Medical Examiner 4-21-23

WEIGHT LIFTING

The world is getting bigger. And bigger. And even bigger still. Carefully examined data has recently led to the disturbing prediction that a little more than a decade from now, more than half the world’s population will be obese. We’re not that far removed from a time when mass starvation (or at least severe malnutrition) was a major concern for the world’s healthcare community. Ironically, that era gave birth to this one.

How did this happen?

An extremely complex set of circumstances are all factors, but one of them is closely related to the scarcity and/or unaffordability of healthful and nutritious food. When people cannot afford those healthful foods (and poverty affects hundreds of millions of people worldwide) they resort to less expensive, less salubrious options. It’s the old “Coke is cheaper than milk” syndrome. The less expensive choices are often calorie-dense processed foods with little nutrition. A steady diet based on such foods can even result in the paradoxical combination of obesity and malnutrition. Beyond the direct food factor, experts point to a frustratingly long list of culprits that will not be easy to fix. Examples: a changing culture where parents don’t allow their children to play outside due to fear of crime, and the design of cities, towns and neighborhood that discourage walking.

The World Obesity Federation, the organization that released the projections, emphasize that solving the world’s obesity problem is nowhere near as simple as telling people to eat less (or healthier) and get more exercise. It’s far more complex and challenging than that.

The stakes could not be higher

A world where half of the population is obese would be a world that would tax the medical community and the world’s economy to the breaking point. Healthcare costs would run into the trillions of dollars, and many of the recipients of care are living at or below the poverty level, wherever they may live in the world. What conditions would be treated? Overweight and obese individuals are at much higher risk for high blood pressure, stroke, and heart failure; they are more likely to suffer from diabetes, whose rates are exploding, especially in Western cultures; nearly 10% of all cancers are linked to obesity; obese people are more likely to be afflicted by asthma and sleep apnea; obese people are statistically 25% more likely to have chronic depression; obese children are 200% more likely to develop multiple sclerosis; obesity is linked to osteoarthritis and joint pain and surgical replacements A problem with so many causes and so many repercussions can easily result in complete inertia: it’s so huge that nothing I or my organization or even my government can do will make even a tiny improvement. So no one does anything. That is the exact

opposite of the correct recipe. Instead, everyone needs to do their little part, whether they are living in a gated community or on welfare, whether they don’t vote or they’re a governor or a senator. It’s really everyone’s problem and everyone’s solution.

PARENTHOOD

by David W. Proefrock, PhD

A couple of weeks ago you discovered your 13 year-old daughter talking on her phone in the middle of the night. You were angry, but thought you handled it and it was case closed. However, her best friend just told you she’s worried because your daughter was talking to a 28 year-old man. She felt she had to tell you. What do you do?

A. Have a talk with your daughter about how dangerous this relationship could be even if it is only over the phone. Share your concerns with her, including the ones that are very difficult to talk about.

B. Report the situation to the police. Your daughter will be angry with you but she will be safe, which is more important.

C. Don’t punish her. She is actually the victim in this situation. However, monitor her phone and computer usage very closely and make sure there is no further contact with him.

D. Do all of the above.

If you answered:

A. This is one part of what you should do, but there’s more. You must notify the police and you must both support and monitor her.

B. This is one part of what you should do, but there’s more. You must have a serious talk with her about how dangerous this situation is, and you must both support and monitor her.

C. This is one part of what you should do, but there’s more. You must have a serious talk with her about how dangerous this situation is, and you must notify the police.

D. This is the correct response in this situation. Every one of these things is vitally important.

This young girl is in serious danger. She must be protected and supported, and the predator she has been talking to must be identified and stopped. Also, her friend should be commended for being a true friend in what must have been a difficult situation for her. This is a friendship that should be encouraged.

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

MEDICAL MYTHOLOGY

DIABETES IS DIABETES

There are different types of diabetes, but they’re basically just different versions of the same disease. Right?

Wrong.

About the only thing type 1 and type 2 diabetes share is their last name. They might as well be two completely different diseases.

True, they both involve abnormalities in blood sugar levels caused by insulin deficiencies. In type 2 diabetes, there may be plenty of insulin, but it’s getting less and less effective over time, a condition known as insulin resistance. Type 1, by contrast, is marked by the absence of insulin. The pancreas has stopped making it.

Type 1 is an autoimmune

disease: for reasons that doctors don’t understand, cells in the immune system attack insulin-producing cells in the pancreas, shutting down insulin production. Other functions of the pancreas are often unaffected, but insulin production is gone. As far as anyone in medicine knows at the moment, type 1 is irreversible and unpreventable. Because insulin is necessary to live, anyone diagnosed with type 1 will be insulin-dependent for the rest of their life. Granted, we’re all insulin-dependent, but for most of us our pancreas takes care of that need. Type 1s have to wear a pump 24/7 or manually inject insulin every day just to stay alive.

By contrast, type 2 is not only preventable; it’s reversible. Genetics can play a role, but quite often type 2 is the result of being overweight or obese, eating an unhealthy diet, and not getting exercise. It might be said that both diseases are life-changing in huge ways. The difference is that if someone with type 2 diabetes, or well on their way to being type 2 (socalled pre-diabetes) makes the changes their doctor recommends, they stand a very good chance of reversing course, leaving the path leading to diabetes behind. And once they achieve that goal, the challenge is to maintain the healthy lifestyle.

For a type 1 diagnosis, the life change is just as monumental, if not greater. Being a much more serious and potentially lethal disease than type 2, type 1 requires a compliant and vigilant patient — at least if that patient wants to stay alive, and do so without amputations and other severe complications.

Speaking of compliance, every doctor’s most unfavorite diabetic patients are the ones who don’t test, or who rely on insulin as an antidote to bad habits, as in “I can still eat donuts; I just chase them with insulin.”

On the other hand, a conscientious patient can change die-abetes to live-abetes.

Here is the standard illustration every type 1 hates, always showing an absolutely perfect blood glucose reading.

April is Head and Neck Cancer Awareness Month

Head and neck cancer is not common, accounting for only 4% of cancers in the U.S.

An estimated 66,920 new cases will be diagnosed in 2023, according to Cancer.Net.1 The population most affected is usually older than 50 years of age, and men are 2-3 times more likely to get head and neck cancer than women. Approximately 49,190 men compared to 17,730 women will get the disease. Survival depends on many factors, such as the type of head and neck cancer, how advanced it is when diagnosed, whether or not treatment is obtained, the affected person’s overall health, and continued exposure to known risk factors. Sadly, this year an estimated 15,400 deaths from head and neck cancer will occur.1

What are the main causes?

About 70%-80% of head and neck cancers are caused by tobacco use and by drinking alcohol, particularly consuming alcoholic beverages often and for a long time.2 There is no safe tobacco product regardless

of the form, flavor, or if it is labeled as “light.” Infection from the human papillomavirus (HPV, a sexually transmitted virus) is a growing cause of head and neck cancers involving the tonsils and base of the tongue. Exposure to the sun’s UV rays or to artificial UV rays from indoor tanning beds also contributes to lip cancer and skin cancers of the head and neck. Using betel nut, a cultural practice in south and southeast Asia, the Pacific Islands, and India, and among these groups in the U.S., increases the risk of developing oral cancers.3

Symptoms vary

fections and hoarseness, may be indications of cancer. Other signs include a lump or thickening in the mouth, jaw pain or swelling in the jaw, difficulty chewing, swallowing or moving the tongue, ear pain or infections, and blood in the saliva. Talk to your healthcare provider if you experience any of these symptoms, especially if you engage in some of the risk behaviors described earlier.

augusta.edu/cancer/community

This cancer is preventable

The Georgia Cancer Center offers tobacco cessation services. Call us at 706-721-0456.

For information about cancers we treat visit the Cancer Center website or Augusta University Health at augustahealth.org/cancer-care.

Resources

Signs or symptoms for head and neck cancer may include a sore that does not heal in the mouth, nasal passage, throat, or esophagus.4 A change in the color of the lining of the mouth, such as a red or white patch, a foul mouth odor, nasal congestion, frequent nosebleeds, or unusual nasal discharge, as well as chronic sinus in-

Besides avoiding tobacco, alcohol, and betel nut, it is important to take care of your teeth and gums with proper oral care every day. Your dentist or primary care provider can conduct a head and neck screening at your annual dental visit or health exam, and can check any unusual changes in the condition of your mouth, nasal cavity, or throat. They will also feel for lumps in your neck and jaw area. Head and neck cancer can be prevented, and if diagnosed early, it is curable

“The C Word” is a news brief of the Georgia Cancer Center at Augusta University. For cancer info visit: augusta. edu/cancer/community. To request exhibits or speaking engagements, contact Christine O’Meara, Community Outreach Coordinator, Cancer Information and Awareness at comeara@ augusta.edu or 706-721-8353.

1. Cancer.Net, a service of the American Society of Clinical Oncology (ASCO) cancer. net/cancer-types/head-and-neck-cancer/statistics Accessed 4/4/23.

2. National Cancer Institute (NCI) Head and Neck Cancers. cancer.gov/types/headand-neck/head-neck-fact-sheet#q2

3. Alcohol and Drug Foundation. Betel Nut. adf.org.au/drug-facts/betel-nut

4. Centers for Disease Control and Prevention (CDC) Head and Neck Cancers. cdc. gov/cancer/headneck

Who is this?

The No Technobabble Zone

by Dr. Chuck Cadle

A BRIEF CONVERSATION ON ARTIFICIAL INTELLIGENCE

Hello Readers,

This incredible scientist, Rosalind Franklin, is not exactly a household name. Why not? One medical historian describes her as the victim of “one of the most egregious ripoffs in the history of science.”

It all started in January 1951 when Franklin was using x-ray diffraction techniques to photograph DNA fibers. One of her x-ray pictures of DNA, known now as Photograph 51, became famous as critical evidence in identifying the structure of DNA. The image was achieved through 100 hours of X-ray exposure from a machine Franklin herself had refined.

Significantly, Franklin had a personality conflict with colleague Maurice Wilkins, one that would end up costing her greatly. In January 1953, Wilkins changed the course of DNA and scientific history by disclosing without Franklin’s permission or knowledge her Photo 51 to competing scientist James Watson, who was working on his own DNA model with Francis Crick at Cambridge.

Upon seeing the photograph, Watson said, “My jaw fell open and my pulse began to race,” according to author Brenda Maddox, who in 2002 wrote a book about Franklin titled Rosalind Franklin: The Dark Lady of DNA

The two scientists used what they saw in Photo 51 as the basis for their famous model of DNA, which they published on March 7, 1953, and for which they received a Nobel Prize in 1962. Crick and Watson took most of the credit for the finding. When publishing their model in Nature magazine in April 1953, they included a footnote acknowledging that they were “stimulated by a general knowledge” of Franklin’s and Wilkins’ unpublished contribution, when in fact, much of their work was rooted in Franklin’s photo and findings. Both Wilkins’ and Franklin’s separate articles were published second and third in the same issue of Nature. Still, it appeared that their articles were merely supporting Crick and Watson’s. Franklin was not one to make waves or complain. Contemporaries say that was bred into her from infancy by her parents. She was known to have a very sharp tongue at times and could nurse both grudges and friendships indefinitely. She might have fought this outright theft with greater intensity had not cancer interfered. She started noticing symptoms of something amiss in 1956, and her doctor found two large tumors in her abdomen. She died in April of 1958.

John Desmond Bernal, a pioneer in X-ray crystallography, spoke highly of Franklin around the time of her death in 1958. “As a scientist Miss Franklin was distinguished by extreme clarity and perfection in everything she undertook,” he said. “Her photographs were among the most beautiful X-ray photographs of any substance ever taken. Their excellence was the fruit of extreme care in preparation and mounting of the specimens as well as in the taking of the photographs.”

Rosalind Franklin was just 37 when she died. +

My last two monthly columns discussed the “why” and the “value proposition” for purchasing and using technology. In this column, let’s discuss how artificial intelligence (AI) may become the artificial neural network (brain) behind machine learning and output. By definition, AI is generally known as the ability for a computer to think, learn, and mimic human behavior.

I enjoy reading articles forecasting how technology (especially medical technology) will change our lives. According to researchers, the current uses of medical AI only relate to diagnostics and prognoses predictions. Global medical databases are linked to form a digital mind, which could be described as an artificial neural network. AI-based technology is connected to these artificial neural networks to introduce verbal and written language output as compelling and convincing responses to inquiries and tasks. If digital minds become a new form of cognitive intelligence, could they become the problem solvers for medical personnel or augment their decision-making? When you call 911, will we have a social AI language generator responding to the caller? If these applications are worrisome, imagine the potential for AI to replace human decision-making for not only medical machinery but also for autonomous vehicles, commercial and military drones, drug development, and medical personnel.

There are two social language AI applications currently available in the marketplace: ChatGPT and Bing Chat. These chatbots are used for automated response systems and content generation. Data is being captured, stored, and programmed to augment our interactions with technology. You might wonder who is overseeing these advancements, certainly a valid concern. If AI is creating content, can I trust the information I read in journals or see in videos? Could AI become an instrument for diseminating misinformation, alternative thinking, and personal tracking, or will its information add value?

According to Microsoft, “Bing Chat is a fullfledged AI chatbot integrated with Microsoft’s search engine. Bing Chat offers an experience that allows you to have a more natural conversation with the chatbot to get answers to long and complex questions. Bing AI search can answer your questions and refine your search by asking follow-up questions or giving feedback. Bing AI search draws on the deep knowledge base behind Bing search, so you can trust that you will get reliable and up-to-date results.”

Well, this all sounds interesting, so I asked Bing Chat if I could rely on ChatGPT and Bing Chat responses to questions as being unbiased and trustworthy, and I was surprised by the answer:

No, you cannot rely on the Chat GPT and Bing Chat responses as unbiased and trustworthy information. Both chatbots are based on artificial intelligence models that learn from large amounts of text data, which may contain errors, biases, misinformation, or outdated information. Moreover, both chatbots may generate texts that are not factual, logical, or coherent, depending on the input and the context. Therefore, you should always verify the information provided by the chatbots with other reliable sources and use your own critical thinking skills to evaluate their responses. ChatGPT and Bing Chat are meant to be fun and educational tools, not authoritative sources of information.

Maybe trust concerns like those mentioned above prompted the Future of Life organization to issue a letter asking for a voluntary pause in artificial intelligence development. Roger McNamee (Co-Founder and Managing Director of Elevation Partners and CNBC Contributor) is advocating for legislation to form an oversight body similar to the FDA. President Biden recently stated that it remains to be seen if artificial intelligence is dangerous, but that he believes technology companies must ensure their products are safe before releasing them to the public. But this begs the question, “What does safe mean?” Do we, as consumers, trust this technology enough to provide personal medical or other information that could be used in harmful ways? Even Elon Musk is calling for a pause in AI development.

As an educator, I like to stay current with the tools availed to students that enable them to supplement learning with technology-generated assistance. Programs like Grammarly or Editor are teaching aids that help students with writing skills. However, the new AI-generative language programs such as Chat GPT and Bing Chat can enable students and others to generate content, including videos, complete essays, and video scripts just by running a query. A student or blogger can upload an outline and ask the chatbot to fill in the content. The chatbot will generate “compelling and convincing” content in response to the request. Supporters of generative language suggest this type of content generation assists writers by giving them compelling videos and manuscripts to aid in their presentations and writing. However, I believe this type of con-

Middle Age

Let’s talk about feet.

BY J.B. COLLUM

Okay, I just lost half my audience. I get it. For most folks, feet aren’t the sexiest or most interesting parts of our body to talk about (but if you think they are, I’m not judging). But let’s face it: if you want to remain ambulatory as you age, you have to take good care of them. I haven’t been exemplary in this regard. That is changing though. I went to Augusta Foot & Ankle yesterday for my first visit.

I have written before about some issues with my feet, but today, I am stepping forward to tell all. I’m putting my worst foot forward to stand up for these humble body parts that, while at the lowest part of our bodies, can be critically important to our health. Alright, those were my last feet jokes (maybe).

To catch you up, I have type 2 diabetes (Did you just hear Wilford Brimley say that word in your head? Me too. I miss that guy.) and along with that comes the likelihood of foot issues. I have those and then some. Poor circulation, neuropathy, severely dry skin, and toenail fungus. You don’t need diabetes for all of these, but it sure helps. I also have Haglund’s deformity. This is essentially an enlargement of the bony part of the heal where the Achilles tendon attaches. It can make finding comfortable shoes more difficult and in the worst cases, cause constant severe pain. The nice folks at Augusta Foot & Ankle took good care of me yesterday and we are now walking the path to healing my feet. (I couldn’t resist.)

Let’s take these issues one step at a time. First, poor circulation. Many diabetics have peripheral artery disease often called simply PAD. This reduces blood flow to the feet. Fortunately, my doctor said I am not too bad off in this regard, but it is common and can be countered by specific exercises that your doctor can recommend, by putting your feet up when you sit down (I like that one), maintaining low blood sugar, stopping smoking, wearing diabetic socks (how do socks even get diabetes???), and eating heart-healthy. That last one is tough for me as I love fat in my diet, but not in my blood stream. Neuropathy, which is just a fancy way of saying nerve death. Diabetes can cause damage to the sheathing around your nerves. My doctor said to think of this like the coating around extension cords. If it is missing, you can get short circuits. Being exposed to the elements, over time the wire can get damaged and eventually it won’t let the electricity flow anymore. It is kind of the same with nerves. Controlling high blood pressure and cholesterol, losing weight, maintaining low blood sugar, and staying under 40 years of age can all help.

In regard to the dry skin of your feet, this is related to the nerve damage because it affects your body’s ability to control the oils

and moisture in your feet. So, you have to handle this manually by following these steps recommended by The American Diabetes Association:

• Wash your feet thoroughly every day.

• Dry them thoroughly. Yes, between your toes too.

• Moisturize those puppies! (Okay, I paraphrased)

• Keep your toenails trimmed, and file down the sharp edges.

• Inspect your feet for sores cuts, corns, blisters or redness, every day. Tell your doctor about anything you observe in regard to this.

• Wear moisture-wicking socks.

• Check your shoes for rocks or other potential sharp objects before putting them on.

• Don’t go barefoot. Even in the house.

• Don’t soak your feet.

• Don’t smoke.

Having diabetes also puts you at a higher risk for toenail fungus. Aging and other factors play a role too, but don’t make the mistake of thinking it is just a cosmetic issue. For diabetics, it can lead to amputation, so see your doctor about this. In my case, they took a culture to see exactly what fungus we are dealing with, if any. My doctor said that sometimes damage to toenails from other causes can look like fungus, and taking a culture can make sure that you get the correct treatment. Some of the treatments, especially the internal ones, carry some risk in regard to your liver. Although he assured me it is a very small risk, you wouldn’t want to take that risk if it wouldn’t help anyway, as would be the case if it wasn’t caused by fungus.

The one outlier for me, is my Haglund’s deformity. This isn’t related to my diabetes. Happily in my case, my tendons still look like they are in good shape and the pain I feel from this is rare and not severe and usually results from accidentally smashing my heal into something. And let me tell you, when that happens, anyone within a few miles of me will know about it because I will scream louder than a howler monkey — and that is saying something because their screams have been measured at 140 decibels. For the sake of reference, the decibel scale is a logarithmic base-10 scale. What does this mean? 0 decibels is the lower threshold of human hearing. Not my hearing, mind you, a normal, young person’s hearing. Normal human speech is around 50 decibels, which is 100,000 times more intense than 0 decibels. A rock concert is about 90-120 decibels. Hearing damage starts at around 85 decibels. Sorry for the sound science lesson interruption (unless you enjoyed it).

My only real daily struggle with Haglund’s deformity is that it makes it hard to find shoes that both look good and feel good, and don’t cost a fortune, so once I find a good

pair, I tend to wear them until they completely fall apart, much to my wife’s chagrin when I get all dressed up except for wearing raggedy shoes.

If you have diabetes, please don’t neglect your feet. They need to carry you around for a long time, so take a moment today to give them a long hard look and see if your humble feet might need some well-deserved attention.

After all, a certain world-famous man whose life millions celebrate even washed the feet of his friends as a lesson for us all.

For more information about diabetic foot complications, check out the tips here: https://diabetes.org/diabetes/foot-complications

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

HAPPINESS

If you are happy, you will live longer. No one ever said, “She was so happy, she just up and died. Poor thing, just couldn’t take all that happiness.”

Hospitals these days have departments dedicated to elevating happiness in sick patients and their families: Social Services and faithbased counseling. Sensation of impending happiness is helpful. Happiness has a positive hormonal effect that bolsters the spirit and helps heal the body. Both are good things. Give us more of both, say I.

Clearly, the more pleasing and supportive things are in your life, the greater your chances of a better future, regardless of your present situation.

A practicing psychologist friend of mine spends more time on the orthopedic ward than the psychiatric ward. Even though orthopedic problems are surgically managed, the thought processes are not. Can’t you just hear the psychologist’s secretary

BASED ON A TRUE STORY

(most of the time)

A series by Bad Billy Laveau

on the phone: “The psychologist will see the multipersonality schizophrenic tomorrow. He is busy with a ballet dancer’s dislocated toe on the orthopedic ward today.”

Happiness is a firm building component in mental and physical rewards for work. It is simple. You work, you get paid. You work harder or better, you get paid more. Ever since our War of Independence (1776) and the Civil War (1865), our society has prospered due to diligent work and family stability.

A frequent symptom of failed societies is destruction of family influence in the general public. The ruling class wants a tight family for themselves. They maintain

power through bloodlines rather than performance.

They weaken opposition by de-emphasizing the family and emphasizing the individual. Confusion to the enemy, they say. It works.

Our country entered that confused process with the “Me Generation” focused upon “how you feel about everything.” The outcome was a generation that either cannot or will not support themselves, financially or emotionally. They are the “basement generation,” more open to taking drugs to alter how they see themselves or feel about themselves. No real sense of direction. That is a downward spiral into the abyss of failure.

The “Me Generation” will have higher medical costs when serious illness arrives. They will suffer from the effects of inadequate happiness, optimism, and purpose to facilitate medical recovery. If they have not prepared financially for the added cost, you and I (taxpayers) will pay for this shortcoming.

What happens to you is not nearly as important as what you think about what happens to you. You decide what you think. It is free. You don’t need anyone’s permission.

Take Brenda Lee, a towering Augusta giant, (she was 4’9” tall and skinny) who grew up in poverty in the Harrisburg area. She went on to influence the development of rock and roll music with chart topping songs: “I’m Sorry,” “Rock Around the Christmas Tree,” “Break It to Me Gently,” and many more. In her mid-teens, she was the family breadwinner. Now she is in the Rock and Roll Hall of Fame. Look her up on YouTube. Clearly, Brenda Lee was not bogged down in self-pity, blaming others for her struggling start. Her attitude and thought, plus a soaring voice, lifted her and her family. No whining, no crying, no blaming others. I’ve never met her, but I would like to.

Our young people need a better sense of family stability. When I grew up, divorce was greatly frowned upon. Illegitimate births were a mark of shame. Welfare was a last resort. If you were in need, your family stepped up and provided. Your church

did the same.

Family and church are two fundamental building blocks of a strong person and a strong society. Present day trends seem destined to destroy, or at least weaken, both. This is not good. This is not productive. This is not progressive.

Decades ago, just before taking the field, a football coach friend conditioned his team to chant: God. Country. Family. Team. There was never a thought of “I”. Once he said, “There is no ‘I’ in “win.” One arrogant player didn’t get the point and disagreed The coach immediate shot him a withering stare and intoned, “Yeah. But there are two I’s in idiot. Don’t you be one.” If a coach had that exchange today, he probably would be fired.

For the sake of medical economics, we must return to strong family ties, religious beliefs, and patriotism. Short of that, we are in for a world of hurt. Life expectancy will diminish. Medical costs will keep increasing. Depression and unhappiness will abound.

I, for one, desire happiness, wellness, and longevity. It beats the heck out of the alternative.

TRYTHISDISH

by Kim Beavers, MS, RDN, CDCES

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

GRILLED TOMATOES & ZUCCHINI

When you grill vegetables always grill extra, because having a bunch of leftover grilled vegetables is great prep for future meals. Healthy cooking begets healthy eating

Ingredients

• 2 zucchinis cut into ½-inch pieces

• 1 pint grape tomatoes

• 3 tablespoons Zoë’s® Greek Dressing (or other Greek dressing of choice)

• 4 tablespoons feta cheese (optional)

• Parsley for serving (optional)

Directions

Preheat the grill for low to medium heat.

Combine vegetables in a large bowl; add dressing, and toss to coat.

Put vegetables in a vege-

table grilling pan (I place the grill pan over a plate so that the marinade will drip onto the plate to decrease grill flare-ups).

Cook the vegetables over medium low heat for ten minutes or until done. Toss the vegetables and stir a couple of times throughout the cooking process. Serve with feta cheese, and parsley if desired.

Yield: 6 servings:

Nutrition Breakdown: 60 calories, 3.5g fat (1.5g saturated), Cholesterol 5mg, Carbohydrate 5g, Fiber 1g, Sodium 110mg, Protein 2g, Potassium 295mg.

Percent Daily Value: 30%

Vitamin C, 10% Vitamin A, 4%

Calcium, 4% Iron

Diabetes Exchanges: 1 Vegetable, 1 Fat

“Planned-Over Leftover” recipes that use grilled vegetables!

Boil noodles of choice, and while the noodles cook lightly sauté the leftover veggies and white beans in EVOO and garlic. Serve over pasta and top with Parmesan. Serve leftover grilled veggies over morning toast. Alternatively try these grilled veggies stuffed into a tortilla and cook in a non-skillet until warm. Better yet make it a morning quesadilla by adding a scrambled egg.

Add grilled vegetables over a bed of lettuce with cucumbers, grilled sliced chicken with Greek dressing.

Lastly, add grilled veggies to a stir-fry with brown rice, soy sauce and edamame.

WILL THIS ROAD EVER END?

As a young boy, our family’s “vacation” was going to visit my grandparents in Salem, SC.

Correct. Salem. No stop lights and the road didn’t even widen out through town! Four of us siblings in the back seat, one usually laying behind the seat in the rear window shelf of our ’53 Pontiac with no seat belts. All of us close enough to our dad’s hand, which would smack us if we misbehaved. We didn’t know what air conditioning was. An open window blowing on our sweaty foreheads seemed good enough. Grandpa had recently installed electricity, so the old farmhouse he built with lumber from his 81acre working farm had one light bulb in each room. A pot-bellied stove heated the place, and there was a well to draw water from. Grandma cooked on an enamel wood stove. The country church

we attended had no running water and a pair of outhouses close by.

On the way we kids constantly whined, “Are we there yet?” It seemed like the road would never end.

It eventually did, of course. Unlike that old two-lane road, the recovery road never ends. Following up on last month’s article listing the first 5 tips on how to choose a treatment center (https:// issuu.com/medicalexaminer/ docs/3.17.23, see page 8) here are a few more ideas:

Sixth, look for a place close to home. I’ve seen scores of clients who flew to faraway places for a geographical cure, only to return to home after a month having no knowledge of recovery groups in their home town, and who fell through the cracks of a poor transition. There is something to be said for being far away from negative associates for awhile,

but then again, your loved one has to come back home sometime and risk seeing them again anyway. Why not learn how to do it with sober support while going through treatment? And form a positive recovery environment and friends from the start?

Seventh, look for licensure and/or accreditation. Centers operating without a state license often have no accountability past the head honcho. Licensure and accreditation insure that the center is part of something greater than itself and has a grievance procedure that is usually effective. These standards run the gamut from having pest control to offering a balanced diet, and from having “counselors” with no training other than their own personal sobriety experience to having staff who are licensed and certified through years of training, education, and mentoring. It could

limit residential services from having 2 per room to having 8 or 10 guys per room. Wow, right? Believe me. While the former (12-stepping staff) are good to have in a recovery residence, the latter (licensed/certified) are best in a treatment program, and even then many licensed therapists are in recovery themselves.

Eighth, look for a center with good access to mental health services in addition to substance use disorder services. Statistically up to 50% of addicts and alcoholics have an accompanying mental health diagnosis other than substance use, and treating one without treating the other is an exercise in futility. At times medications are necessary to recovery from substance abuse, such as in treating genuine bi-polar disorder (Yikes…did I say “genuine?” Yes, I did. Bi-polar disorder is the most over-diagnosed category in the field of mental health today! Don’t get me started here). I know of guys arriving at a recovery program

tent generation could detract from personal thinking and responsibility. Hopefully, the industry will utilize accepted evaluation processes on AI before releasing its decision-making algorithms to run machines

and having their Depakote or detox titrate of Ativan, for instance, thrown in the garbage with disastrous and deadly results.

Ninth, look for a program that has a follow-up program. Recovery has a poor diagnosis for permanence after only a 30-day program unless it has diligent dedication to daily follow-up in the beginning, transitioning in time to weekly (at a minimum) follow-up. “In time” could be a year…it could be forever and a day. I would not work for a program that didn’t provide aftercare, including family aftercare for life.

Why? Because the recovery road never ends. Thankfully the road to my grandparents did.

or to develop AI-generated broadcast information that could misinform readers. Like me, you may be concerned about the potential of AI-based neural networks replacing humans in medical or commercial applications. Should we be worried about the potential for a software malfunction? Could drones fall out of the air, autonomous cars cause traffic collisions, or air traffic controllers make mistakes should a software glitch happen? Could AI-powered robots be used to replace doctors and nurses in treating certain patients? Concerns related to an AI-driven program making a mistake are real and—in my opinion—are behind the push to pause development until some quality assurance process is in place. Of course, you should be aware that this entire article could be the output of an inquiry into ChatGPT. If you have any comments or suggestions, please email me at drchuckcadle@gmail.com

ROLLED SANDWICHES • SOUPS • SALADS

The Money Doctor

RETIREMENT PLAN ROLLOVERS 101

Do you have an old retirement plan? Is it still with your previous employer? Or has your company just been purchased/merged, and the new company has a new plan? Each year many people face this situation. What should you do with your old retirement plan?

You will typically have the option to rollover the old account into your new 401k, 403b, 457 or other retirement plan. Then there is another alternative to consider. Instead of rolling it to the new plan, you can roll it to an IRA or individual retirement account. So, which is better?

Oftentimes you will find that the new plan is very similar to your old plan in terms of options, fees, etc., so it seems like a no-brainer to do the rollover from your old account into the new account. In that meeting, what may not be discussed are the downsides to rolling the old money into the new employer work plan.

Below are some of the key things you should consider when making your decision;

• Flexibility – If you roll your current retirement account to the new company’s plan, your money is often stuck in the new plan until you terminate employment whether its voluntary (retire or take a new job at a new company) or involuntarily (you are terminated or the company shuts down). Unless the plan offers in-service

rollovers, 401k plans usually do not let you move your 401k funds to an IRA until after you terminate employment.

However, most 401k plans allow you to roll your IRA into the 401k at any point. So, by rolling your funds into an IRA you maintain flexibility / options for the future.

With an IRA you keep the key and can unlock the box to move money around when you are ready. With a 401k, your company keeps the key and puts rules around when you can open the box to move money around.

• Investment Options –401ks make you choose from a list of around 20-40 investment options selected by your employer. IRAs allow you to invest in thousands of options that include stocks, bonds, exchange-traded funds, and mutual funds.

• Rules – 401k accounts have lots of rules that must be followed. Your employer can include or not include different options. Can you do in-plan Roth conversions?

Can you take a loan out? Can you do in-service distributions? 401ks are required to withhold 20% from any distributions for federal taxes. IRAs also have rules, but they are not employer dependent. For example, you can always convert your IRA to a Roth IRA, you can’t take loans, and you are not required to withhold 20% in taxes on distributions. It

•

is important to understand the difference between each option and the rules before rolling your money over.

• Fees – 401k accounts have more layers of fees such as participant account fees, fund fees, admin fees, loan fees, etc. IRAs give you access to low-cost investment options at the major brokerages such as Schwab. Most custodians or places that offer IRAs have $0 account fees and minimums for IRAs.

• Other Differences – did you know that there are differences in many other areas, too, such as creditor protection, minimum distribution requirements, early withdrawal exceptions, fund share classes, withdrawal flexibility, and more?

Deciding what to do with your retirement account is a big decision. This year is a big year for these decisions in the Augusta area. We encourage you to discuss your options with a certified financial planner that will provide unbiased feedback for your situation. You want to consider all the pros and cons to help you make the best decision for your situation.

•

•

by

Clayton Quamme, CFP® a financial planner with AP Wealth Management, LLC (www.apwealth.com). AP Wealth is a financial planning and investment advisory firm with offices in Augusta, GA and Columbia, SC.

SO LONG COVID

My daughter, Rhonda, has had COVID four times. Although she is a survivor, she continues to deal with the aftermath of her disease. Rhonda has long COVID. So very long.

Her first bout with the deadly virus was in March of 2020, just when it was being recognized as a pandemic, but well before the protections needed to combat the disease were widely known.

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

There is a fundamental truth that every driver must embrace. When we are behind the wheel, we have only job: driving. Period.

The reason: driving is risky. All by itself it is potentially a dangerous enterprise. Tens of thousands of Americans are killed every year in roadway crashes. When any other activity is added to the mix — eating, talking on the phone, texting, dealing with children or pets in the car, adjusting the radio, applying makeup, reading billboards — driving becomes even riskier.

As just one example, according to one study drivers are statistically 23 times more likely to be in a crash while texting compared with drivers concentrating on their one job: driving. While other studies report lower risks associated with cell phone use and texting, virtually all research has consistently found a significantly higher risk of crashes, injury and death; whatever the exact numbers may be, they are always elevated in all studies.

According to the National Highway Traffic Safety Administration (NHTSA), distracted driving claimed 3,522 lives in 2021, a number very close to 10 people on average every single day of the year. It’s safe to say those are in all probability 3,522 people whose deaths were avoidable by applying common sense and basic respect for the driver’s own life and the lives of others: his passengers, other nearby drivers, pedestrians, bicyclists, and highway workers.

Although the partial list above suggests there are many causes of driving distractions, one gets a huge portion of the blame for distracted driving’s deadly toll:

cell phone use.

According to a national observational study in 2020 reported by the National Center for Statistics and Analysis, 2.6 percent of drivers stopped at intersections at any moment of the day were talking on hand-held phones. Combining that data with other studies of hands-free phone use, the federal government estimates that 7.9 percent of all drivers are using a hand-held or hands-free cellphone at any given moment. Of even greater concern, the same studies found that drivers texting or otherwise manipulating a hand-held device more than doubled in the 10-year period ending in 2020. And it nearly quadrupled during that period among drivers aged 16-24 years old.

Driving while distracted by an electronic device may be just the tip of the unsafe iceberg for many drivers: a different study discovered that drivers who reported frequent cellphone use drove faster, changed lanes more often, and made more hard braking maneuvers than drivers who said they rarely used cellphones while driving

Here’s a simple way to think about it: anything that requires your hands, your eyes or your attention while you’re driving is a distraction. Voluntarily and willingly giving in to that distraction (by texting, for instance) can be extremely costly, and that isn’t a reference to the cost of a potential traffic citation or the higher insurance premiums that would result. It can be all that, but in addition the cost could include injury, permanent disability and even death.

Considering how insignificant 98% of all texts are, it just isn’t worth the risk.

Her major symptoms were and are: bradycardia (abnormally slow heartbeat) and tachycardia (abnormally rapid heartbeat); phantom smells (in her case, smoke especially); difficulty breathing; anger and rage; despair; personality changes (emotional highs and lows); difficulty thinking and concentrating; headaches; coughing; extreme fatigue; anxiety; insomnia; diarrhea; rashes; hair loss; loss of taste and smell; high blood pressure; dizziness; and more.

Because of these conditions, many medical tests were conducted on Rhonda, including a brain scan, CAT scan, and wearing a heart monitor.

Some of her conditions lessened over time only to resurface when COVID came back again and again. She continues to have multiple symptoms today more than three years after her ordeal began.

According to a study conducted by Weill Cornell Medicine researchers in New York, there are 4 broad categories of long COVID symptoms:

• heart, circulatory, and kidney problems

• respiratory issues, anxiety, and sleep disorders

• musculoskeletal and nervous system conditions, including arthritis

• digestive complaints

An interesting article appeared in Diabetes Self-Management which quoted two respected journals (Cell, cell. com; and the Journal of the American Medical Association, jamanetwork.com). The article said, “...people with type 2 diabetes are at greater risk for long-term symptoms, and people without type 2 diabetes who experience long COVID are more likely to develop diabetes...”

Is there an effective treatment for long COVID? There is no cure for COVID, but antiviral drugs are now available by prescription to help alleviate long COVID symptoms.

An encouraging study published in The Journal of Nurse Practitioners found that over-the-counter antihistamines used to treat allergies can help alleviate COVID symptoms.

An online non-profit research and advocacy community called Survivor Corps (survivorcorps.com) offers support and education for those with COVID and long COVID. On the group’s Facebook page, its 180,000+ members have reported more than 900 times between mid-March and mid-July of 2021 about favorable results treating long COVID symptoms using antihistamines.

The treatment is logical, since immune cells release histamine in response to pathogens like a virus or bacteria, or a foreign substance like pollen. The downside of the fight against such invaders is inflammation and swelling, allergic reactions, and increases in heart rate and acid production in the stomach. And in the case of long COVID, the suspicion is that the cells which release histamines run wild following a COVID infection. Antihistamines like Benadryl block the histamines from plugging into receptors, thereby interrupting the cascade of side effects that are the hallmark of long COVID.

Rhonda’s hope is that by sharing her personal knowledge and experience, others may be helped to endure — and even prevent — the seemingly endless scourge of long COVID.

— Contributed by Dolores Eckles Evans, Georgia

the blog spot

— posted by Cindy Tsai, MD on April 8, 2023 (edited for space)

ARE THESE 6 HABITS MAKING YOU UNHAPPY?

We all know that life has its ups and downs. We’re all just trying our best with what we have at that moment in time. (Don’t forget to give yourself some credit!)

WHAT DO YOU NEED TO STOP DOING?

That being said, there are also some habits that you may be (unconsciously) doing that are making your life harder than it needs to be.

Go through this list and see which one(s) may be preventing you from living a life of alignment and purpose.

1. Constantly being on your phone/device. It’s really hard to unplug, but of all the things and time you are spending on your phone what percentage is really necessary and serving you? Are you missing out on life by being on your phone? Life is happening right now, at this very moment.

2. Not prioritizing your own needs. Self-care is not just about pampering moments like going to get a massage. Selfcare is about taking care of and nourishing all parts of your mind, body, and spirit. Your needs are yours. This means it looks different for everyone. Are you giving yourself permission to re-evaluate and experiment?

3. Procrastinating. Do you have a lot going on in your life? You might find yourself putting things off, waiting until the very last minute because that’s when you get things done. Procrastinating might feel good at the moment (get that dopamine hit!), but you’re actually adding the additional layer of disappointment, frustration, anger, and shame from not doing things when you’re supposed to.

4. Not setting boundaries. Being the youngest of four daughters and the baby of the family, I was always doing what I was told and developed people-pleasing tendencies from a young age. The thing is, when you don’t speak up, nobody knows what’s actually going on in your mind. Just like you can’t really know what’s going on in their minds either. When you don’t have strong healthy boundaries in all areas of your life, you can’t truly live the life you desire and deserve. If you’re always feeling drained and overwhelmed, it’s a sign to re-examine and recommit to your boundaries.

5. Comparing yourself negatively to others. Do you find yourself looking at what others are doing or experiencing but using it against yourself? When you don’t have what they have, does it make you feel inadequate? You may say things like “I should be …” further along, more successful, more attractive, stronger, and so on. If so — stop ! Everyone has their own path. You are here to be on your journey, not theirs. Not your circus, not your monkeys.

6. Not believing and trusting yourself. You’ve done a lot as an accomplished high-achiever and still have big goals and dreams. But sometimes, it can seem so far away and impossible. Ugh. That inner critic and judge starts talking, and you can’t get it to stop. You feel like things will never work out for you, and it’s just easier to stay where you are. You’re always selling yourself short. You feel like you should be grateful but something still doesn’t feel right. This negative thought loop cycle can keep you stuck for hours, days, months or longer, paralyzed in indecision and fear.

Go through this list and ask yourself: Which is my biggest obstacle? (Keep it simple.) What do you need to stop doing?

Imagine: what would my life look like if I could make the changes I envision? How much easier would my life be? How much more joy and peace would I experience?

Take action and change for good. You never have to be stuck. Because you deserve to feel so much better.

Not off hand. Why?

Do you know a good CPA or tax attorney? What for? need to set up a dummy corporation.

I plan to open a tutoring school for flunking students.

THE MYSTERY WORD

O kay.

The Mystery Word for this issue: SBRNNUU

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

We’ll announce the winner in our next issue!

ACROSS

1. Of the ear

5. Frau’s partner

9. Incline

13. Calypso music from Trinidad

14. Hip bone

16. Islamic chieftain

17. Some are said to be white

18. Slant

19. Aquatic bird

20. Dated

22. Chemical (atomic #53)

24. Wedding words 25. Blue Goose, in brief 26. Blvd. in medical district 28. Sigh of pleasure

29. Building where 48-A works

32. Biopsy destination 33. AU, once upon a time 34. Nobel Prize winner in Literature (1936) 36. Cleckley/Thigpen title woman 37. Grand ___

28. Knee injury ltrs.

30. Brandon ________ 31. Kettering’s partner 32. Meadow 33. Augusta’s ____ Park 34. Canoe power 35. High tennis shot 37. Dwight’s better half

What you do with 34 & 46-D 41. Charlie of local note 42. Frivolous; unsubstantial

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

QUOTATIONPUZZLE

Building add-on, sometimes

7. Cap. of Brazil (until 1960)

8. Indonesian currency

9. Former employee? 10. Corner of note

11. Bog

Liquids

Scull implement

My ______; friends; kin

Road division

Type of cavity

Be _____ someone; leery

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.

6.

As her slender friend walked up the sidewalk to her front door, the girl watching from inside muttered to her mother, “It’s just not fair. Look at her. She’s so thin it makes me sick.”

Her mother hugged her and said compassionately, “Darling, if this is something that really bothers you, decide right now to do something about it.”

“You’re right,” said the girl, blinking back tears. Turning to the door she opened it, welcomed her friend inside and said, “Would you care for a slice of chocolate cake?”

Moe: Hey, I got a good joke for you.

Joe: Fire away.

Moe: How come the seamstress couldn’t quit her job at the convent?

Joe: I give. Why?

Moe: Because it was habit forming.

Joe: I thought you said it was a good joke.

Moe: Remember when NASCAR used to have an Internet Explorer car?

Joe: Yeah...whatever happened to that?

Moe: It kept crashing.

Moe: Why do vegans always look so unhappy in photos?

Joe: They hate to say cheese.

Moe: You know what they call a Quarter Pounder in Paris?

Joe: Sure, everybody knows that. Royale with Cheese.

Moe: But do you know what indeed.com is called in London?

Joe: I do not.

Moe: They call it indubitably.com.

Moe: The ophthalmologist I go to has the coolest website. You just type in your symptoms and it will give you a preliminary diagnosis and schedule an appointment.

Joe: I bet that’s a site for sore eyes.

Moe: Why was the mountain in the Italian Alps hungry?

Joe: It forgot to avalanche.

Moe: I wonder what Ice Cube’s kids call him.

Joe: Popsicle.

Moe: What’s large, gray, and doesn’t matter?

Joe: An irrelephant.

Moe: I’m trying to think of some example of a perpexing problem of logic but I’m drawing a blank. Can you think of one?

Joe: How about: “the cheapest condoms are actually the most expensive”?

Moe: What’s another word for naysayer?

Joe: Horse.

The Advice Doctor

Dear Advice Doctor,

We’re having our 25-year high school reunion next month, and I would like to get your opinion on using these temporary topical creams that I’ve seen advertised about eight thousand times. Naturally I want to look like the very picture of health, but I don’t want to look made up or fake either. What option do you think would be best?

Dear Looking Back,

— Looking Back (to my younger days)

I definitely understand where you’re coming from. There are quite a few options, but each one has a specific application. Naturally, you want the one that will provide others with the best possible view.

The simplest method, of course, would be x-rays. They are quick, easy, painless, and very effective for finding things that might be abnormal, like a broken bone or a tumor.

A close relative of x-rays (although it might not seem like it) are CT scans. While an x-ray is simply an image, a CT scan combines multiple x-rays to create a slice of the body, a cross section, for more detailed imaging and more accurate diagnoses where a single x-ray is not sufficient.

Next up is Magnetic Resonance Imaging (MRI). As with CT scans, you will lie on a table that slides into the circular opening of the machine. In this case a powerful magnet circles around the tunnel opening, and the magnetic fields and radio waves used are translated into a very detailed image that can diagnose aneurysms, strokes, tumors, joint and tendon injuries, and more. And they are noisy!

At the other end of the sound spectrum, ultrasound imaging is silent, but ironically it uses sound to see inside the body. The equipment interprets the way sound waves bounce off internal structures to create images that can depict growing fetuses, circulatory problems, breast and prostate tumors, gallbladder disease, and more. All using super high frequency sound waves that we cannot hear.

Finally, a PET scan uses radioactive liquids that you drink or have injected to create its images. Like MRIs, PET scans can take awhile to complete. They can diagnose Parkinson’s and Alzheimer’s diseases, cancer, epilepsy and more.

As you can see, there are several ways to obtain a picture of health. I hope this helps you choose the one best for you.

Do you have a question for The Advice Doctor about 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!

THE MYSTERY SOLVED

The Mystery Word in our last issue was: FATIGUE

...cleverly hidden in the grass in the p. 15 ad for AUGUSTA

WEST CLEANING CO.

THE WINNER: BRUCE JACKSON!

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