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AUGUSTA
MEDICAL EXAMINER New “Men’s Health” column, p. 3
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HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS
AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006
APRIL 17, 2015
What if I asked you to..
You guessed it: to play Russian Roulette. Place one bullet in a six-shooter, spin the chamber, put the gun to your head and pull the trigger. You have a five-out-of-six chance of surviving the experience. Would you do it? The very fact that we’ve all heard of this game suggests that it isn’t exactly rare. In fact, every now and then a news report comes along of someone who, usually after a night of drinking with his buddies, pulls the trigger one time too many. It happens. Maybe you would do it on a dare. Maybe you already have. But here’s a different wrinkle: would you do it if there were only three chambers instead of six? One bullet and two empty chambers. You should be thinking, “I wouldn’t do it if there were a hundred chambers and one bullet!” But what if I told you that right this very minute, you might be playing three-chamber Russian Roulette? In fact, there’s a one in three chance you are.
A one in three chance? Public health experts – people like the Centers for Disease Control down the road in Atlanta — say that 29.1 million Americans have diabetes. That’s a lot of people. However, 86 million American adults — that would be one in three — have what is called “prediabetes.” That means your blood sugar is higher than normal, but not high enough to be officially classified as diabetes. This would be fixable except for one thing: 90 percent of the 86 million people with prediabetes don’t know they have it. In fact, an estimated 25 percent of the 29.1 million Americans with diabetes don’t know they have it either. The troubling thing about those statistics is that the bodies of those people know they have diabetes or prediabetes, even if the people don’t. What is even more troubling are the people who do know, yet do little or nothing to manage their diabetes and keep it under control. Diabetes is serious. It is an incurable, progressive disease. There’s a reason it isn’t called live-abetes. Prediabetes makes you much more likely to develop type 2 diabetes, along with a greater risk of heart disease and stroke. If you have or progress to type 2, you are at much higher risk over time to experience blindness, kidney failure, heart disease, stroke, and amputations, especially of toes, feet and legs. Health experts predict that at current levels, 1 out of 3 people will eventually develop type 2 diabetes. The figures are much higher if there is diabetes in your family: parents, brothers, sisters, et cetera. But people with type 2 or prediabetes can manage this disease, dramatically slow its progression, and live a long and productive life. The keys to success: knowing if you have it for starters, and then learning how to manage it. Turn to page 2 to get that three-cylinder pistol out of your hands right this minute.
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APRIL 17, 2015
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f millions of people with diabetes don’t even know they have it, we’re obviously talking about a pretty sneaky disease. So the first step is simply to find out if you have it, or are prediabetic. The diagnostic tool of record is a simple blood test, so simple that if you’re alert you might seen diabetics doing it before meals in restaurants. They have blood glucose monitors, and a tiny finger prick will provide the single drop of blood that is necessary. If you don’t have a monitor — and why would you? you haven’t been diagnosed yet — you can ask your doctor to test your blood sugar at your next appointment. Even cheaper and quicker, however, are various health fairs that seem to happen every other weekend offering free health screenings. One of our advertisers, Barney’s Pharmacy, offers free blood sugar and A1C testing every Wednesday morning at their Peach Orchard Road pharmacy. Hopefully your blood sugar and A1C (a sort of a time capsule look at your blood sugar history) readings will be just fine. Your odds are two out of three, right? But what if you’re the one in three? Management strategies Lifestyle changes can help slow down the progression of type 2 diabetes or prediabetes (perhaps even preventing pre-d from becoming full-fledged diabetes), and the management and prevention strategies are so good they would be beneficial for just about all of us to adopt. In a nutshell, the keys are eating a healthy diet, being more active, and losing weight. The first two will make the
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third key automatic, so there are really only two vital steps to bear in mind. Other important details: • Know what’s going on! It makes little sense to have a blood glucose monitor if you rarely or never use it. You cannot manage a serious disease or coordinate your diet without day to day (or sometimes hour-by-hour) knowledge of your blood sugar levels. Testing only occasionally, or perhaps once a day, is not an active, hands-on
A Diabetes Primer Diabetes is a group of diseases marked by high levels of blood glucose caused either by how insulin is made or how the body utilizes it (or fails to). Insulin is a hormone produced by the pancreas that promotes and enables the absorption of glucose — the body’s fuel — from the bloodstream into body tissue. Type 2 diabetes accounts for as many as 95 percent of all diagnosed cases of diabetes. Type 2, is marked by insulin resistance, meaning cells do not allow insulin to do its job. Glucose is not utilized by cells and remains in the bloodstream. In Type 1 diabetes, the pancreas no longer produces insulin. To survive, people with Type 1 must have insulin delivered by injections or an insulin pump. Prediabetes is marked by abnormally high levels of blood glucose or A1C levels, but not high enough to be categorized as diabetes. Weight loss and increased physical activity can delay or permanently prevent the onset of Type 2 diabetes. +
• MOLE REMOVAL • PSORIASIS
strategy. • Communicate with your healthcare team! This cannot be stressed enough. The Medical Examiner personally knows dozens of individuals who are diagnosed diabetics who rarely if ever test because they’ve never been properly instructed. And dozens more who take their diabetes medicines only sporadically and without real knowledge of what they’re for and what side effects they may cause or what failure to take them means. Still others seem to think diabetes medications are their free pass to keep doing what they’ve been doing, the old, “I’ll just take another pill so I can have seconds on that cake and ice cream.” Your healthcare providers should educate you on dietary choices, and if they don’t, insist that they do. They are your employees. You hired them to help you. Make them do their job. • Be a good boss The flip side of that coin is to be a compliant, obedient patient. Don’t waste your money and your health by trying to cheat. You’re only cheating yourself, and you will pay dire consequences. Diabetes is a serious disease, one not to be trifled with. Compliant patients can live an enjoyable life for decades with it. Non-compliant patients can die in their 30s and early 40s. Diabetes is the domino of the disease world. Manage it well and the first domino may never even wobble. Ignore it or fail to manage it, however, and pre-d becomes type 2. Type 1 can bring with it blindness, amputations, kidney failure, heart disease and death. But if you manage it, you can take the “di” out of diabetes. +
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Caring for Patients Since 1969
APRIL 17, 2015
This Month IN MEN’S HEALTH
F EA T UR
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Guys: let’s face it. We can sometimes be a little stubborn about going to the doctor. Or maybe “cautiously and judiciously reluctant.” Better? The solution — well, a partial solution — will be found right here in every 3rd Friday issue of the Medical Examiner. A real live doctor with real live answers. Right here. Tune in!
Low T: What’s in a Number? month for what seems like the easy way out. If it sounds like I’m against testosterone supplementation, I promise you I’m really not. I prescribe it in various formulations all the time. However, it is disheartening that the more connected our society becomes, people’s daily habits may be centered on doing more at work, at home or on the internet, and the dedicated time needed to stay naturally healthier often takes a backseat to that evening Facebook check. As a physician who manages this condition, the most important factor to me in low testosterone treatment is to do no harm to a patient that often has a host of other risk factors for other potentially lethal complications. This is the focus of recent research, as a Veterans Administration study in 2013 found as much as a 30% increase in cardiovascular mortality in men receiving the medicine. So, is testosterone bad? Absolutely not when used appropriately and with a long term strategy in place that keeps each individual patient’s and provider’s goals in mind. The take-home message is to rely on a thorough workup and follow up by a provider that you trust, not simply someone trying to fix it all with testosterone. It is about perspective. You can put the highest quality synthetic oil into an engine that has one hundred ninety thousand miles on it. It might run a little smoother and quieter, but it’s still going to rattle every now and then. + Dr. Darren Mack is a graduate of the Medical College of Georgia at Georgia Regents University and is a urologist at Augusta Urology Associates. He is accepting new patients at the Augusta and Evans offices and can be reached at (706) 722-0705. Photo:David Russell Photography
SEE PAGE SIX
What’s your story?
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Nearly all of us — even doctors and nurses — are sometimes patients. Perhaps you were recently injured playing your favorite sport, or years ago you somehow got hurt without even leaving your favorite recliner. Maybe you were diagnosed with a dreaded disease, mugged in a dark and lonely parking lot, or you stubbed your toe in the safety of your own bedroom. On the other hand, perhaps you needed medical attention 5,000 miles from home. Whatever your medical experience, we’d like to hear your story for our Medicine in the First Person feature. It can be frightening or funny, ordinary or extraordinary, just a few paragraphs long or quite a lengthy tale, bylined or anonymous. We’ll publish your encounters with the medical profession as often as we receive them. + Send your submissions for Medicine in the First Person to the Augusta Medical Examiner via e-mail: info@AugustaRx.com or to PO Box 397, Augusta, GA 30903-0397. (The Medical Examiner reserves the right to accept, reject, or edit any submission at its sole discretion.)
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No man wants to be told he is below the norm, especially in the urologist’s office. Hypogonadism or “Low T” is increasingly becoming a health concern of both adult men and women that prompts evaluation by their physician. When it comes to testosterone production, more and more patients are deciding to augment their body’s natural production of testosterone with a variety of androgen replacement treatments that include creams, injections, and long acting formulations. With age alone, testosterone production wanes in both men and women, and the exact cutoff point at which this number becomes a true disease that needs treatment is still quite controversial. For me, even with all the benefits of testosterone therapy, the most challenging and exciting question is not necessarily who needs testosterone; rather, it’s who doesn’t. “I’ve been taking the testosterone for six months and my (insert medical malady here) still isn’t better.” I see these types of treatment failures all the time in my office and it isn’t the fault of the patient, doctor, or medication. With erectile dysfunction, for instance, there are a host of reasons for the disease to not improve, no matter how much testosterone is flowing through one’s veins. Also, other modifiable risk factors have a role in the efficacy of testosterone. If you’ve heard the terms “bad fat” or “central visceral obesity” you know what I’m talking about. In these types of patients, they may never feel the effects of testosterone despite how high their level is simply because their body fat aromatizes the hormone into estradiol. In today’s medical economy, there is increasing pressure for the quick fix. Rarely are patients excited to learn that what they really need is to exercise more, change their diet, and work to gain control over chronic medical problems. Many would rather pay a financial premium every
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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: 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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APRIL 17, 2015
AUGUSTA MEDiCAL EXAMINER
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ave you ever had bad service in a store or restaurant? We all have at one time or another. We each have our pet peeves about which type of bad service gets on our nerves the most. For me, it’s the waitperson that brings my food to the table with their thumb in my plate. Sorry, I can’t let that pass. But almost any form of bad service will definitely get my attention. Most of the time I say nothing. Occasionally, I do. Like the time I observed a convenience store employee ignore a spill. I told him if he worked for me, I would fire him. I was lucky enough to be hired by the local grocery store when I was in high school (I’m about to date myself). They paid more than minimum wage and any high school girl who was anyone worked there. The cash registers were the old type that you had to punch in the amount of each item, and use the heel of your hand to hit the lever to record the purchase. I had to count out the change and count it back to the customer, putting it in their hand, coins first, then the bills. It would mean the
loss of my job had I done this incorrectly by much or often. Courtesy, speed and accuracy were the name of the game and the wrath of the front end manager would be upon any of us had we conducted ourselves differently. Not so today. Cashiers don’t count the change back to you - a lot of them don’t have the math skills to figure it out in their heads if they had to - they hand it to you coins, bills and receipt all in a tangle and they do it at their convenience. If you have a legitimate complaint about something and ask to see the manager it’s probably a 50/50 split on whether or not you receive true customer service
as a result or mere lip service. Nobody cares if you return to spend your money, and that is really the only way to respond to a business that does not measure up. Don’t go back. I really enjoyed the food at Sticky Fingers. Unfortunately it didn’t matter what day or time I went, the service was terrible. They are no longer in business. I think it’s a flaw in training. You can hire 30 people, train them all, and end up with 10 or 12 that become excellent employees. It depends on screening properly during the interview process and training. I have a doctor who has a staff of wonderful employees. From her receptionist to the crew in the back, everyone is exceptional. I have seen another medical office where the administrative staff is a nightmare, but the techs and nurses who assist with patients are fine. Training and screening is all important. We are going to get what we expect from people. We should expect much more. +
MYTH OF THE MONTH Is heat better for treating an injury, or ice?
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It’s hard to remember for many people, so this question never seems to go away. Simple rule: when in doubt, ice is usually better. For acute injuries, like twisting your ankle or straining a muscle, ice helps relieve pain by numbing the area, reducing swelling and inflammation, and also helping to stem bleeding. Cold is the general rule for new (acute) injuries within the first 24-48 hours when swelling can be most intense. Don’t overdo it, though. Twenty minutes should be the max, then remove the ice pack. If you aren’t experiencing any discomfort after 20 minutes and think it’s okay to keep
ice on an injury longer, it might be because the area is numb and you can’t feel the tissue damage. Be a good patient and do no more than 20 minutes per hour, or at most 20 minutes of ice, 20 minutes of no ice. The mnemonic to remember for acute injuries is RICE: Rest, Ice, Compression, and Elevation, compression being something like an ace bandage to help support and gently immobilize a sore wrist, ankle or other joint. + — by F. E. Gilliard, MD, Family Medicine 639 13th St Augusta, GA 30901 706-823-5052
APRIL 17, 2015
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AUGUSTA MEDiCAL EXAMINER
WHAT EVERYBODY OUGHT TO KNOW res?
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ABOUT DEATH LETTER BLUES
k good eno r skin can ugh cer? son.” o
ot a letter this morning, Reckon how it read? It read: Hurry, hurry. The girl you love is dead. k
Grabbed up my suitcase And took off down the road When I got there She was laying on a cooling board. I walked up close to her, Looked down in her face I said: Good ole girl, You got to lay here til Judgment Day. 10,000 people gathered Around her burying ground Didn’t know how much I loved her Til they laid her down.
from us. Easter is a time that makes us think of the death and the resurrection of Christ. Frequently, it makes us think of the death of someone physically close to us. More than a half a century ago Son House recorded the lyrics above. He was an uneducated man born near Clarksville, Mississippi, and had a colorful life which included short stay in the Mississippi State Penitentiary (Parchman Prison Plantation) before becoming a preacher and bluesman. His classic song delineates
I didn’t feel so bad Til the good Lord’s sun went down. I didn’t have a soul To throw my arms around. (Stolen, with apologies, from Death Letter Blues by Son House (March 21, 1902 – October 19, 1988). Cigarettes and cancer of the larynx took this innovative preacher and bluesman away
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t s e B the steps we go through with the loss of a loved one. Verse 1 addresses the arrival of the unexpected bad news. Verse 2 addresses the travel one usually makes to attend the funeral. Verse 3 addresses viewing the deceased in her final resting state. Verse 4 addresses the gathering of the deceased’s many admirers and the final interment. Verse 5 addresses the loneliness and emptiness in one’s heart having loss someone near and dear. Death Letter Blues is the deep-rooted feelings of the bluesman Son House. But at one time or another we all experience the same feelings. Son House, a preacher
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before his blues career began, did not use this opportunity to reassure us of the future and explain that death is a normal part of life and is therefore not to be dreaded, but to be accepted as normal. I guess we would have had to attend one of his sermons to hear his feelings on that. Death Letter Blues has been covered by many blues and rock groups, including the Allman Brothers and John Cougar Mellencamp, who have versions on YouTube. Even heavy-metal groups have covered it because it has feelings that resonate deep in our souls.
Somehow, my mind couples Death Letter Blues with the world’s greatest blues song, Amazing Grace. The former deals with the uncertainly of the earthly experience of completing a life. The latter deals with the assurance that after death there is resurrection and hope. The impact of these two songs, from different ends of the musical and emotional spectrum, lifts a burden from my soul as I get old. + 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 706-3069397
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by Ross Everett
THE BIG FIVE-OH
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APRIL 17, 2015
AUGUSTA MEDiCAL EXAMINER
few months back, I looked back on the Affordable Care Act after one year of full implementation and reflected. This month, I want to talk about a much bigger birthday. This is the year that our darling Medicare turns 50. The history of Medicare is fascinating. The bill exemplifies many of the highs and lows of the American political process. Like many large-scale legislative works, Medicare and Medicaid are part compromise, part celestial alignment. Beginning with FDR, healthcare fell into the crosshairs of the executive branch. However, senior citizens were hardly the
only goal at the time. Rather, the early architects of the program eyed universal health insurance for every American. Teddy Roosevelt was probably the first president to publicly call for such reform. But a real chance at national insurance likely first surfaced with Teddy’s distant cousin, Franklin. In all likelihood, though, FDR simply ran out of time. Truman truly took up the call and pushed for a national health insurance, but could not generate the support it needed. By the time a young senator from Massachusetts took over the oval office, obtaining universal coverage in a single step had, for the most
part, been dismissed entirely. However, in the true political spirit, Kennedy set his sights on a highly susceptible portion of the population that also happens to carry a great deal of weight in election years: the elderly. Narrowly missing passage of a Medicare bill in 1962, he was already gearing up to make it his largest campaign issue for reelection when he was killed in 1963. However, Lyndon B. Johnson was able to build on Kennedy’s foundation. After a landslide victory in 1964, LBJ used his nearly unparalleled political skills to push Medicare through the House Ways and Means Committee and on to passage. On July 30, 1965, Johnson signed the bill into law in Independence, Missouri, at the Truman presidential library, with an aged 33rd president there to witness it. The Medicare of 1965 was not the Medicare we have today. This entitlement system has long been the source of reforms for one administration after the next. Initially, it consisted of just Medicare Part A and
Part B. Part A provides hospital coverage, while Part B insures outpatient visits such as the ones enrollees routinely make to their doctors’ offices. Over time we have seen the addition of a Part C and D. The big HMO push of the 1990s led Congress in 1997 to expand a previously existing option for Medicare beneficiaries to enroll in private plans. This effort was adopted as Medicare Part C, but today is commonly just called Medicare Advantage. In 2003, George W Bush enacted Medicare Part D, which provides prescription drug benefits for enrollees. Interestingly enough, Reagan had previously passed a provision for prescription drugs in 1988, but Congress repealed the law a year later. And though it did not add any “Parts,” President Obama’s healthcare plan, the Affordable Care Act, made significant changes to Medicare in 2010. The program is sure to see numerous reforms in the years ahead. Medicare came at a good time. When it originally passed, nearly half of Americans over
age 65 were without insurance. Even those that had it didn’t have much coverage. Now, in 2015, only 2% of these older Americans are uninsured. However, this insurance plan has had a role in numerous other changes over the years besides simply covering elderly Americans. When it was enacted, it did not provide reimbursements to health facilities that were segregated by race. That penalty desegregated hospitals throughout the entire US almost immediately. That kind of power only comes with the title of largest provider in the country. This same power has ushered in innovative new ways in which both hospitals and private physicians are paid. Medicare began paying hospitals prospectively for patient stays in 1983 using Diagnosis-Related Groups (DRGs). Six years later, in 1989, physicians began receiving reimbursement through the use of a Resource-Based RelativeValue Scale (RBRVS) rather than simply billing however they Please see WIDE-EYED page 13
WE’RE BEGGING YOU! We’re never too proud to beg. What we’re begging for is Medicine in the First Person stories. With your help, we’d like to make this a feature in every issue of the Medical Examiner. After all, everybody has a story of something health- or medicine-related, and lots of people have many stories. Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx.com. Thanks!
“The cause was a mystery for a long time.” “And that’s when I fell.” nearest hospital “He doesn’t remember a thing.” “The was 30 miles away.” “I was a battlefield medic.” “He was just two when he died.”
“OUCH!”
“It was a terrible tragedy.” “She saved “I sure learned my lesson.” “I retired from medicine my life.” “It seemed like a miracle.” seven years ago.” “We had triplets.” “It was my first year “I thought, ‘Well, this is it’.” NOTHING SEEMED of medical school.” “They took me to the hospital by helicopter.” TO HELP, UNTIL. . “It took 48 stitches.”
ambulance crashed.” “Now THAT hurt!” “The “My leg was broken “I’m not supposed to be alive.”
“This was on my third day in Afghanistan.” in three places.” “I lost 23 pounds.” “Turned out it was just indigestion.” “At first I thought it was something I ate.” “The smoke detector woke me up.”
Everybody has a story. Tell us yours! Here’s our “No Rules Rules.” We’ll publish your name and city, or keep you anonymous. Your choice. Length? Up to you. Subject? It can be a monumental medical event or just a stubbed toe. It can make us laugh or make us cry. One thing we’re not interested in, however: please, no tirades against a certain doctor or hospital. Ain’t nobody got time for that.
APRIL 17, 2015
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AUGUSTA MEDiCAL EXAMINER
Southern Girl Eats Clean
Clean & Healthy Low Country Shrimp and Grits
Shrimp and grits has been a favorite of mine for a good many years now. However, the version I used to make was full of artery-clogging unhealthy fats like butter, Half & Half, bacon and of course, cheesy white grits. Sound familiar? But since I love shrimp and grits, I was determined to find a way to clean up this dish. It took me a while, but I think I nailed it. I added more veggies, left off unhealthy fats and white flour, and used polenta instead of white grits. This dish is glutenfree, my friends, and full of flavor. It even met my husband’s seal of approval. I was inspired by several recipes on foodnetwork.com and of course, my old version of shrimp and grits from the cookbook, A Taste of Charleston. Give this recipe a try and see how delicious “healthy and clean” meals can be. Ingedients • 2 to 3 Tbsp. of organic cold pressed extra virgin olive oil • 5 shallots, 3 sliced and 2 finely chopped • 5 cloves of garlic, crushed • ½ to ¾ of each: a red, green and yellow pepper, julienned • 1 cup of chopped fresh tomato, seeds removed • 1 to 2 Tbsp. of Blackened Seasoning (See recipe below) • 1 quart and 2 cups of organic chicken broth (or vegetable broth) • 2 Tbsp. of gluten free Worcestershire sauce • 2 Tbsp. of garbanzo bean flour • 2 Tbsp. of organic tomato paste (I used Muir Glen Brand) • 1 pound of wild caught shrimp, peeled, deveined and tails removed (SC local shrimp are my favorite) • Organic corn polenta • Scallions to garnish Instructions Heat 1 Tbsp. of olive oil over medium to high heat. Add 2 chopped shallots and 2 cloves of crushed garlic to oil and sauté until softened. Add 1 quart of chicken or vegetable broth to pan and bring to a boil. Once broth is boiling, slightly reduce heat and slowly whisk in 1-1/3 cups of polenta. When polenta is completely thickened to desired consistency, pour into a parchment lined 9 X
Low Country Shrimp and Grits 13 pan and let cool, then place in refrigerator to harden for approximately 30 min. Remove the polenta from the refrigerator and cut into 3 X 3 inch squares. Place the squares onto a slightly oiled cookie sheet and broil in the oven until brown, turning squares once to brown both sides. (Alternately you may brown both sides of the polenta squares in a skillet with olive oil if you choose.) While polenta is browning in the oven, heat 2 to 3 Tbsp. of olive oil over medium to high heat. Add 3 sliced shallots and 3 cloves of crushed garlic to pan and sauté until softened, 3-5 minutes. Add red, green, and yellow peppers to pan and cook until tender-crisp, stirring often. Pour in 1½ Cups of chicken or vegetable broth. Add blackened seasoning, Worcestershire sauce and tomato sauce, mix well and simmer for 3-5 min. In a small bowl whisk together garbanzo flour and ½ Cup of chicken or vegetable broth, pour into sauté pan with the vegetables, stir to mix well and let simmer until sauce is
thickened. Once the sauce has thickened, add the shrimp and chopped tomatoes. Simmer until shrimp are cooked through, approximately 5-7 minutes, stirring often. Place 2 or 3 polenta squares onto 4 dinner plates and spoon shrimp/vegetable mixture over the polenta. Garnish with scallions. Serve immediately.
spring ing! into the W
THE BEST WINGS SOUTH OF BUFFALO ™ AREN’T THE ONLY THING WE’VE GOT COOKIN’ AT THE WING. AWESOME SALADS, GRILLED CHICKEN FEATHERS, WILD WRAPS, VEGGIE SKEWERS AND MUCH MORE. AFTER ALL, VARIETY IS THE SPICE OF LIFE!
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Recipe for Blackened Seasoning 1 Tbsp. each of garlic powder, onion powder and ground dried thyme, plus 1½ Tbsp. of paprika, 1 tsp. each of cracked black pepper, dried basil and dried oregano. Then add 1¼ to 1½ teaspoons of cayenne, according to your taste. Mix well and store in an airtight container. + Alisa Rhinehart writes the blog www.southerngirleatsclean.com She is a working wife and mother living in Evans, Georgia. Visit her blog for more recipes and information on clean eating.
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OUR NEWSSTANDS Medical locations: • Department of Veterans Affairs Medical Ctr, 15th St., Main Entrance • Dept. of Veterans Affairs Medical Center, Uptown Div., Wrightsboro Rd., main lobby • Doctors Hospital, 3651 Wheeler Rd, ER Lobby Entrance • Eisenhower Hospital, Main Lobby, Fort Gordon • George C. Wilson Drive (by medical center Waffle House and mail boxes) • GHSU Hospital, 1120 15th Street, South & West Entrances • GHSU Medical Office Building, Harper Street, Main Entrance • GHSU Medical Office Building, Harper Street, Parking Deck entrance • GHSU Hospital, Emergency Room, Harper Street, Main Entrance • GHSU Children’s Medical Center, Harper Street, Main Lobby • GHSU, Laney-Walker Boulevard transit stop, Augusta • Select Specialty Hospital, Walton Way, Main entrance lobby • Trinity Hospital, Wrightsboro Road, main lobby by elevators • Trinity Hospital Home Health, Daniel Village, main lobby • University Health Federal Credit Union/ University Hospital Human Resources, 1402 Walton Way, Main Lobby • University Hospital, 1350 Walton Way, Emergency Room lobby area • University Hospital, 1350 Walton Way, Outside Brown & Radiology/Day Surgery • University Hospital - Columbia County, 465 N. Belair Road, Main Lobby • University Hospital Prompt Care, 3121 Peach Orchard Road, Augusta
Around town: • Barney’s Pharmacy, 2604 Peach Orchard Rd. • Birth Control Source, 1944 Walton Way • GRU Summerville Student Bookstore • Blue Sky Kitchen, 990 Broad Street • Columbia County Library, main branch lobby, Ronald Reagan Drive, Evans • Enterprise Mill (North Tower), 1450 Greene Street, Augusta • Daniel Village Barber Shop, Wrightsboro Road at Ohio Ave. • Hartley’s Uniforms, 1010 Druid Park Ave, Augusta • International Uniforms, 1216 Broad Street, Augusta • Marshall Family Y, Belair Rd, Evans • Mellow Mushroom, 12th and Broad Streets, Augusta • Parks Pharmacy, Georgia Avenue, North Augusta • Southside Family Y, Tobacco Road, Augusta • Surrey Center, Surrey Center Pharmacy, Highland Avenue, Augusta • Top-Notch Car Wash, 512 N. Belair Road, Evans • Wild Wing Cafe, 3035 Washington Road, Augusta
Plus... 600+ doctors offices throughout the area for staff and waiting rooms, as well as many nurses stations and waiting rooms of area hospitals.
APRIL 17, 2015
AUGUSTA MEDiCAL EXAMINER
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.
WHAT CAN I EXPECT FROM MY BIRTH CONTROL?
T
here are several forms of birth control out there for women to choose to prevent pregnancy. The most common is the combination estrogen and progesterone birth control pill. There are numerous options to choose from in this pill form. In this issue we are going to discuss an alternative form of birth control that uses progesterone as the only hormone. This is available in a pill, known as the minipill, and also as an injection. While the progesteroneonly form of birth control avoids some of the common side effects associated with birth control forms that use estrogen, there are still plenty of potential side effects to be aware of and deal with. Without the estrogen you can avoid the estrogen-dependent cancers and deal with only certain other cancers and blood clots as the most severe of the possible side effects. The progesterone-only injection is called DepoProvera and is administered as an injection once every three months. There is the possibility of injection site reactions and infection at the site that is not applicable to the pill form of birth control. The other side effects are similar. The most severe warning on the medroxyprogesterone injection is significant bone density loss. This loss may not be reversible upon discontinuation of the medication. As with all birth control methods that use hormones, it is to be used with caution by smokers due to an increased risk for blood clots. This medicine should be avoided in patients with history of blood clots or breast cancer. It is recommended that adolescents and young adults use it as a long term method of birth control only if other methods are not indicated or suitable. Be aware if using the Depo-Provera of sudden vision changes and report these to your prescriber. There can be mental changes and depressive symptoms due to Depo-Provera, as well as more common side effects such as weight gain. As we have found out at my store, weight gain can be significant and persist long after the medicine is discontinued. Other common side effects noticed
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can be menstrual changes, a libido decrease, acne and headaches. Even though you are not taking a pill, stomach side effects such as nausea and abdominal distension or bloating is possible. People using the medroxyprogesterone injection can suffer from fluid retention, back and pelvic pain, muscle pain, excess facial hair growth, loss of hair or alopecia and lack of glucose control. Your doctor will wants to do certain tests before and while on Depo-Provera. Before starting this medicine, as with any birth control form, you will have to take a pregnancy test to ensure you are not already pregnant. This is because these medications will cause a pregnancy to abort. A repeat pregnancy test will be performed anytime there is more than fourteen weeks between doses. If diabetic you will take regular blood glucose tests to check the aforementioned lack of blood glucose control. After being on the medicine for a period of time greater than two years, your doctor will probably perform a bone mineral density test to check for bone loss. In view of all the foregoing, if you’re considering birth control talk to your doctor about all the different options and discover with a physician’s help which method is best for you. Remember that after stopping birth control, it is person-specific as to future ability to quickly conceive. Don’t make the mistake of assuming you will have a delay in being able to cycle and conceive normally. While this has been the case for some women, others can conceive immediately after stopping birth control. This has caused many unexpected pregnancies, so to be on the safe side assume you can conceive to prevent any surprises. + Written by for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson. Questions, comments and article ideas can be sent by email to cjdlpdrph@bellsouth.net
MCR Masters of Clinical Research, Inc. 1113 Garredd Blvd, Suite A • Augusta, GA 30909
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APRIL 17, 2015
9+
AUGUSTA MEDiCAL EXAMINER
DON’T LICK THE BEATERS
Voted “BEST BARBER SHOP” in Augusta Magazine many times!
Daniel Village Barber Shop 2522 Wrightsboro Road
GIRLFRIENDS MAY COME AND GO, BUT BARBERS ARE FOREVER.
Useful food facts from dietetic interns with University Hospital’s Augusta Area Dietetic Internship Program
Eating Right — for Your Blood Type?
W
So is the blood type diet scientifi cally backed or is it simply another fad diet? The association between blood type based dietary patterns and health outcomes has not been studied adequately, nor do existing studies show any correlations.1 One study did evaluate the association between blood type diets and biomarkers of cardiometabolic health and whether an individual’s ABO genotype modifies any associations. According to the study titled ABO Genotype, ‘Blood-Type’ Diet and Cardiometabolic Risk Factors, adherence to the Type A diet was associated with lower BMI, waist circumference, blood pressure, serum cholesterol, triglycerides, and insulin. Following the AB type diet was also found to lower these biomarkers, excluding BMI and waist circumference. Adherence to the Type O diet resulted only in lower triglycerides, which is probably a result of it basically being an extremely low-carb
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What does my blood type mean? When following the Blood Type Diet, there are specific foods and types of exercise that are recommended for each blood type: Type Os are said to do best on a high animal protein, low dairy, low grain diet with intense physical exercise since they are considered the ancestral blood type. According to D’Adamo, the biggest contributor to weight gain in Type O individuals is the gluten found in wheat products, and, to a lesser extent, the gluten found in lentils, corn, kidney beans, and cabbage. Ideal exercises include aerobics, martial arts, contact sports, and running. Type Os are also more
likely to suffer from asthma, allergies, and arthritis because their immune systems are “environmentally intolerant.”3 Type As, say proponents, are more naturally suited for a vegetarian or vegan diet with a high intake of fresh grains, fruits, and vegetables. Predisposition to heart disease, cancer, and diabetes makes this transition critical according to D’Adamo. He also states that Type A individuals should do gentle exercises such as yoga or tai chi.2 Type Bs are claimed to have strong immune systems and tolerant digestive systems, which makes them able to resist most chronic degenerative illnesses. According to the Blood Type Diet, Type B individuals should eat dairy, meat, produce, corn or wheat, and avoid beans. Type Bs tend to do well incorporating moderate physical activity that requires mental stamina, such as swimming, cycling, rock climbing, and trail running. Type Bs apparently have a high allergy threshold, but are susceptible to autoimmune disorders like lupus, chronic fatigue syndrome, and multiple sclerosis.1 Type ABs tend to have the fewest problems with allergies, but are at higher risk for heart disease, cancer, and anemia. Type AB is the most recent blood type in evolutionary terms according to the Blood Type Diet, and is therefore, according to D’Adamo, the most biologically complex. Type AB’\s should consume seafood, tofu, dairy, and fresh produce, but limit animal proteins. Type ABs should include a combination of the Type A and Type B exercises.2
Ohio Ave.
What is the Blood Type Diet? According to naturopath Peter J. D’Adamo, N.D., in his book Eat Right 4 Your Type, there are four blood types: Type O, the ancestral blood type; Type A, the Agrarian; Type B, the Nomadic; and Type AB, the Modern. D’Adamo claims that blood type can determine the probability that a person will be susceptible to certain diseases.2 His research in genetics, medical history, and anthropology has led him to the conclusion that blood type is “the key that unlocks the door to the mysteries of health, disease, longevity, physical vitality, and emotional strength”.3 The basis of the Blood Type Diet is that individuals should live a certain lifestyle based on their ABO blood group. In order to improve their health and decrease their risk of chronic diseases, individuals should eat foods and exercise in a way that best agrees with their ABO blood group.
Head to toe service: Jerry will shine your shoes while we cut your hair. We’re on Wrightsboro Rd. at Ohio Avenue. Highland Ave.
ill eating a diet based on your blood type really help shed those extra pounds before swimsuit season? And will exercising according to your blood type (as opposed to your body type) improve results? A controversial new regimen called the “Blood Type Diet” claims that following a diet and exercise plan specific to your ABO blood group will improve overall health and prevent certain diseases.
736-7230
Call 706-860-5455
Please see BLOOD TYPE page 13
BIG TRAVEL PLANS THIS SUMMER?
Make Barney’s your first stop. Whether it’s a mission trip or a dream vacation, foreign travel usually requires vaccinations and preventive medications. No matter where your travels take you, Barney’s Pharmacy will have your health covered so you can enjoy your trip.
Augusta 2604 Peach Orchard Rd. (706) 798-5645 www.barneysrx.com Opening soon! Barney’s on Furys Ferry Road!
Augusta • Louisville • Grovetown • Wrens • Serenity • barneysrx.com • Furys Ferry (opening soon)
+ 10
APRIL 17, 2015
AUGUSTA MEDiCAL EXAMINER
The Money Doctor
PET VET S
LET’S TALK HAIRBALLS!
ince it seems like we’ve focused a bit more on dogs in this space lately, let’s turn the spotlight on our feline friends and a subject everyone loves: hairballs. Wait... make that a subject no one loves. But hairballs are a reality for cats and their owners, and not exactly the most pleasant reality. And that goes for cat owners and cats. As gross as they might be, hairballs are actually a sign and symptom of something good: meticulous grooming. Anyone who has been licked by a cat knows their tongues are like rough sandpaper. The tiny hooks on their tongues readily grab and comb out any loose hair, which is then swallowed. Most of that hair will never be seen again, if you catch our drift. It will be buried. However, sometimes, just to make things interesting, some of the hair stays in the stomach and gradually accumulates into a hairball. What goes down will eventually come back up, and you get to clean it up as a small token of your gratitude to your
cat for all of his companionship. Why aren’t hairballs round? They may be in the stomach, but by the time they pass upward through the esophagus, they may be extruded into thin or tubular masses. If you love cats but not hairballs — which seems reasonable — there are some steps you can take to minimize hairballs. The more you comb or brush your cat, the less fur will end up in its stomach. Long-haired breeds can get regular hair cuts at the pet groomer’s. Also, ask your veterinarian about various hairball formula cat foods and laxatives. One works to improve the health of their coat and minimize swallowed fur, the other helps it make it’s way safely to the litter box. Speaking of safety, if your cat does a lot of retching and gagging without producing a hairball, or if it has lost its appetite or is constipated — or alternately, has diarrhea — head to your vet’s office without delay. There could be a hairball blockage. +
Estate Planning — Is Your Plan Comprehensive?
E
state planning or planning for death is not something that people like to think about, so it is understandable why 55 percent of adults do not have a last will and testament in place. Along with the psychological barrier of the topic, estate planning can be confusing and hard to understand, which is why talking to an attorney that practices estate lawcan help you navigate the process (which can vary from state to state). Your financial advisor can also help coordinate with your estate planning attorney to ensure many of the moving pieces are put in place. Spending a little extra money with a competent and experienced attorney is well worth the cost to help you avoid major mistakes or family conflicts down the road. Many people do not realize that a significant number of your assets may not pass through your will. You may hear the term “probate assets,” meaning they pass through your will, and the term “nonprobate assets,” meaning they pass to your beneficiaries by other means. A few examples are retirement accounts and life insurance proceeds that have beneficiary designations. One of the best ways to make sure all your property or assets pass to your loved ones the way you desire is to have your estate planning attorney create a funding checklist. The list should include all the assets from your financial statement along with your life insurance policies. Next to each item should be instructions on what steps should be taken to ensure the asset or property passes
according to your estate plan. You can have your financial advisor review this list to ensure all your assets were included and the instructions make sense and fit your overall goals. Here are a few examples of the different assets you may want to ask your estate planning attorney to provide guidance on. Primary Residence or Real Estate - If you own property jointly with someone else, the titling of that property may dictate who gets it when you die. A common form of ownership is Joint Tenancy With Rights of Survivorship (JTWROS) which means the person you own the property with will receive the property. JTWROS assets do not pass through your will. Checking, Savings, or Brokerage Accounts – Most people have these, but many people do not know that they can provide instructions for beneficiary designations which will direct who will receive the funds after your death. Your bank or financial institution calls this a “paid on death” or “transfer on death” request. Be very careful adding family members as joint owners on these accounts. Be sure you understand the impact that has on the accounts at your death and the risks associated with those directions. It may make sense to let these accounts pass through your estate based on your will, but this is a matter that can be discussed with your attorney. Life Insurance Policies - The funds from life insurance pass to your loved ones based on
Boardwalk to Bark Place Kennnel & Daycare welcoming dogs 40 lbs and under 5873 Huntington Drive Grovetown, Georgia (706) 840-3141 www.boardwalktobarkplace.com
the beneficiary designations you provide the life insurance company. A common pitfall when major life events happen is not updating your life insurance beneficiary designations. People who have recently gotten married may still have their parents or siblings listed instead of their spouse. We have even found exspouses listed many years after a divorce. Retirement plans - These accounts are also controlled by your beneficiary designations. A mistake here could cost your beneficiaries a significant amount in taxes. By naming individual beneficiaries you give your beneficiaries the opportunity to extend the required distributions over a longer period of time, which allows them to take advantage of further tax-deferred growth. We have found that clients sleep better at night after putting an estate plan in place. Although the subject is sometimes difficult to talk and think about, everyone will benefit from having a comprehensive plan in place. The key is making sure your plan covers all your assets, including those that may pass outside your will. + by Clayton Quamme. Clayton is a financial planner with Preston & Cleveland Wealth Management, LLC (www.preston-cleveland. com). Preston & Cleveland is a fee-only financial planning and investment advisory firm with offices in Atlanta and Augusta, GA and Columbia, SC.
I+ M.E. Our next issue date: May 1, 2015
An archive of past Medical Examiner issues is available online at Overhead Door Company of Augusta-Aiken 706-736-8478 803-642-7269
WWW.ISSUU.COM/MEDICALEXAMINER
Read farm-fresh new content every day at www.AugustaRx.com/news
APRIL 17, 2015
11 +
AUGUSTA MEDiCAL EXAMINER
From the Bookshelf The blog spot — Posted by Suneel Dhand, MD at suneeldhand.com on Mar. 24, 2015
THE PHYSICIAN WE SHOULD ALL BE LIKE A couple of weeks ago I was on call and had to go down to the Emergency Room to see a patient. Before I entered the room, I was told that the patient was accompanied by her long-time physician who was a bit “crazy and old school.” “Hmm...that’s strange,” I thought to myself. “Why would her physician be in the room with her?” When I went in to introduce myself, sure enough, sitting next to her was an elderly man, probably in his late 70s or early 80s. After he greeted me with a warm and friendly handshake, he told me that he had practiced medicine in the local area for the last several decades. I still continued to wonder exactly what he was doing there and this thought persisted for the next few minutes. However, as I got further into the interview, I quickly realized just why he was sitting by his patient’s side. This doctor had cared for the patient for at least the last 30 years and was in the process of winding down his practice, but felt compelled to come and visit his patient (with no financial incentive to do so) as soon as he heard she was being admitted to the hospital. The patient—elderly herself and hard of hearing—wasn’t able to give me a complete history. But that was okay, because her doctor knew her inside out. Every little detail. When I asked about her medications, he pulled out a notepad and scrolled through it, where he had handwritten all her prescriptions. The relationship between them was obvious, and the respect the patient had for her doctor was also palpable. After I had got through my interview and examination, explained my findings and treatment strategy (by this time the patient’s sister had also arrived), it was approaching 10 pm. The physician said that he felt more comfortable that his patient was in good hands and left as she was being transferred up to the medical floor. My interaction with that elderly physician that evening caused me to really reflect on a couple of things. First, the fact that the ER staff and even the physician colleague who had signed the patient over to me thought that the physician was a bit odd for sitting by his patient’s side in the ER. How have we gotten to the stage where a genuine and caring doctor has become the odd one out? Then there’s the reality that his generation represents precisely what a personal physician should be: a solid physician with great clinical skills and who is highly respected by both the patient and their family. Unlike what medicine has become today, this was a doctor who would look you in the eye and think carefully and thoroughly through the diagnosis and treatment plan. It was obvious when he spoke to me that his clinical reasoning skills were top-notch. He wasn’t a doctor glued to his computer screen, having to spend the majority of his day clicking and typing away—about as far away as possible from the “type-and-click-bot” doctor proliferating on today’s medical frontlines. The majority of his time was spent in direct patient care and not bogged down by healthcare technology. Without the aid of a computer, he was able to reel off highly detailed parts of her medical history and previous hospitalizations. He had obviously spent all of his career being his own boss and hadn’t been constantly mired in the next administrative battle. This was a doctor who knew his trade and the practice of good medicine. Sadly, I also realized how much we’ve lost in our rush to mechanization and consolidation. His solo practice is sure to not be taken over by another similar doctor. But there was also another recurrent thought that stayed with me for the next few days. I kept thinking about the words spoken to me before I entered the room about the “crazy old-school physician.” These words echoed in my mind and I couldn’t help but conclude that it’s actually we (the current generation of physicians) who are the only crazy ones. That old-school physician is exactly who we should all aspire to be like. +
Crazy? Crazy good.
The Sick Rose has been described as a coffee table book you wouldn’t want to leave lying around in plain sight — on your coffee table, for instance. Various descriptions of this book include words and phrases like “squirminducing,” “grotesquely alluring,” “fascinating yet gruesome,” “appalling yet brilliant,” “morbidly beautiful,” and “not for squeamish readers.” Without reading another word, you already know one of two things about this book: it’s either, “I must have it” or “This is not my cup of tea.” “Coffee table book,” by the way, doesn’t mean that it’s oversized (it’s 7 inches by 10 inches), but that it is lavishly illustrated, replete with 354 illustrations, 345 of them in all their sometimes gory fullcolor glory. We have to remember that not every medical practitioner down through the ages has had the good fortune to live in an age of high-resolution color photography, let alone 3-D MRI, CT and other forms of
digital imaging. Not that long ago, medical illustrations were the only game in town, and they were an indispensable tool in teaching medicine and helping to make diagnoses as accurate as possible. Medical illustration continues to be an incredibly useful tool to this day. But this volume, a combination medical/art/ history book, is about what was perhaps the golden age of medical illustration. It’s not just that the illustrations are all pre-photography; it’s also that they were borne of the golden age of disease, too. Medical illustrators of the nineteenth century were
kept busy by poor hygiene in burgeoning slums driven by growing industrialization, with a side of epidemics like tuberculosis, syphilis, cholera and diphtheria thrown in for good measure. At the same time, medical knowledge was expanding too, and the field of public health was born during the nineteenth century. It all added up to a perfect storm for medical illustrators, and massive amounts of their efforts have been preserved. The illustrations in this book are just the tip of the iceberg. In fact, Britain’s Wellcome Library and Wellcome Images has such a vast catalog of images that The Sick Rose is envisioned as just the first of an entire series of lavishly illustrated books chronicling the medical illustrator’s art. In other words, there will be more of these books to collect — or more of them to avoid. +
The Sick Rose, or Disease and the Art of Medical Illustration by Richard Barnett, 256 pages, published in May 2014 by D.A.P./ Distributed Art Publishers
Research News New transfusion risk Ask the most experienced board certified allergist why you have a specific allergy and the answer might be a shrug of the shoulders. An eight-year-old Canadian boy knows the source of his peanut and salmon allergies, however; they came from a blood transfusion he received. An article in the April 7 issue of the Canadian Medical Association Journal documented the unusual case. Donors are not usually screened for allergies (other than to ask if they are currently experiencing allergy symptoms at the time of donation), and Canadian doctors are not recommending the addition of routine allergy screening for donated blood. Although a blood recipient could experience potentially life-threatening allergic reactions from previously safe foods, doctors say the new allergies fade within several months.
Facebook = depression University of Houston researchers have found that, while Facebook can be ab effective tool for connecting with new and old friends, users who spend a lot of time on the social networking site can experience symptoms of depression. The problem seems to arise from what behavioral scientists call “social comparison.” In layman’s terms, it’s viewing all the “perfect” moments and exciting activities posted by others, then feeling depressed and lonely because your life doesn’t seem as happy or glamorous or exciting by comparison. Researchers say Facebook itself isn’t the problem. Instead, it’s a personality that may already leans toward unfavorable comparisons combined with spending excessive amounts of time on Facebook. The simplest and first antidote, says the study, is the reduction of Facebook use.
Jonesing for a fast-food fix? A new study by University of Montana researchers published by the International Journal of Sport Nutrition and Exercise Metabolism had some surprising results. After a 90-minute workout, some athletes were given burgers, fries and hash browns. Others were given traditional sports supplements like Gatorade and Powerbars. Four hours later, the athletes then completed a 12.4 mile bicycle time trial. There was no difference in time trial performance between the two diets. Immediately after the 90-minute workout and again two hours later, muscle biopsies were taken and blood samples were drawn. Again, researchers found no difference between the two diets in terms of blood glucose and insulin response, nor in glycogen recovery. Researchers stressed, however, that the fast food servings given were small. “Moderation is the key.” +
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APRIL 17, 2015
AUGUSTA MEDiCAL EXAMINER
THE EXAMiNERS +
If you mean What happened Red Lobster, yeah, to you? You look I went to the like a restaurant. beach last week.
by Dan Pearson
My doctor told me Did you have You know what? I bet I a nice time - except needed to get away. Isn’t that called my insurance will cover Turns out it was just for the sunburn? a prescribed burn? a week at Hilton Head. what I needed. © 2015 Daniel Pearson All rights reserved.
EXAMINER CROSSWORD
PUZZLE
ACROSS 1. Augusta’s Butler ______ 6. Freshwater fish 10. Remedy 14. Replay mode 15. Image 16. One-third of Earth’s landmass 17. Gun used by police 18. Outstanding; the best 19. Follower of 32-D, sometimes 20. Unevenness 22. Swear 23. 25-time Braves All-Star 24. Spoil 25. Area power source 28. Affliction; cause of distress or annoyance 29. Malarial fever 30. Learning 35. Common inits. of a motor neuron disease 36. Pertaining to the thigh 38. Street in Paris 39. TV figure retiring on 5/20/15 41. Spanish plant? 42. Fay of King Kong 43. NY & SF teams 45. Thespians 48. Matthew Stafford’s team 50. Unimaginative prose 51. Scene of infamous shootings on May 4, 1970 55. Nevada city 56. “Give me ______” 57. Strange and mysterious 58. Latin bibliography notation meaning “the same” 59. Wide-mouthed jug 60. Fish basket 61. Be conquered 62. Meal regimen 63. Former Russian rulers
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VISIT WWW.AUGUSTARX.COM Click on “READER CONTESTS”
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All Mystery Word finders will be eligible to win by random drawing. We’ll announce the winner in our next issue!
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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
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The Mystery Word for this issue: NONTDE
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by Daniel R. Pearson © 2015 All rights reserved
by Daniel R. Pearson © 2015 All rights reserved. Built in part with software from www.crauswords.com
DOWN 1. Our region, for short 2. Exclamation of sorrow or regret 3. Fullness (of hair) 4. Mosque prayer leader’s position 5. Typical 6. Marks that mean “same as above” 7. Future oak 8. Imitate 9. Lowest ranking naval officer (abbrev) 10. Ornamented Indian pipe 11. Sieze power by force 12. Wash cycle 13. Enthusiastic 21. Before, to Wordsworth 22. Augusta ________ 24. Large South American rodent 25. South African river 26. Look at lecherously 27. Sudden rush of wind
28. ______ Unit 30. TV award 31. Dire ER pronouncement 32. Lead-in to 19-A, sometimes 33. Drive out 34. Eliot’s last name 36. Furys follower 37. Periods of history 40. Couple 41. Week recently observed 43. Obtained 44. Fly, for instance 45. Month of 41-D 46. Statement of belief 47. Shades 48. Embankment 49. Like some gases 51. Hairy fruit 52. A of 1-D 53. Level 54. Long fish 56. FBI agent, informally Solution p. 14
— Will Durant (1885—1981)
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.
E5
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by Daniel R. Pearson © 2015 All rights reserved. Built with software from www.crauswords.com
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 at bottom to create words to solve the puzzle above. All the listed letters following #1 are the first letters of the various words; the letters following #2 are the second letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.
H 1 1 2 3 4 5 6 7 8 1 2 3 4 5 P A N P S 1 2 1 2 1 2 3 4 1 2 3 4 5 6 7
V 1 2 3 1 2 3 4 1 2 3 4 5 D 8 9 10 1 2 3 1 2 1 2 3 4
1.W W I D D A A A S N O LT 2.MOOOSHIEEENN 3.RELOAPEET 4.DDRUVPL 5.ESSE 6.SA 7.NS 8.DI 9.O 10.N
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
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D 5
by Daniel R. Pearson © 2015 All rights reserved
WORDS NUMBER
1
THE MYSTERY WORD
APRIL 17, 2015
THE BEST MEDICINE ha... ha...
How do you know that the pollen this spring was even worse than normal? Because drug addicts were turning meth back into sudafed. And God said unto John, “Come forth unto me and ye shall receive eternal life.” But John came in fifth and received a toaster.
D
id you hear that rumor going around about butter?” “No, what?” “Never mind. I shouldn’t spread it.”
“I told my wife she drew her eyebrows too high,” said a man to his friend. “What was her reaction?” “She looked surprised.” Why did Star Wars episodes 4, 5 and 6 come before 1, 2 and 3? Because in charge of scheduling Yoda was. What do you call a black man who flies a plane? A pilot, you racist. How do you make holy water? Fill a pot with ordinary tap water and boil the hell out of it. Rest in peace, boiling water. You will be mist. Women call me ugly until they find out how much money I make. After that they call me ugly and poor.
What do a green apple and a red apple have in common? They’re both red except for the green one. If you’re ever attacked by a gang of clowns, go for the juggler. Sometimes I tuck my knees up to my chest and lean forward. That’s just how I roll. I bought this pair of shoes from a drug dealer. Man, I don’t know what he laced them with, but I’ve been tripping all day. What do fish worry about? Current events. What kind of apple has the shortest temper? A crab apple. Why was the tomato blushing? Because it saw the salad dressing. Officer: Do you know why I pulled you over? Me: No, I’m just as confused as you are. Why did Helen Keller try LSD? She heard it would make you see things. +
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.
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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! NAME ADDRESS CITY
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WIDE-EYED… from page 6 liked. Many other innovations exist. Often, private insurers follow suit when Medicare makes these kinds of changes. It is worth noting, however, that even today, Medicare is not empowered to use this massive bargaining power to negotiate the prices it pays for prescription drugs and many medical devices, though it has been debated before. It is very likely this issue will resurface in the reforms to come. Now Medicare continues to face new challenges. The greatest of these is cost. As enrollees are able to live longer and live with a greater number of simultaneous chronic conditions, costs will only continue to escalate. There are more and more enrollees, too. Even now, Medicare covers nearly one in every six Americans. As baby boomers age, the number of beneficiaries
will continue to grow. Still, it is hard to argue against Medicare. It is more efficient and scores higher in terms of many beneficiary satisfaction components than any private insurance plan. This level of satisfaction is one reason why massive overhauls are not often a challenge that policymakers want to take on. Medicare still needs more changes. This is certain. But at age 50, I’m also fairly certain the ol’ girl will make it to age 65, herself. + Ross Everett is a medical student at the Medical College of Georgia. He graduated from the University of Georgia in 2011. Currently, he is taking a year of leave from medical school to pursue a Master of Public Health degree in Health Systems and Policy from Johns Hopkins University. Please contact him at wideeyedwhitecoat@gmail.com
BLOOD TYPE… from page 9 diet. The B-type diet showed no significant association with lowered cardiometabolic risk factors. Although each diet (excluding the B type diet) seemed to be successful at lowering cardiometabolic risk factors, once matched with the corresponding blood group there was no change in the effect size of any of these associations.1 This study concluded that adherence to certain blood type diets are associated with favorable effects on some cardiometabolic risk factors, but the associations were found to be independent of ABO genotype and therefore do not support the Blood Type Diet hypothesis.1 These results are not surprising. Apart from the specificity of ABO genotype, each diet is very restrictive and requires participants to cut out entire food groups from their diet (excluding type B which recommends high consumption of dairy and moderate consumption of the other food groups). The Type A diet pattern was associated with the biggest decreases in cardiometabolic risk factors and promotes high consumption of fruits and vegetables, and low consumption of meat products.1 This pattern seems very similar to current diet recommendations from various health agencies such as USDA, AHA, AND, and NHLBI.
In summary, one should not expect a Registered Dietitian or other healthcare professional to endorse the Blood Type Diet. The individual diets may produce the desired results, but the Type A diet, for example, may work just as well for an individual who is blood type A as it does for an individual who is blood type O. + A simple “Getting Started” Guide gives recommendations for the first four weeks of the diet and includes what to eliminate and what to add to your diet for each blood type: https://docs.google. com/gview?url=http:// www.4yourtype.com/content/ PDF/getting-started-guide.pdf References: Bibliography 1. Wang J, García-Bailo B, Nielsen DE, El-Sohemy A. ABO Genotype, ‘Blood-Type’ Diet and Cardiometabolic Risk Factors. PLoS ONE. 2014;9(1). doi:10.1371/journal.pone.0084749. 2. Bonchi L. Eat Right for Your Type. The Doctor Oz Show. 2011. http://www.doctoroz.com/article/ eat-right-your-type. Accessed March 23, 2015. 3.Welcome to the Blood Type Diet. D’ADAMO PERSONALIZED NUTRITION. http://www. dadamo.com/txt/index.htm. Accessed March 23, 2015. by Emilie Koetter, University Hospital Dietetic Internship
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AUGUSTA MEDiCAL EXAMINER
THE MYSTERY SOLVED The Mystery Word in our last issue was: TRACHEA ...cleverly hidden (in the grass) in the p. 8 ad for DANIEL VILLAGE BARBER SHOP Congratulations to ANN WIMBERLY, who scores a coveted Scrubs of Evans gift card, 2 movie passes courtesy of Health Center Credit Union, and a $20 Wild Wing Cafe gift certificate. Want to find your name here next issue? 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. 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
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EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC. CONDO FOR RENT 2 bdrm 1 bath unfurn upstairs condo; carport; pool; outside laundry. Country Club Hills condos, Milledge Rd near GRU/ASU. $750/$750 dep. We furnish water, you pay electric. (706) 736-7168; email:ronst79@gmail.com ROOMMATE WANTED! 3 bdrm, 2.5 bath house with pool, 2 minutes from colleges. Perfect for medical or grad students. $425+share utils. 706.993.6082 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: GORGEOUS, immaculate, never occupied townhome located mins from Medical District. 2 bed, 2 bath, master en suite, walk-in closets, office. 1450 sq ft. hardwood floors throughout, fabulous upgrades, custom kitchen and baths. Floor to ceiling windows, fenced yard. Partially furnished! 120k OBO. 803-507-6621.
HELP WANTED CHIROPRACTIC ASSISTANT NEEDED to work mornings. Great job for Mom with school-age children. Some experience
preferred but not necessary. Non-smoker. (706) 860-4001 PART TIME HELP NEEDED Flexible independent contractor tutoring opportunity with locally owned educational services company. Students served include K-12 and college seeking support in ALL subjects. Immediate openings for Spanish, anatomy, physics and statistics tutors. Contact info@maeseducationcenter.com
SERVICES HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706.267.9947 DOES YOUR HOME NEED CLEANING? A little of that extra? Need organizing assistance or help to make clutter vanish? Seniors will get a discount. 706-7553803 BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673)
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CEMETERY PLOTS Side-by-side cemetery plots for sale located at the Heart Section of Hillcrest Cemetery. $3600 for BOTH. (706) 798-8495
QUOTATION PUZZLE SOLUTION: Page 12: “Education is the progressive discovery of our own ignorance.” — Will Durant
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PET CARE in Martinez-Evans area. Dogs to 40 lbs, $9.00. Cats (1-3), $9.00 For interview/information, phone 706-829-1729
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FISHING CLUB wants more grey-haired members. Meet 2nd Thurs of month at Harbor Inn Restaurant, 12 noon. “Adventure Before Dementia” Info: (706) 736-8753 or (706) 829-1729
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CEMETERY SPACES (2) Sunset Memorial Gardens, Graniteville SC adjacent to lighted military flagstaff, includes granite bench with urn space, installation and inscription. All $4700 ($8600 value). Spaces only: $2700. Call (803) 295-3033
F. E. GILLIARD, MD FAMILY MEDICINE Acute & Chronic Illnesses Occupational Medicine PROMPT APPOINTMENTS 706-823-5250
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AUGUSTA MEDiCAL EXAMINER
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PROFESSIONAL DIRECTORY DERMATOLOGY
ALLERGY
Tesneem K. Chaudhary, MD Allergy & Asthma Center 3685 Wheeler Road, Suite 101 Augusta 30909 706-868-8555
CHIROPRACTIC
Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Augusta 30904 706-733-3373 www.GaDerm.com
DEVELOPMENTAL PEDIATRICS
Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A 706-860-4001 www.evanschiro.net Poppell Chiropractic Clinic 1106-A Furys Lane Martinez 30907 706-210-2875 Most insurance plans accepted
COUNSELING Resolution Counseling Professionals 3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866 www.visitrcp.com
DENTISTRY Dr. Judson S. Hickey Periodontist 2315-B Central Ave Augusta 30904 706-739-0071
LASER SERVICES
Karen L. Carter, MD 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com
EMPLOYEE BENEFITS Group & Benefits Consultants Inc. 3515 Wheeler Rd, Bldg. C Augusta 30909 706-733-3459 www.groupandbenefits.com
Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Thomson: 706-595-7825 Primary Care Rates
M.D.S:
Medical Massage Stuart Farnell L.M.T. 803-646-1846 jsfarnell@att.net www.FarnellClinic.com
Roger M. Smith, M.D. 820 St. Sebastian Way Suite 5-A Augusta 30901 706-724-3339
Steppingstones to Recovery 2610 Commons Blvd. Augusta 30909 706-733-1935
F. E. Gilliard, MD Family Medicine 639 13th Street Floss ‘em or lose ‘em! Augusta 30901 706-823-5250 Industrial Medicine • Prompt appts.
Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445
MEDICAL MASSAGE
OPHTHALMOLOGY
DRUG REHAB
FAMILY MEDICINE
Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048
Ideal Image 339 Fury’s Ferry Rd Martinez 30907 1-800-BE-IDEAL • www.idealimage.com Schedule a FREE Consultation
PHARMACY Medical Center West Pharmacy 465 North Belair Road Evans 30809 706-854-2424 www.medicalcenterwestpharmacy.com Parks Pharmacy 437 Georgia Ave. N. Augusta 29841 803-279-7450 www.parkspharmacy.com
SENIOR LIVING Augusta Gardens Senior Living Community 3725 Wheeler Road Augusta 30909 SENIOR LIVING COMMUNITY 706-868-6500 www.augustagardenscommunity.com
...SENIOR LIVING
Cornerstone Compassion Center 420 Warren Road Augusta 30907 706-228-5359 or 706-394-6518 Assisted Living • Personal Care
SLEEP MEDICINE Sleep Institute of Augusta Bashir Chaudhary, MD 3685 Wheeler Rd, Suite 101 Augusta 30909 706-868-8555
THERAPEUTIC Centered in Georgia Diane Young L.M.T. 4488 Columbia Rd Martinez 30907 706-251-2244
VEIN CARE Vein Specialists of Augusta G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 501 Blackburn Dr, Martinez 30907 706-854-8340 www.VeinsAugusta.com
WEIGHT LOSS Medical Weight & Wellness Specialists of Augusta Maycie Elchoufi, MD 108 SRP Drive, Suite B Evans 30809 • 706-829-9906 www.mwwsAugusta.com
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