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APRIL 2, 2021
AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006
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10 Commandments FOR PLAYING GOLF DURING A PANDEMIC
by Bashir Chaudhary, MD; Art Taft, PhD; Coleman King, MD
LISTEN UP! The big question, though: to whom should we listen? In one ear, plenty of people are saying it’s time to start reopening the world, and there are officials here and there doing just that. But in the other ear we hear the battle against COVID-19 has not yet been won, and after all this time it’s still too soon to begin a wholesale return to normal. Who can you believe? It’s quite simple, actually. Just as we don’t tune in to ESPN or HGTV for the weather forecast, business and political leaders are often not best source of coronavirus information. Their pronouncements are often based on political expediency, economic factors, or both. The best source of accurate information about COVID-19 comes from public health experts and those in the medical field. Their recommendations are based on the best science currently available to protect life and health. Keep in mind that just as many restrictions have been voluntary, relaxations are too. No one can be forced to go mask-free if they prefer to be masked. A business can’t be compelled to relax distancing guidelines if the owner’s preference is to maintain them. The best way to emerge from this pandemic unscathed is to patiently follow the advice of public health experts. They aren’t perfect, but at least their guidelines are based on protecting your health, not making a buck or getting reelected. + Please see also “Are we there yet?” on page 3
1. Thou shalt not show up at the golf club if you are sick. Please do not bring the virus to the course. Stay home if you have common flu-like symptoms: fever, cough, sore throat. Get your golf fix from television. 2. Thou shalt not abide any virus on your hands. Wash your hands, wash your hands and then wash your hands some more. Or use a hand sanitizer. Frequently. 3. Thou shalt not receive or distribute virus by shaking hands. Greet your friends with an air fist bump, a bow, a head nod, or a foot shake. A putter tap or a club tap will also suffice. Elbow bumps are discouraged (see Commandment #5) 4. Thou shalt not contact sullied areas. Walk the course if you can. Ride one person per cart. Sanitize your cart. Don’t handle your partner’s clubs, ball, or ball marker. 5. Thou shalt not cough in the direction of a nearby person. Cover your nose and mouth with a tissue when coughing or sneezing, cough into your shoulder or use the inside of your elbow. But then don’t do elbow bumps.
6. Thou shalt not use rakes in bunkers. Smooth the sand using your feet after a bunker shot. 7. Thou shalt not celebrate good shots with a high five. When you want to congratulate your partner, an air fist bump or a bow will aptly convey your sentiment. 8. Thou shalt not covet the close proximity of your golf buddies. Maintain a respectable distance. Remember; “divided we stand, united we fall.” A safe distance is 6 feet (remember the two club-length rule!). 9. Thou shalt not disturb flagsticks. Everyone eventually arrives at the hole and the flagstick is frequently touched but seldom disinfected. Since the virus can survive on surfaces for a long time it is recommended to not touch the flagstick. Ask the club’s staff how they have modified each hole’s cup for easy removal of the ball. 10. Thou shalt not spend too much time on the 19th hole. Safe social distancing may be difficult in dining areas. Take your drinks outside. When settling bets remember that cash is dirty. Venmo is a safe option. +
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THE FIRST 40 YEARS ARE ALWAYS THE HARDEST
APRIL 2, 2021
PART 2
PARENTHOOD by David W. Proefrock, PhD
Your 15 year-old daughter has become extremely moody and gets angry very easily. Her friends won’t have anything to do with her anymore. When she is in one of her moods she says she wants to die. She sometimes goes to her room and stays for hours at a time. When she comes out, she acts like nothing has happened. What do you do? A. Adolescents go through phases like this. there’s no need to do anything. She’ll be back to her old self soon enough. B. Talk with her about how her anger and moodiness are turning her friends against her. Work on ways for her to relate better. C. Take her to a mental health professional for an evaluation. D. Take her to her physician to make sure that there is nothing going on physically that is negatively affecting her mood. If you answered: A. Adolescents do go through phases, but they are not usually this severe or long-lasting. It’s time to seek professional help. B. She has to be well aware of how her moodiness is affecting her friends. She either can’t or won’t do anything about it. Either way, she needs to be seen by a professional. C. This is a good response and may well be where you end up, but it’s not the place to start. Have her seen by her physician first to make sure there is not a physical issue. D. This is the best response. There are a number of physical problems that affect mood and behavior. If there is nothing physically wrong with her, she needs to be evaluated by a mental health professional. Adolescence is a tough time and most kids have some problems navigating it. However, as a parent, you should be aware of when a tough time becomes a real problem. Driving your friends away is more than a tough time. +
Longtime Examiner readers fondly remember “Musings of a Distractable Mind,” the long-running Examiner column by local physician extraordinaire Rob Lamberts, M.D. He returns here in a short series addressing COVID concerns, vaccine questions and more.
The Vaccines Are Risky First off, let me point out that as I write this nearly 100 million vaccine doses have already been administered in the US with minimal reports (See the 3/19/21 of problems. If you look at the Vaccine Adverse Events Reporting from the CDC, you see that the numbers of deaths following vaccination are issue for #1) minimal, and the vast majority of those happened in long-term care facilities, where the normal death rate is high to begin with. So if it’s a 1 in 1,000,000 chance a person would die on any given day from any cause, then by giving 100 million vaccine doses you could predict that about 1,000 people would die from various causes after getting the vaccine whether related to the vaccine or not. And remember, the majority of the earliest vaccinations were given to the most frail, the most likely to die from any cause. Furthermore, if we had 100 million cases of COVID (instead of 100 million vaccine doses), the death toll would be over 1 million from COVID-19 (based on 1% death rates). I don’t think it’s unreasonable to say that we’ve already saved 1 million lives by giving the vaccines we’ve given so far. So what about the most common concern I’ve heard: that these vaccines were developed rapidly and we don’t know the long term effects are going to be? Here’s my answer to that: The vaccine trials for COVID were far, far larger than any previous ones done, with very little ill effects reported. What long-term effects are people worried about? Having practiced medicine for 30 years, I do not know of any long-term effects that show up years after a vaccine is given. If there would be long-term effects (such as Guillain-Barré syndrome in flu vaccines - which, by the way, is far less likely than dying from influenza itself), we’d be seeing them in large numbers now. Some are concerned that RNA is the main ingredient with the two main vaccines in the US. They worry that somehow this could alter our DNA and cause problems. The problem with this is that it doesn’t jibe with how messenger RNA works. Messenger RNA never enters the nucleus (where the DNA is), but instead goes to the cytoplasm of the cell, specifically to a structure in the cell called a ribosome. The messenger RNA goes into the ribosome and is translated into a protein (using the specific code in the RNA) and is then destroyed. In this case, the RNA encodes the spike protein of the COVID-19 virus. That protein serves as a “wanted poster” in the bloodstream (and elsewhere), alerting the immune system what the virus looks like. The spike protein is made in huge quantities and creates a much stronger immune response than the virus itself would elicit (as viruses try to avoid detection), and so are much better at preventing future infection than, say, the natural immunity an infection would offer. Right now it is estimated that the vaccines will give at least 2 years of immunity, while the infection is much lower (for the reasons I just gave). In fact, we are seeing people getting re-infected with the virus within 6 months of first infection. The vaccine is safe and very effective. My last bit of evidence of this is the following table (which speaks for itself):
MYTH #2
Approximate # of people who received the vaccine
# hospitalized for COVID
# who died from COVID
# who died from the vaccine
Moderna
15,000
0
0
0
Pfizer
18,600
0
0
0
Novavax
13,000
0
0
0
5,800
0
0
0
22,000
0
0
0
Dr. Proefrock is a retired clinical and forensic child psychologist.
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Vaccine trial
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Of people vaccinated in the trial
These trial numbers are dwarfed by the number of people who have been vaccinated. The data from Israel, which has the highest vaccination rate, are very impressive so far. There, only 0.04% of people caught the virus a week after their second dose, and 0.002% needed hospital treatment. So I hope you get my drift: the vaccine is very safe and very effective. Next time, Myth #3: I’m young and healthy, so I don’t need no stinkin’ vaccine. +
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AUGUSTAMEDICALEXAMiNER
APRIL 2, 2021
ARE WE THERE YET? Boys and girls, we have made enormous progress. We have traveled many miles down the pandemic road. But are we there yet? Are we where we want to be? Are we safe yet? Is the pandemic dying out? The answer to all of these questions is the same: no. In fact, earlier this week CDC Director Rochelle Walensky, MD — someone who would certainly be in a position to know — said she has a feeling of “impending doom.” Why? She noted COVID case numbers, hospitalizations and deaths are all currently trending upward. This far along in the fight, that is not good news. On the plus side, tens of millions of vaccine doses have been administered, and millions more are soon to be injected. And the 30 million plus people who have contracted the virus so far have some (unknown) degree of (at least temporary) immunity. Those are all good things.
On the negative side, as one health official recently noted, fatigue is winning. All of us are sick and tired of the countless restrictions and inconveniences we encounter, large and small, every single day. We’re so ready for all of this to be over. Perhaps this would be the perfect moment to remember Capt. John Paul Jones and his memorable response to the
invitation to surrender in his Revolutionary War battle with a British frigate: “I have not yet begun to fight!” Amen. This is no time to stop the fight or we risk losing what we have gained so far. Patience and obedience might be the best weapons in our collective arsenal. Let’s not hesitate to use them. The alternative could well be “impending doom.” +
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More and more researchers — and patients — are learning that when COVID goes away, sometimes it doesn’t completely go away. Some people who have had the virus have been fully cured, but don’t tell them that. Their doctors say all their relevant tests come back negative, so they definitely no longer have COVID-19. But these patients say they still have fatigue, brain fog, shortness of breath, chest pains, GI problems, depression, anxiety, and issues with taste and smell, among other issues. Both groups are right. These people no longer have the virus or any active cells of it in their bodies, but many have an emerging condition known as post-COVID-syndrome, or PCS. You may have heard people with PCS described as long-haulers. Scientists are still trying to determine what causes PCS, but there is a short list of suspects. In one European study, 60 percent of the people studied had above-normal levels of inflammation. Another finding being investigated is the presence of excessive antibodies. In other words, the body’s immune system, which geared up to DefCon3 for its COVID response, has not returned to peacetime levels. Doctors think the immune system in such patients may be mistakenly attacking healthy cells. After all, other autoimmune diseases, like lupus and rheumatoid arthritis, produce many of the same symptoms as PCS, like fatigue and mental haze. Another PCS culprit may be the presence of tiny blood clots, and blood vessel damage left behind by coronavirus. Doctors have found high levels of protein in the blood of former COVID patients, making blood extra prone to clotting. One of the effects of the virus is damage to arterial walls, transforming them from Teflon-like slickness to rough and uneven surfaces where platelets can get stuck, leading to clots. Physicians and researchers around the world are looking for ways to alleviate PCS. Past viral outbreaks like SARS and MERS left behind lingering symptoms. So medical science has seen this before and will hopefully have answers soon. +
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APRIL 2, 2021
AUGUSTAMEDICALEXAMiNER
#136 IN A SERIES
Who is this? ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com
T
his installment of Famous People You’ve Never Heard Of features a man who spent his lifetime saving lives in very innovative ways. It’s possible he even saved yours. You see, this is the man who invented the cardiac defibrillator. There is no telling how many cases of cardiac arrest have, in turn, been arrested by this man’s innovation. Nor how many TV shows have featured the paddles being applied to a lifeless victim before someone calls out, “Clear!” and the charge is delivered. Born in Lithuania in 1921, this man, Bernard Lown, was himself saved at age 14 when his family moved to the United States in 1935. Lown once observed, “If I’d remained in Europe two more years I would not have survived” due to the Nazi era and its deadly view of Jews. In 1945 he earned his MD from Johns Hopkins University. While at JHU, Dr. Lown was already making a name for himself as an unorthodox thinker: he was suspended from the school for organizing a lecture by a black physician about public health issues in the black community, and he was briefly expelled for taking a stand against black/white segregation of blood in the hospital’s blood bank. One of his first major innovations was one of the simplest yet most significant, and has impacted nearly everyone who has ever been hospitalized for any reason. In the early 1950s, the mortality rate for heart attacks was 35 percent (today it’s less than 10 percent). Lown realized that the standard post-heartattack regimen of the day — 4 to 6 weeks (or more) of bed rest — was the cause of many pulmonary embolisms, a significant part of the deaths being blamed on heart attacks. Working with his mentor, the noted cardiologist Samuel Levine, Lown instituted the so-called “chair treatment” to enormous hostility, opposition, and derision from the medical community. But when Lown published the results of a study of 81 patients who got the chair, and among whom mortality was reduced by two-thirds, the simple treatment was widely and rapidly adopted worldwide. In short order it went from a post cardiac event treatment to one utilized after most surgeries, saving untold lives. In the early 1960s, Lown spent a year researching and developing a way to use electric current to restore normal heart rhythm. AC current caused burns, but he discovered that DC current consistently reversed ventricular fibrillation and also was useful in other arrythmias, and in restarting stopped hearts after cardiac surgery. Lown also discovered a new use for lidocaine in regulating heart rhythms. Previously, lidocaine was used almost exclusively as a dental anesthetic. Dr. Lown was also a noted peace/antiwar activist, and in 1980 co-founded International Physicians for the Prevention of Nuclear War (IPPNW). Its partnership with Soviet doctors fostered international cooperation and was eventually instrumental in the Soviet Union’s then-president, Mikhail Gorbachev, announcing a unilateral moratorium on nuclear testing. IPPNW won the 1985 Nobel Peace Prize, jointly accepted by Lown and Soviet cardiologist Eugene Chazov. Dr. Lown died about 6 weeks ago at age 99 at his home in Chestnut Hill, Massachusetts. +
by Marcia Ribble Back in the Michigan of my childhood, it was unheard of to be asked to eat hot, spicy foods. Our cooks used salt, pepper, onions, sugar, vinegar, chocolate, and spices like cinnamon, ginger, nutmeg and cloves to give foods extra flavor. But no chili powder. No hot peppers of any variety crossed our lips to burn our mouths and inflame our nasal passages. Even soy sauce was an outlier, used sparingly and infrequently. Garlic was never used and consigned solely to those of Italian descent. But our food was not boring. It was delicious, just not very spicy. We ate spaghetti, but we made the sauce with onions. I was in college before spaghetti with garlic was introduced to me. I remember going home on break and telling my mom that we were doing spaghetti wrong and should add garlic when we made the sauce. She was not impressed. It took her years before she would eat spaghetti with garlic in it. And garlic bread was blasphemy that destroyed the flavor of the bread. Bread had only a limited number of acceptable toppings. We could top bread with butter, jam, peanut butter, mustard, ketchup, cinnamon sugar, and mayonnaise. So many of today’s recipes were not even imagined in those years. I can see my mother trying avocado toast. She would make a face and declare it inedible and slimy. Bread with tapenade was never even thought of, let alone eaten. Yet we were not culinary Neanderthals. Our diet was rich with flavor. My dad’s German background meant introductions to many kinds of sausages, flavorful, but never hot. There were many cheeses, including limburger, and blue cheese, as well as the mild cottage cheese. There were sardines, but never anchovies. Pepper only came in black. Salt was only Morton’s. Sauerkraut was a frequent menu item. So were German and American potato salads. Liver was cooked with bacon and onions. Sunday supper was usually either chicken
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or beef roast and mashed potatoes and gravy. Salad was iceberg lettuce with a vinaigrette made with vegetable oil and vinegar, three to one measurements. Or it could be coleslaw with a mayonnaise and vinegar dressing. Jello was made plain. No additions, until Mom discovered green Jello with cottage cheese and crushed pineapple, which became her favorite. Pork chops were an occasional treat, but never fried, neither was chicken. The chops were dusted with flour, lightly browned, then stewed with water until they were fork tender and nearly falling apart. Always served with more mashed potatoes, pork gravy, and applesauce. Desserts were rare. We didn’t usually have any kind of bread on the table. And the bread we did have was limited to white, cracked wheat, and rye with or without caraway seeds. All of our bread was made with yeast, flour, and salt. Real bread. Vegetables usually came out of a can and were eaten as is. Except for salads, the only fresh vegetables we ate were corn on the cob, tomatoes, and green beans, only in season, and only from local farmstands. We put salt and butter on the corn and beans. Salt and pepper on the tomatoes, except for Dad who put sugar on tomatoes. On those occasions, our entire meal was corn on the cob, or fresh green beans. Until I moved down south, I never had tasted vegetables with hot red pepper flakes in them. I am not impressed. I have learned to enjoy grits and cornbread. I will eat fried catfish, although I still prefer perch and walleye. But rice, PLAIN RICE! is anathema to me. I swear that hospitals and rehab facilities are determined to starve me to death with plain rice on my plate, and plain potatoes with neither butter or gravy. Bread rolls come without so much as a pat of butter. If I ever am forced to be in a nursing home, it cannot be anywhere they give me plain rice or plain potatoes. But if that’s where I end up, I’ll have to convince my kids to bring me contraband butter! +
APRIL 2, 2021
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AUGUSTAMEDICALEXAMiNER
ADVENTURES IN
Middle Age BY J.B. COLLUM
all of the great medicines we have now, we can still live longer despite tempting fate, and we can alleviate some of the suffering along the way. Not in all cases, of course, but life expectancy has continued to increase despite our ever-growing health problems. We just have to pay the
to the beach for the first week of my two-week recuperation period. Once I get back from that rest and relaxation, my employer wants me to take it a little easier and not work as many hours as I have been. They want me to lean on the team a little more and take some time to smell the proverbial roses, or, in my case, literally smell the gardenias in our front yard. I’ve loved that smell ever since I was a kid and smelled them at my grandmother’s house. Not everyone has such understanding employers though. Not all companies recognize that although us older folks might not be as fast as we once were, we still have a wealth of experience that we can share with our younger colleagues, and usually, we have a strong work ethic. (That work ethic sometimes comes at the expense of our health though.) Those qualities have real value to those who recognize them. You could even call us champions. I am coming to grips with my limitations. I know that when it comes to my projects around the house, I have been pushing myself too hard to finish things in a time frame that my body can no longer meet. Now, I set more realistic goals for myself and then try to be happy even though I am accomplishing less. It’s working though. It helps that my wife is also understanding. In golf and life, if your age would qualify you for the Champions Tour, and you are feeling the effects of the calendar, there is nothing wrong with laying up instead of going for it all at once. You still get the beautiful walk; you just need to take it a little easier on the one body you get in this life. Take your time and smell the gardenias. +
THE
{
Welcome to our Tournament Edition! No, this publication isn’t about golf, but isn’t everything in Augusta about golf this time of year? You know it’s true. So, let’s get on with it. Besides that, golf provides lots of analogs to life, growing older, and dealing with problems, like the ones that especially come on in middle age. One of the great things about golf is that you can play it for pretty much your entire life. Of course, your drives get shorter, and your scores go up (not a good thing in golf, by the way), but you can still enjoy the game. Your expectations have to be tempered and you may ride in a cart more often than you walk the course, but you can still play. Professional golf even has a division just for the fifty and over golfers. They used to call it the Senior Tour, but in this age when names apparently hurt as much as sticks and stones, despite what we were told as children, they changed it to the Champions Tour. Come to think of it, maybe I should change the name of this column to Adventures of Champions. Or maybe not. But let’s get back to golf. In golf, you can get yourself into some real trouble when you take risks, like trying to get the ball to go over a water hazard instead of laying up just before it. Sometimes you get past it, and sometimes you end up in it. When it goes in the water, you take your penalty and hit another ball. It’s kind of like that with life too. I took risks when I was young because I was afflicted with a common malady of youth, belief in my own immortality. Spoiler alert, I was wrong. Now I pay the price with bulging discs in my neck, arthritis in joints that were injured decades ago, etc. I was told to eat better, ease off on the sugar and cholesterol laden foods, but I unwisely took the risk and now have type-2 diabetes and clogged arteries among other ailments. I know that it’s my own fault. The good news is that with
{
Sometimes you have to stop and smell the gardenias.
penalty. My prescription bill, even with insurance, probably puts some pharmaceutical CEO’s children through college. In fact, I put the maximum allowed by law into my flexible spending account every year, but I have already blown through all of it for the year, and we’ve just barely reached April. Of course, not all of that spending was for prescription drugs, but quite a lot was. I might have to start a GoFundMe campaign soon just to pay for them for the rest of the year. In golf, if you are walking the course (as I recommend) you just have to slow down a bit as you age and factor in your new limitations when you are deciding which club to use, and whether or not you should lay up or go for the green. You have to be more cautious, but you can still enjoy the beautiful surroundings and you can enjoy learning new strategies that take into account your limitations. In life, I am learning a similar lesson as well. I have learned that I have to slow down and not expect as much of myself. In my job, even my employer sees this, and thankfully has been very accommodating. In fact, they just recently brought in some more help for me and gave me some extra time off to deal with some serious health issues. So, my wife and I are heading
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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by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb
MARGHERITA-STYLE BROCCOLI PASTA Garlic, tomatoes and pasta are a classic combination, toss in some spiralized broccoli stems with the pasta and you have a trendy updated classic.
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Ingredients • 8 ounces linguini • 2 cups spiralized broccoli stalks (3-4 left over broccoli stalks) • 2 teaspoons extravirgin olive oil • 2 cups halved grape or cherry tomatoes (10.5 ounces) • 2 large cloves garlic, minced • ¼ teaspoon salt • ¼ teaspoon pepper • 8 ounces fresh mozzarella cut into cubes (about 2 cups) • ¼ cup thinly sliced fresh basil Instructions Cook pasta and broccoli stalks according the directions on the pasta package (typically 9-12 minutes). Meanwhile add oil to a large non-stick skillet and heat over medium heat. Once hot add the tomatoes and sauté for 2 minutes. Add the garlic, salt and pepper and sauté another minute.
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Place the cooked pasta and broccoli in a serving dish, add the tomato mixture and toss. Lastly, add in the mozzarella and basil, toss again and serve. Yield: 4 Servings Nutrition Breakdown: Calories: 420, Fat 16g (8g saturated fat), Cholesterol 40mg,
Sodium 330mg, Carbohydrate 46g, Fiber 3g, Protein 19g Percent Daily Value: 20% Vitamin A, 80% Vitamin C, 8% Iron, 35% Calcium Carbohydrate Choice: 3 Carbohydrates Diabetes Exchanges: 3 Starches, 1 Vegetable, 2 Medium fat meats, 1 Fat +
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VEGETABLES
TRYTHISDISH APRIL 2, 2021
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ASK DR. KARP
NO NONSENSE
NUTRITION Sarah, a Facebook friend from Montreal, asks, “Dr. Karp, when you go food shopping, what do you buy and what types of meals do you serve at home?” I do just about all the food shopping for our home. I try to make shopping as quick, easy and healthy as possible. I shop for food once a week, and during these pandemic times I go early, Tuesday mornings at 7 am. This is when my supermarket first opens and there are almost no other customers in the store. How do I make grocery shopping quick, easy and healthy? Let me give you a few hints.
P
I almost never use recipes when I put everyday meals together. I use my imagination instead. While preparing meals, if I see that one of my staples is running low, I immediately tell Alexa to add it to my shopping list. Then, to doublecheck, before I leave the house to do the weekly food shopping, I open the refrigerator, the freezer, and the food pantry and I get a quick idea of the types of foods that are running low. I know that if I have healthy foods in the house, I will use this food for cooking. And, amazingly enough, this food will actually find its way onto plates and, ultimately, into stomachs. Who knew? You might say that my approach is to have the foods in our house influence the meals I make, rather than to have recipes influence the foods I buy. The key is to have healthy foods in the house. When I am food shopping, I read the nutrition labels, not the advertising claims on the package. I assure myself that I do not have to spend more money to get nutritious food. It’s very simple to read the Nutrition Facts Label. The “staple” foods on my shopping list are good sources of protein, contain mostly unsaturated, rather than saturated fat, are good sources of fiber, and are lower in cholesterol, sugar, salt, and contain no trans fat. If you stay away from junk foods, junk drinks, all those
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deli meats, pre-packaged and pre-prepared foods, those trendy designer foods (free range, organic, “approved by Mother Nature,” gluten-free, etc.), you’ll be surprised at how much lower your food bill is and how much healthier you and your family will be eating. When I think about making a meal, I simply look at the foods already in my house and then I quickly put them together, making sure that every food group and lots of colors are present at every meal. For example, a healthy, fast and easy family meal might begin with either some lean hamburger meat or a black bean patty or the top of a big portabella mush-
APRIL 2, 2021
room. Next, I sauté the patty or portabella with onions and green peppers, topped with a slice of low-fat Swiss and serve it on a whole grain roll. The plate may also have a side of corn-on-thecob which has been quickly microwaved in the husk at 3 minutes per ear. Notice all the food groups and all the colors? Another very quick meal might be a chopped salad sprinkled with flakes of mozzarella cheese and toasted pecans on a plate, arranged like a wreath, with a piece of gingered salmon in the middle and a slice of whole grain Italian bread on the side. A third example might be
a “tuna-helper-type” meal, simply prepared using whole grain pasta, water-packed tuna, low-fat cheeses such as Parmesan cheese, and served with some grilled veggies. I make hundreds of different meals at home, all simple, quick and without recipes. They all begin by looking at what foods I bought at the supermarket that are now in the refrigerator, freezer, and pantry. By the way, for more ideas, simply go to wbkarp. com and click on the nutrition part of the website. What is the “No-Nonsense Nutrition” advice for today? As you are walking into the supermarket, think about healthy food, as defined by nutrition science, not food companies. Then, as you shop and before you check out, quickly look over your shopping cart and make sure those very foods actually found their way into your cart. The unavoidable fact is that what gets into your cart, gets into your home and onto your plate and…into your body. So, make sure you carry healthy food over your threshold. +
Have a question about food, diet or nutrition? Post or private message your question on Facebook (www.Facebook. com/AskDrKarp) or email your question to askdrkarp@gmail.com If your question is chosen for a column, your name will be changed to insure your privacy. Warren B. Karp, Ph.D., D.M.D., is Professor Emeritus at Augusta University. He has served as Director of the Nutrition Consult Service at the Dental College of Georgia and is past Vice Chair of the Columbia County Board of Health. You can find out more about Dr. Karp and the download site for the public domain eBook, Nutrition for Smarties, at www.wbkarp.com Dr. Karp obtains no funding for writing his columns, articles, or books, and has no financial or other interests in any food, book, nutrition product or company. His interest is only in providing freely available, evidenced-based, scientific nutrition knowledge and education. Dr. Karp The information is for educational use only; it is not meant to be used to diagnose, manage or treat any patient or client. Although Dr. Karp is a Professor Emeritus at Augusta University, the views and opinions expressed here are his and his alone and do not reflect the views and opinions of Augusta University or anyone else.
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APRIL 2, 2021
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FOODS TO IMPROVE YOUR MOODS Feeling Stressed and Anxious? Who hasn’t this year? Choosing the right foods can help. by Karen Cota, RDN, LD, CDE Consulting Dietitian for Aiken-Augusta Holistic Health, St. John Towers and Carolina Nutrition Consultants, Inc.
Last time you were stressed or depressed did you reach for a tub of ice cream, box of cookies or bag of chips, only to end up feeling even worse? There’s a reason for that: pro-inflammatory foods like processed, fried, refined carbohydrate, high sugar foods actually increase anxiety. So what food choices should we make to move us closer to that feeling of inner calm? In general, choose a balanced anti-inflammatory diet, adequate in hydration and limited in alcohol and caffeine. A Mediterranean style diet, which includes less processed fruits, vegetables, nuts and seeds, legumes, whole grains and low-fat dairy with less animal protein or meat, is a good example of an anti-inflammatory diet (see “Easy Mediterranean Diet Plan for Beginners” at Eatingwell.com for more information). Heart health, improved blood sugar, weight loss and support for brain health are all additional health benefits associated with this type of diet. For a more even blood sugar level and increased calm, try to increase complex carbohydrates by choosing unprocessed whole grains, vegetables and fruits instead of processed foods that include simple carbohydrates, salt and additives. Avoid skipping meals, which could result in a drop in blood sugar and a jittery feeling that increases anxiety. Finally, keeping your gut healthy may be an important aspect of mood. 95% of serotonin (feel good) receptors are in the gut lining. Include prebiotic
MY SISTER LINDA’S TURKEY BURGERS • 1.25 pounds ground turkey (93/7) • 1-10oz. package of frozen chopped spinach (cook and squeeze dry) • ¾ cup shredded mozzarella cheese (3-4 oz) • ½ cup old-fashioned oats, uncooked Combine all ingredients and form into 8 patties. Pan fry or grill until done. They freeze well. +
(fiber) and probiotic (fermented) food choices to keep your gut happy and healthy. Specific nutrients that may help reduce anxiety are: magnesium (leafy greens, broccoli, legumes, nuts/ seeds, whole grains); zinc (oysters, cashews, liver, egg yolks, beef); omega 3 fats (wild-caught salmon); Probiotics (yogurt, buttermilk, Kefir, Sauerkraut, pickles, Kombucha) may lower social anxiety; B-vitamins (avocado, almonds); antioxidants (vitamins A, C, E, beta carotene, lycopene, lutein, selenium, manganese, zeaxanthin) found in whole plant-based foods and spices like blueberries. Want to feel calmer and less stressed? Try regularly incorporating these foods into your diet: turkey (tryptophan helps produce serotonin which helps regulate hunger and feelings of happiness and well-being); wildcaught salmon (omega 3 fat for brain and nervous system
function); dark chocolate (70% or greater) relaxes blood vessel walls to increase circulation and decrease blood pressure; asparagus (high in folate and a prebiotic for gut health); yogurt and other fermented foods like kefir, Kombucha, buttermilk and sauerkraut contain probiotics that are important for gut health and have a mood boosting effect; citrus fruits (high in the antioxidant vitamin C); broccoli (high in magnesium); avocado (monounsaturated fat, antioxidants, folate and B6); oats (magnesium, complex carbohydrates and antioxidants); chamomile tea which calms the system; and seeds (flax, pumpkin, and sunflower seeds are high in magnesium which helps regulate emotions). Some ways you can incorporate these calming foods into your daily meals would be to have old fashioned or steel-cut oats with ground flax, sunflower seeds, walnuts and blueberries or try Whole grain Pumpkin Spice Waffles recipe from Cookie & Kate (cookieandkate.com) for breakfast. For lunch add avocado to your turkey sandwich on 100% whole grain bread. At dinner have Wild-caught salmon with broccoli or asparagus. So the next time you are tempted to reach for junk food to soothe your mood, keep handy a healthy trail/ snack mix of pumpkin and sunflower seeds, walnuts, dark chocolate chips and dried blueberries or cranberries to grab instead. It’s the food choices we make that can affect how we feel. Choose to feel good!! +
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CRASH
COURSE
More Americans have died on US roads since 2000 than in World Wars I & II combined
A
with their lofty vantage point of the road ahead, put on their flashers to signal an accident or traffic slowdown ahead. Georgia law requires headlights to be on when it’s raining, but says nothing about using emergency flashers when raining. Why is using flashers illegal in many states, and why do police and highway patrol agencies discourage their use while driving as an unsafe practice? Consider their primary intended use, which is on vehicles that are stopped and usually off the roadway. Using them in other situations, like pouring rain, creates confusion among other motorists. Given that we’re already talking about poor visibility situations to start with, a moving vehicle with flashers on might be mistakenly taken for a stopped vehicle. A driver coming up behind that vehicle might slam on his brakes or swerve, all for no reason. And a stopped vehicle with flashers correctly used might be ignored (and possibly plowed into) because it’s thought to be just another moving vehicle. In most vehicles, using the emergency flashers cancels out the ability to use turn signals. Traffic safety experts also point out that hazard lights are the same as brake lights on many vehicles. That means someone following a driver who is using flashers might momentarily ignore that car’s actual brake lights for just a moment, just long enough to make it impossible to stop safely. Aside from all the various drawbacks and the discouragement of traffic safety experts, the fact remains that driving in bad weather with emergency flashers going accomplishes nothing, or at least nothing that simply having headlights on (as the law requires) accomplishes. As one police department told the Atlanta Journal-Constitution in referring to the fact that this puzzling practice is legal in Georgia, ‘just because you can, doesn’t mean you should.” +
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pril is here with its showers. Can May flowers be far behind? But April showers bring more than flowers. They also bring out some odd behaviors by motorists. We could fill this page and three others just like it with examples. There is the DRIVE phenomenon, for instance, an acronym for During Rain Increase Velocity Exponentially. We’ve all seen that a thousand times. But for this installment of Crash Course we’re going to focus on just one aspect of April showers, the curious custom of turning on emergency flashers when it’s pouring. It’s not super-common, but it’s far from rare. And it can break out any time there is heavy rain, not just during April. It’s hard to pinpoint when and where this practice began, but it’s even more difficult to answer the “why?” question. Generally speaking, there are a grand total of two uses for emergency flashers: 99 percent of the time they are used to alert oncoming motorists when a vehicle is stopped on the side of the road. Other than driving in a funeral procession (which accounts for 0.01 percent) the other 0.9 percent comes into play when other motorists need to be alerted to something unusual, such as if you’re driving well below the speed limit because of a flat tire or you’re hauling equipment or a trailer. That’s pretty much it. And in many states even that 0.9 percent doesn’t fly. Nearly a dozen states ban any use of emergency flashers while driving, and even more prohibit their use “except to indicate a traffic hazard.” In South Carolina, for instance, other than their standard use (while stopped alongside the road), hazard lights can be used to warn other drivers of a “traffic hazard requiring the exercise of unusual care in approaching, overtaking or passing.” Maybe a pickup truck has a long load extending off the back of the truck for example. No mention of rain. Sometimes 18-wheelers,
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April showers bring strange drivers
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APRIL 2, 2021
HUMAN BEHAVIOR FEELING ANXIOUS? SO ARE YOUR KIDS.
Your teenager just stormed upstairs, slamming the door. Meanwhile, your youngest child is crying in front of the by Jeremy Hertza, Psy.D. computer struggling to understand a math problem. Then you get an email from a teacher that your middle child has been acting out in class—and “she’s usually so well-behaved.” None of this is necessarily too unusual. But you may have noticed that your child seems to be struggling more this year. You’re not wrong. Since March 2020, I’ve had more children referred to me, or parents seeking me out, than any time in the past 15 years of practice. About half of these requests are for academic problems and learning disabilities that parents uncovered while homeschooling their children during quarantine. The other half is for depression and anxiety. Research around the world is proving what we as parents and guardians already know: COVID is stressing us out—and our kids are feeling it too.
Why This is a Big Deal I describe it as letting the animal out of the cage. This worldwide situation has brought out anxiety in all of us. For kids especially, if they can’t develop ways of coping, anxious thoughts can become part of who they are as they grow up, affecting everything they do. It can turn into an even bigger issue if kids learn to use what we call “avoided behavior,” because the more you avoid something, the more uncomfortable you are trying to fix it. But kids need to learn to face problems, not avoid them. Children whose parents are clearly anxious also tend to be more susceptible, since children model our behavior. How You Can Fix It With vaccinations we’re starting to get back to a more normal routine. That helps. Routines like sports and getting together with friends give kids an outlet and keep them from feeling lonely. We also have to make a point of telling our kids that it’s OK for them to go out and do normal things—at whatever level you are comfortable with right now. If your child is acting out, first help them to calm down. Later, after they are calm, talk to them about it. Ask how they feel, how often they feel that way, and what has helped them when they felt that way before. Together, figure out a way to cope. When those frustrations or anxieties happen again, remind your child about what you talked about. Talking about issues when your child is calm and teaching through repetition is key. Coping can include: 1) Deep breathing to expand the diaphragm, which delivers more oxygen to help relax you; 2) Clenching muscles tightly all over the body, then relaxing them; this can help release distracted thoughts and break up obsessive thinking; 3) Physical exercise, from crossfit or walking to biking or even just punching a pillow. All of this helps with the physical signs of emotion. It’s also good to challenge negative thoughts. For example, if your child is super anxious about a test, ask, “What’s the worst that could happen?” If it’s failing, ask how low the grade could be. If it’s, say, 71, then ask what would getting that grade mean? This helps your child realize that the worst-case scenario isn’t necessarily a catastrophe. Parents and guardians can and should try these ways of coping too. The last thing is this: Pay attention to your child. Their body language can clue you in to what’s going on with them. By slowing down enough to see what your kids are telling you and following through on working with them, our normal can really be normal—and a lot less anxious. +
Jeremy Hertza, Psy.D., is a neuropsychologist and the executive director of NeuroBehavioral Associates, LLC, in Augusta, on the web at http://nbageorgia.com. Contact him at 706-823-5250 or info@nbageorgia.com.
APRIL 2, 2021
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The blog spot From the Bookshelf — posted by Thomas Rhyne White, MD, on March 22, 2021 (edited for space)
THIS IS WHAT GRATITUDE LOOKS LIKE This week a patient for whom I served as the primary care physician for many years died after an extended illness. I had the privilege of visiting her two days before her death as she weakened and drew closer to her last breath. It was an opportunity to tell her good-bye. We were close. She was very smart. She had an engaging sense of humor. She loved college basketball. She pulled for UNC, and I for Duke. If you understand North Carolina, you appreciate the push and pull of all that. She was a retired teacher, and she taught me much during her life and with her death. Her last lesson was in her obituary. It was published the evening after her death. I saw my name, and my care over the years was noted and appreciated by the family. I was genuinely touched by the acknowledgment. Over my nearly 40 years of practice, whenever this happens it is special. It is most always unexpected. But it is never unappreciated. It brings back memories with not only the patient, but with their extended family. After all, in a small-town practice, multigenerational care is the norm, not the exception. It always makes me even more appreciative of the doctor-patient relationship. So yes, I do read obituaries, those of my patients, those of people I have known, and those of people I never knew. I think many, if not most, doctors peruse them too, especially we “older” ones. These days, of course, you have to find them online. I think obituaries matter. Often, I see mentioned the names of caregivers or nurses closely involved with the person in their last weeks or months. I applaud it and understand it. After all, my own daughter is a hospice nurse, and I know what she does. Those providing care at the end are hard to forget and are truly special. But I have wondered: Why is the primary care doctor not mentioned more often in obituaries, as I was? Did the patient not have one? Did something negative happen? The truth is, I suspect families are dealing with so many issues and arrangements they simply do not give it much thought. A simple innocent omission. I understand. I have been there with the death of my own parents. Not to say we primary care doctors are not thanked in many other ways. Meaningful handshakes. Hugs. Kind words. Thank you cards. Vegetables in the summer. Pies and cakes and cookies. Handmade crafts and woodwork. I certainly do not want to minimize the genuineness and thoughtfulness of such gestures and expressions of love. Those are the never-forgotten joys of practice. And so are the loyalty and trust we receive, the privilege to listen, and the opportunity to solve problems, all true gifts themselves. At age of 66, and after nearly 38 years of practicing family medicine, I have had more than my share of expressions of appreciation. But to be honest, I would like to see primary care doctors mentioned more often in obituaries. Not because we “deserve” it. But because, honestly, I think we doctors sometimes need it. We are human too. When I die, I hope my obituary adequately thanks my primary care doctor, among others who have cared for me, recently and in the past. And I hope my doctor reads it and knows they were appreciated, just as I experienced this week. Regardless of who they pull for during basketball season. To show I learned my lesson and show my gratitude to my patient and her family, I decided to wear a Carolina Blue tie to her funeral today. Yes, that was hard. But had it been my funeral, she would have worn a darker shade of blue to honor me. I know that. Because that is what gratitude looks like. +
Why aren’t doctors mentioned in more obituaries?
Thomas Rhyne White is a family physician
What follows is from a Kirkus Reviews overview of The Gene by Siddhartha Mukherjee:
A panoramic history of the gene and how genetics “resonate[s] far beyond the realms of science.” Mukherjee (Medicine/ Columbia Univ.; The Laws of Medicine, 2015, etc.), who won the Pulitzer Prize for his history of cancer, The Emperor of All Maladies (2010), begins with Mendel and his “pea-flower garden,” and he never lets readers forget the social, cultural, and ethical implications of genetics research. Indeed, he dedicates the book to his grandmother, who raised two mentally ill children, and to Carrie Buck, the Virginia woman judged “feeble-minded” and sterilized according to eugenics laws passed in the 1920s. After Mendel, Mukherjee describes Thomas Morgan’s fruit fly studies in the 1900s, and he goes on to trace the steps leading to the discovery of the double helix, the deciphering of
the genetic code, and the technological advances that have created ethical dilemmas. Early on, there was recombinant DNA, the insertion of genes from one species into another, and this led to mandates initially proscribing certain experiments. Then, there were the first disastrous attempts at gene therapy, which consisted of arrogant and sloppy science. Meanwhile, the human genome has been mapped, more and more genes have been associated with certain diseases (and even behaviors), and a
new technique has been developed that permits the removing or replacing of specific genetic defects. Are we ready to apply that to an individual patient? Should it apply to sperm and egg cells so as to affect future generations? Mukherjee ponders these issues in the final chapters and epilogue, ultimately seeing the need for more research about the information coded in the human genome, since so much of it does not consist of genes. Throughout, the author provides vivid portraits of the principal players and enough accessible scientific information to bring general readers into the process of genetic lab science. Sobering, humbling, and extraordinarily rich reading from a wise and gifted writer who sees how far we have come—but how much farther we have to go to understand our human nature and destiny. + The Gene by Siddhartha Mukherjee, M.D; 608 pages, published in May 2016 by Random House.
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The Examiners +
by Dan Pearson
How long have you As long as I can remember. had amnesia?
Come on. Seriously.
What was the question?
No! I can’t even Maybe the question remember the last time should be: do you I forgot something. have amnesia? © 2021 Daniel Pearson All rights reserved.
EXAMINER CROSSWORD
PUZZLE
ACROSS 1. 1951 Masters champion 6. Last name, with 55-A 10. Medicine 14. Throat dangler 15. By mouth 16. Clinton Attorney General 17. Drug runners 18. Exhort 19. Untie 20. Entirely 21. Capital of Western Samoa 23. Emptied (as a bladder) 25. Unnecessary 27. Snake 28. Famed dancer and actor 29. Itinerary shorthand 30. Gamma follower 32. Israeli submachine gun 33. Wrestling acronym 34. Little old Chevy 35. Cleveland nine, casually 38. Java 39. Cowboy show 40. Welt 41. Pledge 42. UGA conf. 43. To be under the weather 44. Doggie doc 45. Famous area road 49. Noted downtown building 51. Unusual 52. Ed Rice or Philip Morsberger 53. NBA team not ending in S 54. Georgia-based news pioneer 55. First name, with 6-A. 56. Persia today 58. Land grant holder (in Old England) 60. Computer command 61. AU Health’s ____ Lane Parking Deck
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E X A M I N E R
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by Daniel R. Pearson © 2021 All rights reserved.
DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.
by Daniel R. Pearson © 2021 All rights reserved.
62. Duck with soft down 63. River in central Europe 64. Comply 65. Prepared
THE MYSTERY WORD
31. NBA’s Ming 33. Exclamation of surprise 34. Pertaining to the voice 35. Major airline of yore 36. Georgia and Bank separator (once upon a time) 37. Inferential; by inference 38. Write down quickly 39. In law, a defendant’s reply, or put on more Parkay 41. Only movie ever named for an inner ear problem? 42. Caribbean calypso music 44. -ectomy beginning 45. Really, really small 46. Noisy insect not heard for years at a time 47. Preserved produce 48. Mean, stubborn 50. Skinflint 51. Facet; stage 52. Too 57. Steal from 59. Hasten Solution p. 14
QUOTATIONPUZZLE 8 6 3 4 7S 5T 9 T 1 2
I I G A A A T B D D H S B R A N W W N D S T M E C A E E O U Y H V A O O O T S O T N U
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— someecards
by Daniel R. Pearson © 2021 All rights reserved
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.
M 1 2 3 4 5 6 7 8 9 C P L 1 2 3 4 5 6 7
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1.AAAASSTTQC 2.HHOONNRRUI 3.DEEEEEMMMS 4.SEWPP 5.LLTTE 6.EIIIR 7.MSOC 8.NEA 9.TSS 10.E 11.D
SAMPLE:
1. ILB 2. SLO 3. VI 4. NE 5. D =
L 1
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by Daniel R. Pearson © 2021 All rights reserved
WORDS NUMBER
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APRIL 2, 2021
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APRIL 2, 2021
AUGUSTAMEDICALEXAMiNER
THEBESTMEDICINE ha... ha...
W
hat do you do with a drunken sailor? What do you do with a drunken sailor? What do you do with a drunken sailor early in the morning? Don’t let him drive that cargo freighter, don’t let him steer that cargo freighter, don’t let him near that cargo freighter, early in the morning.
Moe: I think all the Suez Canal jokes are getting a little old. Joe: Yeah, that ship has sailed. Guy on a blind date: Hi, my name is Heath. Girl: Nice to meet you. I’m Heather. Guy: This is not a competition. A supervisor asked one of his employees, “Do you think you can come in on Saturday this week? I know you enjoy your weekends, but I need you here.” “No problem,” said the employee, “but I’ll probably be late. Public transport is bad on weekends.” “When do you think you’ll get here then?” “Monday.”
The
Advice Doctor
Moe: That last joke reminded me, when I started my job I told them I could not work Saturdays because it was it was the only day I got to see my little boy. Now, seven years later, he is a star on the football team, gets straight As, and is class president. Joe: They grow up so quickly when they’re imaginary, don’t they? A guy was walking down the street when out of nowhere a clam fell out of the sky and hit him on the head. Dazed, he picked up the mollusk and said, “Where did you come from, little guy?” The shell cracks open slightly and the guy hears it say, “A tornado picked me up and threw me. You’d better get somewhere safe because it’s headed this way!” The guy looked around and saw nothing but blue skies. But then suddenly he realized this was the clam before the storm. Moe: I hate my job. It’s so pointless. Joe: What do you do? Moe: I work at the BMW plant installing turn signals on all the cars.
Moe: What do you call it when your dentist pulls out the wrong tooth? Joe: Accidental. Moe: “I’m sorry” and “I apologize” mean the same thing. Joe: Well, except at a funeral. Moe: What did Moses use to part the Red Sea? Joe: A sea saw. +
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Staring at my phone all day has had no Effect on ME!
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Dear Advice Doctor, I work at a local office that has to stay open until 8:30 pm, which is 5:30 out west where we have a few clients. It’s only enough evening work for one person: me. I don’t mind the hours at all, but working alone can be downright spine-tingling. Every noise is a potential break-in by a serial killer. They won’t spring for an alarm system, and the parking lot is poorly lit. Should I quit, demand changes, or just turn up the radio? — Getting the Creeps Every Night Dear Getting, I can imagine this is a situation that must be quite disconcerting to you. I’m glad you took the time to write to help find a solution. Anything involving the spine is something that deserves to be thoroughly investigated promptly. It might be something simple and minor, but the potential for serious complications means you don’t want to take any chances. Let’s say your spine tingling leads to numbness in your legs. Unchecked, that could affect walking. That could affect the ability to live everyday life, including earning a living. Sometimes spine tingles are the result of a bulging disk that is impinging on nerves. Again, the result could be loss of mobility, difficulty standing or sitting without pain and discomfort, or even paralysis in severe cases. The point is not to alarm you; in fact, any individual case could be something of little concern that goes away in a day or two, or that is relieved by an ice pack and then disappears. It is just something that — serious or simple — should be taken seriously and investigated. How do you know the difference? Anything that persists for more than a week, or that not only doesn’t improve but actually worsens, that deserves a doctor visit. Those symptoms mentioned above — tingling or loss of feeling in one or both legs — also should be looked at promptly by a doctor. Another indicator of a doctor visit in your near future is if the spine issue is the result of an injury or a fall. A word of caution: the world is full of pills, special shoes and shoe inserts, back braces and trusses, all promising to cure back pain, create perfect posture and make life perfect. Let the buyer beware. Get an expert opinion from a doctor. Thanks for writing, and 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.
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THE MYSTERY SOLVED The Mystery Word in our last issue was: OVERBITE
...cleverly hidden in the upper left corner of the p. 6 ad for AUGUSTA WEST CLEANING CO.
THE WINNER: JESSE CHEADLE! Want to find your name here next time? If it is, we’ll send you some cool swag from our goodie bag. The new Mystery Word is on page 12. Start looking!
APRIL 2, 2021
AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED H U M A N A
O V U L E S
G U L L E T
T R I W A L A I L L A A R T L O I S A V O D E
A N L A E S A D L A I U Z B E E V M A I S S E R
L O U P I E S R E I J V O E T R T I R G O O B
A N E D R A L R R G E U A V O I S A D D E T A WW E V O E R O W S E C T O B A P E C U L H E A T A N T H S S E I E Y R E
R E N D E R E D
U N D E R A G E
G O O D
C I C A D A
C A N N E D
O R N E R Y
Y A O
SEE PAGE 12
The Celebrated TheSUDOKUsolution MYSTERY WORD CONTEST 8 4 7 3 5 2 9 6 1
...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.
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ACUPUNCTURE
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ALLERGY Tesneem K. Chaudhary, MD Allergy & Asthma Center 3685 Wheeler Road, Suite 101 Augusta 30909 706-868-8555
CHIROPRACTIC Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A 706-860-4001 www.evanschiro.net
COUNSELING Resolution Counseling Professionals 3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866 www.visitrcp.com
DENTISTRY
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LONG TERM CARE
Georgia Dermatology & WOODY MERRY www.woodymerry.com Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Long-Term Care Planning I CAN HELP! Augusta 30904 (706) 733-3190 • 733-5525 (fax) 706-733-3373 SKIN CANCER CENTER www.GaDerm.com
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EVERYBODY LOVES A GOOD STORY
APRIL 2, 2021
DIABETIC EYE DISEASE by Dr. Preeti Rebecca Poley MD, MPH
Diabetic retinopathy is the leading cause of irreversible blindness in boaworking-age Americans. Diabetic retinopathy develops in over 40% of the people who develop diabetes. Diabetic eye disease occurs when small blood vessels leak and bleed in the retina. The retina is layer on the inside wall of the eye that acts like the film in a camera, where the eye is the camera. Diabetes-related retinopathy is a leading cause of blindness in American adults and it affects over one in four of those living with diabetes, while 4% have severe cases of retinopathy. Most importantly, it is possible to have diabetic retinopathy for a long time without noticing symptoms until substantial damage has occurred. Once symptoms are noted, the diabetic damage in the eyes is likely significantly progressed. Signs of diabetic retinopathy may occur in one or both eyes. Symptoms may include blurry vision, decreased color vision, floaters, shadow in a part of vision. Anyone who has diabetes is at risk of developing diabetic
eye disease. The risk is higher if an individual has diabetes for a longer time, has poor control of blood sugars, high blood pressure, high cholesterol or if an individual is pregnant. At least annual dilated eye exams by an ophthalmologist are recommended for individuals with diabetes. An eye physician can look for signs of diabetes eye disease before any vision loss occurs. In addition, a dilated eye exam will evaluate your vision, eye pressure (looking for glaucoma), the front of the eye (eyelids, cornea, checking for dry eye), lens (looking for cataracts), as well as a complete exam of the retina and vitreous. In addition to this exam, an OCT to examine detailed cross-sectional images of your retina, fundus photographs and FA to check the circulation in your retina may be performed during your visit. There are many approved treatments for diabetic retinopathy, including several types of eye injections (through the white part of the eye), laser treatments, and vitreous and retina surgery. These proce-
dures can be done in an office or surgery center to prevent, treat, or reverse damage from diabetes. Eye injections often result in better vision than laser treatment alone and repeated injections may be needed to prevent blood vessels from leaking fluid and causing vision loss. When more advanced (proliferative) diabetic eye disease develops, this is treated with laser along with eye injections. Vitrectomy surgery (removal of the vitreous) may be used in eyes with bleeding or scarring on the retina (epiretinal membrane or traction retinal detachment). If you have diabetic eye disease or vision loss that cannot be reversed, a retina specialist can help in enabling access to visual rehabilitation that helps make everyday living a little bit easier. + Dr. Preeti Rebecca Poley, with Retina Institute of the Southeast (RISE), is board-certified by the American Board of Ophthalmology and fellowship-trained in Vitreoretinal Surgery and Diseases. Her office is located in Waynesboro, GA. For more information visit www. retinaise.com or call 706-535-7473.
Michael Sharkey, MD Lauren Ploch, MD Caroline Wells, PA-C Chris Thompson, PA-C John Cook, MD, Emeritus GENERAL, SURGICAL & COSMETIC DERMATOLOGY
AND EVERYBODY HAS A STORY. WE’D LOVE TO HEAR YOURS. MEDICINE IN THE FIRST PERSON Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx. com. Tell us if you want it “by you” or if it needs to be anonymous. Thanks!
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Will he ever get one right? Probably not. +
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