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APRIL 5, 2013

New location, same mission for Undercover Artists

last year, 117; and now this year we’ve dropped yet We’re number one! thirty! five! again. Not a good trend. And when I say “we,” I refer collectively to the One other reason why this is such alarming news: citizens of Richmond County. We’re #135 on a list of the poor health and early deaths of Richmond County 159. If that number sounds slightly familiar, 159 is the residents resulted in more than 11,300 years of life number of counties in Georgia. And as you may have lost. That statistic measures premature deaths (years heard, we were recently ranked #135 among them in of life lost by dying prior to age 75) per 100,000 a national county-by-county health study conducted residents. So at just over 200,000 residents, the life lost by the Robert Wood Johnson Foundation and the in Richmond County tops 22,000 years. And University of Wisconsin Population Health Institute. Clearly this was not Want to look up our information that’s deaths in just one year. Next door neighbor Columbia County, welcome news for several reasons. or any county in any state you’ve meanwhile, is in the Top 10 healthiest First, this wasn’t a list where #159 ever lived in, review roadmaps to Georgia counties at #7. was best. That means we rank near the change and other details? Visit So is this a scoring system where rural bottom. Secondly, this is not a measure and residential counties automatically of something insignificant, like People www.countyhealthrankings.org fare better and urban areas don’t? Not at Who Prefer Crunchy Peanut Butter. No, all. In fact, all the counties in the Atlanta this was about our collective health (Fulton, Cobb, Dekalb, Gwinnett, Rockdale, etc.) are in and wellbeing, and we live near the bottom. Just two Georgia’s top tier of healthiest counties. dozen counties are worse off than us, while 134 are, as a whole, healthier than we are. What makes this What’s wrong with us — and how can we fi x it? especially disappointing is that Richmond County There are a few things that jump out when you look is a major medical center. This newspaper alone is at Richmond County statistics and compare them delivered to fourteen area hospitals (granted, not all with Columbia and Fulton Counties. These are areas of them in Richmond County). Did you know we where you and I, our families, our doctors, and our even had that many? Some entire counties who patients can focus our efforts. fared better than Richmond County don’t even have Let’s begin where life does, in the delivery room, fourteen doctors. With such access to healthcare at our and before that, the bedroom. fingertips, we should score better than 135 out of 159. In 2011, Richmond ranked 104 in this same survey; Please see WE’RE #135! page 7 HAT’S RIGHT.

o t n e e b t ’ n e v a h “What, you lately? ”

The 7th annual Undercover Artists Show fundraiser is moving its party to a new location this year—Julian Smith Casino—but its mission to help children and young adults with traumatic brain injuries hasn’t changed. Hosted by the Walton Foundation for Independence, the fundraiser (named Best Fundraiser by APRIL Augusta magazine in 2011) will be held THURSDAY Thursday, April 18, at 7 p.m. at Julian Smith Casino, 2200 Broad St. The event benefits Camp To Be Independent, Walton Foundation’s annual camp for those ages 8 to 21 with an acquired brain injury. Camp TBI provides a true, spend-the-night, summercamp experience—from zip lines and swimming to horseback riding and a camp talent show—in a safe, medically supervised environment. Proceeds from the annual Undercover Artists Show fundraiser help send 50 children and young adults to Camp TBI free of charge. The highlight of the Undercover Artists Show is the popular undercover art auction, featuring original works by more than 100 local artists, community leaders and celebrities—with a twist. All artists’ names are hidden until the very end of the silent auction so that each piece can be judged and bid upon based on its own merit and appeal to the bidder. Tickets are $50. To purchase, contact the Walton Foundation for Independence at 706-826-5809 or email alsalley@wrh.org. +

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APRIL 5, 2013

AUGUSTA MEDiCAL EXAMINER

OUR OPINION

A word to all doctors ...and patients

ix and a half years ago (August of 2006), I was diagnosed with cancer. I had surgery, chemotherapy, and radiation, the whole nine yards, and have pretty much felt fit as a fiddle ever since. I came home from the hospital with a prescription for 100 Oxycontin pills (or perhaps it was Oxycodone). My wife thought that was a lot, so she asked the pharmacist if she could get just part of the prescription filled. He said, “Yes, but you can’t get part now and the rest later. Whatever you get cancels the prescription. I would advise you to get it all. It’s better to have it and not need it than need it and not have it.” She got seven pills. As it turned out, that was plenty. Fast forward to March 22. I finally had my chemo port removed almost seven years after it was put in. This time I was sent home with a prescription for 60 Percoset tabs. Based on that alone, I was expecting some serious pain. Even so, I thought I would wait. I could run to the pharmacy if and when the pain materialized. It never did. Not only did I not need a Percoset, I never even came close to aspirin-level pain. Not even baby aspirin-level pain. Yet I was given a prescription for 60 Percosets. I realize that everyone has a different threshold for what they define as an unacceptable level of pain. In view of that, doctors, why not have a one-minute chat with your patients before a procedure? Ask us about our personal level of pain tolerance. Based on our answers and the procedure we’re having, let us know we’ll go home with an appropriate pain reliever, and write a modest supply. Let us know if we need more, where to call. (Most doctors I call offer “for prescription refills, press X” as one of the choices on their answering system.) Most of us won’t need a refill. And for those who do, that’s a better alternative than writing a single scrip for enough drugs to supply the whole family for a month. It’s also a practical means of fighting the growing problem of addiction to prescription meds. As patients, we need to remember that we are under no obligation to have an entire prescription filled. A therapeutic drug should be taken as prescribed, but addictive pain meds are best doled out in small quantities. Tell your pharmacist to fill only a portion of your prescription if you feel the quantity is excessive. You can always call your doctor for more if needed. Remember: not all pain is bad. Pain tells us to drop something hot we picked up, or to hop off something sharp we stepped on. In a post-operative setting, it’s neither possible nor beneficial to avoid all pain. Pain reminds us to take it slow. It tells us the healing isn’t complete yet. Listen to it. You can’t do that if you can’t feel it. The post-op world is sometimes a place where it’s “know pain, know gain.” + — Dan Pearson Publisher

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

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

MORE ON THE INDIVIDUAL MANDATE

n the last issue, we discussed some of the regulations of the Individual Mandate provision of the Affordable Care Act (ACA). First and foremost, everyone is required to have health insurance that meets the minimum requirements established by the ACA. Individuals that are exempt from this were listed in my last article.

PENALTIES Those that do not comply will be subject to penalties that change every year. These fines will be applied to an individual’s/family’s annual federal income tax filing. The following details have been Russell Head outlined by the ACA: • 2014 The penalty is $95 per adult and $47.50 per child (up to $285 for a family) or 1% of family income, whichever is greater. • 2015 The penalty is $325 per adult and $162.50 per child (up to %975 for a family) or 2% of family income, whichever is greater. • 2016 and beyond The penalty is $695 per adult and $347.50 per child (up to $2,085 for a family) or 2.5% of family income, whichever is greater. Note: The penalty is pro-rated by the number of months without coverage, though there is no penalty for a single gap in coverage of less than 3 months in a year. The penalty cannot be greater than the national average premium for Bronze level coverage in the Marketplace/ Exchange. After 2016, the penalty will be increased annually by the cost of living. PREMIUM TAX CREDITS The ACA created premium tax credit that will assist individuals and families purchase health insurance through the Marketplace/Exchange. The cost of the plan will be reduced by the tax credit to make plans more affordable. The individual/family applying for the credit must qualify.

To be eligible for the premium tax credit, a taxpayer: • Must have a household income for the year between 100% and 400% of the federal poverty level for the taxpayer’s family size. • May not be claimed as a tax dependent of another taxpayer. • Must file a joint tax return if married. • The taxpayer must enroll in a qualified health plan through the Marketplace/Exchange and cannot be eligible for minimum essential coverage from another plan such as their employer. MINIMUM ESSENTIAL COVERAGE Minimum essential coverage includes health plan coverage under one of the following. If a taxpayer is eligible for minimum essential coverage they are not eligible for the premium tax credit. • Government sponsored minimum essential coverage, such as Medicare or Medicaid • Employer sponsored minimum essential coverage An employer sponsored plan must be considered unaffordable for a taxpayer to apply for the premium tax credit. If the cost of the self-only coverage exceeds 9.5% of the employee’s household annual income, then it is considered to be unaffordable. The information presented here is not intended to be a complete outline of the ACA Regulations. It is a summary of key components that are of interest to consumers. Please refer to ACA Final Regulations at www.irs.gov or www. healthcare.gov for detailed information on these topics. + Russell T. Head is a Partner and Chief Visionary Architect with Group & Benefits Consultants, Inc., Augusta’s largest, privately held employee benefits consulting firm. He can be reached at 706-733-3459 or rthead@gandbc.com. Visit Group & Benefits Consultants at www.groupandbenefits. com

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APRIL 5, 2013

AUGUSTA MEDiCAL EXAMINER

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Why do I sneeze two times?

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ou sneeze twice? Some people almost always sneeze three times. Sometimes we just sneeze once and we’re done. Some people sneeze more than that — a lot more than that. The world record was set by a lady in England who sneezed constantly for 978 days. If you’re wondering how she could get any sleep, one of the curious facts about sneezing is that we don’t sneeze in our sleep. The particular nerve that acts to trigger a sneeze goes to sleep when we do. It is odd that we often sneeze once and pause expectantly, knowing exactly one more is on the way. After the second one, we know the sneezing’s done. Believe it or not, scientists have yet to figure that one out. It’s a mystery why some people nearly always sneeze a set number of times. They do know why we sneeze, though. At least most of the time, the reason is something that tickles our nose, like some dust or something we inhale that we’re allergic to, or just something the body wants to get rid of. Sneezing is very effective! Breathing causes air to go in and out at only about 5 mph, but when we sneeze air comes out at 100 mph! That’s like a tornado or a hurricane.

At such speeds, you can see why it’s important to cover your mouth when you sneeze. Scientists say a single sneeze can send 100,000 germs into the air. Sneezing into your shirt sleeve is the way some people try to contain the spread of all those germs. Some people try to hold in all that energy when they sneeze. Maybe they’re in a quiet place and they don’t want to loudly sneeze. It’s not usually dangerous, but since your body is trying to get rid of something, it’s best to let it have its way. Go ahead and sneeze. Just be sure to cover! There are other reasons beside colds and allergies that make some people sneeze. About one third of all people will sneeze from bright sunlight. There are many superstitions surrounding sneezing. One is that in the old days people thought death was near if you sneezed. That’s why some people still say “Bless you!” after someone sneezes. +

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TEACHERS! PARENTS! Send us your kids’ questions, whether they’re in high school, kindergarten, or somewhere in between. Mail them to Dan@AugustaRx.com or to Ask the Doctor, Medical Examiner, PO Box 397, Augusta, GA 30903-0397

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

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Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com Augusta Medical Examiner photography: H + D Photography www.handdphoto.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397

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

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APRIL 5, 2013

AUGUSTA MEDiCAL EXAMINER

Hope IS Possible

Celebrating women this month and every month

Helen Blocker-Adams

here are so many reasons to celebrate women. Did you realize that the month of March was designated to do just that? I hope that did not escape your attention. Not only is March of every year National Women’s History Month, but it is also American Red Cross month. I found an interesting correlation between the two because the founder of the national Red Cross organization is a woman. Her name is Clara Barton and she has a fascinating story. Women have served as leaders since the beginning of time. And often what drives them to lead is not fame or glory, but because they

wanted to fill a need, support a cause, heal a hurt, resolve a problem, or make a difference in someone’s life. Clara Barton was such a person. She was a Massachusetts school teacher who went to work as a clerk for the government in Washington, DC. When the Civil War broke out in 1861, she saw a need for a battlefield nurse, immediately quit her job and went to serve. She began her work caring for soldiers on April 20, 1861 and became known as the “Angel of the Battlefield.” Obviously she was not afraid of the war and the possibility of getting hurt or even killed. She saw a need and her heart led her to her destiny. In 1869 she traveled to Europe and learned about the International Red Cross Movement. She had a determined and passionate spirit that played a role in perhaps her greatest accomplishment: on May 21, 1881 she established the American Red Cross. Twelve years later Barton aided close to 30,000 people who were left homeless after a hurricane on the Sea Islands of South Carolina. She served as the

president of the American Red Cross from its inception until 1904. She died 101 years ago next week at the age of 90 (April 12, 1912). The first Presidential Proclamation in celebration of Women’s History Month was in 1980 when President Jimmy Carter designated March 2 through March 8 as National Women’s History Week. Part of his message was “From the first settlers who came to our shores, from the first American Indian families

The

who befriended them, men and women have worked together to build this nation. Too often the women were unsung, and sometimes their contributions went unnoticed. But the achievements, leadership, courage, strength and love of the women who built America was as vital as that of the men whose names we know so well.” The theme for this year’s observance was: Women Inspiring Innovation Through Imagination. Women all over the world are honoring generations of women who throughout American history have used their intelligence, imagination, sense of wonder and tenacity to make extraordinary contributions in the areas of science, technology, engineering and mathematics (STEM). In the United States, Women’s History Month began as International Women’s Day in 1911. In 1978, a school district in California participated in Women’s History Week and two elected officials noticed the popularity of the event. Senator Orrin Hatch (R-Utah) and Rep. Barbara Mikulski (D-Maryland) in 1981 co-

NEX T

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ISSUE !

sponsored the first joint Congressional Resolution proclaiming “Women’s History Week.” In 1987, Congress expanded the focus to a whole month. Some of the previous theme’s included 2010: “Writing Women Back into History;” 2011: “Our History is Our Strength;” and 2012: “Women’s Education, Women’s Empowerment.” Women today serve in virtually every role that one can think of. They are making a difference in their homes, their jobs, their communities and their world. That hasn’t always been the case. We celebrate all women and I encourage you to take the time every month to show your love for the women who are making a difference in your life. + Helen Blocker-Adams is Executive Producer/Host of “The Helen Blocker Adams Show with Co-Host Sammy Lilly”, which airs Monday through Thursday 1 p.m. – 3 p.m. on 103.7 FM/1600 AM WKZK The Spirit. She is also Founder of Unlikely Allies Emerging Leaders Conference. You can contact her at hba@hbagroup-intl.com or visit her at www.helenblockeradams.com

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appears exclusively in the Medical Examiner’s 3rd Friday issue of even months, written by Augusta’s own Bill Cleveland, a Certified Financial Planner named by Medical Economics magazine as one of the “150 Best Financial Advisors for Doctors” in the U.S.

Read it and reap

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APRIL 5, 2013

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW

ABOUT THE ART OF TERRIBLE WRITING

n this era of computers with spellcheck, we should never have a misspelled word in a published document. But the English language has over 1,000,000 words (the average person regularly uses less than 5,000), so we still have slip ups when spellcheck thinks we want one word and we intended another. That is understandable. But in documents that reportedly have human perusal prior to dissemination, we should not have slip ups. Newspapers are written by professional journalists, many of whom have degrees in English or Journalism and much experience, right? The following accumulation of headlines clearly dispels that seemingly lucid assumption. To prove my point, sit back and let your mind wander about how ridiculous, lurid, or stupid a literal interpretation of the following headlines might be: Diana still alive hours before she died (Most people are still alive a few hours before they die. However, some continue to vote for years after they die.) Bugs fly around with wings are flying bugs (What are flying bugs supposed to fly with? Their toes?) Statistics show teen

pregnancy drops off after age 25 (Is this some kind of new math? Or maybe a new federal regulation that expands the teens into the twenties for statistical purposes?) Federal agents raid gun shop; find weapons (What did they expect? Girl Scout cookies?) 17 remain dead in morgue after shooting spree (Does someone think shooting a live person or a corpse would bring them back to life?) Student excited dad got head job (This was about Dad’s promotion at school.) Missippi’s literacy program shows improvement (They will take up spellcheck next year.) Illiteracy an obstable, study finds (No, spellcheck here) Lady Jacks off to hot start (A ladies basketball team wins several games in a row.) Republicans turned off by size of Obama’s package (No comment) Girl’s school offering something special: head Tiger Woods plays with own ball, Nike says A-Rod goes deep; Wang hurt Marijuana issue sent to joint commission (Was that a mellow decision?) Homeless survive winter: Now what? (I think spring comes next, and that is not news.)

Best Cow urine makes juicy lemons (No comment) Worker suffers leg pain after crane drops 800 ball on head (He must be the World’s champion hardhead.) Bridges help people cross river (Wow, now that is an insight.) City unsure why sewer smells (You would think elected officials know what goes into toilets) Study show frequent sex enhances pregnancy chances (Did someone think abstinence causes pregnancy?) Puerto Rican teen named Mistress of the Universe (Don’t you know her mother is proud.) Caskets found as workers demolish mausoleum (What did they expect to find? Tricycles?) Barber shop singers bring joy to school of the deaf (They must be the only signlanguage barber shop singers in the world.)

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Hospitals resort to hiring doctors (Did someone think doctors worked for free?) Man with 8 DUIs blames drinking problem (You mean you don’t get a DUI for signing too loud in the choir?) New sick policy requires 2day notice (How do you know two days early that you will fall and break your arm?) Nudists fight erection of towers near Wreck Beach (Are they afraid to be seen without clothes?) Parents keep kids home to protest school closure (I wonder if the kids learned anything that day.) Starvation can lead to health problems (But it will cure obesity.) Miracle cure kills 5th patient. (Are they trying to solve the over-population problem?) The bra celebrates a pair of historic milestones (It was monumental event. Pun intended.) Total lunar eclipse will be broadcast live on National Public Radio (How do you hear an eclipse?)

Rangers get whiff of Colon (This was about a baseball game) And the greatest one of them all: Bulldogs Fight Cocks with Dicks Out. (That one is actually accurate. Happy Dicks [a Georgia Bulldog from Macon] was out with an injury when the Bull Dogs played the South Carolina Gamecocks. Louis Grizzard, a student sports writer for The Athens Banner Herald, wrote the story and, knowing his editor “had taken drunk” and probably would not proof the story, slipped the headline in and was thrilled when it was printed. It was the first, and maybe only, factually accurate but seemingly pornographic headline in Bulldogs history. In case you wonder, I did not make any of those up. I am not that smart, nor is my imagination that good. So the next time you say one thing when you meant another, have no fear: professionals misspeak worse that you do. + Bad Billy Laveau is a retired MD with a pointed sense of humor. Bad Billy speaks and entertains at public and private events for audiences not subject to cardiac seizure secondary to overwhelming laughter and glee BadBilly@knology.net or 706306-9397

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APRIL 5, 2013

AUGUSTA MEDiCAL EXAMINER

Adventures in Administration

So long for now A

s I sat there on the examining table, I was told that my blood pressure was 210/98. The doctor’s next question was, “Do you have any stress?” My answer, Stress? Don’t be silly, I thought. All I am is the caregiver for my beloved wife. Does that sound stressful? Even as I sat there I was missing one of my opportunities to be with her. As I write this it is now 2:00 a.m. Another restless night. I had laid in bed thinking about things I wanted to do. One was to talk to local author Naomi Williams. I attended her session last week for book writers. Naomi had gotten us together to discuss the challenges of writing a book. She wanted to start a book-writing club. I had not said anything at the meeting and I sensed that Naomi was getting impatient with me. As they say, she and I go way back and she was looking for me to say something in support of the club. She keep glancing over at me and finally said, “Bill, you haven’t said a word.” In response I told the group “I haven’t written a book and therefore do not feel qualified to advise others about book writing.” Actually, there my book lay on the card table, disassembled but poised for completion. I spoke briefly of pressures and being busy. Naomi moved on with the meeting. I decided that no one cared how busy I was or how much stress I was experiencing. “Stress?” the doctor had asked me Pressure causes stress. I have both. Teaching Bible, working on a soft-shoe presentation, helping a fellow prepare for piano playing at Vespers, writing for two publications. And caring for Nancy. There I sat trying to think of what element in my life would give me sufficient stress for a blood pressure reading of 210 over 89. Maybe the truth is I was trying to be so busy as to blow the top of my head off so I would never be able to write again or be helpful to anyone, in particular Nancy. At Naomi’s book meeting I had unwittingly blurted evidence that something in my life had to go. Even as the doctor’s first pill was working on me and now at 2:44 a.m. I have a BP of 176/88, I realized that I have to take more measured steps and not let stress squeeze the life out of me. Therefore, one of my changes will be to resign as guest writer for the Medical Examiner. I enjoy writing and I have thoroughly enjoyed the series that I have been doing about my career as a hospital administrator. But there comes a time. This article will be my last. Maybe with less pressure and more time I will be able to finish the disassembled book I’ve been trying to assemble. Best wishes to the Examiner and the readers who have been following this series and to its publisher Dan Pearson. My admiration for his skills of publishing is endless. If I sleep like a baby for the rest of this night it might be telling me that I have turned a corner. Hope so. + — Bill Atkinson Bill Atkinson is the former CEO of Trinity Hospital (then St. Joseph Hospital), and the author of the comprehensive 2009 Medical Examiner series on the founding of the Augusta area’s major healthcare providers.

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NEW COL UMN MED ! ICAL E XC E X A M L US IVE! INER

MEDICARE MATTERS +

MEDICARE PART B COSTS

recently met with a newly enrolled Medicare beneficiary who was surprised to learn Medicare will be deducting $104.90 from her Social Security check every month to cover the Part B premium. In addition, she did not know the annual deductible for Part B coverage this year is $147.00. These are the costs most people receiving Medicare will have to pay. However, if you earn between $85,000 and $107,000 per year, the monthly premium for Part B will be $146.90. These numbers also apply to married couples filing taxes jointly and earning up to but not more than $214,000. A single Medicare beneficiary earning between $107,000 and $160,000 can expect to pay $209.80 for the Part B premium. This is the same for married couples earning between $214,000 and $320,000. If you are single and earn between $160,000 and $214,000, your Part B premium increases to $272.70. The same amount stands for married couples earning between $320,000 and $428,000. For singles and married couples earning over $214,000 and $428,000, cost for the Part B premium is $325.70. The Part B annual deductible of $147.00 is the same for everyone regardless of income. Should you decide not to take advantage of Medicare Part B and do not have comparable coverage, there is a 10% penalty for every calendar year you do not have it. The penalty is permanent and will be deducted from your Social Security check each month. People receiving Medicaid may be eligible for state funding of the penalty. If you have Part A and Tricare, the insurance for active duty military or retirees and their families, you must have Part B in order to maintain Tricare coverage. You do not have to enroll in Part B to keep your Tricare coverage while the service member is on active duty. Prior to the active duty member retiring, you must enroll in Part B to maintain Tricare without having a break in coverage. You can sign up for Part B during a Special Enrollment Period which takes place during your original enrollment in Medicare at age 65 or older or if you become disabled. If you have end stage renal disease, you should enroll in both Part A and B when you are first diagnosed. The Annual Enrollment Period begins October 15th and ends December 7th of each year. If you are not satisfied with your Part D coverage (prescription medications) or your Medicare Advantage Plan (Part C which works in conjunction with Part B), this is the time to change. The enrollment period is open to everyone. There is also an Open Enrollment Period for Medicare Advantage Plans only which starts January 1st and ends February 14th. During this enrollment period, the only change that can be made is moving from a Medicare Advantage Plan to Part D. You cannot choose a different Medicare Advantage Plan or move between one Part D and another. Individuals receiving Medicaid can change any plan at any time. For questions regarding Part B or any other Medicare issues, please refer to your “Medicare & You” book. You may also contact Medicare directly at 800-633-4227 or GeorgiaCares at 866-552-4464. +

Author: Trisha Whisenhunt, Certified Medicare Counselor, Area Agency on Aging. Source: Medicare & You

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APRIL 5, 2013

AUGUSTA MEDiCAL EXAMINER

WEâ&#x20AC;&#x2122;RE # 135! â&#x20AC;Ś from page 1 Low birthweight babies represent 11.4% of Richmond births. The statewide average is 9.5%. In Fulton itâ&#x20AC;&#x2122;s 10.8% and 7.5% for Columbia residents. The teen birth rate in Richmond stands at 64 (per 100,000 females aged 15-19). The state average is 50; Columbiaâ&#x20AC;&#x2122;s is half that; Fulton is below the state average at 46. Sexually transmitted infections (chlamydia cases per 100,000) are 212 in Columbia; add 1,000 to that and you wonâ&#x20AC;&#x2122;t yet reach Richmondâ&#x20AC;&#x2122;s rate. Fulton (at 669) is above the state average of 466. Another negative factor in overall health: children who live in single-parent households. Would you believe the statewide average is 36%? In Richmond County, the figure is approaching 60% (57). Fulton and Columbia are 41% and 24%, respectively. The preceding are all areas where family therapists, pastors, doctors, public health workers, and perhaps most importantly, parents can make significant steps in the right direction. Fixable problems Under an umbrella category entitled Health Behaviors, the study lists a significant handful (four, to be exact) of threats to good health that are well within the power of each of us to minimize, eliminate, or otherwise control or improve. They are: excessive drinking, physical inactivity, adult obesity, and adult smoking. They arenâ&#x20AC;&#x2122;t the four horsemen of the apocalypse, but for their damaging health effects they might as well be. In brief, the study found that 18% of Richmond adults engage in excessive and binge drinking, which is higher than Columbia, Fulton, or the statewide average. Ditto for those who report absolutely no leisure time physical activity. That describes 28% of Richmond residents versus 19% in Fulton County and 22% in Columbia. One-third of all adults in Richmond County are obese (BMI above 30) compared with about one-fourth in Fulton (24) and Columbia (26) counties. Finally, tabulating adults who smoke, the figure is 22% in Richmond, compared to 13% and 18% in Fulton and Columbia counties, respectively. The average for all of Georgia is 19%. A few suggestions More than one smoker has made an unexpected discovery when trying to quit: when you drink, alcohol can rob you

of your willpower. Quitting excessive drinking then, can be the secret to quitting cigarettes for some people. Thatâ&#x20AC;&#x2122;s two for the price of one. Other smokers have also made discoveries. Some of them have quit daily marijuana use without breaking a sweat; they have conquered alcoholism and crack addiction and other heavy-duty drug habits, yet have failed miserably trying to quit tobacco. As these people have discovered, nicotine is extremely addictive. It needs the big weapons to overccome it, so use them. This is not a battle to fight alone. Talk to your doctor and enlist his help. Youâ&#x20AC;&#x2122;ll pay for the cost of the office visit and prescription in no time flat and be a healthier person with a longer life ahead of you. A winwin-win-win-win-win situation if there ever was one. Like drinking and smoking, obesity and lack of exercise go together like love and marriage (or like a horse and carriage). Obesity kills the desire to exercise. Lack of exercise fuels obesity. Itâ&#x20AC;&#x2122;s a downright vicious circle. (We could also throw in smoking as a contributing factor to lack of exercise. For some smokers, exercise causes wheezing and shortness of breath.) Where do you start if you want to slay obesity and inactivity, these two halves of the same circle? One suggestion: start first thing in the morning. The Medical Examiner has long noted the crowded drive-thru lanes of fast food restaurants in our fair city. Ask these people why they donâ&#x20AC;&#x2122;t eat a healthy breakfast at home and you know what theyâ&#x20AC;&#x2122;ll say? They donâ&#x20AC;&#x2122;t have time. But they do have time to sit in line at a fast food restaurant. What do they get when they finally have the bag handed through the window? Even something very modest is often not healthful, especially as a daily breakfast. A simple McDonalds Sausage Biscuit, for instance, has over 1,000 mg of sodium and 27 grams of fat. Thatâ&#x20AC;&#x2122;s 45 and 42 percent, respectively, of the daily allowance of those two nutritional bad boys â&#x20AC;&#x201D; and itâ&#x20AC;&#x2122;s not even 8 oâ&#x20AC;&#x2122;clock yet! Instead of spending your time wasting gas, time, and money idling in a drive-thru line for the privilege of eating something that isnâ&#x20AC;&#x2122;t even good for you, consider spending the same amount of time (but less gas and less money) on an athome breakfast.

Compared with a sausage biscuit, a bowl of cereal has a fraction of the sodium and none of the fat (even with milk). And most cereals have all kinds of vitamins and minerals thrown in. Plus fiber. Bring a healthy lunch from

home several days a week too. The pounds will start to evaporate, but sadly, your wallet will begin getting fatter. What will you do with all the money you save? Perhaps youâ&#x20AC;&#x2122;ll buy some walking shoes and get in the

SOLID

habit of taking a regular stroll. Hereâ&#x20AC;&#x2122;s one plan weâ&#x20AC;&#x2122;ve endorsed on these pages before: at least four days a week at a time thatâ&#x20AC;&#x2122;s convenient to you, strap on your new shoes and walk out your door. Walk ten minutes. Turn around. Walk home. Done! +

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APRIL 5, 2013

AUGUSTA MEDiCAL EXAMINER

P harmacy 411 Very little if anything about healthcare is inexpensive, and that includes medicine. Tiny pills can command large prices. Over-the-counter medications may be less expensive, but are they also less effective? Find the answers to lots of your drug store questions in this column written by Augusta pharmacists Chris and Lee Davidson exclusively for the Medical Examiner.

ARE ANTIBIOTICS ALWAYS THE ANSWER?

ver the past few decades physicians have been under increasing pressure to prescribe for every runny nose and cough in hopes of preventing the symptom from turning into something worse. This has worked at preventing some infections from lingering and turning into more serious conditions, but at a great cost. Our current supply of antibiotics no longer stop germs like they once did. New bacteria are emerging that are resistant to most common antibiotics and in some cases to almost everything we have in our arsenal. MRSA (methicillin-

resistant staphylococcus aureus) is now a common infection in both hospitals and the community. While we still have antibiotics to treat this new superbug, it is not alone on the list of dangerous infectious enemies. The latest bug to emerge on the scene is CRE (carbapenemresistant enterobacteriaceae) which is the most resistant type of infection to date. It is resistant form of E. Coli and Klebsiella, usually stomach bugs, but able to cause a widespread host of infections in the blood and respiratory system. Occasionally a CRE infection is found that is resistant to

all known antibiotics and the incidence of CRE infections in the United States is on the rise. As with other superbug infections, they are first seen in hospital and other acute and long-term care settings. They do, however, spread to the community setting in time. All is not lost, however. The prevention of infections can be easier than treating superbug infections. Basic hygiene and contact precautions can prevent transmission of many infections, including these “super” infections. The Centers for Disease Control (CDC) in Atlanta has issued guidelines on how to lower your risk of contracting a superbug infection. Ironically enough, since we’re talking

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about bugs that have challenged the strongest weapons in the arsenal of medicine, the basis of the CDC guidelines is just plain common sense. While they were adopted as steps for a healthcare facility’s employees to prevent either contracting or passing along a resistant infection, the same rules and principles can be used on a daily basis by the general public to prevent and control the spread of infections, including infections by multidrugresistant organisms (MDRO). Step one is hand hygiene, which is nothing more than thorough hand-washing using appropriate supplies. Alcohol-based hand sanitizers are very effective at eliminating germs, but even these products cannot replace a good thorough washing with soap and water. Disposable hand towels seem to me to be the best solution to drying your hands. They cannot be contaminated with something from a previous hand-washing attempt that may have been less than perfect. I don’t know about the effectiveness of hot-air dryers since the cleanliness of the machine inside is not known. I prefer a towel that I pull out and then throw away when I am done. More for the landfills I know, but it is, after all, clean and effective. And paper is a natural, recyclable, biodegradable product. The second step in controlling the spread of infections is contact

precautions for those who have a resistant infection. This especially includes healthcare workers taking precautions to avoid contact with an infected patient in a way that can cause the infection to be spread, whether to the next patient, or carried from the healthcare facility into the wide world outside. In a healthcare setting, using gloves and gowns if in contact with bodily fluid or secretions is expected. This is in addition to, not instead of, step one. Hospitals and other facilities will often use patient placement to help control the spread of a type of infection. This is done by placing patients with the same resistant infection in the same unit or occasionally in a multi-bed room if private rooms are not available. While contact precautions are primarily for hospital workers, they can give us guidance as visitors. If you are visiting a person with any type of contagious infection,wash all clothes taken into the patient room upon arriving home. Treat your health and wellness just as diligently as hospitals treat their employees. + Questions about this article or suggestions for future columns can be sent to us at cjdlpdrph@bellsouth.net Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson (cjdlpdrph@bellsouth.net )

APRIL 5, 2013

AUGUSTA MEDiCAL EXAMINER

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+ 10

APRIL 5, 2013

AUGUSTA MEDiCAL EXAMINER

i e D tit ian a k s A I

t’s time for our annual spring ritual again. No, not the swoosh of the golf clubs and roar of the crowds. I mean the other one – what we do before the crowds arrive: Spring Cleaning! As we try to freshen the house and eradicate pollen, do we ever stop to wonder what foods require a good scrubbing? I can remember a time as a child when so little attention was paid to food safety that we would polish an apple on the leg of our pants before taking the first juicy bite. Think about that for a moment – dirty apple, dirty hands, dirty pants, big bite. It’s a wonder I’m here to write about it. Flash forward what feels like a few hundred years and now we have gadgets for washing food, special food soaps, and confusion over what does and does not need to be washed. Let’s clear the air on the recommendations concerning the cleaning of food. The perfect place to begin: shining an apple on a shirt or pants leg. Was this sufficient? Absolutely not. According to the FDA the proper way

to handle fresh fruits and vegetables is to first wash all produce thoroughly under running water before eating, cutting, or cooking. It doesn’t matter whether this produce was tenderly nurtured in the privacy of your back yard or was handled by hundreds at the grocery store; it still needs to be washed. Notice, however, that the FDA recommends using just running water – no detergent or special soaps mentioned. This is because some household soaps, while safe to use on hands and dishes, are not designed for consumption (which comes by way of residue left behind after the rinse). The rationale for washing foods before eating is obvious, but you may wonder why before cutting, especially if you only plan to eat the interior. Once a knife or thumb has pierced the unwashed exterior of an item (fruit or vegetable), the bacteria has easy access to the interior where it can reside and potentially multiply on the very portion you plan to eat. This is why you should wash an oranges and bananas before

peeling. Think of it this way: would you drink from a cup that was left on the bleachers after a sporting event if all you were going to consume was the beverage you pour inside? I didn’t think so. Peel is an outside container for what is inside and like your hands, it needs to be cleaned. You should wash soft drink cans before affixing your lips to them for the same exact reason. How about those bigger, sturdier items like melons and cucumbers? The FDA recommends that melons, cukes,

and other firm items be washed with a clean produce brush. An emphasis on clean is required here, since a dirty brush – say one that is used and then thrown in the cabinet under the sink – can harbor bacteria that would give the direct opposite effect of what you desired. Drying produce after washing using a clean towel or disposable paper towel may further reduce bacteria that may have survived the wash. Pre-washed bagged items are an exception to the wash rule if — and only if — the bag indicates the product inside was prewashed and is ready to eat. Let’s follow the garden path over to the barnyard to determine what from that area may or may not need to be washed. Many believe that you must wash raw chicken before cooking. However, the FDA states that washing raw meat and poultry can actually spread bacteria because their juices may splash onto utensils, sinks and countertops, thereby providing the perfect avenue for cross contamination. Likewise, since all commercial eggs are washed

before sale, washing them again is unnecessary. Speaking of contamination, some staples like dried lentils and beans should be rinsed before cooking to remove residual dust, dirt, and possible small stones. Quinoa should also be rinsed before cooking, since it contains a natural coating called saponin designed to repel insects and birds. Left unrinsed, the final product will have a bitter taste. Like lettuce, some quinoa is prewashed and does not require further rinsing. Check the package label for proper cooking directions. Blow the driveway, wipe down the windows and wash the food, because Spring was sprung on March 20th and sooner or later it has to get warmer! + For more information on food safety log on to: http://www.foodsafety. gov/ Author Cindy Elia, M.S., R.D., C.D.E. is the Nutrition Specialist for the CSRA Area Agency on Aging, your gateway to aging resources. Got a question? Drop us a line: info@AugustaRx.com.

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APRIL 5, 2013

11 +

AUGUSTA MEDiCAL EXAMINER

The blog spot — Posted Feb. 16, 2013 at medhealthwriter.blogspot.com

STAY HEALTHY WHILE TRAVELING Spring break, March break, reading week, whatever you call it, it’s upon us. Beyond that looms the summer travel season. Wherever you choose to go, however, it’s up to you to be sure that you stay as healthy as possible. Illness while away is inconvenient at the very least, and could be fatal at its worst.

“ Wanna get away?

Preparations We can’t prevent all illnesses from occurring, but there are many that we can avoid through vaccinations and using caution while abroad. Vaccinations are vital for some parts of the world and some countries won’t let you in unless you can prove that you have been vaccinated. Check out the CDC site. The World Health Organization (WHO) also has travel health information. You should speak with your healthcare provider or visit a tropical disease clinic at least three months before your trip because some vaccines must be given in stages over the course of a few weeks.

”

Staying healthy Now you’ve had your necessary vaccinations and you’re on your way. How do you stay healthy? A lot of it is common sense. Washing your hands at home is one of the most important things you can do to help spread infection. The same holds true while you are on vacation and maybe more so as you may be touching more things than you might at home. Access to soap and water may not be always easy, so be sure to carry waterless hand cleansers with you so you can wash your hands frequently. Traveling, particularly by air, can be dehydrating. Be sure you drink plenty of water to prevent drying out. Part of your defense against viruses, like colds, is your nose and its moist membranes. If your body dries out, the membranes can crack, allowing viruses to enter your body, making you sick. If you travel to less developed countries, there are some rules to follow regarding your food and drink. In order to prevent illness, drink only drinks that come to you in a sealed bottle. Be sure the bottle is sealed or else tap water may have been used. Don’t accept ice cubes: they may have been made using tap water. Do not eat any fruit that you can’t peel, and be sure that all cooked food you eat is thoroughly cooked. Bring your medications If you take any prescription medications or regular overthe-counter medications, be sure to bring a full supply and some extra for the duration of the trip. Keep them with you, in carry-on luggage if you fly, so you know where they are. Not all medications are available everywhere and you could run into trouble if you run out. It’s also a good idea to bring along a fresh prescription with you, just in case something happens with your supply. Although it’s not likely that a local pharmacy will or can fill your prescription, a doctor will be able to use the information to write a local prescription. What to do if you become ill The CDC has good information here regarding what to do if you do become ill while traveling, so it doesn’t make sense to write it out again. For their advice just go to www.cdc.gov, click on “T” and scroll down to Travelers’ Health. If you are from another country, just replace their references to U.S. embassies and consulates for your own country’s. If you are going away, playing it safe is not only smart, it’s vital. +

From THE Bookshelf Every village and hamlet has its roster of volunteer firefighters, and big cities have scores of them on duty around the clock ready to respond to a conflagration anywhere in the city. The federal government sends members of the National Transportation Safety Board to the scene of major carrier accidents, whether it’s a jet crash in a remote Florida swamp or a train wreck in tiny Graniteville, South Carolina. So who responds when there’s a biological conflagration — a major medical disaster? That’s the story of this book, and it’s a story with its roots in Georgia. It might be true that most people know what the letters VFD mean on the side of a big red truck, and what the letters NTSB signify on the jackets of people combing through an acre or twisted and smoldering wreckage. But how many people know what the letters EIS stand for? The answer: 100% of the people who have read this book. The Epidemic Intelligence Service is a rapid-response

team of doctors, nurses, epidemiologists and other health professionals from the Centers for Disease Control in Atlanta whose assigned territory is the entire planet. Why is the U.S. meddling in the health affairs of countries a million miles away from our borders? Several reasons: Americans travel all over the world, so protecting people in Zaire can ultimately protect American citizens. Speaking of world travel, disease outbreaks have a nasty habit of ignoring international borders and invading country after country if left unchecked. The mission of EIS is to make sure health professionals have the tools necessary to fight back against disease

outbreaks and impede or completely stop their march across the international landscape. Their job, therefore, is a fascinating mixture of medical treatment and detective work, with a fair amount of ambassadorial public relations mixed in — and McKenna does a masterful job of telling their story, whether the trail leads to the Far East and the first outbreak of SARS, to remote African villages investigating Ebola outbreaks, or urban centers of the eastern United States, pursuing anthrax attacks delivered by mail. It’s a fascinating look at a unique and dynamic part of the medical world. As we sometimes do in this space, we also want to give a heads up to a cousin of Devil, McKenna’s more recent book, Superbug: The Fatal Menace of MRSA. Some people say it should be mandatory reading for every person who works in a hospital. That applies to several thousand people within the sound of this newspaper. + Beating Back the Devil by Maryn McKenna, 320 pages, published in July 2008 by Free Press.

the

Clipping File Upset about the Laney Supermarket closing? Early reports had all that food being hauled to the landfill. While it turned out everything possible was rerouted to the Golden Harvest Food Bank, wouldn’t it have been a tragedy if it all had been dumped in the dump? Truth be told, it would have been like wasting an ice cube on the North Pole. According to the Natural Resources Defense Council, almost 40 percent of all food nationwide is wasted. Reread that. 40 percent. It is estimated, for example, that 7 percent of food crops are never harvested, that 17 percent of food prepared in restaurants and cafeterias remain uneaten, and that families throw out some 25 percent of the food they purchase. Useless but thought-provoking The following information, released by the United Nations on March 22, may not affect

you and I personally or be a problem we can help solve, but it may give us pause the next time we’re tempted to complain because we’ve run out of bottled water or a public bathroom isn’t spotless. Although exactly forty years ago nobody had one, today six billion people on earth have mobile phones. (The world’s population is seven billion, give or take.) However, the number of people with access to indoor plumbing and basic sanitation is only 4.5 billion. got milk? College kids, listen up. If you don’t get at least three servings of dairy foods daily, your risk of developing metabolic syndrome is triple that of those who do. Metabolic syndrome, for the record, is when a person has at least three risk factors from the following menu: • high blood pressure • abdominal obesity • high blood sugar • high cholesterol

• high lipid levels Having metabolic disorder greatly increases your odds of developing heart disease and type 2 diabetes. Scientists aren’t sure if the good effects of dairy are the result of protein or calcium or both, just that consuming three daily servings of dairy products is “effective in attaining and maintaining a healthy weight.” Better vision without glasses — or surgery This month’s issue of Optometry and Vision Science reports on an emerging treatment for near vision called hyperopic orthokeratology (OK). Borrowing a page from orthodontics (using braces to align teeth) OK treatment involves wearing rigid corrective contact lenses overnight to reshape the cornea and restore near vision. Test patients report immediate vision improvement after the first night of wearing contacts. OK has in the past been used to treat nearsightedness. +

+ 12

APRIL 5, 2013

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS

THE MYSTERY WORD

What’s another word for disemboweled?

by Dan Pearson

I need a word that sounds more medical.

This again?

That’s too medical. Something in between. How about gutless?

How about eviscerated?

The Mystery Word for this issue: YINDEK

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

EXAMINER CROSSWORD

PUZZLE ACROSS

VISIT WWW.AUGUSTARX.COM TO ENTER!

Click on “Reader Contests”

QUOTATION PUZZLE

35 38 41

48 56

D D T D D W A E E P U T D Y E F N B T C R R A A L S A O E M I O E P K T I

57 59

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may only be used once. Black squares indicate spaces between words, and words may extend onto

DOWN 1. Scope prefix 2. Forthright 3. ICU for babies 4. Thrifty management 5. Dish of raw vegetables 6. Sect 7. Double curve 8. Promontory 9. Trauma pt. destinations 10. Trachea access hole 11. Poorly adjusted 12. Advanced in years 13. Type of station 18. “I will not stand ___ by!” 21. Long narrow wooden game surface 23. Flat-bottomed boat 24. Jewish sect of the 2nd C. BC 25. Glided over ice 26. Headache site, sometimes 27. Spain and Portugal 28. Discourteous 29. Teeth adjective?

— Mitch Hedberg

T T M E E I H E S N N

30. Choose 31. Ring-shaped surface 34. Glowing ember (archaic) 37. Equipped with; carrying 41. Type of marker 44. Prolonged unconsciousness 46. Rule of ____ (in burns) 47. Nostrils 49. Heap 50. _______ bomb 51. First female US attorney general 52. City feller on a ranch 53. Element no. 26 54. Irish of centuries past 55. Warning letters to burglars 56. Extinct flightless bird 57. Young boy

a second line. Solution on page 14.

X A M I N E R

1 5

9 1 3 8 4

4 2 6 3 5 9 3 9 8 1 6 7 7 4 8 7 3 3 2 8

Solution p. 14

U D O K U

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

Use the letters provided — one per dash — to create words to solve the puzzle. All the listed letters following 1 are the 1st letters of each word; the letters following 2 are 2nd letters of each word, and so on. Try solving short words and entering unique and minimal choice letters (such as 5 thru 7 in this puzzle). A sample is shown. Solution on page 10.

K 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 1 2 3 4 H A K 1 2 3 4 1 2 3 4 1 1 2 3 4 1 2 3 4

O 1 2 3 4 5 6 2

1.DEHKMPRTW 2.AEIEIOOVH 3.AEODLRRRT 4.PNEKRDIL 5.SLR 6.EE 7.M 8.E 9.N 10.T

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

WORDS NUMBER

22 26

1. Francis, for instance 5. Bakery offering 10. Urban haze 14. Heroic 15. Tool for boring holes 16. Money of Western Samoa 17. Like some rifles 19. Auto line defunct since 2004 20. Floods 21. Doc’s org. 22. Medical College beginning 23. Shoulder bones 26. Lassie’s master 29. The _____ position 32. Inquire of 33. Online auctioneer 34. In abundance 35. Prostate test ltrs. 36. Adult males 37. Anaphylaxis 38. Vietnam Offensive 39. “As needed” (Latin abbrev) 40. Save 41. Mr. Sarazen 42. How a golf ball sits 43. Track events 44. Yielded 45. Merited 47. Invasive cancellation? 48. Hat (informal) 49. EMT 55. Corner named by Herbert Warren Wind 57. Writings of lasting merit 58. Measure 59. Isolated 60. Object of adoration 61. Soviet news service, once 62. Dealer-used cars 63. “Red” coin

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

APRIL 5, 2013

THE BEST MEDICINE

he day before a big livestock sale, a farmer noticed his prize cow had suddenly gone cross-eyed, which would seriously reduce the price the cow would bring at auction. He called his veterinarian and an hour later the vet showed up. After examining the cow the vet said, “I’ve seen this before. It’s serious, but nothing I can’t handle. Do you have a length of rubber hose or tubing?” The farmer told his hired hand to run to the barn for some tubing. When he brought it back, the vet told the farmer to stand in front of the cow while the vet went around back and inserted one end of the tubing into the cow’s rectum, then blew into the other end. “Did the eyes pop back into place yet?” asked the vet after blowing until his face was blue. “No,” said the farmer. The vet blew again, harder this time, and soon heard the farmer say, “There they go. You got it. They’re back to normal.” The vet said, “Glad I could help. That’ll be $150. And if it happens again, just call me.” The farmer was shocked by the price, but he paid it. The next morning when the farmer got up

to get ready for the livestock sale he was horrified to see the same cow was cross-eyed again. Determined to not pay the veterinarian another $150, he told his hired hand to go get the tubing. Repeating the procedure he saw the vet perform the previous day, he told his hired hand to stand in front of the cow while he blew furiously into the tubing. “Are they straight yet?” he called out. “No sir,” said the hired hand. The farmer blew into the tubing even harder. “Now?” “Still the same,” said the hired hand. The farmer blew until his face was beet-red and he thought he might pass out, but the cow’s eyes were still cross-eyed. Gasping for breath, he called the farm hand back. “Here,” he said, gasping. “You try it.” The hired hand took the tube and started pulling it out of the cow. “What are you doing?” yelled the farmer. “He’s still cross-eyed. Stop! Why are you pulling out the tubing?” As he turned the tubing around and put the other end into the cow, the farm hand said, “I’m not about to blow on the same end of the tubing where you just had your mouth!” After completing some tests, the doctor took his patient into his office and said, “I have some good news and some bad news.” The patient said, “Give me the good news first.” The doctor said, “They’re going to name a disease after you.” +

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

+ +

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

The Patient’s Perspective by Marcia Ribble

hat a gorgeous sunny day in Augusta! I have been struggling this morning to learn how to use an electronic grade book. My brain is getting tired from the effort. I did manage to send my first emails to students today, but saving and importing assignments into gradebook has proven less amenable to persuasions of various kinds, despite my repeated attempts. I remind myself that I have learned other things that appeared to be un-learnable at first, and that persistence does count in succeeding, not instant gratification. Doctors meet us as patients knowing very little about our lives beyond the fact of an isolated illness or injury. For example, most orthopedic surgeons want to know about the amount of pain their patients are experiencing, but seldom really understand the costs to the patient of being hampered by that pain. My right knee, along with the pain, gradually meant increasing numbers of falls, along with increasing lack of mobility beginning with using a cane and eventually using a walker. I became more and more sedentary and gained weight. That kind of information the doctor would have, but not know that as the pain and lack of mobility increased, I gave up the teaching in college that I truly loved. In 2005 when I had my first knee replacement, my doctor had assumed that after the surgery he would need to fill out the papers for me to go on permanent disability. But that didn’t happen. Instead I taught for another five years, retiring in 2010. He gave me the ability to serve hundreds more students during those years. Since I choose to teach the students who struggle the most with writing tasks in college, teaching them meant they could go on to graduate,

t ha n a Less

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

Talk is cheap. Not talking can be deadly.

support themselves and their families and provide to their children and grandchildren a model of success made possible by attending school. This knee surgery is having a similar result. The surgery was done September 5th and now, since January, I am again in a classroom teaching writing to my students. The experience of teaching is once again giving me huge amounts of joy and satisfaction, even though learning the ropes at a new college is proving to be challenging for me. It is so good for me to be meeting new folks, both on the student and faculty sides of the equation. To teach my students, I had to learn how to get to a mall I’ve never shopped at since arriving in Augusta. My world is once again expanding to encompass people and places I might not have experienced otherwise. That means that as I approach the age of seventy, I am growing — and growth means being fully alive again. So fixing my knee had much farther reaching consequences than just relieving the pain in my knee. There was a corresponding pain in my psyche that is healing too. + Marcia Ribble received her PhD in English at Michigan State and recently retired from the University of Cincinnati where she taught composition. She taught writing at the college level and loves giving voice to people who have been silenced. She is now teaching again at Virginia College in Augusta. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.

million people can’t be wron g.

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APRIL 5, 2013

AUGUSTA MEDiCAL EXAMINER

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

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

The Celebrated MYSTERY WORD CONTEST ...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then be the first to find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries you’ll score our goodie package: gift certificates from Wild Wing Cafe, Top Notch Car Wash, and movie passes from Health Center Credit Union! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (WInners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher.

The new scrambled Mystery Word is found on page 12

EXAMINER CLASSIFIEDS TOWNHOME 3 bedroom, 3 full bath townhome. 2 master suites, like new, end unit with extra parking, single garage, covered patio, $125,000. 706-799-0394

HOMES, APARTMENTS, ROOMMATES, LAND, ETC. WEST AUGUSTA House for rent. 3 bdrm, 2 bath, 1500 sqft, 1-car garage, 3024 Sterling Road, located off Stevens Creek at Riverwatch Pkwy. $850/mo. Call 678467-7187. FOR SALE Brand new contemporary townhome/end unit in The Vista on Hwy 1, minutes from MCG. 1450 sqft. Two bdrm, two baths, office. Walk-in closets, lots of upgrades. Hardwood throughout, custom tiled kitchen/bathrooms. Floor to ceiling windows, pristine condition. Ready today. $125K - OBO. 803-5078991. HOMESBYOWNER.COM Buy • Sell • Rent Apartments available 706-564-5885

MISCELLANEOUS ENTERTAINMENT SHOPPING: Online penny auction, play and win for 80-95% off. Lots of fun. www.WorldwideOnlineBids.com Income positions available. Go to www. ExtraMoneyInterview.com MATTRESS We have a Queen Pillowtop Set that is new and still in the wrapping $150 Call or Text 762-444-7615.

SERVICES 1.1.13

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

HOUSE CLEANING Want someone to clean your home the way you would if you had the time? I take the time to make sure nothing is overlooked and clean as if it were my personal home. Call 706.833.9787

FULL-SERVICE MOVER Anthony’s Professional Moving, 28 years serving the CSRA moving hospital equipment, offices, homes, apartments, etc. Estimates are FREE. Call 706.860.3726 or 706.814.8141 NOTICE! ATTENTION! If any current or past employer has failed to pay you min. wage or time and a half overtime pay, you may be entitled to an order from US Federal Court awarding you twice the amount of your unpaid wages plus atty. fees. For info, call Arthur H. Shealy, Attorney at Law, 803-278-5149, 1010 Plantation Rd, North Augusta SC 29841. You may be entitled to a similar award for unpaid wages if your employer required you to perform duties during your lunch hour, before clocking in, or after clocking out. LAWN SERVICE Commercial, residential. Call Vince: (704) 490-1005

Thanks for reading the Medical Examiner!

BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673)

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

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

(OURS IS COFFEE)

Augusta Medical Examiner Classifieds

M O

M M Y

.75

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M O

QUOTATION QUOTATION PUZZLE SOLUTION: Page 12: “My fake plants died because I did not pretend to water them.” — Mitch Hedberg

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

B A

SEE PAGE 12

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

.25

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The Sudoku Solution 3

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5.75

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

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

WORDS BY NUMBER “Retirement kills more people than hard work ever did.” — Malcolm Forbes

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

Thanks for reading!

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APRIL 5, 2013

15 +

AUGUSTA MEDiCAL EXAMINER

The Short White Coat M

y classmates and I have embarked upon the exploration of the Endocrine system for the past few weeks, so everything “hormones” whips in our sails as we make our journeys today. Among our various lectures are discussions dedicated wholly to diabetes, its subtypes, manifestations, management, and consequences. To me, diabetes has been one of the scariest diseases to learn about so far in medical school, so I thought I’d make it the focus of my article for this month. I am certain just about everyone is either directly affected by diabetes, either Type 1 or Type 2, or is close to someone who is affected, and has therefore some idea of how devastating the disease can be. I didn’t realize just how extensively diabetes could destroy a person’s body until my medical school lectures, though I’ve known people who have lost both their limbs and lives because of it. The high levels of sugar circulating in a diabetic’s blood stream wreak unbelievable havoc on a body. Blood vessels everywhere are damaged and destroyed, leaving diabetics vastly more susceptible to disasters like heart attacks and other types of cardiovascular disease than non-diabetics. Kidney failure as a result of diabetic nephropathy is another common and dangerous complication, as are peripheral neuropathies (or profuse nerve damage), especially in the legs and feet. A diabetic’s eyes can develop cataracts or lose vision completely as

“A healthy attitude is contagious, but don’t wait to catch it from others. Be a carrier.” –Tom Stoppard a result of the damage to retinal blood vessels, and neuropathy can leave legs and feet so numb to sensation that sores and infections develop without a patient even being aware of them. Diabetic patients are not only at a greater risk for infection but cannot fight off an infection well, should one set in. Both pregnant women and their growing babies are at risk for many serious complications if the mother’s diabetes is not well controlled, providing further testament of just how serious this disease can be. Even more serious is the frightening rate at which diabetes is increasingly affecting Americans today, and at younger and younger ages, too. This is truly a public health concern that needs to be tackled without delay. During our lectures, I was a little surprised to learn that the first line of treatment for Type 2 Diabetes, at least initially, consists primarily of managing the patient’s diet, weight, and exercise routines, rather than immediately prescribing medications. Most patients are not started off immediately with medication unless exercise and weight control alone have failed. While the disease can eventually progress to a state requiring medications in addition to lifestyle changes, the progression varies from patient to patient.

This is different than the treatment of patients with type 1 Diabetes Mellitus, also known as childhood onset or insulin-dependent diabetes, which requires the use insulin as part of therapy for the rest of a patient’s life, regardless of diet and lifestyle. Type 2 Diabetes Mellitus, in contrast, does not initially require insulin as part of its management. Type 2 diabetes, also known as adult onset or non-insulin dependent diabetes, stems from the widespread resistance of the body’s tissues to the effects of insulin, and is closely associated with obesity. In fact, type 2 diabetic patients initially produce adequate amounts of insulin by themselves, but their bodies just do not respond to it normally, leading to the increased blood sugar levels and consequent damage throughout the body over time. Fortunately, there are ways to combat insulin resistance and lower the body’s blood sugar levels with nothing but dieting and exercise. Exercise actually stimulates the cells of the body’s tissues to take up sugar for use, and diets that are lower in sugar content will help keep blood levels under even better control. Yes, there are medications that doctors prescribe to further help manage blood sugar levels, but I think

A med student’s notebook the fact that most physicians will advise changes in eating and activity habits first, before medications are started, is quite encouraging. The avenue by which patients can take charge of their own health care is greater in that respect – if we can implement strategies that help us stay healthier on our own, why not go for it? Furthermore, I think it is important to note that all individuals, not just diabetic patients, would benefit from a few alterations in their lifestyle, such as incorporating more exercise and less sugar in their daily routines. The differences it can make on our health can be enormous. Mary Poppins once claimed that a spoonful of sugar helped the medicine go down, but maybe without the sugar, we won’t need as much of the medicine in the first place. Perhaps we can stop diabetes before it even starts, and force this growing epidemic sweeping the country to sweep itself into the dustpan instead. So let’s go for something even sweeter than sugar: a healthier body and a better tomorrow. + — by Caroline Colden 2nd-year medical student at MCG

SEE THIS CASH? +

It’s yours!

(if you are the randomly chosen finder of this issue’s Mystery Word)

NOW OFFERING PRIMARY CARE Including Gerontology (Geriatrics)

New & Same Day Appointments Available Most Insurance Accepted

Anytime you see the Scrubs of Evans ad on our front page, that issue’s randomly chosen Mystery Word Contest winner gets the usual haul plus a $40 gift card from Scrubs of Evans!

706-434-1590 www.MedExMD.com

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AUGUSTA MEDiCAL EXAMINER

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APRIL 5, 2013