When you think about it, the Monopoly game instructions, “Do Not Pass Go,” are kind of counterintuitive. Logically, “Do Not Pass Stop” makes a lot more sense, doesn’t it? It’s a clear and automatically understandable direction that anyone should understand in any setting. Or so you would think.
The exception seems to be when a school bus is involved. Whenever a bus stops to pick up or drop off passengers, dozens of red and yellow flashing lights are activated, including a brightly illuminated STOP sign that extends out from the side of the bus.
It’s all impossible to miss, plus the vehicle itself is the size of, well a bus. How does someone not see all of that?
Talk to local bus drivers (as we did) and they will tell you that cars passing their stopped buses with all warning lights activated is a regular occurence.
“Every week there are at least one or two incidents on my bus alone,” said one Columbia County bus driver. “How do they not notice a school bus?”
It’s not just a CSRA problem. Poke around a little on places like YouTube and you can find dozens of videos from all over the country featuring school and/ or law enforcement officials discussing the problem and begging drivers to drive safely and obey the laws protecting kids.
The beauty of the school bus safety law is its simplicity. Stop means stop. Period. It applies to all traffic in both directions,
even on a wide road like Mike Padgett Highway or Columbia Road. If you stop on the other side of the road, five lanes away from the bus, expect other drivers to honk at you or pass you. They don’t know the law. You do. Stay the course. You’re doing the right thing. (The only exception for not stopping in oncoming lanes is on divided roads with a median or other physical barrier between opposing lanes of traffic.) Drive around a stopped school bus and several things can happen, none of them good. A new Georgia law makes illegally passing a stopped bus a high and aggravated misdemeanor with a minimum fine of $1,000 and up to a year in jail. And it could be even worse than that — much worse.
2 years ago the new number — 988 — for the National Suicide Prevention LifeLine was activated, replacing the old and cumbersome 1-800273-TALK. 988 connects callers nationwide to free and confidential emotional support 24 hours a day provided by trained counselors who will listen, understand, provide support, and connect callers to additional support when needed.
+
PARENTHOOD
by Dr. Warren Umansky, PhD
Your teen comes home from school every day, grabs a snack, takes a nap on the sofa, and disappears into his room for most of the remainder of the day to spend on electronics. He is a junior in high school and is barely passing his classes. He has shown no aspirations for after high school. He also has shown no motivation to get his learner’s permit to drive. What do you do?
A. You tell him he is getting a job, walk him through identifying where he might want to work, help him with applying and preparing for interviews, and keep doing it until he has landed a job for afterschool and on weekends.
B. Don’t worry about him. All teens are doing what he’s doing.
C. Walk him through preparing for his learner’s permit test and have him keep taking the test until he passes.
D. Have the religious leader from your mosque, church or synagogue talk with him.
If you answered:
A. You’ve allowed your child to get by for years developing this pattern. Now it will take more of your effort to change the pattern, perhaps against strong resistance. Stay with it. It will pay off.
B. Not a good choice. Only those teens who are allowed to be irresponsible or who have had poor supervision develop this pattern of behavior. The future is bleak unless there is a change.
C. Your persistence is needed to move him in a forward direction. A learner’s permit is the start toward more independence.
D. This can only help. You also want to engage as many extended family members and friends to get behind him and support you.
Poor life habits are nurtured over time either through neglect or poor role models. Parents of young children should take note. Work ethic grows from doing tasks at home beginning as a young child and feeling good about accomplishments. Good time management is learned in a home environment where there is a daily schedule for meals, homework and studying, chores, recreation/exercise, bath or shower, and bedtime. And, a vision of the future begins at an early age with parents talking with their children about interesting jobs and careers they might enjoy. It should all start early, but it never is too late to right a ship that has no direction. Dr. Umansky has a child behavioral health practice in Augusta.
There are many myths surrounding Sexually Transmitted Diseases, or STDs. The entire spectrum of sexual topics, in fact, is often the source of misinformation. Here is an alltime favorite:
Some years ago a group of teenagers were surveyed about their knowledge of various matters relating to sex. There were a number of questions that were posed to both genders, and some specific to only one. The all-time classic happened to go to the teenage boys. They were asked (in so many words): “If you get a girl pregnant, it is biologically impossible to get another girl pregnant until the first girl delivers her baby. True or False?” This study was performed decades ago, so the exact numbers are lost to memory, but “True” carried the day by a wide margin.
True story.
That may be an extreme example using an under-informed segment of the populace, but people who know about these things say it’s typical of all age groups across the board
The Institute of Human Anatomy compiled a Top 10 list of STD myths. Here they are.
Myth #1: Only skanky people get STDs. As any physician would tell us (if they could), people from all walks of life, all age groups and political affiliations, and every
MEDICAL MYTHOLOGY
socio-economic bracket get treated for sexually transmitted infections (STIs). They’re like the shingles virus; STDs don’t care. They are equal opportunity infectors.
Myth #2: If your partner has an STD, you’ll know it. Think about that for half a second. If it was true, STDs wouldn’t be spreading as widely and easily as they are. The majority of STIs can be asymptomatic, whether throughout their course or just temporarily.
Myth #3: Once you’ve had an STI you usually can’t get it again. Most of these infections are curable, although some, like HIV, can require lifelong care and after-treatment. But even after an STI is cured, it can come back. Again and again.
Myth #4: You can only have one STD at a time. It would be nice if one STD magically offered immunity from all the rest. That ability could probably be used to develop a vaccine — if only it were true. But it’s quite possible to have more than one infection at the same time, and many people do.
Myth #5: If your STD test comes back negative, your partner is in the clear. A negative test is always a good thing, but as established above, STIs can be asymptomatic. It is possible that your partner has an infection, but no symptoms. The only way to be sure is for the second person to also be
tested.
Myth #6: You can avoid getting an STD if you engage only in oral or anal intercourse. Herpes is an STD that can be spread simply by skin contact, so how logical is this myth? The Institute of Human Anatomy points out that the pathogens that cause these diseases do not discriminate based on the orifice involved, and in fact, the throat and anus can be the sites of STIs. They say safe sex practices are important no matter the form of intercourse.
Myth #7: Birth control will protect you from an STI. That might be true for condoms, although not 100%, but it does not apply to oral contraceptives or using an IUD. They may offer a measure of pregnancy protection, but not from an STD.
Myth #8: True or false: you can’t get an STI in a hot tub. Assuming you’re doing nothing more than sipping a margarita you’re safe. But sexual contact in a hot tub carries the same potential risks as sexual contact outside a hot tub.
Myth #9: An orgasm is required to get an STI. Skinto-skin contact is all that is required for some STIs (herpes, for instance), so that alone destroys this myth. So-called coitus interruptus is not only a very weak method for preventing pregnancy; it’s similarly weak in the protection it offers against getting an infection.
Myth #10: You can get STDs from toilet seats. This must be the granddaddy of them all, the age-old Myth #1. Or in this case, #10. If it gets mentioned at all — and it does from time to time — it should be viewed as the joke that it is. Not funny. Not in good taste. And definitely not accurate.
One of the very best ways to avoid contracting an STD is the time-honored, time-tested practice of monogamy. It seems to work well for that purpose.
WHAT IS WHIPLASH?
We’ve all heard of this injury, and it’s estimated that there are 3 million new cases every year. Do you prefer the more technical term, cervical acceleration-deceleration? Sorry, but we’re sticking with whiplash.
The vast majority of whiplash cases are caused by rearend collisions, but anything that causes the neck and head to violently whip forth and back can result in whiplash.
The body is well designed to prevent whiplash. The cervical spine, quite sturdy in its own right, is bracketed front and back by ligaments that let the head and neck flex just so far forward and so far back. Other elements of cervical spine construction strengthen the area even more.
As well-built as it all is, the forces that come into play in an acceleration-deceleration event can overwhelm the checks and balances and result in big trouble. The shock-absorbing discs between cervical vertebrae, connecting facet joints, cervical nerves, and the anterior and posterior ligaments, are some of the potential sites of hyperextension. In addition, the nuchal ligament extends from the cervical region all the way down to thoracic and lumbar regions of the spine. A strain or sprain in the head and neck region can thus easily cause pain all the way down the spinal column, to say nothing of shoulder pain, headaches, and of course, pain, discomfort, and limited mobility in the neck itself.
Incidentally, what’s the difference between a strain and a sprain? A simple way to remember the difference is that strains (with a T) affect tendons (with a T) and muscles; sprains affect ligaments. Ligaments, to clarify, are restrictive and limiting, whereas muscles and tendons are designed to facilitate movement. Both strains and sprains are graded by their severity (1, 2, or 3), and a single whiplash event can result in numerous strains and sprains of various grades.
The standard advice in whiplash cases is get checked out by a physician. Thinking that even minor pain and stiffness is normal and will go away on its own in a day or two is rolling the dice and could wind up being a very costly decision. It’s better to be safe than sorry.
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Who is this?
This man, as you can plainly see, is Hermann Boerhaave. Why have we chosen him for a profile in “Who is this?”
It is no stretch to say that the Medical College of Georgia would not be here without him. And that goes for any academic teaching hospital anywhere in the world.
Before Boerhaave, clinical teaching was really not a thing. Medical education was a combination of “book learnin’” and skills practiced on cadavers. Boerhaave is regarded as the founder of clinical teaching and of the modern academic hospital. What patients, medical students, and clinicians all over the world consider to be routine today is something Boerhaave invented in the late 1600s.
Clinical teaching, to make sure we’re all on the same page, is a method of teaching and learning directly from patients and their symptoms rather than books, charts, illustrations, or cadavers. It is a fundamental component of medical training, which makes it all the more significant that Boerhaave brought this method to reality well over three centuries ago, yet it remains a staple of healthcare education.
Born in 1668, Boerhaave earned his doctorate in medicine in 1693 in the Netherlands from the University of Harderwijk (which today is known as Gelderland) with a doctoral dissertation that was also on a topic still current in today’s medical landscape: De utilitate explorandorum in aegris excrementorum ut signorum. If you haven’t brushed up on your Latin lately, that’s The Utility of Examining Signs of Disease in the Excrement of the Sick
To give you some idea of how farsighted Boerhaave was, modern medicine’s history of “examining signs of disease in the excrement,” dates back only as far as 1908, and using stool samples for cancer screening was only approved by the FDA in 2014. Also, this summer there have been numerous news reports of a COVID wave. Since states are no longer reporting cases as they did during the pandemic, the stats are generated from two main sources: ER visits, and bacterial analysis of municipal wastewater.
Another innovation introduced by Boerhaave is an emphasis on quantitative study and research over a qualitative approach. The difference? Quantitative studies rely on definite, measurable, numerical data, while qualitative research measures subjective phenomena, for example, how different people experience grief or pain.
Boerhaave was the first physician to use patients’ thermometer measurements in clinical practice. One of his favorite maxims was Simplex sigillum veri: “Simple is the mark of truth.” He is sometimes called the Dutch Hippocrates.
Perhaps you never heard of Hermann Boerhaave before reading this article, yet he is credited around the world for developing — in the 1600s, no less — the system of medical education still in use today. That’s pretty ama zing. +
THE NAKED TRUTH
IT AIN’T ALWAYS PLEASANT PART II
As Part I of our tale ended last issue, my friend and I were trapped in a room full of strange strangers in a strange coven welcome ceremony. I did not know where my clothes were, and we were miles from the safety of my plane and civilization.
We were required to wear a metal object during the induction ceremony. The metal would be blessed by the coven. Wicca said we were to wear the blessed metal forever for strength and protection. Witches seem to be big on strength and protection. I chose my Medical College of Georgia class ring. (It is distinctive with a prominent skull and cross bones.)
My friend asked if her IUD qualified, which caused lots of strange looks, but then she recovered and said she always wore a necklace that belonged to her grandmother, who might also have been a witch. Witches and warlocks nodded approval.
“Blessed be,” they chanted in semi-unison. All was well in witchdom.
The ceremony morphed into several healing spells for friends and loved ones and a special spell for financial gain for anyone befallen by financial disaster. I blurted out, “I could use a pocketful of Benjamins right now.” Instead of laughing at my joke, they quickly did a money spell for me
Taken back by their seriousness, I suddenly regretted saying such a selfish thing. If spirits were truly there, it might not be a good idea to bother them with extra work. How was I to know if they really liked me or not? The spirits had known me only for a few minutes, and I had not been overly impressive so far. With more candles lit at every juncture, I recalled what my friend had said as we arrived: “This place is a worldclass firetrap.”
Wicca interrupted my fire marshal meditations by announcing we were now accepted into the coven. Consequently we no longer needed our robes because henceforth the spirits would forever shield and protect us. (From what, I don’t know.) She announced our new coven names, which sounded about as comfortable
BASED ON A TRUE STORY
(most of the time)
A series by Bad Billy Laveau
as a cowbell in a symphony orchestra. I forgot mine immediately.
We both were reluctant to disrobe, but actually it wasn’t as bad as I anticipated, although I was acutely aware of my far less-than-perfect physique. Charles Atlas, I was not. My muscles were not big enough to flex for effect. Not once did I look directly at my now naked friend, nor she at me. Our relationship was not at that level. And after that night, we might not even be on speaking terms.
Finally, we were rubbed down with another ceremonial oil. Everybody rubbed everybody almost everywhere and in no particular order. No discrimination in witchdom. I had more oil rubbed on me than night than the rest of my life put together.
After various chants, magic signs and spells, the ritual ended. The special greeting for the faithful would forever be, “Blessed be.” They said John, the disciple of Jesus, popularized the greeting 2,000 year ago. My memory did not recall any such reference in the Bible. I did not bother to mention that minor detail.
As everyone put on robes, I thanked Wicca and her coven for such a unique and lovely evening. We needed to leave immediately because the weather forecast warned of an approaching storm front.
The witches leapt at the chance to do a weather spell for us. I refused. One selfish spell was enough for the day. Then I thought, perhaps I was being ungrateful. I had passed on the chance to have sex with the big boobed High Priestess. I had asked for money at the first chance.
Wicca reassured me, “Have no fear. White witchcraft is here. You must have faith in your spells if you want them to work.” They did the weather spell anyway. Maybe they needed the practice.
Wicca returned our clothes, which reeked of sweet oil. I
suggested to my friend that maybe we should quickly shower before dressing. She answered intently, “I shall shower. Then, you shall shower.” Joint showers were no longer on the agenda.
Through out this adventure, I avoided referring to my lady friend by name. The guilty must be protected. Public knowledge that she had been naked in a witch’s coven might not advance her medical career; it might curb courtship possibilities in her future. A gentleman protects a lady’s reputation at all costs, even if she is a newly minted witch.
Back at the airport and civilization, I filed a flight plan. There was a squall line between my takeoff and landing sites. I ventured forth with proper avionic caution and prudent uncertainty, but slipped through a nice hole in the squall line. My plane barely got wet. Should I have been surprised? Did the weather spell work? I don’t know. After landing safely, my friend finally broke her silence, “I did not have sex with that man or warlock or whatever he was, so I don’t know if spells will work for me or not. But I must say one thing: when you ask a girl out, it sure ain’t boring.’ Blessed be.” She did not bother to call me for some time. Probably too busy with her medical practice.
About a month later, my bank made a $55,000 mistake in my favor. Had my money spell kicked in? Not wanting to tempt fate or the FDIC, I didn’t spend the money. But neither did I report it to the bank. Ten days later, the bank found their own error and took their money back. The bank apologized for any difficulty they might have caused me. I accepted their apology with the grace of a gentleman. Not enough faith in witchcraft spells on my part, I guess.
But I do know one thing: If you stand naked in a crowded room, you need a thick skin, a good self-image, and hope that everyone has poor eyesight. Most naked bodies, mine included, are far better appreciated through touch and imagination rather than direct gaze.
Truly, the naked truth ain’t always pleasant.
Middle Age
BY J.B. COLLUM
Nostalgia can be like a drug, and with our current technology it is even easier to get lost in a rabbit hole for many hours in a quest to relive the past. It is such a tempting distraction for those of us who know that there is less life in front of us than behind us. Many times this happens when looking at old photo albums, whether real or virtual, or old family movies. Other times, I will start following a chain about something from my past by searching for it online, or I stumble across a related story or video by accident. In each of these cases, you can bet that many lost hours are on the horizon for me. The videos are sometimes about visiting the ruins of an old theme park or an abandoned shopping mall, but sometimes they are recordings or even old 8mm films recorded contemporaneously. Just the other day I watched one from the Regency Mall from the mid-eighties. The nineteen eighties for all of you wise-acres who would have asked. I’m not that old, I just feel like it in the mornings, evenings and random other times.
My cancer
EVERYONE HAS A STORY and my radiation
WITH BIFOCALS, HINDSIGHT IS 20/20
Nostalgia is like a worn out old t-shirt that may not look like much, but has gotten soft and comfortable over the years. We don’t notice or perhaps willfully ignore the holes, the thinning fabric, or the old stains. We just feel good in it. Our past is like that too. It wasn’t all good, we just tend to look back at it with rose-colored glasses.
They say that hindsight is 20/20, but it is from a frame of reference after we overcame the struggles of the time. When it was happening we were facing the uncertainties and anxieties of that time without knowing the outcome. Looking back now, the worries of our younger years may seem silly and easy to deal with, and our successfully overcoming them may now seem to have been inevitable. But in the moment they loomed large and perhaps even consumed us at times, and an escape from our troubles may have seemed anything but inevitable. This is a lesson for our future too. Whatever challenge you are facing now may seem insurmountable, but in a few years you will likely look back and laugh about it. You may not even remember it. Our memories can work that way if we let them.
In my early forties, I started to think about how brief life felt and how recent years seemed to fly by in comparison to those of my childhood. This progression seems almost logarithmic, like the Richter scale for earthquakes where each whole number increment represents a tenfold increase in earthquake magnitude. Maybe each year doesn’t seem to pass 10 times faster, but they do fly by at
a breakneck pace and in my experience they get shorter every year. When it comes to comfortable ratty old t-shirts, sometimes when I go to look for a certain one, I can’t find it, only to discover that my always practical wife has thrown them away and bought me some new ones. It is amazing to me, and especially to her, how upsetting this can be for me. It’s just a shirt she says, but the nostalgic man inside me sees it as more than a shirt. Like a lot of things I am nostalgic about, it is a sentimental tie to a simpler time with simpler problems. From a time when I hadn’t yet lost some of the most important people in my life. It is a shirt I wore fishing with my father, or one that I bought at a concert. Perhaps it is one that has a stain from one of my children, or maybe just from too much mustard on a hot dog at a baseball game. It is an old Buck pocket knife with a chipped blade that served me well, and before that my father, for many years. Of course, they are all just things, but they are also touchstones that connect us to our memories and our history. It’s why museums have “please do not touch” signs. We want to make that palpable connection with the past by touching the artifact, even though touching it accelerates its disintegration, just like wearing and washing the old t-shirt also does. I don’t think spending time reminiscing about the past and enjoying some nostalgia is bad. It is analogous to what we eat. Having a doughnut or French fries is just fine once in a while. We just need to keep it balanced. Spend a little time indulging in some nostalgia, but don’t move in, board up the windows, and take up residence in the past. Get out and enjoy life today. Make some new memories with your friends and family now that you can all look back on ten years from now. Live in the moment while you still can. Don’t get stuck on the reruns of life. Live in each new season, even as you age and have to adapt to your ever changing situation. Things never get back to what they used to be. They just find a new equilibrium and we have to keep our balance and trudge through life the best we can. The quicker we realize and accept that, the happier and more well-adjusted we will be when change catches up to us in its relentless and unforgiving manner.
J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. Reach him at johnbcollum@ gmail.com
On March 15, I was diagnosed with lung cancer. In September I was hospitalized with a severe concussion. A routine CT scan found a nodule in my left lung.
Appointments and tests with a pulmonologist, oncologist, radiation oncologist, and a surgeon followed.
A second biopsy was performed in February, indicating the original 3 cm had grown to 6 cm. It was cancer.
The doctors told me there were 3 options for treatment— surgery, chemotherapy and/or radiation. I chose to have radiation. The treatments would be Monday-Friday for 6 weeks.
I asked the doctor about the side effects of radiation. The doctor said there may be two, fatigue and esophageal irritation. After the first two weeks I had some minor fatigue. I took a nap occasionally but maintained my energy level to get things done. Light brown circles, some about the size of a pencil eraser and others smaller, appeared on my skin.
Before my first treatment, three “x” marks with adhesive were applied to my chest which showed the area to be aligned so treatment could begin.
The name of the massive machine which administers treatment is a linear accelerator. I did some research and found that, “Newer linear accelerators are now incorporating MRIs, which significantly improve visualization of patient anatomy and tumors, further advancing treatment precision and accuracy.”
Each time I enter the room for radiation, I am asked my birthdate for identification. I then go into a dressing room to remove my clothing from the waist up. A towel is provided for modesty.
The radiation therapists help me onto my back on a metal slab called a “couch.” A control panel moves me into and out of the accelerator.
A mold especially for me had been made for my head and shoulders to hold them immobile. The mold is called a “vac lock” and contains air which is refilled after use. At my request, a folded towel is placed under my tailbone and a knee cushion under my knees for comfort.
My feet are held together by a large “rubber band” to prevent motion during the treatment.
My arms are placed over my head with my hands holding onto sturdy pegs. In this position I am slid into the linear accelerator.
The treatment process takes about 15 minutes to complete. I was not uncomfortable during the time spent in the gigantic machine.
We have to be careful when I sit up after the procedure. The therapists assist me by giving their arms for me to pull myself up. I inherited vertigo (dizziness) from the concussion when I fell in September and my inner ear malfunctioned. When I change positions too rapidly, dizziness is the result. We had to wait several seconds for it to subside and not cause another fall.
The director of a 501(c)(3) non-profit organization arranged and paid for the cost of my round-trip transportation to treatments.
The office and medical staffs of the facility smiled, were friendly, helpful, professional and compassionate.
The day before my treatments ended, I brought the receptionists and radiation therapists containers of individually-wrapped milk chocolate kisses to be shared with their teams. I appreciate all they did for me. It is comforting to know people care.
My next CT scan is scheduled for this week. On August 7, I see the radiation oncologist for the results of the scan. I trust the news will be good and my heath returns
—
Dolores Eckles Evans, GA +
SHORTSTORIES
THE STRANGEST MEDICAL THING THAT HAS HAPPENED TO ME? I had a severe pain shoot down the inside of my right arm one night, but no other symptoms of anything that I noticed.
A couple of days later I noticed that my right wrist had no pulse.
I set up a doctor apt for the next day and had fun shocking the check-in nurse as she tried to take my blood pressure and it was pretty much 0/0.
The doc came in, and once he ascertained that I wasn’t just playing some strange sort of zombie joke on them, he set me up for an angiography the next day.
As I lay there the next day watching blood flowing through my arteries on the angiography screen, I eventually noticed the juncture between my heart, right arm, and the nice big artery running up to my brain. It was pretty much all clogged up with a big black mass that jerked a little more up toward toward my brain with every heartbeat.
The angiographer looked at me and I said, “That’s not real good, is it?” She responded by asking me to lie very still while she ran out, grabbed the master vascular surgeon out of a formal luncheon or somesuch (he was dressed in a fancy suit… obviously not on current medical duty!) and the surgeon immediately asked if I’d mind very much if he wheeled me right into surgery to try to save my life. I assured him that would be fine and dandy with me.
They got it in time, replaced my right subclavian artery with a McDonald’s straw or something similar, and I’ve been fine in the 20 years since!
The cause? A bicycle accident from a week or two previously when a car turned sharply in front of me, causing an internal injury that resulted in an internal dissection of the arterial wall, thereby blocking the blood flow.
The outcome: Still bicycling around.
TRYTHISDISH
This is light, fresh and full of fiber rich goodness. The flavors are subtle and sweet making this updated classic a great new comfort food.
Ingredients
• 1½ cups frozen or fresh shelled edamame (8 ounces)
• 1 tablespoon organic canola oil
• ½ cup chopped onion
• 2 cloves garlic, minced
• 1 tablespoon grated ginger
• 1 teaspoon coriander
• 2 cups corn kernels (fresh or frozen)
• ½ cup lite coconut milk
• 2 tablespoons lime juice
• ½ teaspoon salt
• Fresh cracked pepper to taste
• Cilantro, an optional but delish garnish
Directions
Cook edamame according to package directions.
Heat the oil in a large nonstick skillet over medium heat. Add onion, garlic, ginger and coriander; cook, until vegetables start to soften, about 2 minutes, stirring
frequently. Add corn, edamame, coconut milk and lime juice to the pan; cook for 4 minutes, stirring occasionally. Remove from the heat. Top with cilantro and enjoy!
Diabetes Exchange Value: ½ Carbohydrates, 1 Vegetable, 1 Fat
ASK DR. KARP
NO NONSENSE
NUTRITION
Sharon, a Facebook friend from Minnesota, asks:
“What is a FODMAP diet, and is it recommended for people with digestive problems like diverticulitis? ”
Anyone suffering from any type of digestive issues — ranging from simple indigestion to more serious digestive diseases such as inflammatory bowel disease (IBD), diverticulitis or Crohn’s Disease — has probably heard about the FODMAP Diet.
What is the FODMAP diet and is it effective?
The term FODMAP stands for (get ready!) Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols. Now there’s a term that is truly hard to digest!
FODMAPS are types of sugars in the foods you eat which, in some people, may cause bloating, diarrhea, cramps and lots of gas. The idea is that if you eliminate foods containing these types of sugars, your symptoms will improve. But there are important negatives about this diet. For one thing, it is highly restrictive in the foods you are allowed to eat. Examples of restricted foods include dairy, wheat-based foods, beans and other lentils, and specific fruits and veggies. Green-light foods include eggs, meat, specific fruits and veggies, rice, quinoa and certain cheeses. Your R.D.N. (Registered Dietitian Nutritionist) can give you a much more detailed list of these foods.
Overall, people find a FODMAP diet is extremely hard to follow, but the recommendation is that the FODMAP diet should be temporary, lasting no longer than 6 weeks. The idea is that once all the recommended foods are eliminated from your diet, you can add them back, one at a time every 3-4 days, to see which one causes any symptoms.
Chronic diseases, like many digestive diseases, tend to come and go, or wax and wane. Any cyclic disease is ripe for
all sorts of nutrition and diet claims. People are constantly searching forsimple solutions to complex medical issues. Dietary and nutrition manipulations can provide a person with a false sense of control over the disease. Many times whatever a person ate or drank during a period of “waning” gives the impression that that specific dietary manipulation is responsible for the improvement. The other side of the coin is that a person is misled into thinking that whatever she or he ate or drank prior to the disease getting worse caused the downward slide. Although it seems to make perfect sense to the person, it is rare and highly unlikely that such a simple and direct relationship exists between a food or drink and a disease process. However, it sets a person up for “magical” thinking. Digestive problems and issues may be due to many different causes, some genetic and some environmental. Crohn’s disease
is an example of a complex digestive disease that may have both genetic and environmental triggers.
Besides being overly restrictive, there are many other problems with the FODMAP diet. The approach of using your own subjective perceptions to test out different diets is fraught with difficulties. Science has often shown us that what appears to work is usually not what actually works. That’s what is known as wishful thinking.
Finally, this is a diet that should be undertaken under the supervision of a physician and monitored by an R.D.N. as part of your healthcare team. Experimenting with the FODMAP diet on your own is not recommended.
Looking at all the most recent data on the FODMAP diet up to 2024, evidenced-based medical studies and reviews of this diet are, unfortunately, still based on feelings and experiences. There is little hard scientific data to back up this dietary approach.
What is the “No-Nonsense Nutrition” advice for today? Presently, there is little evidenced-based objective science behind recommendations for the FODMAP diet. It is an overly-restrictive diet that should only be used short-term and under the supervision of a physician, with an R.D.N. as part of your healthcare team. However, this is a highly active area of research, so within the not too distant future we may have the answers. Don’t get ahead of science. Stay right behind the cutting edge. One final warning: although the FODMAP diet may lead to weight loss because the diet is so restrictive, this diet should never be considered a weight-loss diet.
at www.wbkarp.com Dr. Karp obtains no funding for writing his columns, articles, or books, and has no financial or other interests in any food, book, nutrition product or company. His interest is only in providing freely available, evidenced-based, scientific nutrition knowledge and education. The information is for educational use only; it is not meant to be used to diagnose, manage or treat any patient or client. Although Dr. Karp is a Professor Emeritus at Augusta University, the views and opinions expressed here are his and his alone and do not reflect the views and opinions of Augusta University or anyone else.
Dr. Karp
SHORTSTORIES
Healthcare workers are people. Just like anyone else, they are often poor patients.
I’m an oncologist at a cancer center. I work with staff who don’t get mammograms despite ample evidence that mammograms save lives and also reduce the need for mastectomy and chemotherapy by finding smaller cancers earlier in the course of disease.
I work with staff who have never had a screening colonoscopy despite ample evidence that a colonoscopy will lower colon cancer risk by removing polyps and also find earlier cancers to reduce need for chemotherapy.
I work with staff who are obese, and a few who are morbidly obese with BMI of 37 plus. They have a 50 percent higher chance of getting a major cancer.
I work with staff who have diabetes and don’t take their meds or follow their diet. I work with staff who don’t take their high blood pressure medication or their statins.
Because they work in the healthcare field doesn’t mean that they are good patients. I’ve also worked with doctors that smoke, and doctors and nurses who abused drugs or alcohol.
If these individuals didn’t choose to get the COVID vaccine, it’s not because they know something you don’t about the vaccine. It’s because they have denial or anxiety issues about medication and medical tests,
or home and family issues that burden them emotionally.
More than 1.2 million in the US died from COVID. About 20% of those that survived moderately severe infection have some long term health problems, some very serious and life altering.
The side effects of the vaccines are published in top line peer reviewed journals for anyone to see.
Someone from Australia responded to an online post of mine by saying that 1 in 3 Pfizer-vaccinated people got Bell’s palsy based on what she read on Facebook.
Our medical center vaccinated more than a thousand healthcare workers twice. That would mean 300 plus individuals coming to work with facial droops. Instead there isn’t even one individual.
Our healthcare workers would be a lot healthier if they lost weight and exercised most days, stopped smoking, drank in moderation or not at all, took their medications for diabetes, hypertension and hyperlipemia, stopped eating crap, got their first colonoscopy at age 45, yearly mammogram starting age 40, and took their COVID vaccine. The ones who don’t do any of the above don’t know something that all of you don’t know.
They just can’t or won’t. It’s human nature, nothing more.
CRASH COURSE
Here is a basic truth: driving safety information can be kind of boring. It just isn’t riveting reading.
But here’s another basic truth: after a traffic ticket or a wreck, the stuff we should have been doing to avoid that incident seems very appea ling. We can easily perceive that the huge rush we were in to get someplace was counterproductive. Speeding cost 30 minutes by the side of the road and an expensive ticket. Or speeding cost thousands of dollars in car repairs and hours upon hours of delay.
All of which is to say that what follows may not be the most fascinating article you’ve ever read. But that doesn’t lessen its importance. It’s about a subject that is the direct or indirect cause of millions of traffic incidents every year: distracted driving.
Let’s see if, just in our little corner of the world, we can take steps to minimize this major traffic safety issue.
Tip #1: Put away devices when driving Sure, GPS is a legitimate reason to use a phone while driving. So navigation gets a pass (however, see Tip #2). But how many times have you been sitting at a red light while cars on the cross street are turning left in front of you? If you’re not looking at your phone at that moment, you may note that half the cars or more are being driven by people with a phone in their hand. So they’re turning with one hand, holding the phone on the other. That’s not all. They’re talking on the phone. Or when they finish their turn they might be dialing up a Spotify playlist. Or sending a text. Those are absolutely crazy behaviors to undertake while piloting a speeding ton or two of metal, glass, and plastic down a congested highway. Focus on one thing: driving.
Tip #2: Get ready, then get set, then go GPS was given a free pass above. That doesn’t mean it’s cool to fiddle with it at 50 mph. Set your destination in the driveway or the parking lost before you set sail. Ditto for your tunes selection. Ditto for adjusting the mirrors. All in Park. All done? Drive.
Tip #3: FOCUS Yes, we already used that word once. It’s still a good word to use. Eating is one example of multitasking that sounds simple and uneventful — until it isn’t. You drop the sandwich or knock the french fries off the seat. Chaos ensues. Other activities, like applying mascara while driving, for example, are not conducive to safety.
Tip #4: Control yourself Barreling down the road is not a good place to have an argument or stressful conversation, especially if it’s on the phone (see Tip #1). When another driver cuts you off or tailgates you, stay calm. Control your emotions. Be an adult.
Tip #5: Limit passengers Particularly for new and inexperienced drivers, too many passengers can be a major distraction. For those passengers who are on board, establish the rules of the road. For your own toddlers, as one example, teach them from as early as possible that when mom or dad is driving they are not to be disturbed. As the parent, if they are acting up in the back seat, resist the impulse to reach back and do things while you’re trying to drive.
Tip #6: Take a break On long trips, one of the biggest potential distractions may be fatigue. Sitting in one position for hours can be sleep-inducing, so take breaks to get out and stir around a little. The minutes you spend doing that might save hours of delay (see paragraph 2 above).
Tip #7: Stay alert Related to #6, that drowsiness or lack of focus might not be from a long trip; maybe it’s due to medication you’re taking, or perhaps drinks you had at dinner. Not a good way to stay on top of your game for an activity that deserves complete attention and focus.
Follow these tips and you and your fam will be safer, and so will everyone else around you on the road.
+
* Except when we don’t. The 4th of July interfered with 1st Friday this month, so we’ve temporarily switched to 2nd and 4th Fridays for July and August. We’ll be back on schedule in September.
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The blog spot
—
posted by Veronica Bonales, MD on
August. 4,
2024
AMA: A PLAY IN ONE ACT
SCENE: Interior hospital setting. Patient screaming and crying out as they are wheeled in through the ambulance bay and brought into a room in the emergency department.
Doctor: What brings you in today?
Patient: You gotta help me, Doc. My chest hurts. I think I’m having a heart attack!
Doctor: OK, sir. We’re going to do a series of tests, including an EKG and chest X-ray, and give you aspirin.
Patient: Do whatever you’ve got to do, I don’t wanna die! I’ve got family … I’ve got kids! Don’t let me die!
Doctor: We’re going to do everything we can to help you … (About 90 minutes later …)
Doctor: Okay, sir, your tests show you’re having a heart attack. We’re going to admit you for further work-up. You’ll probably go to the cath lab first thing in the morning.
Patient: You mean I have to stay in the hospital?
Doctor: Yes, we’re going to do an echo, start you on some heparin, and monitor you.
Patient: Well, I’m feeling better, and if all you’re going to do is monitor me, then I can come back in the morning …
Doctor: Well, no. You need the blood thinner to keep your heart arteries from clogging further, and you need to be monitored.
Patient: Well, I have things to do; I can’t just sit around all night waiting.
Doctor: You do understand you’re having a heart attack?
Patient: You say I am but I don’t think so. I feel good now.
Doctor: That’s because we’ve given you medications to help increase the blood supply to your heart, but there are other things we need to do …
Patient: Well, I’ve got to go feed my dogs, and I can’t just call in to work. Plus, my elderly mother needs me to get some things from the store for her … I’ll come back in the morning … Besides, I’m dying for a smoke.
Doctor: Okay, well, this AMA form says you’re leaving Against Medical Advice, and you understand you could die from your heart attack or your heart could suffer irreversible damage. There’s also a risk of stroke…
Patient: I’m not signing that! You don’t need to get all dramatic with “you’re going to die” and all that.
Doctor: You have to understand the risks of leaving without getting proper treatment for your heart attack.
(Patient starts removing all of their medical monitoring equipment and starts getting their clothing.)
Patient (pointing to their IV): Get this out of my arm and let me go. You’re just trying to make money off me, and I’m not staying around for that! Just write me for some pain meds and get me a taxi because I’m leaving!
Doctor: You’re leaving AMA, so we’re not going to do that.
Patient: So I’m just supposed to walk home, I guess, with my quote-unquote heart attack?! What kind of place is this? You didn’t do anything. I’ve been sitting around waiting, and now you just want me to sit around all night. Plus, I didn’t even get anything to eat; I hadn’t eaten all day.
Doctor: We couldn’t give you anything to eat in case you got worse and needed to go to the cath lab sooner.
Patient: No wonder everyone says this place sucks …
(Patient is screaming and yelling at everyone as they are escorted out by security…) And... Scene.
by Dan Pearson
The Mystery Word for this issue: ALAIARM
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. Augusta mill
5. Augusta’s “The _______”
10. 2nd son of Adam and Eve
14. Potpourri
15. Hilo greetings
16. Uber competitor
17. A version of Baal
18. Occur before something else
20. Part of a combo with feathers
21. Carry out
23. Bible coin
25. Speed abbreviation
26. Make a mistake
27. Business matters
31. Fancy word for doing nothing
35. And not
36. Guides
38. Ukraine seaport
39. Got bigger
41. Rejoice
43. Capital of Ukraine
44. Iron feature
46. A goat might have one
48. Dr. of rap
49. State of having a will
51. Young girls
53. Nurse asst.
54. Stroke abbrev.
55. Greek island
59. Like a mobile, but stationary
63. McKinley’s First Lady
64. Sure
66. Joy Luck Club author
67. Reuben seller
69. Average Joe’s last name
70. Distasteful; yucky
71. Shaker contents
72. Luster
73. Mets’ former home
1. Honshu port
2. Holly genus
3. West ____ Virus
4. Depart
5. Big event Masters Week
6. On sheltered side
7. Former weight for wool
8. Central African republic
9. Intense dislike
10. @
11. Nearby South Carolina town
12. Test
13. Old Italian money
18. It’s in the center of an iris
19. Type of bird?
22. Nashville awards prog.
24. Floorboard sound
27. Anguish
28. Specialty
29. Liberates
30. Sen. Chambliss
31. Religion with a billion followers
32. Glass under a microscope
33. _____-wheeler
34. Roof overhangs
37. ____ date
40. Fossil product
42. Sustained pull, as on a leg
45. Frenetically busy
47. Sofa
50. Stroke gently
52. Apply lightly, as paint
55. Children, informally
56. Notion
57. Lofty
58. Lead-in to rival or enemy
59. Identical
60. Scratch
61. Michigan or Ontario
62. New Age singer
65. Definite article
68. Type of girl Clara Bow was
70. These are dotted
DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.
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
the
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.
RTHEBESTMEDICINE
oses are grey, violets are grey, I’m a dog.
Moe: You’re saying you guys didn’t make it to the hospital in time?
Joe: That’s what I’m saying.
Moe: So your wife delivered your baby boy in the back seat?
Joe: Sure did. Why do you think I named him Carson?
Moe: You’re being sued? By who?
Joe: The roofing contractor I hired.
Moe: What seems to be the problem?
Joe: He clearly said my new roof would be on the house. Now all of the sudden he expects me to pay for it.
On the first day of school a teacher who is a huge South Carolina fan asked everyone in class to raise their hands if they’re Gamecock fans. Everyone raised their hand except for one girl.
“Why didn’t you raise your hand?” the teacher asked.
“Because I’m a Clemson fan.”
The teacher asked her, “So tell us all, why
are you a Clemson fan?”
“Well,” began the girl, “my momma is a Clemson fan and my daddy is a Clemson fan, so I’m a Clemson fan.”
“Let me ask you something,” countered the teacher. “What if your momma was a moron and your daddy was an idiot. Then what would you be?”
“A Gamecocks fan,” said the girl.
Husband, arriving at hospital: How is my wife?
Doctor: She’s critical.
Husband: Wow, you noticed that too. But I’m pretty much used to it by now.
Moe: If cardboard had a favorite sport, I wonder what it would be.
Joe: Probably boxing.
Moe: Can you name something better than food poisoning?
Joe: Sure. Lots of things.
Moe: Ok then. Name away.
Joe: Well for starters, baseball.
Moe: Why baseball?
Joe: Because in baseball you want to get the runs.
Moe: Quick, name a vegetable that begins with Q.
Joe: Cucumber.
Moe: Did you hear that KFC just donated $50 million to the hospital?
Joe: No. Oh wait, I did heard somebody say something about a chicken wing.
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Dear Advice Doctor,
When I was a teenager I got into a lot of trouble at school. I eventually realized the error of my ways and I have been a straight arrow for many years now. But to this day, whenever someone at work says “I need to talk to you later,” or “See me in my office,” I break out in a cold sweat, even though I know I haven’t done anything wrong. How can I break this cycle?
— Still Feeling Like Trouble
Dear Still,
The calendar may say “back to school,” but the thermometer is still screaming “summertime.” It has been dangerously hot this summer, and the high temperatures pose a definite threat to people who are outside for any length of time.
The body’s automatic natural response to a hot environment is perspiration. There are two kinds of sweat glands, apocrine and eccrine, many millions of them in number, found wherever we have skin. Apocrine glands are most concentrated in places like our armpits, and they are sensitive to adrenaline, which means they generate “emotional” sweat induced by things like fear, anxiety, and pain. The eccrine glands are more universally distributed, and they’re the ones involved in thermoregulation. The evaporation of sweat has a cooling effect that helps to protect us from overheating when we’re in a hot environment. Sweat, by the way, is sterile. Odor from sweat is caused by bacterial activity, mainly from secretions of apocrine glands.
All of that is just a little background to provide general information to help put the answer to your question in context.
While perspiration is a good thing — we would be in big trouble without it — what you describe, a cold sweat, is well on the way to a different kind of big trouble: heat exhaustion, which is marked by profuse sweating, nausea, dizziness, feeling faint, and yes, cool or cold skin, even in extreme heat. That cold, clammy skin is a red alert that cooling and hydration need to be on your immediate to-do list.
The urgency comes from the fact that, without those cooling steps, heat exhaustion can quickly morph into a much more serious medical emergency known as heatstroke, marked by high fever (104°F and up), hot, dry skin, and disorientation. Seizures and coma can follow, and even death.
So don’t ignore your cold sweat. Take immediate action to cool down and prevent even more serious problems.
Thanks for writing, and I hope I answered your question.
Do you have a question for The Advice Doctor about health, life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.
THE MYSTERY SOLVED
The Mystery Word in our last issue was:
...cleverly hidden in a doctor photo in the p. 16 ad for AIYAN DIABETES CENTER
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 DIRECTORY
Dr. Eric Sherrell, DACM, LAC
Augusta Acupuncture Clinic 4141 Columbia Road 706-888-0707 www.AcuClinicGA.com
Evans Chiropractic Health Center
Dr. William M. Rice 108 SRP Drive, Suite A 706-860-4001
Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048
Karen L. Carter, MD 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com
