Medical Examiner 3-3-23

THE FENTANYL BLAME GAME

by Bad Billy Laveau

Matthew is a solid family man. Computer expert for our national defense for many years. Security clearances. Stationed in various countries. He has seen and heard things you and I can only imagine. But he is not perfect. Sometimes he drank too much at night. He controlled it. He functioned. Never missed work. Never failed to perform. He was self-controlled. I trust Matthew.

Matthew and I saw a family on TV whose 15-year-old son bought a pill online. The pill, supposedly Percocet, was delivered to the family’s front yard. The kid took the pill. Parents were oblivious. A fentanyl overdose ripped his soul from his body. The parents wept on national TV while announcing a non-profit to “stop cartels from killing American kids.”

Our hearts wept for their loss. But not once did they accept any blame for their son buying and taking an illegal, non-physician-prescribed drug. Physicians have a quarter century of training and education before they prescribe a

OVERSLEEP IT IS IMPOSSIBLE TO

Now there’s a statement that could keep you awake at night. Impossible? Really?

The assertion was made by Harvard University professor of neurology Elizabeth Klerman in a recent discussion about sleep. It certainly has its logic. She said, “Unlike chocolate cake you can eat when you’re not hungry, there’s no evidence you can sleep when you’re not tired.”

When you put it that way...

If we had the chance to interview professor Klerman she might add a few caveats. She’s most likely talking about a healthy person who isn’t taking medications or ingesting any stupor-inducing substances. Those could be scenarios where a person sleeps all day and still wants more.

Despite the prevalence of sickness and drugs with a whole list of side effects, we are not as a rule people troubled by too much sleep.

The actual problem is exactly the opposite: too little. And in the same way that July 4 is peak season for people blowing their fingers off, March of every year is

peak season for sleep problems.

Why March? Two words: spring, and forward. This year it happens on March 12, with an immediate loss of of a full hour of sleep for some 330 million Americans (or at least the adult segment of that number).

As Crash Course points out (see page 10), the National Institutes of Health says most adults aren’t even getting 7 hours of sleep per night. That means one hour represents 15%of our nightly slumbers. That is a significant loss for a population that, as a group, is already sleep deprived.

Medically speaking, a single night of inadequate sleep is all it takes to have an impact the next day (and perhaps the next few to follow), and for millions of people, the start of Daylight Saving is all the proof they need.

What are those impacts? It’s a surprisingly long list, and it underscores the tremendously important

A lethal dose of fentanyl next to a penny for perspective.

MEDICAL MYTHOLOGY

PARENTHOOD

by David W. Proefrock, PhD

You used to have lots of patience with your kids, but lately you are snapping at them for little things and you always seem to have so much to do that you can’t spend the time with them that you would like. Maybe it’s just you, but the children seem to be harder to deal with and seem to be getting into more trouble lately. What do you do?

A. You are probably just being too hard on yourself and on the kids. Relax and things will get back to normal.

B. You have probably become too lax in your discipline. Tighten up the discipline and things will quickly get back to normal.

C. Take an honest look at what’s going on in your life. Make changes to reduce or to better deal with your stresses.

D. You are just worrying too much. Don’t do anything different. This is just a phase they’re going through.

If you answered:

A. It will probably help to relax, but in order to really relax you should examine what’s going on in your life and try to better deal with it.

B. This is not the best choice. In fact, more discipline when you are already stressed may make things worse.

C. This is the thing to do. You have already realized that you don’t have as much patience and you don’t have time to do things you enjoy doing. The problem is more likely to be with you than with the children.

D. This isn’t worrying too much. You’ve already noticed that you don’t have as much patience or as much time. You should take these warning signs seriously.

Children may not understand everything that is going on in their parents’ lives, but they certainly react to it. It’s always a good idea to include a good look at yourself when dealing with child-rearing problems.

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

TEEN SLEEP MYTHS EXAMINED

Not that anyone is really listening, but sleep experts have been shouting from the rooftops for years that adolescents’ sleep needs are different from other age groups and need to be recognized accordingly. One of the major themes based on extensive research is that teenagers are not, to put it in plain English, “morning people.”

Adolescents have their own unique biological clocks in the same way that babies do. Trying to change it is about as likely to succeed as a person wishing to be taller. It may not be likely, but it could happen.

A few months ago, a study was published by Brigham and Women’s Hospital examining parents’ reactions to several statements, each one of them a sleep myth specific to adolescents.

One of the recurring recommendations from experts for better sleep for teens is to abolish crack-of-dawn start times for school. The teen brain simply does not function well when the morning sun is near the horizon.

The prevailing wisdom among parents — 70% according to the study — is that if school starts later, adolescents will just stay up that much

later. So starting school later would be pointless.

In truth, numerous studies have established that delayed middle and high school start times resulted in significantly more sleep for teens, with extended sleep in the morning and minimal impact on bedtimes.

The percentage of U.S. high schools convening their first class of the day at 9:00 am or later is 3.8%.

Another myth believed by many parents (74%) is that if teens stay up late on the weekends and then sleep late too, it’s no big deal.

Ah, yes. Many adults remember those days. Sleep ’til noon on Saturdays. Now, accustomed to getting up every weekday at 5:30 am, they couldn’t sleep past 8:00 am if their lives

depended on it. The biological clock is on autopilot these days.

But that’s not necessarily bad. As we try to remind ourselves when we wake up for no reason at 6 o’clock on a Saturday morning, wildly varying sleep schedules are not healthful. For teens, getting up on Monday morning as many as 5 (or more) hours earlier than they did the day before is directly associated with all kinds of ills, the least of which is lower academic performance.

What’s the solution? Another myth: melatonin supplements can safely promote healthy sleep for adolescents (and adults). After all, melatonin is natural, right?

Sleep experts say this of questionable safety and a myth, particularly for teens, whose brains are not yet fully developed. Melatonin’s effects on puberty and adolescent development have not been studied. Researchers say melatonin supplements for teens should not be taken without a medical evaluation first. Insomnia may have a medical cause which is being masked rather than treated when melatonin is used. Additionally, OTC supplements are not as closely regulated, so their content can vary widely from one brand to another. Even so, two-thirds of parents believe OTC melatonin is ok for teens.

Kids, parents: sleep well. +

It might seem logical that a bad night’s sleep could contribute to a cranky, bad mood. If it made you less productive at work, you would not be surprised. “Although it won’t happen to me,” you might think, “I could see where it could make it more likely to be in a wreck.”

All of those assumptions are correct (except the part about thinking you can defy the odds against sleepy drivers), and as simple as those sleepless side effects might seem, each one could have extremely serious repercussions. What if the bad mood or the lack of productivity resulted in losing your job? What if the wreck killed someone?

Potentially, there is no such thing as a minor side effect to some health problem, especially if that problem is preventable. Think how often a bad night’s sleep was caused by staying up past your bedtime just to watch a movie. That’s avoidable. Maybe the movie was violent or scary, and it keeps you tossing and turning instead of sleeping. Another avoidable situation.

Some people wish that tossing and turning was the only sleep deprivation issue they had to deal with. Medical science has discovered links to far more serious conditions as the result of chronic sleep deficits.

Surprising as it might seem, not getting sufficient sleep on a regular basis elevates the risk for high blood pressure, type 2 diabetes, obesity, heart disease and stroke, mental health problems, and even early death.

Most of those might seem logical enough, but what about obesity? How could sleep loss contribute to someone’s weight?

Even scientists think this is a head-scratcher to a degree, but there are definite chemical and behavioral clues that have emerged from research. One study found higher levels of an appetite-stimulating hormone and lower levels of a fullness-indicating hormone in subjects that

were deprived of sleep. Outside of the laboratory, other lines of reasoning include the fact that people who aren’t well-rested have less energy; they are less physically active and therefore burn fewer calories. And there’s the simple fact that the longer someone is awake each day, the more time they have to eat.

How crazy would it be if the culprit in many people’s futile efforts to lose weight ended up being, not their eating habits, but their sleep habits.

The bottom line for each and every one of us, whether we’re skeletal or morbidly obese, toddlers, teens, or adults, is that getting sufficient sleep appropriate to our age group (toddlers: 11-14 hours; teens: 8-10 hours; adults: 7 or more hours) is an extremely important element in our overall salubriousness.

Now go to bed! +

WHAT IS BLOOD SUGAR?

Blood sugar is slightly different than the sugar we sprinkle on our corn flakes in the morning. In fact, blood sugar can start out life as bread, potatoes, milk, popcorn, and a host of other foods we don’t usually associate with sugar or sweetness.

Everything we do requires energy, even sitting perfectly still and pondering the meaning of life. The brain is processing your thoughts and performing a myriad of other automatic functions. The heart and lungs are working, as are all our other organs and systems.

The energy needed to keep everything running comes from what we eat and drink, and none of it is usable in the form in which it goes down the hatch. It has to be broken down or digested into components the body can use, one of the main components being glucose, a simple sugar that often comes from foods classified as carbohydrates. The foods listed above in Sentence #2 are all typical carbs. Popcorn simply cannot fit into a cell, but glucose from popcorn can, and thank goodness for that because every cell needs the fuel glucose provides. The brain in particular is a primary glucose customer.

The pancreas is instrumental in monitoring and regulating blood glucose (aka blood sugar) levels, and it does so continuously. When it detects an increase in blood sugar, it pumps the hormone insulin into the bloodstream. Chemically, insulin moves glucose from blood into cells where it can be used as energy. When blood sugar levels are normal again, insulin production goes offline until it’s needed again.

Conversely, if we haven’t eaten in a while and blood sugar levels drop, cells aren’t getting the fuel they need. In that scenario the pancreas releases the hormone glucagon, which sends a chemical signal to the liver to break down stored glucose (called glycogen) and release those hounds into the bloodstream. Blood sugar equilibrium restored.

Of course, all of the above describes what is normal, what is supposed to happen. It doesn’t always work that way. Some people develop insulin resistance, which is exactly what it sounds like. Being less effective, insulin doesn’t trigger glucose absorption into cells. Blood glucose therefore rises, so the pancreas pumps out more and more insulin in a vain attempt to restore order. The name for this condition is diabetes.

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Who is this?

FENTANYL from page 1

known drug. Even then, doctors don’t prescribe for themselves. And here we have a 15-year-old kid prescribing for himself.

Matthew and I commiserated and agonized profusely over our society’s drug problems. It is a sad situation to say the least.

A few days later the problem hit home like a ton of bricks crashing through a house of glass.

Matthew’s daughter invited her boyfriend to their family home for dinner. The boyfriend had a colorful history. He had spent a few months in jail for a minor drug offense. Came out of jail and into court-ordered drug rehab. He was doing good. Working. Getting back into the swing of the good life. He and daughter were considering marriage. Daughter had some college and a job.

buying illegal drugs.

We must teach our children self-preservation, responsibility, integrity, duty, and civility. Children must grow up to be moral individuals. Children must learn real history, the good and the bad. Children must learn math, science, and proper English. They must learn this at school and at home. Moral fiber, we used to call it. Political parties matter not. Integrity does.

Every reader undoubtedly recognizes the legendary visage of Florence Nightingale, widely considered to be the pioneer of modern nursing. The reason we all recognize her face is that there is, for all intents and purposes, a single photograph of her, at least one that is the most wellknown by a wide margin. And the reason for that, in turn, is that she strongly objected to having her photograph taken or her portrait painted. Image makers apparently respected her wishes, because the inventory of available images is scant. Early on she wrote in her diary, “God called me in the morning and asked me would I do good for him alone without reputation.” She was not in search of fame, although it came anyway. Her first published work, in fact, was released anonymously

One thing that we’ll go out on a limb and state with certainty is that no one has ever seen an image of Florence Nightingale smiling. Instead, she usually looks very serious, if not downright sad. There’s a reason for that, too. From about 1857 onward (she was born in 1820) Nightingale suffered from depression and was often bedridden. Biographers today also believe she suffered from an extreme form of brucellosis, a highly contagious zoonotic disease caused by ingestion of unpasteurized milk or undercooked meat from infected animals, plus spondylitis, a form of arthritis affecting joints of the spine.

Despite such challenges, Florence Nightingale radically transformed nursing, basically inventing the profession we know today. Before her, hospitals were places where people went to die, not for treatment. Nurses were untrained and disreputable characters, almost exactly as they were described by contemorary chroniclers like Charles Dickens: “The Dickens character Sarah Gamp, who was more interested in drinking gin than looking after her patients, was only a mild exaggeration. Hospitals were places of last resort where the floors were laid with straw to soak up the blood,” said one historian.

Nightingale has her detractors for one reason or another, but objective observers to this day credit her with countless practices and innovations that remain standards of care to this day. Prior to the discovery of germ theory, she was a champion of strict sanitation; she was a pioneer of statistics, carefully tracking patient outcomes as a method of evaluating the efficacy of various forms of treatment; she promoted nurse training, an all-new concept, as strange as that might sound today; although she never married and is thought to have pursued a chaste life until her death at age 90 because of her religious calling to nursing, she nevertheless campaigned to abolish laws against prostitution (not because she endorsed prostitution, but because laws against it targeted women only; their customers were ignored); she created an enormously important intangible: she gave nursing a favorable reputation that it had never before enjoyed.

Florence Nightingale died in London on Aug. 13, 1910. +

After dinner, daughter used the bathroom. Boyfriend sat down on the bed. When she came out, he was laying face down on the bed. She thought it was one of his jokes. He was a funny guy. She rolled him over. He was comatose. Matthew responded with skilled CPR until the EMTs and police arrived.

The EMTs figured it was a heart attack and transported him to the ER. Continued CPR and resuscitation failed. He died. He was 36. Blood tests later shed its dark light on the real problem: fentanyl and methamphetamine overdose.

Rehab had failed. Family setting and normality had failed. He preferred to experience mind-altering drugs. Fentanyl soothes perception and increases pleasant sensations. Meth excites and increases consciousness. In his case, fentanyl won. Breathing stopped. Heartbeat stopped. All in a matter of minutes. His life was gone.

Boyfriend’s story hit home. It was local. He bought drugs he knew were illegal and not manufactured under the rigorous oversight of the FDA. The kid mentioned earlier did the same thing. Both elected to pay a few dollars for illegal drugs of unknown origin, unknown content, unknown compound(s), unknown chemistry, unknown concentration, and unknown quality. Both wanted to “get high and chill,” whatever that means. Who do we blame for these two all too common deaths? China selling precursor drug compounds to Mexican cartels? Cartels manufacturing fentanyl and meth for export to the US? “Undocumented workers” hauling drugs across the border? Drug wholesalers buying in bulk and suppling distributors? Street dealers selling pills in small amounts to anyone who can walk a dark street or use a cellphone in a suburban home? Or our government’s open borders letting in over 5,000 unknown people per day?

Neither you nor I can alter any of the above.

But we do have a responsibility herein. Cartels won’t smuggle drugs if they can’t sell them for high profits. End users must stop

No one ever failed to get a job (or lost a job) because he knows the Three R’s. Because he has good manners. Because he respects others. Because he is sober. Because he is drug free. Because he has a skill. Because he refuses to use profanity. Because he doesn’t bully. Because he respects women. Because he supports his children. Because he obeys traffic laws. Because he doesn’t steal. Because he is honest. Because he is truthful. (“He” is used to indicate both male and female.)

Each adult is responsible for himself. If you don’t buy or consume illegal drugs, you will not overdose and die. Don’t play the blame others game. We must make sure our kids grow up to know and embody this simple but profound concept.

One of the most beautiful girls I have ever known said she liked “pleasant opioid feelings.” She was introduced to opioids secondary to a car crash and fractures in her neck. When she could no longer get them legally, she went into an outpatient rehab program and was prescribed buprenorphine. The treatment was successful. No street drugs. But the desire for altered mental states through opioids lingered. The doctor thought that ill-advised, and continued the successful treatment.

She changed doctors. Moved to a bigger city where things were more available. Two years later she was 28. She was still beautiful. She was also dead. Guess why? Overdosed on meth and fentanyl. Have you heard that story before? It happens everywhere.

Most likely you know someone on this Road to Destruction. Do something about it. The question is not: CAN YOU HELP? The question is: WILL YOU HELP? Show them normal, drug free life. Direct them into rehab programs. Church sponsored programs can help, and are often free. Get professional help.

Don’t give me this “I got a head full of doubts” cop out. Don’t blame everyone else.

Adults are responsible for themselves. Parents are responsible for their children. Adults must live right to teach their children to live right. All it takes is time and dedication on your part. This is how you pay rent for your room on Earth.

Failing that, you and yours might be the subject of a future column. No one wants that. Certainly not me. I don’t like how I feel while I write about such profound sadness.

BY J.B. COLLUM

Loss is something we all eventually have to deal with, but the older we get, we typically have to become a lot chummier with it. It comes in lots of forms. Some major, like when loved ones die or when abilities we once had fade. The minor losses might be from when stores and restaurants we frequented and assumed would live on past our lifetime bow to the pressure of disruptive changes. Brick and mortar bookstores and record stores give way to online versions. Even the books, records, tapes, DVDs, and CDs go from being real things you can hold in your hand, to ethereal versions of themselves that can disappear without a trace at the whim of the provider, or after their technology becomes obsolete. I remember wearing out cassette tapes of my favorite bands and having to buy another copy. They could also get damaged or erased if they got close to a magnet. They took up a lot of space too. In that sense, and a few others, I like that I don’t have to keep up with a music, movie, or book collection in racks, cases, or shelves, but there are distinct disadvantages too.

What happens when the power or internet is out? How do we watch a movie then? How do we listen to music? Of course, there are ways to get around some of these issues, but lately I have been buying old TV shows and movies on DVD and Blu-Ray. We have backup power, so I can still watch a classic movie when the internet and power are out. I mean, at our age, when the power goes out we don’t instantly think of the thing that leads to the baby boom that follows nine months after a long-term power outage. We might, but if we do, it probably won’t occupy enough of our time to get us through the darkness. Without power, I can still enjoy a real book too. No batteries required.

Don’t get me wrong. I don’t want to sound like a Luddite or an old fogey. My job involves new technology and I have always been fascinated by the latest high tech. That said, I do sometimes look longingly back at simpler times and see some of the drawbacks to our increasingly complex world. I also worry about how it is re-shaping young minds in ways that aren’t all good. This is especially on my mind now as we are raising our three grandchildren. The teenager in the group is attached by the eyeballs and fingers to her phone. We have tried to coax her into being more balanced and have therefore instituted some rules about not bring the phone to the dining room table when we are eating, among others. So as not to be a hypocrite, I also leave my phone on the bar, out of sight and reach while we eat now. I don’t like having to make hard and fast rules, but I believe that children need them.

When it comes to the loss of businesses, it seems to hit me harder than I would expect. It isn’t just about that store or restaurant. It is about the memories you have there of the people you loved and have lost. It is about a connection to the younger you who looked at some of these places with wonder, or the warmth that accompa-

Age

nies familiarity.

As a child, I greatly enjoyed visiting the Sears store at 15th and Walton Way in Augusta. The basement floor was like heaven for Dad, my brother, and me. It had toys, outdoor gear, tools, and by the mid-seventies, video game systems. The only time my brother and I left the basement floor was to either leave the store entirely, get some candy at the candy shop on the ground floor, or to be forced to try on clothes or shoes. We really didn’t like that last one. Somehow, we thought that Mom should just know what size we needed without us having to go through that drudgery.

On the basement floor, Dad’s eyes lit up when looking at the camping gear, fishing gear, and tools. He built up a nice set of Craftsmen tools over the years, and often took advantage of the fact that if you broke one, you could go back to the store and exchange it for free, right on the spot. I still vividly remember the day that our parents surprised us by buying us an Atari video game system at Sears on what we thought was a routine visit. We were out of our minds with joy over that. These memories with Dad, especially now that he is gone, are special. When stores close, or move, or even go out of business, we are cheated out of re-visiting the actual source of our memories. We know we can’t see and hold our loved ones in an embrace, but if we can go back to that spot that made them smile, it perhaps can rekindle an old memory that was fading away.

Fortunately, we have more permanent places like the national parks, that we hope and even expect will remain well past our too brief lifetimes, that can remain mostly unchanged and therefore continue to serve as touchpoints for our old memories. As we age, our memories might need more of these assists to take us back to mentally spend time with the people and places we have lost. The good news about grief though, is that over time, you don’t always cry when remembering a lost loved one. You begin to remember the happy things and you might even have a laugh or two.

I am not sure where things are going with technology and how it may continue to evolve our culture in unexpected ways both to good and bad effect, but I am glad that I have lots of memories of simpler times to see me through it. As things continue to change, I will do my best to adapt and to learn to accept it. I say that because my wife says that survivors accept change and adapt to it. I wish I could be that pragmatic. At least she is, and perhaps it will rub off on me eventually. In the meantime, I am going to try to not just enjoy memories, but to make the most of the present as much as I can, because everything else is just a memory or a dream. The present is

THE MIND OF GOD

A local radio talk show host needed some material to fit between advertisements. He came up with a plan. Let listeners call in for two days and argue pros or cons of evolution. Was human life on Earth an accident? Or a product of divine intervention?

Callers invaded his phone. The airways crackled. Everyone had The Answer. Or at least their version of The Answer.

I listened. Most all of them were convincing enough, or at least entertaining. The host had a gold mine of opinions to fill the holes between ads in his show. Dollar signs reverberated in his mind and bank account. He stayed mostly neutral, saving his profound insight for the end of the second day. The known world perilously teetered on the edge of destruction awaiting his enlightenment.

Darwin came up as often as did God. Each had dedicated devotees with various degrees of articulation.

Some dated the Earth at 6,000 years. Others at 4 billion. No one addressed how years are counted. No

one talked about Einstein’s Theory of Relativity or noted time is altered depending up how fast you move or which cosmic mass you are near. We measure a year by one complete revolution of our planet around the Sun. By our measure, a year on Mercury is 88 Earth days. But if you were on Mercury, one year on Earth is 4.15 Mercury years. No self-respecting Earth lady denotes her age in Mercury years. A year on Pluto is equal to 148 Earth years. In Pluto Time, an Earth year is a day and a half.

With that in mind, I stopped worrying about how long the Earth had been here. A long time, any way you look at it. The debate seemed a waste of time and taxed my meager brain too much. Besides that, it made no immediate difference. I reverted instead to thinking of the chemistry of the human body. Chemical reactions are in constant equilibrium. Matter and energy can neither be created nor destroyed, said Einstein. But under the right circumstances, one can be converted to the other.

BASED ON A TRUE STORY

(most of the time)

A series by Bad

Billy Laveau

Scientist say thousands of chemical reactions are happening at all times in our bodies. Think of your blood glucose. It should be between 80 and 120 if you haven’t eaten in 4 hours. Just one Twinkie puts shock waves in blood sugar equilibrium. Blood glucose might briefly jump to 250 before starting back toward the fasting range … unless a sip of Coca Cola gets mixed in, and then there is an upward shift again. The pancreas puts out a bit of insulin, and down comes the blood glucose. If you walk during all this, energy is expended and the blood sugar goes down. Spending energy requires calories, so the liver gets into the act and converts some fat into glucose and the blood sugar shift upward. These up and down shifts are

continuous. In just this one chemical reaction, there are thousands upon thousands shifts per day.

A computer keeping track of all our zillion chemical reactions would go into meltdown.

So you might think: Does all this happen by accident? Or is it by divine intervention?

Well dear hearts, fear not. I called the radio talk show to give the world The Answer. Or at least my answer. There I was, talking on the air with Lord knows who listening. I told myself I did not care what anyone else thought. It made me nervous just the same.

I said: The answer is simple. Both answers are correct. Evolution is real. Divine intervention is real. Scientific research is simply man’s way trying to understand the mind of God, and how God created man and life as we know it. The Bible tells us what happened. Science tells us how it happened. We will never truly understand all the details, but I am impressed by what we know now. That is education in progress.

Needless to say, the radio host was not thrilled by my answer. He did not want the issue resolved so simply. He needed controversy to sustain the time-consuming dialogue. He had holes to fill between advertisements. That’s how talk radio works.

When you walk across the room or work out in the gym or mow the grass, you are just a huge bundle of chemical

reactions seeking equilibrium. Every time you breath, you shift carbon dioxide and oxygen levels. Movement makes blood glucose levels oscillate. Every drop of sweat affects your serum sodium level. Light rays produce chemical reaction in your retina and your brain reacts.

You don’t have to be biochemist to grasp this infinite number of chemicals that make up your body. You don’t have to be a theologian to be amazed by the mind of God.

However, you are responsible for the alterations your daily decisions make in your biochemistry. Do you eat too much? Do you inhale chemical fumes you could avoid? Do you intake chemicals that encourage cancer? Many chemical reactions are beyond your control. Others are determined by your decisions and actions. (Examples: alcohol, nicotine, excessive salt, recreational drugs, and the like.)

Whether you are a “Divine Interventionist” or an “Evolutionist,” don’t tinker with what works when left alone.

My mother told me more than once: Act like you have good sense … whether you do or not. Sears Roebuck doesn’t have new bodies on layaway. I think she may have been right.

Oh, I almost forgot the radio host’s sage opinion. He punted and said, “Everyone should make up their own mind.” Losing or offending listeners doesn’t help ratings or make money

TRYTHISDISH

by Kim Beavers, MS, RDN, CDCES

BAKED KALE CHIPS

You just never know what your kids will eat until you try something. I have two kids and one of the two loves this recipe. I call that a win, I hope you like it as much as at least one of my kiddos does.

Ingredients

• 1/2 bunch of Kale, about 4 oz (cleaned, dried and steams removed)

• 1 tablespoon extra-virgin olive oil or canola oil

• ¼ teaspoon salt (or to

taste) OR ½ teaspoon Jane’s Krazy Mixed-Up Salt

• Vegetable oil cooking spray

Directions

Preheat oven to 300°. Line a baking sheet with parchment paper. Tear kale into bite size pieces, toss with oil, and lay single layer on baking sheet or 2 sheets (limit overlap). Sprinkle with seasoning and spray lightly with cooking spray. Bake until edges are brown but not burnt (about 20-30 minutes).

Do watch these closely as there is a fine line between done and burnt.

Yield: 4-6 servings (nutrient information for 4 servings)

Nutrients: Calories 70, Fat 4g (0g saturated), Sodium 150mg, Carbohydrate 8g, Fiber 1g, Protein 3g.

Percent Daily Value: 260%

Vitamin A, 170% Vitamin C, 10% Calcium, 8% Iron.

Diabetes Exchange Values: 2 Vegetables, 1 Fat

Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb

ASK DR. KARP

Are there any foods or supplements that you should turn to when you have a cold or are trying to prevent one?

For most of us, the answer is, no. For people in high stress occupations or high-intensity sports, there may be some benefit to taking Vitamin C. The science and data are not conclusive, however, so don’t jump on the stress/ sports Vitamin C bandwagon.

NO NONSENSE

NUTRITION

Willie from Aiken asks:

“I have one of those miserable, late winter/early spring colds. Should I take Vitamin C for it? Anything else I can do nutritionally?

I’ve heard that chicken soup helps.”

There are many urban and social media myths about the relationship between foods, supplements and the common cold. Most people automatically think that one or more of these substances can help cure the common cold: vitamin C (ascorbic acid), echinacea, zinc, chicken soup or hot tea with lemon, honey, and sometimes, whiskey. What the data does not show right now is any overwhelming scientific evidence to recommend the use of any of these foods or supplements for treating the common cold.

When I think about whether there is a connection between the common cold and foods or supplements, three separate questions arise related to the frequency, severity or duration of the common cold.

• Can a food or supplement decrease the number of times (the frequency) you catch a cold? The data on this is clear. No. If you are interested in decreasing how many times you catch a cold, then wear a mask (not very popular these days), stay away from infected individuals and large groups and wash, wash, wash your hands. Don’t cough into your hands and wash your hands, repeatedly, after touching surfaces in potentially infected environments, like those in public places.

• Can a food or supplement de-

crease the risk of having a very bad cold (the severity)? The data here again is very weak that a particular food or supplement can have a meaningful effect on cold severity. It is just not worth the time, money and effort.

• Can a food or supplement decrease how long (the duration) you have that cold? There actually is some evidenced-based data that shows vitamin C may slightly decrease the duration of a common cold, from perhaps 7 days on average to 6.9 days (a few hours). This effect is weak and variable, and there is not a strong justification for taking foods and supplements for this reason. There is some controversy about this in the scientific community, so more data might emerge in the future. Stay tuned.

I grew up in a family that swore up and down about the beneficial effects of chicken soup on a cold. At the slightest sniffle or cough, the chicken stock, carrots, celery and matzo balls magically appeared. What does the data show? Overall, there are no scientific or nutritional reasons to eat chicken soup as a cold treatment or cure-all. Yes, the thought does bring some sentimental tears to my eyes and makes me feel warm and cozy. There is some data to show that if you “think” a treatment for a cold is working, then that alone might have some positive effects. This is known as the placebo effect. The placebo effect is definitely real; however, it is quite variable and cannot be counted on for consistent, reliable, reproducible results.

Probably the most helpful part of eating chicken soup or drinking hot tea, honey and lemon is inhaling the steam and helping you stay hydrated, which may help loosen mucus. When you have a cold, should you add that shot of whiskey to your hot toddy? Not a good idea. Whiskey may interfere with prescribed and over-the-counter medications. If you are at genetic risk for alcoholism, this can also be a problem.

What’s the “No-Nonsense Nutrition” advice for today? Want to avoid catching a cold? Stay away from large groups of people, wear a mask, and routinely wash your hands.

Want to try some of the home remedies and supplements to decrease the severity or duration of a cold? If you think a home remedy is helping, then it just might. At any rate, enjoy your homemade chicken soup, and have it with a salad.

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.

Dr. Karp

COLORECTAL HEALTH

and deli meats) has been found to significantly increase the risk of developing colorectal cancer. These highly processed foods are preserved with nitrates and nitrites which are converted to carcinogenic nitrosamines during processing and cooking. Research shows that high consumption of red meat is also directly associated with increased risk of developing colorectal cancer. Limit intake of red meats such as beef, pork, and lamb. Choose leaner animal protein sources such as turkey, chicken, fish or other seafood options, and eggs. Increase intake of plant protein sources like beans, peas, lentils, quinoa, nuts and nut butters, and seeds such as chia or flax.

by Lizzie Keen, MS, RD, LD, CNSC Augusta Oncology

March is nationally recognized as Colorectal Cancer Awareness Month. Colorectal cancer is defined as the formation of cancer cells in the colon or rectum, both of which are part of your large intestine. According to 2022 statistics from the National Cancer Institute, colorectal cancer is the second leading cause of cancer death in the United States, behind lung cancer. It is estimated that around 52,550 people will die from colorectal cancer in 2023. The average lifetime risk of developing colorectal cancer is approximately 1 in 23 for men, & 1 in 25 for women. However, this type of cancer can be preventable, and has a high treatment success rate when caught in early stages. In fact, the 5-year survival rate for localized colorectal cancer is 90.6% according to statistics from the National Cancer Institute’s SEER program (Surveillance, Epidemiology, and End Results). Did you know that you can significantly decrease the risk of developing colon cancer by early screening and making healthful lifestyle changes? Here are some tips!

• Early Colonoscopy Screen-

ing: Everyone should get screened for colorectal cancer! A person’s individual risk factors such as genetics or family history will determine when one should start getting screened. For those with no family history, the American Cancer Society recommends initial colonoscopy screening begin at age 45.

• Consume a diet rich in plant foods: Increasing fiber intake has been shown to decrease the risk of developing colorectal cancer. Fiber is like Drain-O for your gastrointestinal tract. Fiber helps keep your bowel movements regular which in turn keeps your colon clean and healthy. Fiber is found in plant foods which contain a wealth of health benefits. They are chock full of phytochemicals and other cancer fighting antioxidants. Fiber also helps with blood sugar management, and improves satiety meaning you will stay fuller for a longer period of time. Load up at least half of your plate with a colorful array of plant foods such as vegetables, fruits, whole grains, beans, peas, lentils, nuts, and seeds!

• Limit processed meats and red meats: High intake of processed meats (such as hotdogs, sausage, cured ham,

• Get regular exercise: The American Institute of Cancer Research recommends being physically active for a minimum of 150 minutes per week. This can be easily met by walking for 30 minutes five times a week. If that seems like a daunting task, start with a small, achievable goal and work toward increasing stamina. Experiment with different areas of exercise such as aerobics, strength training, balance, or flexibility. For those with joint pain, swimming and water aerobics are great forms of low impact exercise. The overall takeaway regarding exercise is move more, sit less!

• Limit or avoid alcohol: Evidence strongly suggests that alcohol consumption is correlated with developing at least six different types of cancer, including colorectal cancer. It is recommended to limit alcohol consumption or avoid altogether if possible. For those who wish to consume alcohol, try to limit intake to no more than two drinks per day for men, and one drink per day for women. Be mindful in social settings. Try alternating alcoholic drinks with water or club soda, and skip the double pours and extra-large brews. Follow these tips to decrease your risk of developing colorectal cancer. Healthy eating and regular exercise can also help prevent or aid in management of chronic diseases such as diabetes and hypertension. Even the smallest healthful lifestyle changes can make a big difference!

Resources:

• American Association for Cancer Research

• American Cancer Society

• American Institute for Cancer Research

• Colorectal Cancer Alliance

• National Cancer Institute: Surveillance, Epidemiology, and End Results Program

• National Center for Biotechnology Information

• NCCN Guidelines for Patients, Colon Cancer, 2022

Tasty tips from registered dietitians with the Augusta Dietetic District Association

In honor of St. Patrick’s Day, add some green fruits and veggies to your plate to increase your fiber intake!

CRASH COURSE

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

Several cups of ink in this issue have been devoted to words pertaining to sleep and the various effects of not having enough of it, or having plenty of it. Why? March is peak season for sleep issues, courtesy of those two little words, “spring forward” (which takes place in the wee hours of March 12) Losing a full hour of sleep is a pretty significant loss: studies by the National Institutes of Health found the average American adult gets less than 7 hours of sleep per night. So losing an hour represents about a 15% sleep loss from people who already aren’t getting enough.

that sleepy semi-zombie zone, replete with compromised alertness and delayed reaction times. Nationally, and right here in Aiken and Augusta, drowsy driving is a big deal, and it can happen at any time of day. Statistically, sleepyheaded drivers are involved in more than 328,000 crashes annually, including 20% of all fatal crashes. That is perhaps no surprise considering that nearly half all adults say they have driven while struggling to stay awake.

AWAKE AT THE WHEEL

That might not be a huge deal for someone who is retired or works from home. Maybe a short afternoon nap will address the sleep deficit and help things along until the adjustment to Daylight Saving Time gradually happens on its own.

But for someone who has no choice but to maintain their usual rigorous schedule despite their fatigue — well, fatigue greater than their typical fatigue — it can be even more of a challenge.

And because this is “Crash Course,” let’s zero in on fatigue behind the wheel.

What comes to your mind first? Long distance truckers? Maybe. But let’s hold off on them. After all, how many of them read this newspaper? A handful? By comparison, how many of us drive down I-20 or Riverwatch Parkway every day? Thousands. And that afternoon drive can happen at a time when the sleepies are apt to strike on a good day, let alone in the aftermath of the clocks changing. Put the pedal to the metal and maybe the adrenaline alone will get you home safely (or to the scene of your wreck more quickly), but throw in a traffic jam — like the daily 2-mph crawl to get to the Grovetown exit, or to finally make it through the Riverwatch light at Alexander — and it can be hard to keep your eyes open.

When traffic finally does clear, drivers are resuming full speed while they may still be in

DEARREADERS

High-risk groups who need to be especially cautious include night shift workers who drive, drivers with sleep disorders such as sleep apnea, people taking medications that can cause drowsiness, and anyone who is sleep-deprived (which studies suggest is a majority of us).

What are the early warning signs? Constant yawning is an obvious signal. Drifting out of your lane is another big red flag. Suddenly realizing you have no recollection of the past few miles you’ve driven could also be a warning sign. In that stretch of time you could have missed your turn or exit. If so, you are clearly not thinking clearly.

What can be done to prevent waking up in a ditch, the ER, or the morgue?

It isn’t a “game-time” decision. It starts way ahead of time with getting sufficient sleep, every night if possible. At least 7 hours nightly is the recommendation for adults.

We have all recognized the signs of drowsiness and kept on driving. Not a good idea. The wise course is to recognize drowsiness and do something about it: on the interstate, for example, get off at the next exit and find a park, a Walmart, or a truckstop. Get out and walk around. Go into a restroom and splash cold water in your face. In a safe place you might even set an alarm on your phone and take a 20-minute nap in the car. Whatever works for you, the extra few minutes you spend could pay huge dividends if they prevent a serious accident.

Let’s agree that sleeping cars should be on passenger trains, not on the road.

MEDICALEXAMINER

As you probably know, the Medical Examiner is normally published twice a month with an issue date of every 1st and 3rd Friday. Once in a while something interferes with that routine, like a certain golf tournament, for instance. Instead of publishing an issue dated April 7 (during tournament week), we’ll take advantage of this month’s five Fridays and do that issue on March 31. We’ll all pretend that’s our 1st Friday edition, then resume the normal schedule on the next issue, April 21, April’s 3rd Friday. Mark your calendars today!

03

17 31

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SHORTSTORIES

A HARD LESSON LEARNED As an immunologist/allergist, I have seen many patients with various health issues. But there is one patient, a woman, who stands out in my mind. She had been experiencing difficulty breathing and had been seen by five doctors before coming to me. As I listened to her lungs with my stethoscope, I heard something that made my blood run cold. On the left side, everything sounded normal. But on the right side, in the middle and lower lobes, there was nothing. Absolutely nothing. No sound whatsoever. I knew something was terribly wrong. I sent her immediately to the emergency room for a chest x-ray.

The results were devastating. A massive tumor was blocking the air from reaching the lower lobe of her right lung. We could not tell how long it had been there, but it had grown to an enormous size. Despite five doctors seeing her before, none of them had listened to her lungs. Her condition amounted to a death sentence, and died within a couple of months.

This experience left me with a deep appreciation for the importance of listening to the lungs and the need to pay attention to the small details. I encourage my patients to sit still and do exactly what I say during their visits. It’s a small thing, but it can make a big difference.

the blog spot

— posted by Nathan J. Hemberly, DO, on 2/26/2023 (edited for space)

A DOCTOR’S PERSPECTIVE ON CHILDHOOD OBESITY PREVENTION

Now here is a book that delivers. You’re promised bones, and bones you shall get.

take 300,000 of them placed end to end to span the space inside this “o.”

WE CAN’T SIMPLY IGNORE IT

I’m starting to see a trend of podcasts and articles that seem to be raising the white flag of surrender against childhood obesity. We should all agree that these conversations should be approached carefully and thoughtfully. We should agree that there are clear reasons to promote regular exercise and a healthy diet. We should agree with the clear health benefits of maintaining a healthy weight. There are clear mental health benefits as well. I didn’t think I would see a day where these points would be debated.

Suddenly I see an argument that we should give in to any diet; any weight is acceptable. Recently, one podcast went as far as to say doctors are to blame for poor outcomes in obese patients because we treat them differently and poorly. After all, we make assumptions based on their body shape.

What about the stigma that doctors don’t have their best interests in mind? That’s a battle we fight daily; we don’t care, lack empathy, and want to make money. Those who try to help our pediatric patients lose weight are doing it because we want our patients to be healthy. We battle every day to fight the chronic conditions created by obesity, knowing that weight loss isn’t realistic for most patients due to the complications of their conditions, orthopedic issues, and so on. I almost have to ignore their obesity because there are so many other issues to address. So to say I’m focusing on that is outrageous.

I worry this is another example of doctors giving in to what patients want to hear. They don’t want to be told what they should do better. There is not enough personal responsibility in every corner of society. Our job is to honestly – yet thoughtfully – coach patients toward goals that will improve their quality of life. If we’re going to quit helping them eat better and exercise, we might as well quit our profession completely.

As a child, I was overweight and grew up lacking self-esteem. I remember constantly pulling my shirt out so my belly would stick out less. It was impossible to talk to the opposite sex. My entire life made a pivot when I got to college and succeeded academically, but I also lost about 40 pounds. I had confidence I never imagined.

Fast forward to 2020, when the pandemic hit. Like most of us, I had a lot of anxiety to deal with and, surprisingly, extra time as our appointments were canceled to keep everybody home. I started running – a lot. The resulting 50-pound weight loss and the marathons I’ve finished are things to be proud of. Seeing the number come down on the scale was one of the few things in my life I could control, and it gave me a sense of satisfaction in a chaotic world.

Did my dieting in college put me at risk for disordered eating as an adult? Possibly. Did my obesity as a child lead to anxiety and potential depression that has been lurking somewhere ever since? That’s possible too. I actually consider myself lucky that my anxiety manifested in exercise rather than a controlled substance like alcohol, gambling, or even physically harming my family. I came out of the deal healthier than ever.

Most of my anxiety came from everything I learned as a doctor being flat-out ignored during the pandemic. When things go right, it’s because somebody without qualifications has “done their research.” When times are tough, the doctor is mean and doesn’t know what he or she is doing.

I’ll have to learn to be mindful of how I react to this new war – or list of excuses – against childhood obesity.

Nathan J. Hemerly is a family physician

You and I might not be able to fill more than 300 pages with what we know about bones, but then, neither you nor I happen to be orthopedic surgeons, or clinical professors thereof at UCLA. Roy Meals, MD happens to be all that and then some. The good doctor has been practicing his trade for forty years, and it shows.

The problem with someone who knows his craft ”Inside and Out” is that they sometimes forget that what is ordinary, everyday knowledge to them is totally Greek to the uninitiated.

Fortunately for those fortunate enough to read this book, Dr. Meals goes easy on medical terminology — real easy — and when he does throw in some 14-letter word (sometimes he apologizes for doing so, explaining that it was unavoidable), he not only explains how to pronounce it but then explains its job within bones using an analogy a ten-year-old would easily understand.

For example, early in the book he explains that bones

are built from individual collagen molecules that resemble corkscrew pasta. They connect with each other extremely tightly both mechanically and chemically like, he writes, tiers of Legos smeared with Super Glue before being snapped together. It isn’t difficult to picture than word picture.

The same is true for his explanation of the extremely minute scale at which bone building occurs: It would take seventeen hours of collagen molecule building at the rate of one molecule per second to build a stack as thick as this page is thick. Another word picture he paints for us about collagen molecules: “It would

The book is liberally sprinkled with these kinds of gee whiz facts, and Meals’ favorite word may well be “remarkable.” As it should be.

But this is far more than just a book about bones. It is also a thorough history of the medical treatment of bones and the assorted troubles they sometimes give us, and the medical pioneers who have refined and improved the art and practice of orthopedics over the centuries.

Also covered in detail are the many practical uses of bones when they aren’t inside a body anymore. Human and animal bones have been used for centuries as tools, art, weapons, religious objects and talismans, musical instruments, and clues for paleontologists and homicide detectives, and much more.

Bones is a fascinating book, one that anyone (including practicing orthopedic doctors) will learn from and enjoy.

Bones: Inside and Out by Roy Meals, MD, 304 pages, published in October 2020 by W. W. Norton & Company

What are you giving up for Lent?

Be serious! I’m giving up on all my New Years resolutions. Hope.

If you insist, I’m giving up lunch meat for Lent. All of it.

Cold turkey?

THE MYSTERY WORD

The Mystery Word for this issue: ASNSKC

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. Part of a pirate’s logo 6. Medic beginning 10. Cone dropper 14. Lofty nest 15. Money of Cambodia 16. An addict 17. Desert region of Israel 18. Not written 19. One of 18 in golf 20. Unity 22. Varies; disagrees

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

32. Bell description

33. Noted Augusta burn survivor Shirley

35. Character famously played by Joanne Woodward

37. Belonging to us

40. Like a frozen lake

41. Soviet spacecraft

9.

10.

11.

12. Close

13. Energy units

21. Gannet or goose

23. Anti-aircraft fire

26. Augusta intro to 1-D 27. ____ Flu

28. The narrow tops of bottles

29. Daughter of Mariel (Hemingway)

31. Leisurely stroll (Literally, “step” in Spanish)

44. Small recess 46. Relating to the thigh 49. Local Army hosp.

Pertaining to skin

Relating to the nose

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.

1. Augusta follower of 26-D

2. Sharp

3. Exhort

4. Mortgage

5. A mason’s trowel can be one

6. Gland in men

7. Atmosphere

8. What cards are scanned by

______ health professions

Uses a pipe

Small island

THEBESTMEDICINE

A man driving down a lonely country road realized he was hungry, and fortuitously, he came around a curve and saw a rustic roadside cafe that promised classic southern country cooking. He liked to eat healthy, so after looking at the menu for a moment he asked the waitress, “Do you have anything that doesn’t have lots of sugar and fat?”

“Napkins,” she said helpfully.

The Advice Doctor

Anew recruit at NASA’s rigorous Astronaut Training Center vomited on his first day of training. He asked the instructor, “Is this normal?”

“Not during the written exam, no,” the instructor replied.

Moe: When I die, I’d like my remains to be scattered over Disney World.

Joe: Aww.

Moe: Also, I don’t want to be cremated.

Moe: Whenever I’m in trouble I always ask myself, what would Jesus do?

Joe: And?

Moe: Usually I play dead and disappear for three days at a time.

Moe: I need to get a really fragrant tomato for a recipe. Any suggestions?

Joe: A roma.

Moe: I really hate being schizophrenic.

Moe: So do I.

Moe: I hate being indecisive. Or do I?

Helvetica and Times New Roman walk into a bar. The bartender takes one look at them and yells, “Get out! We don’t serve your type!”

Doctor: Unfortunately, you have only about three minutes to live.

Patient: Three minutes? Doc, is there anything I can do?

Doctor: You could boil an egg.

A man was walking down a certain stretch of Washington Road when a seductively dressed woman approached and said she would do anything he wanted for $200.

“Anything?” the man asked in disbelief.

“Anything, sugar,” she said with a wink.

“That’s great,” the man said, reaching for his wallet. “I need my house painted.”

Moe: What’s the fastest way to stop an argument between a bunch of deaf people?

Joe: Turn out all the lights.

Clerk: What day is your birthday, sir?

Patient: February 29.

Clerk: That’s cool! What year?

Patient: Let’s see...1996, 2000, 2004, 2008...

Dear Advice Doctor,

Back in the day I will admit I was a terror behind the wheel. Speeding, tailgating, you name it. I got a few tickets, but that just made me an angier, more aggressive driver. Over time, though, I began to realize the stupidity of my actions. I’ve toned it down by several notches. Dozens, I would say. What still makes me scratch my head are these smart young kids of today. You would think they would straighten up and fly right. But they’re just as dumb as I was. Is there any hope for them?

— In the Slow Lane Now Dear Slow Lane,

Thank you so much for writing to get an answer to this intriguing issue. I’ve had the same question myself: why am I scratching my head all the time?

It can definitely be annoying, but in most cases it isn’t serious. Even so, anything that doesn’t go away in a few days really should be checked by a doctor. Granted, doctor appointments can be expensive, but is anything more valuable or precious than our health? Imagine if you finally went to see your doctor and were told, “If you had come in sooner this situation wouldn’t be so serious. This is going to be quite a challenge to treat.” Sometimes the old saying “a stitch in time saves nine” applies.

Among the simple reasons for an itchy scalp could be nothing more than dry skin, scalp psoriasis, eczema, dermatitis, a fungal infection, or even a reaction to hair dye or a new shampoo. Several of these possible causes will not go away on their own without medical treatment. Some sources suspect nutritional deficiencies, like a lack of vitamins B6 and B12

Most of us are in the habit of washing our hair every day, but dermatologists and hairdressers alike tell just about anyone who will listen that daily shampooing is unnecessary. The dry skin it can create is certainly a possible cause of that itchy scalp.

Taking showers with super-hot water can likewise exacerbate the dry skin; ditto for blasting hair with a blow dryer.

Once the itching starts, habitually scratching the itch can irritate the skin and make the symptoms even worse.

The best course of action if simple steps don’t provide relief is to visit a dermatologist or your family doctor.

Thanks again for writing. I hope I answered your question.

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!

NAME ADDRESS CITY STATE ZIP

Choose six months for $22 or one year for $40 . Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903- 0397

THE MYSTERY SOLVED

The Mystery Word in our last issue was: MUSCLE

...cleverly hidden in the p. 8 ad for ATTORNEY GREG LEOPARD

THE WINNER: BRANDY HALL!

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!

The Celebrated

MYSTERY WORD CONTEST

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

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

PROFESSIONAL DI

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LONG TERM CARE

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SHORTSTORIES

HOW DID THIS PATIENT SURVIVE? PART I We responded to a scene where I initially thought the person must be dead, but was actually fine.

A person had been driving down a long highway in a fairly remote area, not wearing their seatbelt, going at least 70–75 mph, when they dozed off or otherwise lost control of their car. They went off the highway into the dirt, rolling their car a few times. We were called out when another driver came along who knows how much later and saw a car on its side.

When we pulled up to the scene over half an hour later – as I said, this was remote — I saw a car on its side and a body on its underside that appeared to be partially ejected. I thought the patient was going to be dead. As it turns out, the person was tossed around in the car during the rollover (as expected with an unrestrained driver), and ended up on the side the car landed on (because…gravity) with their head between the top of the door frame and the rocky dirt ground. Which, of course, would normally squish a person’s head and there wouldn’t be much that any human could have done for them.

But this car happened to also land up against a large rock against the top of the doorframe of the rear door, almost exactly the height of the driver’s head. So the patient’s head was saved because one rock prevented their head from the weight of a car landing on and probably rolling over it.

The patient was quite angry with us for using jaws of life to get them out and for calling in a flight medic (we were over an hour out from a hospital by ground). I assumed that this was due to head trauma because, really, who is going to complain about us trying to safely remove them from their destroyed car that sat on their head?

I found out later that the patient only had a couple fractures and no head injury and was released after a couple days. The patient of course was incredibly lucky. Most unrestrained rollovers do not end happily, and I hope the driver ultimately learned something from his experience.

SHORTSTORIES

HOW

DID THIS PATIENT SURVIVE? PART II When

I was young I picked up shifts at a nearby skilled nursing and rehabilitation facility. I worked there maybe twice a month for about 2 years. It was not your typical nursing home. The residents ranged in age from 14 to very old. Most had either a spinal cord injury or a head injury. Many of them were wards of New York state, which had a contract to send patients to this facility in Massachusetts. There were a lot of cool people there. Some people can’t cope with their physical limitations. Some people had injuries so severe they needed constant care. Most of them simply didn’t have anyone to care for them.

There was a patient, a teenage girl age 16 when she arrived. She was there because she shot herself in the head with her father’s gun. The bullet passed through her brain, but she could walk and talk. She could feed herself. But she was like a 6-year-old child, mentally and emotionally. She loved to play checkers, even though she wasn’t very good at it. I played with her many times and I lost most games. Win or lose, she loved to play, but she really loved to win.

I wondered how she was alive. I wondered why she was alive. Mostly I wondered why she was there. Why didn’t her family keep her home and take care of her? I don’t know the answer. But I hated her parents for it. I never met them, but honestly, all these years later I still hate them.

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