasch

THEBESTMEDICINE

group you joined going?

Joe: Great. I see a lot of new faces every week.

Moe: Hey, I got an aardvark joke for you!

Joe: I always say there’s nothing better than a good aardvark joke.

Moe: Alrighty then! What do you call an aardvark that’s three feet long?

Joe: A yaardvark! I have one for you: What do you get when you cross an aardvark and a pig?

Moe: A laardvark?

After the Titanic struck the iceberg, its captain called the crew together and told them, “I have good news and bad news.

“The bad news is that our ship is sinking, and nothing we can do will save it.

“The good news is that we will win eleven Oscars.”

Moe: What’s faster than a calculator?

Joe: I’ll go with a calcu-sooner.

Moe: I should have told you this joke in December, but what do you call a wreath made of $100 bills?

Joe: Aretha Franklins?

Moe: I’ve been diagnosed as a kleptomaniac.

Joe: What are you taking for it?

Moe: Whatever I can get my hands on.

Moe: What has 5 fingers, but isn’t your hand?

Joe: Ok, I give. What is it?

Moe: My hand.

Moe: How is that plastic surgery support

Joe: These are horrendous, Moe. Let’s stop with this one: What do you call an overcooked aardvark?

Moe: I think that would be a chaardvark.

Moe: Do you think Dr. Pepper was really a doctor?

Joe: I heard he was a fizzician.

Moe: So this fortune teller walks into a store and looks at a blouse and asks the clerk if they have it in her size...

Joe: Let me guess... she’s a medium.

A big muscle-bound construction worker is constantly teasing his scrappy little co-worker.

One day the little guy decides he’s tired of it and wants to end it once and for all.

“I’ll bet you $100,” he says to the muscle man, “that I can put something in that wheelbarrow over there and move it 10 feet forward, but you won’t be able to push the very same thing back.”

“You’re on, little man,” says the big guy. The little guy walks over to the wheelbarrow, points at it and says, “Get in.

The Advice Doctor

Dear Advice Doctor,

On vacation over the Christmas holidays I set my purse down in a restaurant, and it was out of my sight for maybe two seconds, but when I looked for something I had in there later it was gone. I don’t know who did it or how, but in the blink of an eye they stole my identity, ruined my credit rating, and drained my bank account. I’m still recovering. Help!

— Cleaned Out

Dear Cleaned Out,

I’m sure this is a difficult situation for you, and I don’t mean to seem uncaring, but it’s a wonder this doesn’t happen more often, or that it has never happened to you before this.

Why do I make a statement like that?

Do you realize the average person blinks 15 times a minute? That adds up to more than 10,000 blinks a day, quite a lot of shuteye. “The blink of an eye” is an idiom meaning a very brief period of time, and in fact, the length of a typical blink is a mere 100 milliseconds long. Even so, University College London (UCL) neurologists estimated in a 2005 study that if all our blinks in an entire year were consecutive, they would add up to 9 full days spent blinking.

We blink for several reasons, including as a response to eye irritants and as flirting or other forms of body language, and the majority of blinks, performed to lubricate the eyes and rinse away any foreign matter.

How is that we don’t notice so much blinking?

Those same UCL neurologists conducted an elaborate study to measure the effects of blinking on the brain. Subjects blinked while lying in a darkened MRI brain scanner with a fiber optic light cable in their mouth to make their entire head glow. This was to ensure that light falling on the retina was constant even while blinking, enabling scientists to measure any effects on brain activity independent of light.

The surprising discovery of the study was that blinking instantaneously suppresses brain regions associated with sight. That’s why we are only rarely aware of our many blinks. When people say (as you did) that they missed something because it happened in the blink of an eye, well, the brain misses it too.

I hope this answers your question. Thanks for writing!

Do you have a question for The Advice Doctor about health, life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.

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!

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THE MYSTERY SOLVED

The Mystery Word in our last issue was: PARAMEDIC

...cleverly hidden in the p. 16 photo for AIYAN DIABETES CENTER

THE WINNER: DENISE MEDAGLIA!

If that’s your name, congratulations! Send us your mailing address using the email address in the box on page 3. The new Mystery Word is on page 12. Start looking!

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...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package!

SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.

PROFESSIONAL DI

Dr. Eric Sherrell, DACM, LAC Augusta Acupuncture Clinic 4141 Columbia Road 706-888-0707

www.AcuClinicGA.com

LONG TERM CARE

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Long-Term Care Planning I CAN HELP! (706) 733-3190 • 733-5525 (fax)

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Zena Home Care

Personal Care|Skilled Nursing|Companion 706-426-5967

www.zenahomecare.com

AUGUSTAMEDICALEXAMiNER FEBRUARY 3, 2023 14
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Everyday Elder Care LLC Certified Home Health/Caregiver 706-231-7001 everydayeldercare.com
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Sleep Institute of Augusta SLEEP MEDICINE Bashir Chaudhary, MD 3685 Wheeler Rd, Suite 101 Augusta 30909 706-868-8555
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Boulevard Augusta 30901 706-555-1234 CALL 706.860.5455 TODAY! YOUR LISTING YOUR LISTING HERE Your Practice And up to four additional lines of your choosing and, if desired, your logo. Keep your contact information in this convenient place seen by thousands of patients every month. Call (706) 860-5455 for all the details! CALL THE MEDICAL EXAMINER (706-860-5455) TO BE LISTED HERE WORDS BY NUMBER The family is a haven in a heartless world. — Christopher Lasch QUOTATION PUZZLE SOLUTION It’s a shallow life that doesn’t give a person a few scars. — Garrison Keillor 3K BODY CONTOUR (NON-SURGICAL) WEIGHT LOSS/DETOX BYE BYE BELLY • Detox Juice/Tea 233 Davis Road Suite H Augusta GA 30907 706-403-7536 9 1 7 6 7 4 2 5 6 1 7 4 2 3 9 8 7 2 8 3 5 9 6 1 4 4 3 9 1 8 6 2 5 7 9 4 6 2 1 5 7 8 3 8 1 5 4 3 7 9 6 2 2 7 3 9 6 8 5 4 1 6 5 2 8 7 4 1 3 9 3 9 4 5 2 1 8 7 6 1 8 7 6 9 3 4 2 5 J E T S S T D S W A T E R O T I C A W R Y E X I L E E U C L I D E A N S E N D S L I K E D E P C O T G E T R O U T E F L Y E R S B E C A L M T A U I R E A C L U K A I N E B I L L S N P R E N T E R B E L I E A N N A C M A P A R B A T H O S P L A S T Y N I C E R L O G B E G I N O U T E R A W A R E I N T E N S I V E N E P A L B E R M T R E E T R E N T E S A U Y E R K PILL
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REALLY, OFFICER? Many years ago I was at home after being up all night on call. It was an uncommonly busy night and I think I did 7 or 8 deliveries. I was beat. I was not supposed to be on call that day, but even so I got a call around 10 am on Sunday morning that a baby was having severe heart rate decelerations and needed a STAT c/section. The on-call doctor was in another delivery and they could not find anyone else to help. According to the charge nurse, the baby was dying in front of them and I had to come right now.

On the way I was pulled over doing 70 in a 55 zone. I was driving carefully, in good weather, on a mostly empty major highway without construction or other hazards. I explained calmly and respectfully what was happening, why I was speeding, and asked if there was any way she could let me go and give me a citation at the hospital after I did the c/section. I offered to have the officer call the hospital.

What followed was the most bizarre interaction I have ever had with an officer. I have had a great working relationship with police officers throughout my career, but this officer berated me, purposefully stalled, and called the labor unit to demand that the charge nurse give her the patient’s name and a second identifier. The charge refused. After about 30 minutes she finally let me go, after telling me that “doctors are not gods and can’t just speed around everywhere.” She also followed me to the hospital after telling me that she would arrest me if she tracked me going even a mile over the posted limit.

Again, every other officer I have ever met personally or professionally has been great. I don’t know what the issue was.

I raced into the hospital, and did the section. The baby required some CPR. pH was around 6.9 (low) but the baby did ok. I paid the $172 ticket and later took a class to avoid points.

I realize that nobody is above the law. However, I also suspect that the officer involved would have no issues driving 70 in a 55 if, for example, someone from her family had a stroke, or was shot, or was bleeding to death. I did not expect to escape from a citation, but I did not need to have the officer yell at me when I was trying to save a baby.

Ambulances, fire trucks and police cars speed around all the time. I wonder if it would be helpful to have emergency lights and a “first responder” driving course for doctors who live in communities where emergency response doctors need to get to the hospital rapidly.

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AUGUSTAMEDICALEXAMiNER FEBRUARY 3, 2023 16 + Diabetes Center Julian
Jamie
Khalil
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Nussbaum, MD Ophthalmology
Steinsapir, MD, PhD Endocrinology
Al Soutary, MD Endocrinology
Nadarajah, DPM Podiatry

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