Aug10 18 by Daniel Pearson

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AUGUST 10, 2018

AIKEN-AUGUSTAʼS MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

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WHO ARE THESE PEOPLE? All you wanted was a quick and simple visit with your doctor. Instead you may have been treated by an alphabet soup of CNAs, RNs, LPNs, NPs, PAs, NNs, DOs, PTs, RTs — but maybe no MDs. Who are these people and why are they treating us instead of our doctors? See page 2 and 3.

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AUGUST 10, 2018

WHO ARE THESE PEOPLE?

Not too long ago, if a healthcare professional was introduced to you as a PA, your next question would have been, “A what?” Today everyone knows that PA stands for Physician’s Assistant. They seem to be everywhere these days; many patients say they see PAs more often than their doctors. Some prefer it that way while others feel cheated if they aren’t seen by an actual MD. How did PAs and other non-MD types come to have such a prominent place in our healthcare landscape? By means of something else we’re all familiar with: the high cost of healthcare. In addition, news reports of doctor shortages, current and future, are not uncommon. That leads to long wait times for doctor appointments, sometimes months. There are still more

reasons: patient quotas set by some networks and practice groups that stretch physicians and their available time. There are also increasing time demands in documenting every patient-physician encounter in electronic records. What is the answer? Who can free doctors from many routine tasks of patient care without sacrificing quality of care? Enter the Physician Assistant, the perfect (say some) extension of care, offering faster access to healthcare for patients and more time for physicians to focus less time on routine matters and more on challenging cases. The official history of Physician Assistants dates back only to the mid-1960s as a product of the Vietnam War. Hundreds of battlefield medics with extensive experience in the most advanced trauma care were

Have you heard?

Henry “Buddy” Treadwell

serving in the military. How could those skills be put to post-war use when these men returned home? Dr. Eugene Stead, chair of the Department of Medicine at Duke University School of Medicine, invented the PA profession in 1965, developed a suitable 2-year teaching curriculum, and graduated the fi rst class of PAs in 1967. The concept didn’t originate in Vietnam, however. It was conceived a lot closer to Duke, in the tiny rural town of Garland, North Carolina.

Garland had all of 500 people in the 1940s (it’s up to 625 now), and one doctor, Amos Johnson. Running a solo practice had its demands back then too, and Dr. Johnson hired the farmhand son of a local family upon his graduation from high school, putting him to work as an orderly stocking supplies, cleaning, and doing minor direct patient care chores like helping patients move from bed to wheelchair. Through simple observation this young man, Henry Lee “Buddy” Treadwell, gradually learned how to take blood pressure, draw blood, take x-rays and develop film. Eventually he learned how to suture wounds (“Better than I can,” said Johnson), and distinguish the chest sounds of flu versus pneumonia. The two worked so well together and were so accepted by the community, black and white alike, that when professional duties took Johnson away from the practice, Treadwell was more than

capable of keeping the office open to serve basic patient needs. Johnson often referred to Treadwell as his assistant. Treadwell also transported patients needing advanced care and diagnostic referrals, often to Duke. Through those visits, both Dr. Eugene Stead and his administrator, James Mau, became very aware of the tiny rural practice and the unique but very practical concept they employed there. Stead often said his development of the Physician Assistant program was modeled closely on the life and work of Buddy Treadwell. When Dr. Johnson died in 1975, Treadwell was offered a similar position with a physician group in a nearby town, but declined. He also declined to take a PA certification exam, retiring from medicine after 30 years. In 1970, however, through the efforts of Duke’s James Mau, Treadwell was named an Honorary Physician’s Assistant. Treadwell died in Garland in October, 1990. +

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AUGUST 10, 2018

WHO ARE THESE PEOPLE?

There are too many healthcare professionals identified by acronyms than we could realistically tackle in this space, but here are a few highlights. Some of these jobs and their training requirements can differ slightly from state to state, practice to practice, and country to country.

Nurse Practitioner In the same way first-year medical students already need to have a college degree under their belt, before becoming an NP a person must already be an RN (registered nurse), which itself requires an undergraduate degree in nursing. The next step is a master’s or doctorate degree in a specialized field such as women’s health, pediatrics, or family medicine. NPs are often involved in counseling and educating patients as well as diagnosing and treating patients. Some people have an NP as their primary healthcare provider. Registered Nurse RNs usually have an associate’s or Bachelor of Science degree in nursing or a degree from a certified nursing program. They are often the primary mediator between doctor and patient, taking medical histories for the doctor’s information, as well as following up with patients to ensure doctor’s orders are understood and complied with. By some accounts, RNs get much more person-toperson relationship-based training than doctors get in medical school. Licensed Practical Nurse Considered slightly lower than RNs in the pecking order of nursing, LPNs are licensed by passing a nationally administered competency test after what is in most states a 1-year program at a nursing school. They perform basic patient care and treatment.

Certified Nursing Assistant CNAs are some of the hardest working members of any healthcare team. Despite being an entry level position in most settings, CNAs play a key role in healthcare delivery, usually working under the supervision of an RN or LPN. Many times they are employed in nursing homes and do shift work, but there is high demand for CNAs and the training is quick and inexpensive compared to just about every other position in medicine. It can be a springboard to more advanced positions and responsibilities. Nurse Navigator This position is filled by an RN who helps patients navigate the healthcare system. They coordinate their care at every stage of treatment, advocate for them, help them understand the need for various treatments and educate them on what to expect in terms of side effects, outcomes, aftercare and more. They also need to communicate well with doctors and the patient’s family members. In some areas they are called a case manager. Physician’s Assistant PAs can do many of the same things MDs do, including (in most states) ordering x-rays and prescribing medcations, although they can only work under a supervising physician. They are often credentialed as “PA-C.” Why not PA-A or PA-B? Because PA-C denotes that particular PA is Certified. For more information on PAs see p. 2 +

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Why do muscles get sore after a workout? It doesn’t make a lot of sense, does it? You shoot some baskets or take a brisk walk through the neighborhood or around the track and feel just fine. Then the next day when you get up your muscles feel sore and tight. Logically enough, this common phenomenon is called delayed onset muscle soreness (DOMS). Generally it isn’t soreness that’s felt at rest. Your leg muscles aren’t throbbing while you’re in the old La-Z-Boy, but when you get up to get a snack (like carrot sticks - or a Twinkie), it’s painful to walk. DOMS can last anywhere from a day or two to up to a week. As common as DOMS is, it isn’t fully understood, but the general consensus is that it’s caused by microscopic tears in muscle fibers. Hence the pain. But be thankful. You’re proving the truth of the “no pain, no gain” maxim. In other words, today’s pain is a signal of future gain. Anyone who has ever broken a bone knows that the site of the break is not likely to be the site of another fracture. It heals stronger than the original. In a similar way, microtrauma in muscles primes them to heal stronger than they were before you exercised. The mistake some people make is doing too much initially, experiencing DOMS, and because of it, putting the brakes on their plans to get fit. Aside from wasting the initial effort, that approach also wastes the strengthening the muscles do in response to DOMS. Next time will be easier and less painful, a phenomenon known as “exercise-induced analgesia.” A better approach than throwing in the towel is to start differently in the first place. Let’s say someone has decided to briskly walk a mile several times a week. That Day One DOMS can be prevented by starting out with a leisurely walk around the block. Wait a day or two and do it again, maybe slightly farther or slightly faster, but still not trying to set any records. Do that for a week or two and then go for the mile. Take it slow. You plan to make this a habit, so there’s no rush. Ease into it. If you already have DOMS, anything that promtes blood flow to the sore muscles — massage, low-level activity, hot baths, etc — can help alleviate the pain and speed healing. +

MEDICALEXAMINER

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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 salubrious news within every part of the Augusta medical community. Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397

(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net www.Facebook.com/AugustaRX Opinions expressed by the writers herein are their own and/or their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., nor its agents or employees take any responsibility for the accuracy of submitted information, which is presented for general informational purposes only. For specific medical advice, diagnosis and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2018 PEARSON GRAPHIC 365 INC.

AUGUST 10, 2018

AUGUSTAMEDICALEXAMiNER

#72 IN A SERIES

Who is this? ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com

by Marcia Ribble

ave you ever had an experience that profoundly and permanently changed your life? This man had such a transforming moment in 1969, and there are many, many people in Augusta and all over the world who owe their lives to him as a result. His name is Ioannis Yannas, born in 1935 in Athens, Greece. His career brought him to Massachusetts Institute of Technology (MIT) as a professor of mechanical engineering. He was studying collagen, the main structural protein found in skin and other connective tissues in man and animals. At around that time Dr. John F. Burke, a medical researcher and professor of surgery at Harvard University, as well as chief of trauma services at Massachusetts General Hospital and head of Boston’s Shriners Burn Institute, simply asked Yannas to go for a walk. It was a walk that changed medical history. It wasn’t a pleasant stroll. It was a tour of the burn unit for pediatric patients at Shriners Burn Institute. Even during a recent interview almost 50 years after that walk, Yannas fought back tears at the recollection of the pain and abject misery experienced by burn patients, haunting memories he still carries today. Something had to be done. The two collaborators, a doctor and a materials engineer/ chemist, set out to invent what Yannas later described as a sophisticated band-aid to replace skin grafts, a painful and imperfect option that often led to severe blood loss and sometimes death. Yannas and his students at MIT synthesized all kinds of materials for laboratory testing: plastics, rubbers, fibers, and human tissue. None of them made a single step in the direction of their goal: helping burn wounds close and heal more quickly. Yannis decided to employ some of his previous research on collagen to create a more natural polymer. It was an idea that should have been a no-brainer, considering his already existing body of research into collagen. But the resulting “band-aid” represented their biggest failure yet: not only did it fail to promote healing, it actually slowed down an already slow process. They were going the wrong direction. They took a day or two to regroup and ponder what should be their next step, and to explore why this latest and best idea had failed. And that’s when lemons became lemonade. With the extra couple of days having passed, they could see that the collagen was actually promting - slowly - the actual regrowth of both epidermis and even the inner, thicker, more complex dermis. This was not scar tissue; it was actual skin that eventually was almost as good as the original. It was difficult in those early days to grow enough of the material to meet the demand at just one Shriners hospital, but when the process was sold to a company called Integra, in time they developed a process to accelerate production, and Integra artificial skin (or “dermal regeneration”) is the standard of care. Although Dr. Burke died in 2011, Dr. Yannas was inducted into the National Inventors Hall of Fame in 2015 alongside such luminaries as the Wright brothers and Steve Jobs. +

One of the things I am learning is to pay attention to my weight, not just for heart health, but to use the information to show the presence of cellulitis before any other indicators emerge. A sudden rise in weight for me almost certainly means that my cells are not functioning normally because they are inflamed due to cellulitis. Also, an unexplained rise in blood sugar is another sign that a battle is being waged to fight cellulitis in my legs. This pair of factual, observable indicators is frequently chalked up to a patients’ unwillingness to follow a lowsalt or diabetic diet. In the hospital this last time under controlled conditions of a low sodium, diabetic diet, my weight increased more than 10 pounds in a week, and my blood sugars hit and stayed in the mid-300s until the IV antibiotics were able to overcome the cellulitis. I also ran a low-grade temperature, something difficult to track in me because my normal temperature is only about 97°, so it’s not even noteworthy until it’s in the high 90s or even over 100. The day I came home my temp was 98.6°, which is perfectly normal in most folks, but the equivalent of 100° for me. My blood sugars were still in the 250-350 range. And I weighed over 10 pounds more than I had weighed before entering the hospital. Today as I write this, three days after returning home, my temp is 97.2°, my blood sugar is 111, and I’ve lost 7 pounds. Those are quite substantial differences, but my legs are still substantially swollen so the fight is not won. Now the trick will be to teach my doctors what I know that doesn’t fit with their

assumptions about how things work. For people like me with chronic health issues, doctors with erroneous assumptions are often the biggest challenge we face. These are assumptions that are critical for me. Gain X amount of weight in X number of days and that means I’ve ingested too much salt, or I am in active heart failure, or I am not keeping my legs elevated enough. Cellulitis is nowhere on that diagnostic list. A temp of 99° when 97° is normal (as in my case) is a 2° raise in temperature, a significant finding which is completely ignored when the assumed “normal” is 98.6. As for blood sugars, I can’t begin to count how many times in hospitals I’ve been told that blood sugars well over 200 are nothing to be concerned about. The sheer ignorance of a statement like that when treating an infection is amazing to me! This is the truth: the higher blood sugars are, the more difficult it is to treat an infection, the more likely it is the infection will become more serious, and the more likely it is that permanent damage to the body and its organs will occur. Infections cause blood sugars to rise. Those high blood sugars are not innocuous, but an integral aspect of fighting any kind of infection. Doctors who are supposedly well trained about fighting infections have told me that blood sugar as high as 460 is no big deal, perfectly fine, and not going to cause any problems, even when I was struggling to fight pneumonia, cellulitis, and sepsis simultaneously. As patients and families of patients, people need to know that these issues do matter and must be addressed by medical providers. To do any less is out and out neglect of their patient’s welfare. +

NEED A DETOX?

WHICH WILL IT BE? Are you sure about that? Like a number of healthrelated myths swirling around out there in that great medical encyclopedia some people call the Internet, this one will fall apart very easily. All it takes is to calmly sit down, eliminate distractions,

and activate the brain for a few moments. Through the magic of print, we can fast-forward and show you the results of this mental exercise. The first fact that confronts us is that the so-called “detox” will take place over somewhere from a few hours to a few days. It will typically be marked by (allegedly) strict adherence to some kind of odd diet, like consuming nothing but asparagus-kale smoothies for two days, followed by a final day of charcoal tablets washed

down with reverse-osmosis water. Sounds like a plan! Obviously, no one can maintain a regimen like that for long, probably not even the planned 3 days. How much good can any such temporary action do? Can a person get physically fit by exercising for a day or two? The human body has a number of amazing systems designed to keep out or eliminate toxins. To help those systems, the best advice is to eat salubriously every day, not just occasionally. +

AUGUST 10, 2018

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AUGUSTAMEDICALEXAMiNER

Musings of a Distractible Mind

by Augusta physician Rob Lamberts, MD, recovering physician, internet blogger extraordinaire, and TEDx Augusta 2018 speaker. Reach him via Twitter: @doc_rob or via his website: moredistractible.org

MEDICALEXAMINER

t’s been a very slow week in my office. Today we almost pitched a no-hitter, having only one patient come in toward the end of the day. Overall, we’ve been quiet in nearly every way - few phone calls, few patients stopping by, few appointments, few secure messages. What’s wrong? Nothing. That was a trick question. In my practice, this is exactly what should be happening when things are going right. My patients are happy. My patients don’t need me now. My patients are satisfied with my care. This would be a problem in most offices, since revenue depends on a steady flow of people having problems, having questions about their care, or anything else that would fi ll the schedule. In practices like mine, however, this is exactly what we want; after all, I am paid just as much for an empty office as a full one. The hardest thing about weeks like this (which seem to happen in June and July) is how to fill our time with tasks (other than going on Facebook, playing Candy Crush Saga, or having a

happy hour with the staff). These slow times are not the norm, especially as my number of patients grows. Some days are quite full. I had one day a few months ago where I actually had more than 10 patients come in for appointments! Around here, that is seriously busy. I used to see between 25 and 30 patients on normal days,

My definition of a busy day is laughable and sometimes ended up seeing more than 40 (once I saw over 60). So my current definition of a “busy day” is quite laughable in comparison. Remember, however, that I am not limiting care to office visits. It doesn’t matter to me if patients’ problems are handled in the office, via messaging or on the phone, as long as it is good care. Office visits are just one form of communication. Prior to leaving my old practice, I kept tabs on what percentage of visits actually required the patient to be

physically present in the office. Three-quarters of the visits weren’t necessary. Of the remaining fourth, only a small segment of the actual visit required face-to-face time. So now that I am out of the gravitational pull of obligatory office visits, I give care however it will work best. I love it. My staff loves it. My patients really love it. Still, on these slow days we are challenged to do the tasks we can’t do when we are “busy.” Those tasks aim at two main goals: to improve the quality of the care we give and to make our system more efficient (so those busy days aren’t as busy). The nice thing is that I can do that task with Van Morrison playing loudly in my office. So yay for boredom! Yay for healthy patients! Yay for a job that doesn’t encourage me to have sick patients and to spend as little time with patients as possible! Yay for Van Morrison! It’s so quiet in here. These are the days. That’s what Jackie Wilson said. It’s a marvelous night for a moondance. My momma told me there’d be days like this. +

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GARDENVARIETY

Summer gardens are full throttle in Augusta now so I have created a Crudités, which is a traditional French appetizer consisting of sliced or whole raw vegetables served with a dipping sauce. For my dipping sauce, I whipped up some Roasted Garlic Hummus which is an easy, healthy recipe that your friends and family will enjoy. Hummus is a healthy dip which is traditionally made from mashed chickpeas, tahini (sesame seed paste), lemon juice, olive oil, and spices. It is low in saturated fat and high in fiber and protein, and it has complex carbohydrates that make you feel full and satisfied. Chickpeas contain a good variety of amino acids which are the building blocks of protein, and their protein is easily digested. A single serving of hummus can supply 2.4 grams of protein. It also is full of key nutrients our bodies need such as B vitamins, calcium, folate, iron, magnesium, phosphate, potassium, and zinc. My Roasted Garlic Hummus recipe has a mellow, almost buttery flavor thanks to the roasting of the garlic. It is simple to roast garlic. Just cut the top of a whole bud off then drizzle with a little olive oil and top with freshly ground salt and pepper. Place the garlic bud on a large • 1/4 teaspoon cayenne the packet. Squeeze each square of aluminum foil and • Paprika and minced fresh garlic clove from the bottom close tightly. Put the bundle parsley for garnish and place roasted garlic into on a cookie sheet and roast the food processor. for 35 minutes in a 400° oven. INSTRUCTIONS Process on high until Not only is the garlic great in Preheat oven to 400° hummus is smooth and the hummus, but it is also an Peel the outer layer of garlic creamy. If needed add more excellent spread on toasted skin off the bulb. Cut the top chickpea juice 1 tablespoon bread instead of butter. of the bulb off so all the tips at a time until smooth and of the buds are exposed. creamy. ROASTED GARLIC HUMMUS Place in foil, drizzle with Store in the refrigerator for olive oil, then salt and pepper up to one week. + INGREDIENTS to taste. Wrap foil tightly • 1 very large head of garlic and place bundle on a cookie by Gina Dickson, Augusta • 2 – 15 oz cans of chickpeas sheet in the oven. Bake 35 wife, mom and grandmother, drained, saving the liquid in minutes. colon cancer a cup survivor, Place drained chickpeas, • 1/4 cup tahini (sesame tahini, olive oil, lemon passionate paste) about creating juice, salt, cayenne and 3 • 1/4 cup extra virgin olive tablespoons of chickpea juice a community oil in a food processor that has to help women • 1/3 cup freshly squeezed the blade in. serve healthy lemon juice (don’t buy that Once garlic is done, remove meals to bottled stuff) from oven and allow to cool their family. Visit my blog at • 1 teaspoon pink Himalayan to the touch. Carefully open thelifegivingkitchen.com salt

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ASK DR. KARP

NO NONSENSE

NUTRITION Dionda from Edgefield, South Carolina asks, “Dr. Karp, since it’s summer, can you enlighten me on the nutritional value of melons?” When I think of sum mertime, I think about how much I love to eat ice-cold cantaloupe and watermelon on hot summer days. Some folks say melons are a great snack with plenty of fiber, vitamins and water and others say melons offer no nutritional value and raise blood sugar levels. So what are the facts?

Are the people who are badmouthing melons drinking smoothies and eating protein bars while they tell you that melons are unhealthy? That might be a good clue about whether to heed their advice or not! Yes, people come up with so much nutrition misinformation when it comes to food, information which is very easy to verify by just looking at the no-nonsense data. Most health organizations, both in the US and abroad, recommend that a healthy diet should contain no more than 10% sugar calories. They also recommend that the sugar in your diet come from fruits and low fat dairy, not cakes, cookies, soft drinks, smoothies, Frappuccinos, cereal/protein bars, ketchup, juices, sauces, vitamin waters, other flavored waters, etc. The fact is that melons are low calorie, zero fat, zero cholesterol, very low in sodium, usually high in vitamins A and C and contain varying amounts of fiber. Some melons contain more fiber than others. Melons and other fruits are certainly higher in sugar than veggies, which is why recommendations usually call for eating more veggies than fruit. For example, in the “5 or more servings a day” recommendation for fruits and veggies, it is prudent to

eat more veggies than fruit: at least 3 servings of veggies and 2 servings of fruit. In our home, we eat 10-11 servings of fruits/veggies each day. No, we don’t graze like cows! We simply include veggies and fruits at every meal, and when we make a sandwich, we make sure we put lettuce or kale, tomatoes, cucumber slices, etc. in the sandwich. In addition, if we want a snack, it might be cherries, grapes or even cherry tomatoes. Melons are a great snack and great in salads and compotes. Even people with diabetes may eat melons. The important point for someone with diabetes to understand is that your weight, your blood sugar and blood cholesterol levels and your blood pressure are most important, not overfocusing on dietary sugar. Although dietary sugar should be moderated and adjusted depending upon a diabetic person’s reaction to specific foods,

AUGUST 10, 2018 even a person with diabetes can eat foods with sugar, as long as the foods come along with other nutrients and fiber. For example, the American Diabetes Association website has recipes for using watermelon and other melons. One suggestion that my wife and I love (even though neither have diabetes) is a watermelon, arugula, and feta salad. This salad is delicious. Don’t knock it until you try it! The key for a person with diabetes eating melons can be found in the recipe. You can easily decrease the amount of sugar in your melon meal by mixing the melon with other foods, such as arugula and low fat feta cheese.

What is the bottom line? Ignore people who offer nutrition advice without having the facts and the data to back it up. Nutrition is a science, not a subject for non-evidenced-based anecdotal “chit-chat.” Enjoy your melons and if you want to worry about sugar in your diet, worry about all the cookies, cakes, candy, cereal bars, power bars, granola cereal you are eating, and the smoothies, soft drinks, “designer” teas, coffees and sports drinks you are drinking.

Have a question about food, diet or nutrition? Post or private message your question on Facebook - www.Facebook.com/AskDrKarp - or email your question to askdrkarp@gmail.com If your question is chosen for a column, your name will be changed to insure your privacy. Warren B. Karp, Ph.D., D.M.D. is Professor Emeritus at Augusta University. He has served as Director of the Nutrition Consult Service at The Dental College of Georgia and is past Vice Chair of the Columbia County Board of Health. You can fi nd out more about Dr. Karp and the download site for the public domain eBook, Nutrition for Smarties, at www.wbkarp.com Dr. Karp obtains no funding for writing his columns, articles or books and has no fi nancial or other interests in any food, book, nutrition product or company. His interest is solely in providing freely-available, evidenced-based, scientific nutrition knowledge and education. The information is for educational use only; it is not intended to be used to diagnose, manage or treat any patient or client. The views and opinions expressed here are Dr. Karp’s alone and do not reflect the views and opinions of Augusta University or anyone else.

Dr. Karp

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AUGUSTAMEDICALEXAMiNER

Ask a Dietitian KNOW YOUR FARMER, KNOW YOUR FOOD

by Capt. Lori W. Maggioni Nutrition Care Division, Eisenhower Army Medical Center National Farmers Market Week is an annual celebration sponsored by the United States Department of Agriculture highlighting the important role farmers markets play in the nation’s food system. America’s 8,600 farmers markets serve as vital civic, economic, and nutritional anchors in communities across the country. National Farmers Market Week emphasizes the different ways farmers markets benefit our communities. According to the Farmers Market Coalition, farmers markets: • Preserve America’s rural livelihoods and farmland Farmers markets provide one of the only low-barrier entry points for beginning farmers, allowing them to start small, test the market, and grow their businesses. • Stimulate local economies Growers selling locally create 13 full-time farm operator jobs per $1 million in revenue earned. Locallyowned farmers markets return more than three times as much of their sales to the local economy than do chain competitors. Farmers markets serve as invaluable educational sites and a rare bridge between urban and rural communities. • Increase access to fresh, nutritious food In many cases, food at the farmers market is more affordable and tastes better than from a commercial grocery store because it is locally grown and naturally ripened. The USDA reports lower prices for both conventional and organic fruits and vegetables at farmers markets compared

NATIONAL

WEEK

AUGUST 5 – 11

with supermarkets. • Support healthy communities. Farmers market vendors educate their shoppers. Four out of five farmers selling at markets discuss farming practices with their customers, and three in five discuss nutrition and how to prepare food. Proximity to farmers markets is associated with lower body mass index (BMI). Farmers markets provide great opportunity to teach children about fresh, local produce. • Promote sustainability. Behind the rows of produce and eager customers, farmers markets are a bustling hub of sustainability. Three out of every four farmers selling at farmers markets say they use practices consistent with organic standards. Food from the farmers market uses less packaging and travels fewer miles to get to your table, making it better for the environment.

opportunities for you to support local farmers. • The Augusta Saturday Market is open Saturdays 8 a.m. to 2 p.m. from March through November on the 8th Street Plaza downtown. The market has sellers offering items such as freerange eggs, fresh breads and pastries, local honey, grassfed beef, fresh-cut flowers, local produce, and features entertainment and activities for the whole family. • The Veggie Park Farmers Market, open Tuesdays 4:30 to 7 p.m., is located adjacent to downtown Augusta at the Mill Village Trailhead behind the Kroc Center. This modest market runs April through October and highlights some of the most highly regarded farmers in the CSRA. It features several free educational programs throughout the season including kids cooking activities, kitchen utensil giveaways, and vegetable gardening advice. • Augusta Locally Grown On-Line Market supports small farms and gardeners by making their all-natural, locally-grown, sustainablygrown fresh foods available for sale in the Augusta-area community. Customers place their order for the week online any time between noon Friday and 8 p.m. Sunday Orders are picked up on Tuesdays in person at one

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Deanna Shaffer, Food Service Manager at the Charlie Norwood VA Medical Center, volunteers with the Augusta Fruit & Vegetable Prescription Program and finds it “incredibly rewarding to motivate people to eat healthier while helping to sustain local farmers.” Julie Coats, Medical Illustrator for Eisenhower Army Medical Center on Fort Gordon, also volunteers with the program assisting with data collection. “There’s a lot more reinvestment in the

10.4 million reviews

Facial landmarks Working now? Yes (unless you’re reading our Braille edition) Take-Out Available? Not recommended Good for: Reading, looking at stuff

Ed “Tiny” H. Augusta, GA

• The Augusta Fruit & Vegetable Prescription Program is created and funded in partnership with Wholesome Wave Georgia, Harrisburg Family Healthcare, and Augusta Locally Grown. Qualifying participants with diet-related illnesses – such as diabetes, high blood pressure, obesity or heart disease – who are also limited in income, receive: free clinic visits; prescriptions for fresh fruits and vegetables for self and all family members; monthly cooking and nutrition classes; and peer support.

H H H H H 8/1/2018 Of all five senses, vision is definitely the most precious. Unless it’s taste. Come to think of it, I’d rather taste food than look at it. Ok, so never mind. +

Bilbo B. Graniteville, SC

H H H H H 8/2/2018 My friend told me the special effects in this one new movie are eye-popping. There is no way I’m going to that movie. +

Melvin Q. Aiken, SC

H H H H H 8/2/2018 My girlfriend asked me if I only had eyes for her. I said “No, I can see other stuff.” So she broke up with me! Thanks for nothing, eyes. +

Randy C. Martinez, GA

H H H H H 8/2/2018 I’m going on a blind date next weekend. My friend told me that Sally, my date, is really eye-catching. I sure hope the safety glasses I ordered get here in time for our date. +

Sally K. North Augusta, SC

H H H H H 8/2/2018 I’m going on a blind date next weekend with a guy named Randy. I guess I won’t even need to wear makeup or fix my hair or anything. Poor guy. +

Laurie B. Appling, GA

H H H H H 8/4/2018 My friend was in the middle of eye surgery when he heard someone ask, “where is that eye-dropper?” If that’s your nickname, do you really think you should work for an eye doctor??? +

NEXT ISSUE: MEDICARE SUPPLEMENTS MEDICARE ADVANTAGE PLANS DENTAL, VISION, LIFE

H H H H H 8/6/2018 I know this lady who everyone says has eyes in the back of her head. That is freaky! But with her hairdo, know one really knows for sure. +

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Sources: Direct Market Farmers: National Survey (2015). American Farmland Trust and Farmers Market Coalition. http://farmersmarketcoalition.org/ education/farmers-markets-promotesustainability/#_edn5. 2018 National Farmers Market Week | Agricultural Marketing Service. United States Department of Agriculture. www. ams.usda.gov/publications/NFMW. Augusta Fruit & Vegetable Prescription Program 2018. Augusta Locally Grown. http:// augustalocallygrown.org.

SERVING

Chuck N. Beech Island, SC

Augusta community,” said Coats. “It builds a sense of community by supporting local farmers and businesses. You can really see the impact that eating less processes foods and more fruits and vegetables has on overall health.” Before you shop, fi nd out what fruits and vegetables you might find at the market and what’s in season. Spend some time meal planning and try to buy produce that you and your family can eat within a few days. National Farmers Market Week is a time to highlight the farmers who provide Americans with access to healthful locally and regionally produced foods. Take the opportunity this month to explore the diverse array of agriculture produce Augusta has to offer at your local farmers market. +

THANKS

FOR READING

FLOYD & LEOPARD

LLP

ATTORNEYS AT LAW

MAUREEN O’LEARY FLOYDGREGORY LEOPARD PERSONAL INJURY • CRIMINAL DEFENSE • FAMILY LAW 461 Greene Street • greenestreetlaw.com • 706-303-1874 • 800-785-6894

AUGUST 10, 2018

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AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf What follows is from a Kirkus Reviews overview of The Gene by Siddhartha Mukherjee:

— posted by Andrea Eisenbrg, M.D. on February 10, 2017

THE LAST TWO PATIENTS OF THE DAY COULDN’T HAVE BEEN MORE DIFFERENT The other day, the last two appointments on my schedule were “unable to get pregnant, consult” and “pregnant, desires a termination.” Even my medical assistant commented about the timing of those last two patients. Although these are not unusual issues for patients to see me about, the fact that I was seeing them back to back haunted me all day. Why? Why did life deal them these cards? Did fate make a mistake and now, as if to tease them more, consire to have them sit next to each other in my waiting room, anxiously awaiting what comes next? And why at my doorstep, challenging me to be in two different mindsets, to support one that cannot get pregnant and one who can but doesn’t want the pregnancy, one right after another? Life forming when it’s not wanted, when the timing isn’t right; and then not, even though the timing is perfect and the desire is huge. In the beginning, the sources of life approach each other; sometimes cells come together that aren’t normal; sometimes they come together and divide incorrectly; sometimes they just have a mind of their own and make something with no human likeness; and sometimes, they never collide at all. In the darkness, what forms clings onto the womb for dear life; sometimes it can hold on; sometimes it can’t endure and loses its hold; or sometimes it clings on in a way that will kill its host. Then it unfolds, quiet, unassuming, swaying in the warm fluid. Sometimes it becomes contorted and can’t unfold fully; sometimes it swims with blessed freedom; sometimes it never unfolds. The time passes slowly, passes quickly, with sadness, with hope, with fear, with love. This life knows it can’t stay like this forever — some won’t accept this and will not survive the journey out, some leave with great expectations and joy, and some are so contorted, they must make the journey out a different way. I think about all these complicated processes and how many times steps can go wrong, how miraculous it is that they ever come out right. I think about all the complicated expectations, disappointments, relationships that go into making life and how all this affects the processes too. I take a moment before I enter the first room, knowing it is filled with the disappointment of life not forming, and knowing I will need to reset myself for the last room which is filled with disappointment of the opposite. +

It’s miraculous that they ever come out right.

Andrea Eisenberg is a obstetrician-gynecologist who blogs at Secret Life of an OB/GYN.

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A panoramic history of the gene and how genetics “resonate[s] far beyond the realms of science.” Mukherjee (Medicine/ Columbia Univ.; The Laws of Medicine, 2015, etc.), who won the Pulitzer Prize for his history of cancer, The Emperor of All Maladies (2010), begins with Mendel and his “pea-flower garden,” and he never lets readers forget the social, cultural, and ethical implications of genetics research. Indeed, he dedicates the book to his grandmother, who raised two mentally ill children, and to Carrie Buck, the Virginia woman judged “feebleminded” and sterilized according to eugenics laws passed in the 1920s. After Mendel, Mukherjee describes Thomas Morgan’s fruit fly studies in the 1900s, and he goes on to trace the steps leading to the discovery of the double helix, the deciphering of the genetic code, and the technological

advances that have created ethical dilemmas. Early on, there was recombinant DNA, the insertion of genes from one species into another, and this led to mandates initially proscribing certain experiments. Then, there were the fi rst disastrous attempts at gene therapy, which consisted of arrogant and sloppy science. Meanwhile, the human genome has been mapped, more and more genes have been associated with certain diseases (and even behaviors), and a new technique has been

developed that permits the removing or replacing of specific genetic defects. Are we ready to apply that to an individual patient? Should it apply to sperm and egg cells so as to affect future generations? Mukherjee ponders these issues in the fi nal chapters and epilogue, ultimately seeing the need for more research about the information coded in the human genome, since so much of it does not consist of genes. Throughout, the author provides vivid portraits of the principal players and enough accessible scientific information to bring general readers into the process of genetic lab science. Sobering, humbling, and extraordinarily rich reading from a wise and gifted writer who sees how far we have come—but how much farther we have to go to understand our human nature and destiny. +

The Gene by Siddhartha Mukherjee, M.D; 608 pages, published in May 2016 by Random House.

Research News When the health discussion is politically correct Remember the “Research News” article in our previous issue (July 27)? “Obesity alone is not a killer” was the headline. Still true, more than two weeks later. To add to that story and clarify to a degree, some public health discourse in recent weeks and months has focused on an unintended consequence of the backlash against socalled “fat shaming.” Correctly, the practice of ridiculing people because they’re overweight has been judged in the court of public opinion to be thoroughly unacceptable. It has been condemned to death row (meaning it’s going to stick around for quite a while). In its place - or in opposition to it - the “body positive” movement arose. It says accept who you are — no wait, that’s not good enough — celebrate who you are, no matter what

size you happen to be. Maybe we’ve swung from one extreme to the other in the overall discussion. There is no need for disrespect, but it is still a medical fact that obesity is unhealthy. It is undeniably linked to coronary artery disease, high blood pressure, and diabetes, among other issues, and is a contributing factor in a host of other illnesses. There’s no proper place for fat shaming, but neither should anyone confuse societal issues with medical ones. True, we published that accurate July 27 headline referenced earlier. It’s also true that a grossly overweight person can indeed have perfect blood pressure and blood sugar readings. And let’s not overlook the fact that skinny people get colds, the flu, and even cancer. So it isn’t “skinny people are healthy, fat people aren’t.” But it is a true statement

that everyone of every weight should be as healthy as possible. And it’s also true that being excessively overweight sooner or later causes serious health problems. A baby aspirin question Here’s news of a study published a month ago (July 12) in The Lancet that prompts a single question: What took so long? The study looked at the advice we’ve all heard and many of us have taken: take a baby aspirin every day to prevent heart attacks, strokes, flat feet and several other maladies. What the study examined was, why is that same one-aday advice given to 110-pound women and 290-pound men? Shouldn’t dosage be adjusted for weight? The conclusion of the study? Yes, absolutely. Ask your doctor how your dosage should be adjusted during your next visit. +

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AUGUSTAMEDICALEXAMiNER

THE EXAMiNERS +

Know any good lawyers?

What about Jacque Hawk?

by Dan Pearson

That’s him. He is short, but he doesn’t like to be Isn’t he that real described that way. short attorney?

Well if he isn’t He prefers the term short, what is he? “trial-sized.”

PUZZLE

ACROSS 1. Separate wheat from this 6. Japanese port city 10. Serpents 14. Star in Orion 15. Noted English school 16. London apartment 17. Farewell 18. Covered with gold 19. Type of truck 20. Guide and leader 22. Mongrel dog 23. As previously given (Latin) 24. Field official, in brief 26. Withered (of a plant) 28. Trite; unoriginal (adj.) 33. Beta Kappa starter 34. Organic fat 35. Pitcher stat 37. Rattling breath sound 41. “Baby Brave” outfielder 42. And not 43. Leaning 44. Attack on all sides 45. SRS acronym 46. Smell, for example 47. Deep sleep acronym 49. Halfway submerged 51. Scrapes away 55. Upper limb 56. Authenticating mark 57. Bad ER outcome 59. Heart of note in Augusta 64. Othello villain 65. 4-Ds have a dozen of these 67. New Zealand evergreen 68. Member of an Augustabased Southern rock band 69. Bacterial beginning? 70. Banks in Chicago 71. Whirlpool 72. Undergo lysis 73. Change, as an alarm

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

VISIT WWW.AUGUSTARX.COM 1

Click on “READER CONTESTS”

QUOTATIONPUZZLE

E H W A M E E F A R L S O T O D M N F K A E B N E H R I F N E L O E N N T

W B I T M D C L O I N E E I W

— Eleanor Bron

DOWN 1. Stuff 2. Conceal 3. Not fer 4. These go into shoes 5. Water that’s treated 6. Small cask 7. Of the ear 8. Big dose (as of medicine) 9. Snare 10. Related; associated 11. It’s put under a microscope 12. Trims 13. Stalks 21. Some blood cells 25. Demon 27. A speechwriter could be one of these 28. Reveal a secret 29. Augusta painter Ed 30. Literary work 31. Study of rocks 32. Criminal 36. The A of JBA 38. Queue

39. Otherwise 40. Pace 48. Toward the center (med.) 50. Trauma pt. destinations 51. To one side 52. Lee & Betty of Augusta 53. Stormed 54. Former Georgia governor (to friends) 58. Book #5 of the New Testament 60. Type of package 61. Flows 62. Great Lake between Huron and Ontario 63. Eating regimen 66. Hasten; go quickly

Solution p. 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.

E X A M I N E R

8 4

S 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 keypad letters to convert numbers into words suggested by the definitions provided. Sample: 742 (body part) = RIB. Solution on page 14. 1. 863 (body part) ___

6. 8346 (body part) ____

2. 534 (body part) ___

7. 25663 (body part) _____

3. 3668 (body part) ____

8. 72257 (body part) _____

4. 2663 (body part) ____

9. 847627 (body part) ______

5. 6325 (body part) ____

10. 26782 (body part) _____

TEXT

THE MYSTERY WORD The Mystery Word for this issue: GUHCO

EXAMINER CROSSWORD

AUGUST 10, 2018

13 +

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE

The

Advice Doctor

Moe: My mother, bless her heart, is 97, and she still doesn’t need glasses. Joe: That is amazing. What’s her secret? Moe: She drinks straight from the bottle.

ha... ha...

Moe: Where have you been? Joe: I was going to donate blood, but it didn’t work out. Moe: Why not? Joe: Too many questions. Moe: Questions? Like what? Joe: Like “Whose blood is this?” and “Where did you get it?”

team of very bad counterfeiters discovered that by mistake their latest batch of bogus money was all 18-dollar bills. They realized they could never pass them in the big city, so they headed out into the sticks to pass them off to unsophisticated hicks in the boonies. Stopping at a country store on a dirt road, the city slicker encountered a scruffy, bearded, toothless old man behind the counter. Perfect, he thought. “Can I get change for this?” he asked, placing an 18-dollar bill on the counter. The old man picked up the bill and looked it over carefully, front and back, and then said, “Sure, I can make change. You want two $9s or three $6s?”

Moe: Where have you been? Joe: I just drove down a street that had the craziest addresses. The first house was 64K, then the next one was 128K, then 256K, 512K, and finally the last house was 1MB. Moe: That was a trip down memory lane. Moe: Where have you been? Joe: Jail! I got pulled over by a cop, and although I admit I was annoyed. I was very polite. In fact, I remember sharing a few words of wisdom with him. I told him it’s not how many times you fall. It’s how many times you get up. Moe: That was nice. What did he say? Joe: He said that’s not how field sobriety tests work.

Moe: How did your job interview go? Joe: I’m not too sure. Moe: What happened? Joe: Well, one of the questions he asked me was, “What would your friends say are your biggest weaknesses?” Moe: And? Joe: I told him I don’t have any. Moe: Weaknesses? Joe: No, friends.

Moe: How did your doctor appointment go? Joe: You know I had to take a hepatitis test, right? Moe: Right. Do you know the results yet? Joe: I got a C. +

Why subscribe to theMEDICAL

INER?

What do you mean? Staring at my phone all day has had no affect on ME!

Because try as they might, no one can stare at their phone all day.

Dear Advice Doctor, About a year ago I had what I now realize was a life-changing experience as the victim of a crime. I don’t want to go into all the unpleasant details here, but at the time I thought I would quickly recover and move on. Maybe I still will, but it’s starting to feel like the rest of my life was taken away in the blink of an eye. I’m not ready to accept that. Can you offer any advice? — Facing (or Fleeing) the Future

Dear Facing, First, please let me offer my sympathy and support. Know that you are not alone. You would be amazed how often this happens. The blink of an eye occurs far more often than we realize. Thousands of times a day! The average is about 15 times a minute. That means if we’re awake 16 hours a day, we blink more than 14,000 times (15x60x16) each and every day. That number can drop dramatically (down to only 3 or 4 times a minute) if we’re doing visually intense work, like reading columns of numbers or working on a computer, which is why those activities cause dry eyes and eye strain. It isn’t even a conscious act most of the time, but rather a semiautonomic action taken to keep our eyes clean and lubricated. Each bilateral blink washes lacrimal fluid — aka tears — across both eyes. Blinking only one eye (winking) is a form of body language. There are other forms of blinking that have nothing to do with lubrication of the eyes. Researchers (and perhaps you and I) have noted that blinking often has nothing to do with dust or dry eyes. Blinking sometimes happens in connection with pain, bright lights, as a reaction to medication, and oddly enough, things we see and hear. For example, someone asks a difficult question, and in response we may blink five or six times. In one Japanese study, people observed while watching a lecture, a TV show or a video all blinked at about the same time. The reasons are still a mystery, but one hypothesis based on observations while study subjects were in an MRI and brain activity was being monitored is that blinking offers a mental reset: as soon as subjects blinked, cortical/cognitive brain activity decreased and “default-mode” brain activity increased. Excessive blinking, especially hard, forceful blinking, usually resolves itself without treatment. + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.

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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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Choose ____ six months for $20; or ____ one year for $36. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

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THE MYSTERY SOLVED The Mystery Word in our last issue was: DENTISTRY ...cleverly hidden in p. 7 ad for CAMELLIA WALK THE WINNER: FLOYD MONTGOMERY Want to find your name here next time? If it is, we’ll send you some cool swag from our goodie bag. The new Mystery Word is on page 12. Start looking!

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.

TheSUDOKUsolution

THE PUZZLE SOLVED C

S C

SEE PAGE 12

The Celebrated TEXT ME 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!

AUGUST 10, 2018

AUGUSTAMEDICALEXAMiNER

1. TOE 2. LEG 3. FOOT 4. BONE 5. NECK

6. VEIN 7. BLOOD 8. SCALP 9. THROAT 10. AORTA

QUOTATION QUOTATION PUZZLE SOLUTION “Both men and women are fallible. The difference is women know it.”

READ EVERY ISSUE ONLINE

— Eleanor Bron

The new scrambled Mystery Word is found on page 12

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AUGUST 10, 2018

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THAT BEACH MYSTIQUE by Caroline Colden, MD Medical Examiner “Kid’s Stuff” columnist I’ve been at the beach for a week, down in South Carolina, somewhat Beaufortish. It’s a mother-daughter, post-residency getaway with my mom. At this time of year, just before summer ends and school starts back up, there are a multitude of other families at the beach here with us this week. I’ve been contemplating the beach. What brings us all here? Out of all the beautiful places we could visit (given time, resources, time off work), what is it about the beach that is healing, rejuvenating, family-friendly, that appeals to us all? One must admit, there is a certain mysterious je ne sais quoi to the beach and its majesty. There are so many familytypes represented here. For starters, there’s the motherdaughter pairing like my mom and me. There’s the older, retirement-age couple that bought a condo on this island at some point - usually with a good story to tell: “We got this place last year just before the hurricane, hadn’t even stayed in it yet and then we had to pay for all the renovations and repairs...” Then there are the multi-generation families, with grandparents, daughtersand/or sons-in-law, and grandchildren all staying in one house together, bonding under one roof with the help of sunshine, sandcastles, and a pool close by. “Daddy! You are the shark! You can’t come on base (the pool steps). Daddy, base is safe from sharks!” And Daddy (or grandpa or grandma, however many participating sharks there were) would obey, of course, because after all, even sharks have to play by the rules, especially in resort swimming pools.

Perhaps the appeal is the fried food we eat while vacationing on the beach. Since it’s vacation, we are forgiven for any fried food we eat. “It protects us from sunburn!” an old friend of my mother’s used to proclaim, as if internally the oil and grease somehow provided insulation from the inside-out that kept the sun’s rays from piercing us with any burns. Plus with all the walking one can do along the shore, the calories are sustenance, fueling us for the next journey into low tide, where the sandbar we seek may be impossibly far out, but so lovely to reach. Or maybe it was all the exercise and fresh air one gets at the beach that is the appeal. In a single morning, my mother and I may walk farther at the beach than we would all week around the block at my parents’ house. Little kids and teenagers alike become robust in the fresh sea air and run down the beach, swim out into the water and run back again and again. Even little babies wear themselves out. Jumping and crashing into the incoming waves of high tide - the likes of which they’ve never seen before - that continuously lap the shore, the foam and sand admixture engulfing feet and ankles in their gentle grasp. As quickly as the waves whip across the beach, just as quickly do they retreat, gathering strength for the next attempt. In low tide, it’s a much different picture. The tranquility of the ocean at low tide, rising and falling so gently, perfect for exploration or solitude. Some children sit peacefully in the waves and splash in the wet sand. Older ones hunt for crabs and shells for the sheer elation of discovering something. Oh mom, LOOK! A hermit crab! (As if this were the only

hermit crab on earth, and now it had been discovered out of sheer luck - and skill) and the child runs back up to shore to display their find(s) with great pride. At dusk and dawn waters actually look like ten thousand diamonds woven together against the horizon Personally, what draws me to the beach most of all is the beach itself. I really, really mean the beach itself. Maybe I should specify the ocean, primarily. A person can access their deepest, innermost self when they look out into the ocean. And I mean really look out into it. Maybe a person accesses God, or their definition of God. Maybe we become one with God when we stare into the ocean. Its glittering waves, capable of such great power and magnificence, so gently lapping the sand during low tide, but capable of tearing a beach house to oblivion during a hurricane. As I walked the beach, past the old houses that still had not been repaired from a hurricane which wreaked havoc on the island two years ago, it was a terrifying reminder of how much power there was in the ocean. “Nature always wins,” my mother often says. The ocean reminds us of this. Humans are top of the totem pole on earth these days - for the most part - but when one looks out into the ocean, wondering what lurks out there (are sharks really the scariest thing in those salty depths?), pondering the waves themselves as they roll towards us on land, threatening until the very last second to overtake us with water and fury, we are reminded once again that we really are small. Looking at the expanse of the sky above us, I mean it is just SO BIG. The clouds alone, billowing

and growing... and they go on and on, off into the distance. Does the horizon really end? (No, flat earth conspiracists, it does not...) I am dizzy in the whole experience. And full of wonder. It is beautiful, the splendor and abundance of it all. And maybe all of this is what we love about the beach. We cannot conquer it. We can never ever conquer the ocean. It will always win - this unstoppable power that can always overwhelm us. But if you respect its greatness you may bask in its glory. And maybe you will appreciate your own glory, the glory of being alive, of being in touch with yourself, with your family and all

its generations. For all the mothers and fathers and children out there wishing to connect and rejuvenate. To rehab the soul, to spend what little time we all ultimately have on this earth together, if only for a week ... I am sitting here on the porch, enjoying the lull of it all. The frogs are out tonight. It rained today, and nature spoke. It calmed the sands and dissipated the heat. The waves ripped upon the beach for a few minutes, then all was calm again. Now the cicadas hum in the trees and nighttime falls. Tomorrow will be a new day, and the world can continue on with its never-ending quest to find itself and find peace. +

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AUGUSTAMEDICALEXAMiNER

IT’S A QUESTION OF CARE After someone dies, how can we celebrate their life?

This is a good question, and based upon your spiritual, religious or cultural beliefs, you might have certain expectations in this area. However, when we think about our lives and those of the ones we love and that have died, it’s really all about relationships. As you are faced with planning a memorial service, a celebration of life, or a funeral for a loved one, think about what made their life special. Who were the important relationships in their life? Perhaps you could have those people speak. It is becoming more common these days for friends and relatives, often multiple ones, to share their memories of the loved one during a remembrance service. It can be helpful to add humor when telling these stories, as it makes us remember that we are all born to die, and life, with all its joys and sorrows, is the journey to that end. A memorial service, celebration of life or funeral is a time to really talk about the person and their impact on those around them. You might have their favorite foods at a reception before or after. You could also have some of their favorite music playing if the

AUGUST 10, 2018

setting allows for this. Aside from a formal service, there are other ways to remember those we love. One is by vacationing where they loved to travel with their family, visiting the people they used to visit regularly and talking to those people about your loved one to share memories together. You might also donate to a civic organization or church in memory or honor of them with a note to that organization as to why you chose to donate and what they meant to your loved one. As a family, you might all get together and share your best or funniest experiences and write these down so you can go back and read them together. That history can be passed down from generation to generation and it can be entertaining in the process. Use your imagination when thinking about how to remember and honor those you loved who have gone before you and enriched your life. + by Amy Hane, a licensed Master Social Worker in South Carolina and Georgia, an Advanced Professional Aging Life Care Manager and also a Certified Advanced Social Work Case Manager.

PROFESSIONAL DIRECTORY +

ALLERGY

Tesneem K. Chaudhary, MD Allergy & Asthma Center 3685 Wheeler Road, Suite 101 Augusta 30909 706-868-8555

AMBULANCE SERVICE

AMBULANCE • STRETCHER • WHEELCHAIR

706-863-9800

CHIROPRACTIC Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A 706-860-4001 www.evanschiro.net

DENTISTRY

Dr. Judson S. Hickey Periodontist 2315-B Central Ave Augusta 30904 706-739-0071

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Medical Center West Pharmacy 465 North Belair Road Evans 30809 Floss ‘em 706-854-2424 or lose ‘em! www.medicalcenterwestpharmacy.com

Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048 Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

DERMATOLOGY

Parks Pharmacy 437 Georgia Ave. N. Augusta 29841 803-279-7450 www.parkspharmacy.com

PSYCHIATRY Psych Consultants 2820 Hillcreek Dr Augusta 30909 (706) 410-1202 www.psych-consultants.com

Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Augusta 30904 Augusta Gardens Senior Living Community 706-733-3373 3725 Wheeler Road SKIN CANCER CENTER www.GaDerm.com Augusta 30909 SENIOR LIVING COMMUNITY Resolution Counseling Professionals 706-868-6500 3633 Wheeler Rd, Suite 365 www.augustagardenscommunity.com Augusta 30909 706-432-6866 Karen L. Carter, MD www.visitrcp.com 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com Your Practice And up to four additional lines of your choosing and, if desired, your logo. Keep your contact information in Steppingstones to Recovery this convenient place seen by tens of 2610 Commons Blvd. thousands of patients every month. Augusta 30909 Literally! Call (706) 860-5455 for all 706-733-1935 the details

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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

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If you would like your medical practice listed in the Professional Directory, call the Medical Examiner at 706.860.5455