Aug22 14 by Daniel Pearson

AUGUSTA

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DO UNTO OTHERS... I

n this very space in our last issue we noted a disturbing trend that is morphing into an even more disturbing trend. We started out talking about so-called helicopter parents, a term describing parents who hover protectively — some would say smotheringly — over their children from pre-school through college. That phenomenon has been around for awhile, but a new version that we just touched on in our last issue is proliferating across the fruited plain. The new model widens the helicopter blades considerably. Now people are helicoptering the children of complete strangers, and they’re doing it on an unprecedented scale. Specifically, we are talking about the perception that a felony has been committed if children are not under constant supervision by an adult. As we noted last time, most of our own parents would be convicted criminals in today’s climate of fear and paranoia. Does this mean the Medical Examiner advocates leaving children home alone without supervision or left alone in parked cars while parents shop? Not at all. As regular readers will recall, as recently as our July 11 issue we suggested the Cobb County man alleged to have deliberately left his young son in a hot car all day may well be the most despised man in America. But compare his case to another one that has made headlines. Here’s the scenario in brief: a woman and her two children, ages 1 and 4, were visiting her out-of-state mother. Shortly before they were to leave for the airport to return home, the woman borrowed her mother’s SUV and went to a nearby store for one item. Her 4-year-old son wanted to come

along, but then refused to go inside once they got to the store. He was gearing up for a major tantrum when she made the fateful decision to leave him alone in the car. It was morning, the parking lot was nearly empty, the skies cloudy, the temperature was in the 50s. She was parked close to the store entrance, so she locked the car, got her one item and was back within five minutes. Shortly after they got back to her mother’s house they left for the airport. When her husband greeted her at baggage claim at their destination, he looked worried. “Call your mother,” he said. When the mother returned from taking her daughter and grandchildren to the airport, police were waiting at her home. Someone in the store parking lot had seen the daughter leave her son in the car and used a camera phone to videotape the child and the license plate, then called police. To cut to the chase, the daughter was charged with contributing to the delinquency of a minor, a charge that the prosecutor — two years and many thousands of dollars in attorney’s fees later — agreed to drop if the mother completed 100 hours of community service and attended parenting classes. Whether or not a 4-year-old should be left alone in a parked car — even on a cool day inside a locked car in a safe neighborhood for only five minutes — is a perfectly debatable point. Probably the stronger argument could be made that it was the wrong decision on that mother’s part. But if you were the “Good Samaritan” with the camera phone (side point: a stranger coming right up to a car to videotape an unknown child is more

WHAT HAPPENED ON DAY 3 Woman: Hello little girl! Little girl: Hi. Woman: Where is your mother? Little girl: She’s at work. Woman [dialing]: Hello, 9-1-1?

than a little creepy), would you wait a few minutes to see if the mother would return promptly before calling police? Would you still call 9-1-1 if she was back in her car within five minutes? Or consider the North Augusta case we cited in our last issue. A single mother dropped her 9-year-old daughter off at a small neighborhood park while the mother worked at McDonald’s. It’s a popular park with a splash pad and plenty of shade. Everything went well for two days. But on the third day, well, read what happened (above). Authorities declared the girl “abandoned,” took her into protective custody, and arrested the mother. Her bail was set at $8,000.00 But consider what could have happened (above right). By South Carolina law, the minimum age at which a child can be left alone

AUGUST 22, 2014

WHAT COULD HAVE HAPPENED ON DAY 3 Woman: Hello little girl! Little girl: Hi. Woman: Where is your mother? Little girl: She’s at work. Woman: Are you here all by yourself? Little girl: Yes ma’am. Woman: Do you have any way to get in touch with her? Little girl: Yes, I have a cell phone. Woman: Can you call her right now and see if she could talk to me? Little girl: Ok. (Hands woman the phone after she reaches her mother.) Woman: Hello? My name is Jane and I was just talking to your lovely daughter here at the park. Do you not have anyone to watch her while you’re at work? ... No?... Well, I am here with my kids at least 3 days a week. I’d be happy to keep an eye on your daughter for you if you’d be comfortable with that... Yes, we should meet... I’ll still be here then. Okay, see you then! Bye.

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AUGUSTA MEDiCAL EXAMINER

AUGUST 22, 2014

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

MLR REBATES

he Affordable Care Act (ACA) requires health insurers to spend at least 80% or 85% of their premiums on health care and health care quality improvement. Insurers that do not meet the percentage, which is called a medical loss ratio (MLR), must pay rebates to consumers. MLR rebates for 2013 are due by Aug. 1, 2014. Beginning with the 2014 MLR reporting year, rebates will be due by Sept. 30 following the end of the reporting year. The Department of Labor (DOL) has provided general guidelines on how employers should handle MLR rebates. The following will help you decide what to do with your MLR rebate. You must determine whether the rebate, or any portion of the rebate, is a plan asset under ERISA. This step is crucial because any rebate amount that qualifies as a

plan asset must be used for the exclusive benefit of the plan’s participants. You, as the employer, cannot retain any portion of the rebate that is a plan asset. Unless you pay the entire cost of health insurance without any employee contribution, at least a portion of the rebate will typically be a plan asset. Who pays the premiums? The portion of the rebate that must be treated as a plan asset depends on who paid the insurance premiums. • If the employer paid 100% of the premiums, the rebate is not a plan asset and the employer may retain it. • If participants paid 100% of the premiums, the entire rebate amount is a plan asset. • If the employer and employees each paid a fixed percentage of the cost, the percentage of the rebate equal to the percentage of the cost paid by employees is a plan

asset. If the employer was required to pay a fixed amount and participants were responsible for paying any additional costs, the portion of the rebate that does not exceed the participants’ total amount of contributions for the MLR reporting period would be a plan asset. If participants paid a fixed amount and the employer was responsible for paying any additional costs, the portion of the rebate that does not exceed the employer’s total amount of contributions during the MLR reporting year would not be a plan asset. Can I distribute the rebate to employees? The rebate can be distributed to employees under a reasonable, fair and objective allocation method. Should I distribute the rebate to former employees?

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If you find that the cost of distributing a rebate to former employees approximates the amount of the proceeds, you may decide to limit rebates to current employees. Former employees are those who participated in the plan for the MLR reporting year, but are not participating in the plan when you receive the rebate. What are the tax consequences of rebates? The rebate’s tax consequences largely depend on whether employees paid their premiums on a pre-tax or after-tax basis. • If premiums were paid by employees on a pre-tax basis, the rebate will generally be taxable income to employees in the current year and will be subject to employment taxes. • If premiums were paid by employees on an after-tax basis, the rebate will generally not be taxable income to employees and will not be subject to employment taxes. However, if an employee deducted the premium payments on his or her prior year taxes, the rebate is taxable to the extent the employee received a tax benefit from the deduction. How much time do I have to distribute the rebate? The DOL has provided relief from the trust requirement for rebates that are used within three months of their receipt. Thus, employers who decide to distribute the rebate to participants should adhere to this three-month time limit.

• PSORIASIS • RASHES • WARTS • ITCH RELIEF

Are there other options for using the rebate? If distributing payments to employees is not costeffective, you may utilize the rebate for other permissible plan purposes, such as applying the rebate toward future employee premiums or toward benefit enhancements. Directing an insurer to apply the rebate toward future employee premiums or toward benefit enhancements would avoid the need for a trust and may, in some circumstances, be consistent with ERISA’s fiduciary responsibilities. Employers may find the premium reduction approach to be administratively easier than sending out checks and calculating the additional taxes. + For further explanation of the ACA/PPACA provisions outlined in this article, please refer to the following resources: www.hhs.gov www.irs.gov www.healthcare.gov www.cms.gov Russell T. Head is a Partner and Chief Visionary Architect with Group & Benefits Consultants, Inc., Augusta’s Russell Head largest, privately held, locally owned employee benefits consulting firm. He can be reached at 706-733-3459 or rthead@gandbc.com. Visit Group & Benefits Consultants at www. groupandbenefits.com.

We welcome Chris Thompson PA-C to our practice, welcoming new and established patients.

AUGUST 22, 2014

TO GME OR NOT TO GME - PART 1

have been planning to write on the topic of Graduate Medical Education (GME) for quite some time. It’s a topic I wanted to save until I had time to do some in-depth research and present a fail-proof case for why the government should expand it. That time finally came over the course of this past month. This opportunity could not have come at a better time, either. Just a few short weeks ago, a specialized committee of the Institute of Medicine (IOM) that deals specifically with GME released a 200+ page monster of a report, titled Graduate Medical Education That Meets the Nation’s Health Needs. I write today to report that my previous opinions may very well have been wrong. For those who do not know, GME is the period of training a young physician pursues right after graduating from medical school. This training, commonly referred to as residency, typically ranges from three to six years, and is what makes a pediatrician different from a ophthalmologist, even though both have trained the same way up to that point. GME is required for a physician to obtain licensure to prescribe and practice medicine. Historically, the federal government has largely funded this training, mostly through Medicare. However, as part of a 1997 bill, Congress capped the number of positions it would fund at then-current levels. The problem comes when news of an impending physician shortage began to surface. For example, the Association of American Medical Colleges (AAMC) projected in 2010 that the U.S. would already have a shortage of 63,000 physicians by 2015,

a number that will continue to rise, passing an estimated 130,000 by 2025. The AAMC and other groups, like the American Academy of Family Physicians, say that a critical area of this shortage is in primary care. Of the 130,000 total shortfall, the predicted primary care shortages alone range from 52,000 to 66,000. But these projections were made prior to 2010. In fact, concern for the physician workforce prompted the AAMC in 2006 to call for medical schools across the country to add 5,000 students to their enrollment figures. Medical schools obliged. As of 2012, allopathic (M.D.— receiving) medical schools are up 18% in first year enrollment, having added 3,000 students nationwide compared to 2002 numbers. Osteopathic (D.O.— receiving) medical schools have grown at a much faster rate, up 96% and contributing an additional 2,800 students to the pool. This growth doesn’t really appear to be slowing down, either. In fact, the number of allopathic programs has grown by 16 schools, while osteopathic schools doubled from 15 to 30. Many of these are expected to expand their class sizes. Additionally, plans are in place to create even more medical schools. Perhaps you already begin to see the problem. To recap, to become a doctor one has to complete medical school and then a residency. In the face of a physician shortage, the U.S. added a significant number of medical students over the past decade. Yet thanks to congressional action, the number of residency spots is frozen at 1997 levels. The system has essentially created a bottleneck.

The problem is further exacerbated when one considers the approximately 12,500 students graduating from nonU.S. medical schools who are also applying for these precious GME spots. While many point to an easy solution — filling all slots with U.S.-based graduates before opening them to foreign grads — it is a far more complex issue. For starters, the majority of these students are U.S. citizens who have pursued their training in Caribbean medical schools. However, these programs do not have residency programs to certify physicians for practice in the U.S. Second, a much greater proportion of international medical students go into primary care. Thus, if we are truly heading towards the chaotic future that the previously mentioned organizations project, these physicians will be a precious resource for our health system. Citing the points I have presented to you, the AAMC attempted to introduce funding for an additional 15,000 residency positions (not all first year positions, mind you, but positions total) as part of the Patient Protection and Affordable Care Act (PPACA). Yet, despite PPACA funding some efforts to aid in the recruitment of primary care physicians, the AAMC’s measures largely failed, much to the dismay of many medical institutions and medical students nationwide. But, if the decision is such a no-brainer, why would they not expand? Was it the right call? To GME or not to GME? That is the question. I’ll let you know what I think next time. + 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

SEE PAGE SIX

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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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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. +

AUGUSTA

by Ross Everett

AUGUSTA MEDiCAL EXAMINER

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AUGUST 22, 2014

AUGUSTA MEDiCAL EXAMINER

TAKING RESPONSIBILITY FOR OUR MEDICAL CARE

n the July 11th issue of this paper I read a story about a man who died because he failed to see a doctor. The sadness of it had an impact on me and it got me thinking. When we feel unwell in a general, non-specific way it may be easy to ignore. Vague symptoms aren’t going to get our attention as dramatically as a heart attack or stroke. They’re easy to ignore. But we need to pay attention to these lesser but persistent warnings, and if they persist we should see a doctor. If it were happening to a loved one, we would urge them to seek medical treatment but when it comes to ourselves, we shrug it off. Once diagnosed with something chronic, most people will accommodate it and do well. However, there are some who will deny or ignore their condition, or be unable to afford medication or treatment. They take their chances. This can complicate matters. If it’s a question of cost, I urge people to call their local DFACS office

and apply for Medicaid even if there is doubt about qualifying. If your income is too great for Medicaid, there are patient assistance drug programs that can help with the cost of medications. Call the Area Agency on Aging (706-210-2018) for applications and assistance with both of these options.

“You cannot escape the responsibility of tomorrow by evading it today.” — Abraham Lincoln For others who, for whatever reason, don’t take responsibility for their care, the outcome can be devastating. It’s important to follow medical instructions, respect any limitations imposed, and take medications as prescribed. If we comply, we are doing all we can to ensure the best possible result. If not, then start researching nursing homes and even funeral expenses, because being noncompliant may land you in one place or the other sooner rather than later.

I WONDER IF I CAN TAKE UP TO 12 MONTHS TO PAY?*

It’s disheartening to see people give up, deny the prognosis, or just not care. It’s a waste of resources as well as the effort and time of caregivers and medical personnel. Nothing can be done about the lung cancer patient who won’t stop smoking or the diabetic who doesn’t watch his diet. You can’t force a person to take their medication, exercise, or keep doctor appointments. The heartbreak of the families involved can’t be measured. It also begs the question as to whether mental health intervention may be appropriate. There are those of us who can listen to instructions tossed over the doctor’s shoulder as he writes his notes and there are others who need him/her to make eye contact and be very direct about what must be done at home and what to expect if we don’t obey. Not all of us absorb information the same way. So the source of better patients may be, at least in part, better communication between doctor and patient. We can help ourselves in this area by making a list of our questions for the doctor, asking for clarification on instructions, and making sure we have a good understanding of our condition before we leave the office. It’s your health. Who better to take responsibility for it? +

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AUGUST 22, 2014

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW ABOUT DOING RIGHT WHEN YOU ARE WRONG

AUGUSTA

larisa had three kids, an inside cat, an outside dog, and a hardworking husband who watched football on Saturday and took her to church on Sunday. Clarisa’s future was predictable by American standards. Things rocked along just fine until one day she rushed into her family doctor’s office in a more-than-minor panic, asking for a Pap smear even though her last Pap was only 4 months prior. Clarisa’s panic was justified: she was 10 weeks pregnant, not something she wanted at age 34 with her youngest child being 9. And there were other complicating factors: She was well endowed by Mother Nature and her mammary tissue had always responded dramatically to the hormonal shifts for pregnancy, a fact that her husband had appreciated and correctly assumed meant pregnancy. And to make things even more complicated, her husband had a vasectomy a couple years back because neither wanted her on birth control pills for another 10 years. An abortion was clearly necessary in her mind. Her

husband concurred. But she had no idea how to salvage a marriage that might be teetering on the brink of ruin. To her doctor she owned up to a chance indiscretion with a high school boyfriend with whom she had a fling long before meeting her husband. She needed the charitable wisdom of Solomon from her doctor. His dilemma was how to handle a family-rattling misadventure with the least amount of collateral damage. “I will try to help you. But I cannot - and will not - lie for you. I will answer any question your husband asks me with the truth. You have to live with that. Have your husband come in for an examination. You come with him.” The examination was within normal limits, as was his well-healed vasectomy scar. “Clearly my wife is pregnant. Is it possible that my vasectomy did not work? Or is there something strange about me,” the husband wondered out loud. Seizing the glimmer of hope offered, the doctor said, “Well, no surgical procedure is 100% perfect. So a surgically excised vas deferens could reFREE T AKE-H OME C OPY!

t s e B anastamose. And the human body is known to have many anatomical variations, so an extra or aberrant vas deferens could exist.” All of that was true. Not a lie in it. The doctor waited in fear that the husband would ask for a sperm count, which might show he could have been the father. The question did not come. Instead, the husband said, “Put me on the surgical schedule as soon as possible. I don’t want any more slip ups.” Surgery was uneventful. The pathology specimen was a single severed right vas deferens. The socially adept surgeon saw no need to mention both vas deferens had been properly severed previously and he merely took out another section of the right side. The wife’s integrity and future were spared. She was most thankful and

•

e n i c i d ME

appreciative. Within our story reside several moral conflicts: abortion of a physically normal pregnancy; the infidelity of the wife; evasive answers by her family doctor; misleading surgery by the surgeon; duping the husband; placing social peace and convenience above truth. I could produce arguments for and against each. You can make you own choice on each. But before you get too dogmatic and vindictive, know this: Years later, the husband invited the family doctor and the surgeon to lunch. Each dutifully attended but with great trepidation, both fearing the husband had discovered the truth and was about to excoriate them with accusations for which they had no moral, medical, or legal defense. Haunting thoughts of testifying

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before an ethics committee abounded. License to practice medicine could be at stake. The meal was nice. The conversation was guardedly polite. Near the end of the meal, hubby said, “Gentlemen, I know you are wondering why I invited you here. It is about the ‘aberrant vas deferens.’” A chill fell over the gathering. Mercifully, he went on without too much of a pause. “I know there was no surgical failure or aberrant vas deferens. I know my wife was not pregnant by me. I also know my wife could not weather public awareness of her indiscretion and subsequent pregnancy. So gentlemen, I want to thank you for your compassion, discretion, professionalism, and risk. Without you, my wife’s mental survival — and our marriage — might not have been possible. “Gentlemen, I am in your debt. You have my gratitude. Thank you.” Tonight before going to sleep, consider the moral struggles each of our characters — wife, husband, surgeon, and doctor — must have suffered over the years, and then tell me what you think you might have done were you them. + 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 706-306-9397

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AUGUST 22, 2014

AUGUSTA MEDiCAL EXAMINER

4 ways primary family caregivers can manage stress by Kathy Crist First, Dad needed help monitoring his daily medications, and then he needed to be taken to physical therapy twice a week. During the next few months, Crist Dad’s health continued to wane and he wrestled with losing his independence. If you are a primary family caregiver, you recognize this scenario and understand the tough sacrifices and rewards of helping your elderly loved one maintain their independence. You step in when there are medical and financial decisions to be made. You break the doctor’s news and listen to the reminiscences of days gone by,

and you show your love and are there whenever needed without question. Yet, like millions of other family caregivers, your life is expanding in responsibility. If you juggle caregiving with your own family’s needs and a career, you sense the intense squeeze of time and commitments all the more. With your loved one’s care continually on the front burner, your care needs stay on the backburner. Primary family caregivers are more susceptible to high blood pressure, stroke, diabetes and anxiety. Such stress also can increase the likelihood of headaches, disrupted sleep and depression. Primary family caregivers deserve a supportive round of applause because they work so tirelessly to serve their senior loved one, often without a break or even a “thank you.”

It is vital for family caregivers to reserve time for their own mental, physical and emotional health. Your aging loved one needs you functioning at your best, and so does your family. So relieving stress is vital to everyone’s health to manage day-to-day and long-term priorities. Here are four proven stress busters for principal family caregivers: Refresh your own health Exercise at the gym or go for a brisk walk a few times a week. Be sure you maintain good nutrition and sleep habits. Check in with your own doctor for regular exams and practice the things that you know make you feel better, even if it’s as simple as a cup of hot tea or a soothing bath.

Recruit help Enlist the support of family members, friends and neighbors who can lend caregiving help. Also, rely on regular respite breaks through the assistance of a professional in-home agency. From getting help for a few hours a day to regular overnight care, securing adult home healthcare is a sign of wisdom and strength, not a sign of weakness.

the fun events or forgo your normal faith and community activities. In summary, when primary family caregivers learn to relieve stress regularly, before any health issues arise, they help safeguard their loved one’s care and preserve the relationship with their loved one, one shared meal, one doctor’s report and one fond memory at a time. +

Stay connected Keep up your own family connections and friendships. Having a confidant who listens to you is crucial as you navigate the unknowns and challenges of caring for another person.

by Kathy Crist, co-owner of Right at Home of the CSRA. Right at Home is dedicated to helping the elderly by providing private-duty care giving services in Augusta, North Augusta, Aiken and surrounding areas in SC. Right at Home is available to discuss your family care giving needs. If you have further concerns about caring for a loved one, please contact them at 803-278-0250 or on the web at www.rightathome.net/csra.

Continue with your own life To maintain balance, it’s important to stay active with your own interests, hobbies and social groups. Don’t skip

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.

“

You treat a disease, you win, you lose. You treat a person - I guarantee you win - no matter the outcome. -Patch Adams

“

AUGUST 22, 2014

Southern Girl Eats Clean

Peach Blueberry Crisp.....A Healthy Sweet Treat

Peach Blueberry Crisp

736-7230

A FAMOUS PERSON’S HAIRSTYLE WILL OFTEN SPARK A WORLDWIDE FAD.

BUT NOT ALWAYS.

Head-to-toe service: Jerry will shine your shoes while we cut your hair. www.danielvillagebarbershop.com lemon juice and drizzle the honey over the fruit. Use a spoon to mix well and coat all the fruit with other ingredients (from the first list). • Evenly divide the fruit mixture into four ramekins and set aside. (Slightly overfill the ramekins because the fruit will cook down.) • In another medium mixing bowl, toss the rolled oats, 3 Tbsp. of almond flour, 1/4 tsp. of cinnamon and 1/4 tsp. of allspice. • In a separate small bowl, whisk together coconut oil, 1 Tbsp. of honey, 1 Tbsp. of maple syrup and vanilla extract. • Pour the coconut oil and honey mixture over the rolled oats. Stir well to coat all the oats. • Place the oats onto a parchment lined baking sheet and place into a pre-heated oven at 400 degrees for 15 minutes or only until oats start to turn slightly brown. (You may want to stir around

We’re on Wrightsboro Rd. at Ohio Avenue. with a spatula half-way through cooking.) • Remove from oven and set aside to cool for a few minutes. • Place the oats back into the bowl and sprinkle in the finely chopped pecans and stir to incorporate nuts into the mixture. • Spoon oats onto the top of the fruit filled ramekins. • Place back into the oven and cook for approximately 15 more minutes or until the fruit starts to bubble, making sure not to let the oats burn. • Remove from oven and allow to cool slightly. Top with coconut milk ice cream if desired. • Serve immediately. +

DANIEL VILLAGE BARBER SHOP

Medical Complex

76 Circle K former Smile Gas

Highland Ave.

Directions: • Peel and slice peaches and place into a medium size mixing bowl. Wash blueberries and place into the bowl also. • Sprinkle in the cinnamon and almond flour. Add the

Daniel Village Barber Shop

Ohio Ave.

For the Crisp topping • 1 cup of gluten free rolled oats • 3 Tbsp. of almond meal/ flour • 1/4 tsp. of cinnamon • 1/4 tsp. allspice • 1/4 cup of finely chopped pecans • 1 Tbsp. of coconut oil • 1 Tbsp. of honey • 1 Tbsp. of maple syrup • 1/2 Tbsp. of vanilla extract • Vanilla coconut milk ice cream (Optional)

Voted “BEST BARBER SHOP” in Augusta Magazine many times!

2522 Wrightsboro Road

I used to love one particular dessert when I was younger: peach cobbler. My mom made this very often in the summer with fresh peaches, and in the winter she used canned peaches. Yes, it was loaded down with refined sugar, white flour and butter. And then we topped it off with vanilla ice cream. Not so good for me, but I loved it just the same. I decided to try and create a healthier and cleaner alternative to peach cobbler, but something that would still satisfy the sweet tooth. I used a yummy local Georgia raw honey from Byne Blueberry Farms. This honey is delicious and has a unique flavor since the bees pollenate the blueberry bushes. This honey was perfect to sweeten up my Peach Blueberry Crisp. Of course, I used Byne Organic Blueberries and fresh Georgia peaches too!

Ingredients: • 4-6 fresh peaches • 1 cup of fresh blueberries • 1/4 tsp. of cinnamon • 1/4 cup of raw honey • 2 Tbsp. of fresh squeezed lemon juice • 2 Tbsp. of almond meal/ flour (I used Bob Red’s Mill brand)

AUGUSTA MEDiCAL EXAMINER

Wrightsboro Road

Daniel Field

Augusta Mall

Tue - Fri: 8:00 - 6:00; Saturday: 8:00 - 2:00 IMPORTANT GROOMING NEWS: Note our new hours!

Call 706.860.5455. Let’s talk ads.

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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P harmacy 411

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... 500+ doctors offices throughout the area for staff and waiting rooms, as well as many nurses stations and waiting rooms of area hospitals.

AUGUST 22, 2014

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.

WE ARE HERE TO HELP — AND THAT GOES FOR INFORMATION TOO

very week in the pharmacy we see the same thing: people would require the patient to contact his doctor. Sure enough, in the middle of a cell phone conversation or otherwise later in the day the doctor calls in an oral medicine to help occupied with kids while picking up their prescriptions. We with the pain. Shortly thereafter the patient called to ask if the are here to provide you with important medications, but with prescription was called in and to say how bad the gel burned these medicines come instructions and information. This is when applied. an important part of the pick-up process. If a patient is Metronidazole, the oral medicine now being prescribed, not focused or is unwilling to take advice about the is an antibiotic that causes a severe reaction when medicines, problems can occur. In some cases it can be mixed with alcohol. We always counsel patients to a mild problem, but other times serious consequences avoid alcohol in all forms when taking this medicine can result from not following dosage or administration — even mouthwashes and cough syrups containing instructions. The doctor prescribes the medicine you alcohol — and so did the pharmacist involved in this need, whether it’s to get better or to maintain treatment instance. But the patient thought he was invincible of a chronic disease, but much more can happen than and went home and took the medicine with a you might casually assume. Sometimes the beer. doctor’s verbal instructions their patients go The next morning the doctor calls in an unprocessed, forgotten, or misunderstood and anti-nausea medicine to help with upset the patient is then left to try to recreate on their stomach and vomiting, and another round It might be good own what those instructions were. This can be to listen to what of the antibiotics since the patient had lost the a problem because the doctor went to medical entire dose from the previous day. This time he he has to say. school for years. The rest of us didn’t. listened intently to the patient instructions. Let’s go over a simple problem that occurred in This one episode illustrates a few of the hundreds of things a pharmacy this week, and then got complicated. that go wrong from a lack of listening. The pharmacy is not here An elderly patient had been given a cream for nerve pain. just to hand out pills. We are here to help you get the most out The problem was probably a pinched nerve in the spine that was of the medicines your doctor has prescribed. The instructions causing problems in the upper thigh. The presentation of the and information we give out are intended to protect you and problem was a numbness and ice cold feeling in the inner part help you get better. So do your part and try to take to heart of the upper thigh. We know this is very close to a very personal as much of the information as you can. We also do not mind and very sensitive area. The patient’s assumption was that the having patients call back to clarify instructions. We know a lot prescribed gel should be applied to the location of the pain. Sounds of sometimes complex information comes with a prescription reasonable enough. But in this case treatment was needed where and it can be a lot to process when you already don’t feel good. the nerve is being pinched, not where the pain is presenting. We Pharmacies seldom mind repeating themselves, so utilize us as explained this in the pharmacy and I am sure the doctor did too. a resource to help you get better. + The next day the patient called back to the pharmacy and the conversation is repeated along with which topical products can Questions about this article or suggestions for future columns and cannot be applied that close to the personal area. Since the can be sent to us at cjdlpdrph@bellsouth.net patient didn’t seeem to understand that the goal was to treat where the pain was originating, not where it was showing up, mention Written for the Medical Examiner by Augusta pharmacists Chris and was made that an oral medication may be better in this case. That Lee Davidson (cjdlpdrph@bellsouth.net )

We apologize. William E. Durrett, Jr., M.D. Pain Management, Anesthesiology & Perioperative Medicine www.aikenpain.com / email: thepaincenter@aikenneuro.com

P / 803.642.6500 F / 803.649.7551 410 University Parkway, Suite 2360 Aiken, SC 29801

440 Society Hill Drive Suite 201 Aiken, SC 29803

Boardwalk to Bark Place Kennnel & Daycare welcoming dogs 40 lbs and under 5873 Huntington Drive Grovetown, Georgia (706) 840-3141 (706) 556-8127 www.boardwalktobarkplace.com

Unlike our big box drug store competitors, we do not carry motor oil, hammers, cigarettes, barbecue grills, picture frames, frozen pizzas, clothing, or lawn furniture. We apologize for any inconvenience.

ARKS

HARMACY

Hometown. Not big box.

437 Georgia Avenue, North Augusta, SC

803-279-7450 parkspharmacy.com

AUGUST 22, 2014

AUGUSTA MEDiCAL EXAMINER

DON’T LICK THE BEATERS Useful food facts from dietetic interns with University Hospital’s Augusta Area Dietetic Internship Program

sign of good hydration. Dark colored urine, say the color of apple juice, is one indicator of dehydration. (Note: you may also see darker urine soon after consuming vitamin supplements and some medications.) A good tip to remember is to not wait until you are thirsty to drink. Although thirst encourages you to drink, when you feel thirsty, the process of dehydration has already begun to some degree. At the sign of thirst, your body has already lost about 1% of the total water volume. So sip water regularly throughout the day. Dehydration may not seem that grim, but if it gets severe enough it can lead to dizziness, nausea, cramps, impaired thinking, and a dangerous drop in blood pressure. If drinking plain water is boring to you, try infusing the water with fruit to add a little flavor. Simply add your favorite fruit (or even vegetables like cucumbers) to your water, let it

sit for up to a day, and enjoy! There are many types of fruit fusion bottles and pitchers available that make fruitinfused water fun, delicious, and easy. Another fun tip is to use frozen fruit, like berries or grapes, instead of ice cubes to keep your water cool. Or, freeze fresh fruit in ice cube trays. To do this, put the fruit into each square of the tray, top off with water, and freeze. To add more fun and flavors, you can add fresh herbs like mint and rosemary to water as well. Experiment with different flavors to find your favorite, like strawberries and blueberries, orange with cranberries, or lime with mint. To add even more water to your day, choose foods that have a naturally high water content. Summer produce such as berries, melons, peaches, squash and cucumbers all have a high water content. Most weight management experts recommend a tall glass of water, whether it is sparkling, flavored, or from the tap, at the beginning of the meal to help curb your appetite and give your body a sense of more fullness. So, grab that water bottle and enjoy the results of being well hydrated, especially during the hot, humid days of August. +

GET THE CARE YOU NEED FROM KNOWLEDGEABLE PROFESSIONALS

STAT

lthough you can survive almost a month without food, the body can survive without water for no more than 5 to 7 days, and unlike other nutrients, water is usually not stored in the body. No matter how little we might exert ourselves, or stay indoors away from the heat, our bodies are still losing water through natural processes, like when we sweat, urinate, and with every breath we exhale. When it’s hot outside, we lose the water faster. If the water isn’t replaced, dehydration is the result. Hydration comes from drinking water or anything that adds water content to your body. But that doesn’t mean to reach for sodas and other beverages that have sugar in them. When you drink a beverage that has sugar in it, the sugar draws in water and quickens the urge to urinate more often. The more you urinate without replacing that water, the more likely you are to become dehydrated. Also, beverages that contain caffeine are not the best choices either. In effect, they are diuretics that pull water out of your system and lead to further urination. Speaking of urine, the best way to monitor your level of hydration is the color of your urine. Straw- or lemonadecolored urine is a

PAPER OR PLASTIC?

— Paige Adkins University Hospital Dietetic Intern

WE HONOR VETERANS

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recipe feature PAGE 7

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Swimsuit season... Is that the annual drive to lose weight and firm up so we can look good enough in swimwear to go bake in the sun on a beach or poolside and thereby raise our risk for skin cancer? Uh, can we rethink that? Here are some much better reasons to celebrate “swimsuit season.” • Live longer We might as well start off on a high note: the same kind of stuff that would offer the trivial benefit of looking better in a bikini or — perish the thought, a Speedo — is the same kind of activity that lengthens life. And the good news is that a mere 15 minutes a day can make a big difference.

• Have fewer migraine headaches. Anyone familiar with migraines knows that relief can be hard to come by. But a small 2011 study found that regular exercise worked just as well as medication or relaxation therapy at stopping debilitating migraine headaches before they start.

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• Lower your diabetes risk. Not that diabetes rates are skyrocketing or anything, but one study found that people who walk just 3,500 steps a day (there are roughly 2,000 steps in a mile) had a lower risk of developing diabetes than the people who walked the least in the study.

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• Strengthen your bones Regular, weight-bearing activity has been shown to build up bone strength, which prevents some of the natural decline in bone health often seen as we age. Weight-bearing activity — like walking — does the trick. • Get sick less Thank your walking shoes next time you’re the only one at the office who hasn’t caught that bug going around. Regular exercise seems to boost the immune system. Translation: fewer colds and bouts of the flu. • Decrease your cancer risk Let’s see... look good in a bathing suit or have a lower cancer risk... That is a certifiable no-brainer. The risk for certain types of cancer — colon cancer for one — seems to be significantly affected by regular physical activity. Other studies suggest that teenage and early adulthood exercise may protect against breast cancer down road. • Reduce your risk of stroke According to the National Stroke Association, up to 80 percent of all strokes are preventable. Lowering blood pressure and losing excess pounds help, but just moving more makes a big difference too. In a 2013 study, inactivity was linked with a 20 percent increase in risk of stroke. Experts say a moderate-intensity workout at least five days a week has the most benefit, but any and all exercise is a step in the right direction. • Sleep better A 2013 poll by the National Sleep Foundation found that people who self-identify as regular, vigorous exercisers got better sleep than their sedentary peers. Of the vigorous exercisers, just 17 percent said they got fairly or very bad sleep, while nearly half of the non+ exercisers reported the same. +

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If you prefer paper, we’re all over town. If you like our digital version, it’s always available on your favorite device at the Medical Examiner blog (www.AugustaRx. com/news) or online at www.issuu.com/medicalexaminer. You can easily view back issues, too. +

+ 10

AUGUST 22, 2014

AUGUSTA MEDiCAL EXAMINER

NEW

PET VET

FEAT

U RE

PREVENTING DOG BITES, PART ONE Believe it or not, more than 4.5 million people are bitten by dogs in the U.S. each year, almost 360,000 of them children (age 14 and below). Twenty percent of victims require medical attention, and more than 27,000 people wind up needing some type of reconstructive surgery. There were 31 dog-bite-related deaths in the U.S. last year. It sounds like a lot of bites, and it is, but when you consider that there are 70 million dogs, it makes you realize the problem could be a lot worse. The experts, however, say the problem could be a lot better. Dog bites are considered to be a largely preventable problem, and the solution falls mainly upon two parties, and guess what? They’re both human: dog owners, and dog bite victims.

This time we’ll talk just to and about dog owners. Preventing bites begins with dog owners selecting the right dog for their situation. That means everything from whether you’re home all day or gone all day; whether you have a ten-acre backyard or a condo with no yard. To illustrate, if you live alone, buy a large breed, and have a full-time job, your dog will be hard to control and have zero social skills. You may find it difficult to control your huge dog in situations that frighten him. A smaller dog who was accustomed to interaction with people would not find the same situations threatening, and if something did arise, you would be able to control it. Socializing is a “no time like the present” proposition. The earlier your

dog gets adjusted to unfamiliar settings, the better. Selecting a dog you can control at home and in public is the first step toward preventing bites. And you will want your dog to be in public settings. A dog whose only time outdoors is spent taking care of business in a tiny square of a tiny yard is a dog who is being neglected. “Walk the dog” should be a daily event. More than once a day, in fact. That’s not to say your dog needs a constant chaperone. Feel free to open the back door and turn him loose to do all the things dogs do. But another key

to dog bite prevention is having fences and gates that keep him contained. Or if not, a secure leash that gives him the run of the yard — and only the yard, not the neighbor’s yard or the public sidewalk. Getting your dog out into the world beyond your yard is taking him to both the scene of the crime in dog bite cases and the source of bite prevention. Getting out means your dog gets used to being around unfamiliar people, and where he learns to obey your commands, where he learns you’re the boss. Speaking of commands, they shouldn’t be delivered just to Fido. Give them to people too, including total strangers. If your dog has a nasty habit of putting on the face you see to the left, be sure to warn people who get a little too close for comfort. Someone who comes walking along may be a lifelong “dog person,” but your dog probably doesn’t know that. That person might get in your dog’s face, and he might return the favor. That’s why another antidote to dog bites is a sturdy leash and a collar. If the collar can slip off, it will, and it will

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uccess in investing or saving for future goals many times comes down to being aware of our natural behavioral instincts. The cost of making casual or spur-of-themoment financial decisions can be significant. As humans, we are hardwired with a number of traits that might have helped when we were cave men, but not so much today. One behavioral bias to think about and be aware of is the herd mentality. This term, sometimes called mob mentality, describes how people are influenced by their peers to make purchases, follow trends, and adopt certain behaviors. In a recent article by Michael Kitces, he noted an example of the herd mentality discussed in Robert Cialdini’s book, Influence: Science and Practice, which covers a wide range of research on what influences our behavior. He highlights one incident from Singapore in the 1980s when one day the customers of a bank began

withdrawing their money in a frenzy despite the fact there was no notable news and no apparent reason. As it turned out, the cause was surprisingly simple: a bus strike had created an abnormally large crowd waiting at the bus stop in front of the bank. Customers passing by mistook the large bus-stop crowd for bank customers waiting to make a withdrawal. Consequently, they got in line to get their money out too. The longer the line grew, the easier it became to assume that the bank was in trouble. The bank was forced to close its doors to prevent an actual bank run. Since uninformed herd thinking is probably the number one reason for major financial mistakes, there is a vast amount of research on the subject. In a recent newsletter, Jeremy Grantham commented on the herd mentality, noting “the enthusiasm of the crowd is hard to resist. Watching neighbors get rich at the end of a bubble while you sit it out

patiently is pure torture. The best way to resist is to do your own simple measurements of value, or find a reliable source. Then hero-worship the numbers and try to ignore everything else. Ignore especially shortterm news; the ebb and flow of economic and political news is irrelevant.” In making good decisions it is important to recognize this natural human tendency in our own thinking. It is easy to see how the herd mentality can factor into our decision making. The markets go down and people become more concerned. The media tells scary stories and we jump in with the herd. The market goes up and people get more excited. The media tells stories of people getting rich and we jump in with the herd. But

always be at the worst possible time, just like windshield wipers that never fail on bright beautiful sunny days. The leash needs to be securely attached at the other end, too — to you. Have a grip that won’t allow the leash to slip from your grasp if your dog makes an unexpected move on a squirrel or some other distraction. Back at the hacienda, experts like the friendly folks at the American Veterinary Medical Association don’t recommend playing with your dog in “highly excitable games like wrestling or tug-of-war.” He might decide to playfully wrestle with a small child in the neighborhood one day, and the child probably will not enjoy the experience (nor will your homeowners insurance provider and attorney). Spaying or neutering your dog can also even out his temperament and prevent bites. In summary, the keys to dog bite prevention are simple: practice the basics of responsible pet ownership. Next issue: how to avoid becoming some dog’s personal chew toy. +

making long-term decisions on today’s news is like trying to determine if global warming is fact or fiction based on today’s weather. To avoid this cycle, have a plan focused on your goals as the main driver of your investment strategy. This forces you to focus on the risk you are taking, and allows you to contemplate and understand how your portfolio responds to good and bad times. If you understand the risk you are taking and investing consistently based on your goals, then you will be less likely to follow the herd in stressful times. The most successful investors use this to their advantage. Look at investors like Warren Buffet who bought companies in 2008 and 2009 at the height of the financial crisis. Planning and contemplating risks ahead of time allows you to take advantage of others’ mistakes by not following the herd. + by Bill Cleveland, a Certified Financial Planner (CFP®) and CPA with Preston & Cleveland Wealth Management, LLC (www. preston-cleveland.com).

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AUGUST 22, 2014

11 +

AUGUSTA MEDiCAL EXAMINER

From the Bookshelf The blog spot – Posted July 31, 2014 at drgrumpyinthehouse.blogspot.com

MEMORIES It was the early 1970s. I don’t remember the man’s name. Maybe I never knew it. My Dad didn’t know it either, but he helped him. Dad was downtown, driving home from his law practice one afternoon. I don’t remember the time of year. He was stopped at a red light while people crossed in front of his car. One was an elderly man with a cane. One of his legs was shorter than the other, and so he had a shoe with a platform bottom on that side to support him. As he hobbled across the street, he tripped and fell, landing on his chest. The cane went flying, and he was unable to get back up. While he struggled to get to his feet the typical rush hour traffic began honking and [drivers were] yelling at him. Dad got out and helped the man up. The cane was gone, smashed by a car trying to beat the yellow light. He got the man to his feet, but without the cane he couldn’t walk. So Dad put an arm around the elderly stranger, and got him to his car. He put him in the passenger seat, figuring then he’d find out where he lived and drive him home. The man was scared, and badly shaken up. A stranger had just run out in front of traffic yelling for people to help him. And now he was in that man’s car. It was then that my Dad learned he didn’t speak a word of English - just Italian. Nowadays maybe people would have left the man lying there, called police on their cell phone, and driven around him. Or helped him to the edge of the curb and left him there for someone else to find. Or just not given a flip at all and continued honking at him. But Dad brought him back to our house. The first hint we had that anything was up was when Dad came in the carport door, supporting an elderly man I’d never seen before. As he explained what happened to my Mom, they got him to a chair at the kitchen table. Mom got him some water and a few band-aids for his bumps and scrapes. Dad went to the phone. A friend of his was a doctor whose father was an Italian immigrant. He reached him at his office as he was finishing up for the day, and the good doctor immediately called his father (who was fluent in both English and Italian) and they came to our house. While the doctor checked him over, his father spoke to the man, and they quickly got his information. He didn’t know the phone number of the building he lived at, but knew the address. It was a few miles from where he’d fallen, and he’d been on his way to the bus stop to go home when the accident happened. The doctor’s father drove the man home a short while later, though they stopped at the drugstore for a new cane. I never saw the man again, but the memory is still there. A frail looking elderly man in a black suit, white shirt, and dark Homburg hat. The one shoe with the platform bottom. Sitting at the formica table in our yellow Seventies kitchen. I don’t recall my Dad ever mentioning the events of that day again. I don’t think I even remember him talking to me directly about it while it was going on. But I learned a lot that day that I hope I never forget. +

He couldn’t speak a word of English.

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If you’re a regular reader of this newspaper, you’ve probably figured out that we’re not the biggest fans of Dr. Oz. He seems to be America’s favorite doctor — and to others, America’s favorite quack. If you’ve ever watched his daily television program (once upon a time the Medical Examiner himself was known to), you could be forgiven for thinking, “Dr. Oz could fill up a book like this every few days.” The sheer volume of magic pills, creams, herbal teas and life-saving exercises covered on that program each day require a DVR, a pause button, and a notebook and pen at the ready at all times. By contrast, Dr. Agus (who, it must be admitted in all fairness, has apparently been a guest on the Oz show), has filled 208 pages with solid, simple health advice — and this isn’t Vol. 1 with 25 more installments on the way. This is it. This is a book that, in large part (but not completely) could have been written by the worldclass editorial staff of your very own Augusta Medical Examiner. For instance, I’m not sure this

newspaper has ever printed a sentence containing the words “St. John’s wort.” Well, not before this moment, anyway. Not that there’s anything wrong with St. John’s wort. But you and I have heard people whose approach to health is so complex that Einstein himself would have trouble following the regimen. “Don’t ever consume citrus and dairy products in the same sitting - unless you also plan to load up on carbs and St. John’s wort tea within 30 minutes thereafter.” If you do an ocular exercise (an eye-roll) when you hear something like that, you might enjoy this book, full of simple yet

practical advice that promotes health. For instance, one of his rules is to wear good shoes. Granted, that doesn’t have the exotic appeal of brewing a tea from some Chinese herb that is only available online from a Canadian pharmacy. But Agus tries, and pretty much succeeds, to separate the helpful from the hypeful. The book is neither extreme nor dogmatic. In fact, Agus begins with several caveats that encourage readers to take the advice offered with a grain of salt (or salt-free substitute). Very few rules — that is how Agus labels his recommendations — apply to all of Earth’s billions. Added to that, science and medicine are evolving by the day, and the cutting edge advice of one year is sometimes discounted the next. In short (literally), this is a short and sweet general guide to good health. Being written by a doctor, however, it’s not stuffed with generalities. It’s basic but solid info. + A Short Guide to a Long Life, by David B. Agus, M.D., 208 pages, published in January 2014 by Simon & Schuster.

Research News This is your brain — on fish Maybe Catholics were onto something with their fish on Fridays regimen of old. That’s because UCLA research published in the current American Journal of Preventive Medicine reports that eating fish is great for brain health. Eating fish — even just once a week — is associated with bigger brains. The old nickname for fish, “brain food,” may not be too far off. Researchers found that the hippocampus, the brain’s large learning and memory center, is some 14 percent larger in weekly fish eaters compared to people who eat fish less often than weekly. That’s pretty significant, and suggests a major reduction in the risk of Alzheimer’s disease and dementia. The benefit was initially thought to be a by-product of omega-3 fatty acids in fish, but that didn’t pan out in lab tests. As a result, researchers aren’t sure if the benefit comes specifically from eating fish or if it’s the result of unidentified

lifestyle factors associated with the diet. But directly or indirectly, the fish connection is clear. There are important caveats. The type of fish appears to be unimportant. Fish is fish, as far as the brain is concerned. What is important is preparation: baked or broiled is the key. Fried fish offers no benefit. Pajamas that save lives That is the goal of an Israeli professor of chemistry at the Bar-Ilan University Institute of Nanotechnology and Advanced Materials. Aharon Gedanken is motivated by the sobering statistics on deaths from hospital acquired infections (HAI). Every year, some 90,000 Americans go to the hospital for one thing and end up dying from something else, something they acquired at the hospital. You may be thinking unwashed hands, unsterilized instruments, airborne pathogens in a place where there are hundreds of sick people. And

those are all bona fide sources of HAIs. But you might be shocked to learn that the biggest culprits can be a lot more mundane: gowns, pillowcases, curtains, sheets, and yes, pajamas. Textiles are among the most common conveyors of bacteria. Prof. Gedanken was involved in a project to make socks for soldiers that could be worn for a week between washings. The culprit behind smelly socks is bacteria. Eliminate that and you eliminate the smell — which is exactly what Gedanken did: develop socks with anti-bacterial nanoparticles embedded in the fabric. The technology Gedanken developed has been applied to many surfaces, including metals, polymers, ceramics, and paper. Even with glass, tests confirm the particles penetrate the glass and become part of the material. The same is true of textiles even after repeated washings, holding out the real hope that one day soon anti-bacterial materials — even pajamas — will be standard issue in hospitals. +

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AUGUST 22, 2014

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS

THE MYSTERY WORD

by Dan Pearson

How does having Because you can choose Then wouldn’t a What is this Ice Bucket It’s to raise icewater dumped on the icewater or you better option be Challenge that is you do that? suddenly everywhere? awareness for ALS. can make a donation. boiling water?

You make an excellent point.

The Mystery Word for this issue: TAST

Simply unscramble the letters, then begin exploring our ads. When you find the correctly spelled word hidden in one of our ads — enter at AugustaRx.com

EXAMINER CROSSWORD

PUZZLE

ACROSS 1. Spit 7. Ancient fortress in Israel 13. Ice river 15. ________ Ferry 16. Cooked but still firm 17. Fingernail 18. Acid beginning? 19. Charlottesville univ. 20. ____ Bee 24. Passageway 26. Female sheep 30. Type of run or balloon 32. Nonexistent 33. Sound of a BB hitting a bottle 34. Of tears 36. Twist and turn in pain 37. Keyboard key 38. Furnished with or operating by a valve 40. Something some people take into their own hands 41. Capital of Niger 43. Adjective for Hardie Davis 45. Start for a tot? 46. Pretense 47. Major eastside Atlanta avenue, for short 48. Once more 49. Put forward as an argument 51. Double S-curve molding 52. Title for Alec Guiness 53. Ball intro 55. Excuse 59. Originate; radiate (with from) 64. Emblems of royalty 65. Proposed candidate 66. Strip of pasta 67. Five-star, for example

VISIT WWW.AUGUSTARX.COM Click on “READER CONTESTS”

QUOTATION PUZZLE

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19 24

25 32

52 55

B E T L B U E D R A W O T O T W E B H O Y T I E O D D R I E A I R A O A N N S E B S V V N N G

47 51

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.

27. Would-be wit 28. Improve 29. Cockeyed 31. Abdominal organ 33. Before surgery, in short 35. Augusta park 36. Sept. 11 target 39. A of PSA 42. Cry of a cat 44. Bovine comment 46. Main artery of the body 49. Type of dust? 50. Abnormal mass 52. Exchange for money 54. Papa’s partner 55. As needed (in med.) 56. Flying Cloud auto maker 57. Self-esteem 58. A small amount 60. Louse egg 61. Black bird 62. Commandments intro 63. Brain activity ltrs.

DOWN 1. Campus org. 2. American start 3. Young boy 4. Type of storm we had in February 5. Stringed instrument of India 6. Hartford-based insurer 7. Pale bluish purple 8. Rectangular pier 9. Reagan “Star Wars” letters 10. Primary survey letters 11. Indian dish 12. Where the Wild Things ___ 14. Pertaining to part of the inner eye 15. Regatta entry 20. Hawks’ home 21. Pertaining to the Ural Mountains 22. Wink 23. Old sailor 25. Study of trees 26. Biblical high priest

— Frank A. Clark

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X A M I N E R

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9 2

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.

Solution p. 14

Use the letters provided at bottom to create words to solve the puzzle. All the listed letters following 1 are the 1st letters of each word; the letters following 2 are 2nd letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.

B 1 2 1

F 1 2

1 2 3

6 P 1

7 E 2 3

O 1 2 4

1 6

2 7

A 4 5 6

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1 2

7 — Benjamin Franklin

1 2 3 4

1.TAPTBFPYF 2.AROORROAY 3.EIEIEU 4.PLLP 5.AIA 6.RRN 7.IGE 8.N 9.G

SAMPLE:

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

L 1

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E 4

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WORDS NUMBER

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

AUGUST 22, 2014

THE BEST MEDICINE ha... ha...

new patient was waiting nervously in the examination room of a famous specialist. The doctor finally entered the room, chart in hand, and began to question his new patient. “So who have you seen before coming to me?” asked the doctor. “Just a chiropractor,” said the patient. “A chiropractor?” scoffed the doctor. “How quaint,” he added with a smirk. “Just for my own personal amusement, do you mind telling me what sort of useless advice that quack give you?” “He told me to come see you,” answered the patient. Patient: “Doctor, I think I’m invisible!” Doctor: “Who said that?” In his attempt to put a new patient at ease during a checkup, the gynecologist struck up a casual conversation. He happened to notice the label on her sandals read “Hecho en Mexico,” and they had a handmade, non-store-bought look, so he asked his patient, “So when were you in Mexico?” Flabbergasted, she asked, “You can tell that from a pelvic exam?”

There was a young lady who was five feet three inches tall and pleasantly plump. One day she had a minor accident, so her mother drove her to the emergency room. When the triage nurse asked for her height and weight, she blurted out, “Five-foot-ten and 125 pounds.” While the nurse pondered this information, the mother leaned over to her daughter and said, “Sweetheart, this is not the Internet.” A dentist completed work on a patient, who remarked gratefully that the procedure was completely painless. “Even so,” said the dentist, “would you mind screaming as loudly as possible?” “But why, doctor? It was a breeze.” “Because my waiting room is packed and I’ve got a tee time in 45 minutes.” A man went to see his opthalmologist one days and asked for his eyes to be tested. “What seems to be the problem?” asked the doctor. “I can’t see things far away,” said the man. “Well, let’s run a few tests,” said the eye doctor. First, he took the man outside and pointed to the sky, asking, “What’s that up there?” “Why, that’s the sun!” The optician said, “Good gracious, man, exactly how far do you need to see?” “Doc, my wife thinks she’s a chicken,” the man told the psychiatrist. “You should bring her in to see me.” “I would, doc, but we need the eggs.” +

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

+ +

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

13 +

AUGUSTA MEDiCAL EXAMINER

STATE

The Patient’s Perspective by Marcia Ribble

t last the casts are off and I can take a shower and wash my hair again! The old saying is that cleanliness is next to godliness. I’m not entirely sure that is a true statement, because I haven’t felt particularly godless while I couldn’t get my legs wet; however, I sure do feel a lot better when I am able to get into the tub and take my shower. I did wash up while I couldn’t take a shower, of course, but given the heat and humidity, it was hard to feel entirely clean. I felt cleaner than a lick and a promise, but not as clean as a shower provides. Unlike a lot of youngsters who avoid taking baths, when I was growing up I didn’t want to be in social settings where I wasn’t quite sure I was clean enough not to offend others. Could I pass the sniff test? I wasn’t sure, knowing that we can become unaware of odors if we’re exposed to them long enough. Would family members tell me, “You stink!”? It reminds me of my poor mother who lost her senses of taste and smell and who would ask us to sniff her underarms and tell her if she smelled clean. As a young adult it totally grossed me out, but it also taught me that sometimes people can’t tell if they smell badly. At the same time, I resisted the urge many older folks have to drown the possibility of reeking by dousing themselves with so much perfume that they actually do reek — of perfume. Sit near them in church, in meetings, in gatherings of all sorts, and smell the overwhelmingly dense drifts of their favorite scents. In some people (like me) their perfumes cause excruciating migraine headaches and nausea. That can send us fleeing to a place — any place — where there is

Talk is cheap. Not talking can be deadly.

no perfume. While excessive perfume is barely tolerable in large meeting rooms, it is intolerable in small spaces like cars. I have actually refused to drive with someone overly perfumed until they wash off the perfume or whatever contains it, like hand lotion, hairspray, deodorants, or even the laundry detergents they use. Men can be offenders just as much as women if they splash aftershave liberally over their faces, and then enter an elevator, which carries their scents long after they’re gone. Many of the products intended to remove odors from the air actually add odors that are equally offensive. In addition to migraine headaches, many people inhaling those particles face hours of coughing or wheezing from asthma as well. In one apartment complex I lived in, some well-meaning people plugged scents in the halls. After making complaints, I began to simply confiscate them and deposit them in the basement. Second hand scents can be as significant in impacting one’s health as second hand cigarette smoke. + Marcia Ribble received her PhD in English at Michigan State and retired from the University of Cincinnati. She taught writing at the college level, most recently at Virginia College in Augusta, and loves giving voice to people who have been silenced. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.

ZIP

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

TO OUR READERS AND OUR ADVERTISERS

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AUGUST 22, 2014

AUGUSTA MEDiCAL EXAMINER

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

EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC. WEST AUGUSTA Luxury 3 bdrm, 2 bath townhouse. Garage, quiet neighborhood off Pleasant Home Road. $795/mo. Call 706228-4655.

6.7.8

...cleverly hidden (in the car picture) in the p. 7 ad for COMFORT KEEPERS Congratulations to ROBERT OLIVER, 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 be the first to find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries you’ll score our goodie package! 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

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

1BR/1BA FURNISHED CONDO $950 partially furnished or $900 unfurnished. Pristine, hardwood, includes W/D. Walton Way close to GHSU. 706-7385606. Photos www.coolcondoforrent. wordpress.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.

HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706.267.9947

Augustagahomesearch.com Foreclosures • Rentals • MLS Roman Realty 706-564-5885

NOTICE! ATTENTION! If any current or past employer has failed to pay you min. wage or time and a half overtime pay, you may be entitled to an order from US Federal Court awarding you twice the amount of your unpaid wages plus atty. fees. For info, call Arthur H. Shealy, Attorney at Law, 803-278-5149, 1010 Plantation Rd, North Augusta SC 29841. You may be entitled to a similar award for unpaid wages if your employer required you to perform duties during your lunch hour, before clocking in, or after clocking out.

SERVICES HEALTH CARE - CNA offering in-home care: companion/assist with daily activities, light housekeeping, meal prep, assist with ambulation, medication reminders, grocery shopping, Dr. appts, errands, etc. Since each person’s needs are different, I will consult with you one-on-one to discuss your needs. CALL 706.833.9787 BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673) FULL-SERVICE MOVER Anthony’s Professional Moving, 28 years serving the CSRA moving hospital equipment, offices, homes, apartments, etc. Estimates are FREE. Call 706.860.3726 or 706.814.8141

TELL A FRIEND ABOUT THE MEDICAL EXAMINER! THE PUZZLE SOLVED

WHAT’S YOUR DRUG OF CHOICE? (OURS IS COFFEE)

Augusta Medical Examiner Classifieds

BUSINESS ASSISTANCE Ridiculously affordable and highly visible advertising available through the pages of Augusta’s Most Salubrious Newspaper, aka the Augusta Medical Examiner. Have you heard of it or seen a copy? Rates can be reviewed at AugustaRx.com. Questions? Send an e from the site, or call the publisher directly: Dan Pearson at 706.860.5455. E: Dan@AugustaRx.com

S A L I V A G L A C I E R A L D E N T E A N T A U N T A I T R I A L N L A C R I M A A L T V A L N I A M E Y T A T E R A A N E W P O S I R P R E T E X T R E G A L I A N O O D L E

CLASSIFIED ADVERTISING FORM Name Address Work number (if applicable) ( ) Home phone ( ) Category of ad (leave blank if unsure):

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Send this form with payment to: Total ad cost by number of words as shown above: $

T U M O R

A R E S K E W G E E E E G

QUOTATION PUZZLE SOLUTION: Page 12: “A baby is born with a need to be loved and never outgrows it.” — Frank A. Clark

The Sudoku Solution

COFFEE IS GOOD MEDICINE

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

AUGUSTA MEDICAL EXAMINER, PO BOX 397, AUGUSTA, GA 30903-0397

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QUOTATION

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

M A U V E

SEE PAGE 12

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

.25

S C U S L I L L V A I N C T S I G E N

VISIT DRUGOFCHOICECOFFEE.COM

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WORDS BY NUMBER “By failing to prepare you are preparing to fail.” — Benjamin Franklin

Multiply by number of times ad to run: x Total submitted: $

The Augusta Medical Examiner publishes on the 1st and 3rd Friday of every month. Your ad should reach us no later than 7 days prior to our publication date.

Thanks for reading!

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AUGUST 22, 2014

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AUGUSTA MEDiCAL EXAMINER

DO UNTO OTHERS… from page 1 is not specifically addressed, although there are regulations that do not carry the weight of law. Those guidelines suggest no child under the age of nine should be left alone. Georgia guidelines (not law) establish the minimum age as 8. The majority of states likewise offer guidelines only, ranging from 12 in Colorado to age 6 in Kansas. Until her laptop and its video games were stolen in a home burglary, the North Augusta girl was being left home alone which, as you just read, is legal (as it would be in Georgia). But what do you think is a better scenario: a child sitting alone inside an empty house watching television? or a child playing outside in the fresh air in a public park? Either option is 100% legal.

Perhaps you saw the recent back-to-back What Would You Do? and 20/20 programs which addressed this topic. A realistic doll was left in a parked car while hidden cameras rolled. As soon as bystanders noticed, the “mother” returned to the car. In one encounter, one of the women standing by her car said, “If that’s your baby I’m going to have to call it in.” Call it in. There are enough “call-it-in” tales to make your head spin at the website freerangekids. com. Many seem like overkill. Like the boy, 8, who walked out on a Sunday morning (with his parents’ knowledge), ostensibly to board a church bus, but who instead played Sunday School hooky. Someone saw him alone at a Family Dollar and called police. The father was arrested.

Or the woman who left her sleeping infant alone in her locked, air conditioned, running car while she darted into a drugstore. A person entering the store walked past the vehicle, saw the infant, and called police. At that very moment,

the woman was already in the checkout line. Store security cameras revealed the child was unattended for a grand total of about four minutes. Paramedics were called. Naturally, the child was perfectly fine, but the mother was charged with child endangerment. That would have been an appropriate response had the child been left alone for 40 minutes. But four? Without question there are unfit parents who deserve to have their children taken away and placed in a safe, clean, healthy environment. There are definitely times when police need to be called. But in the current 9-1-1-happy environment, parents who give no evidence of neglecting their child except for the one incident that sparked “the call” are being

arrested for what might happen or what could have happened. If that’s the standard, then statistically by far the most dangerous thing a parent can do that involves a car and their children is simply drive down the road, and we all do that. We also live in a place where most people claim Christianity as their faith. We have all heard of The Golden Rule: Do unto others as you would have them do unto you. Somehow, many of the recent cases seem like the polar opposite. Please don’t do that unto me. Which one of the scenarios on page 1 strikes you as coming closest to the ideal of The Golden Rule? If the situation ever presents itself, that is the one we should follow. +

PROFESSIONAL DIRECTORY DEVELOPMENTAL PEDIATRICS

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

DRUG REHAB

CHIROPRACTIC Poppell Chiropractic Clinic 1106-A Furys Lane Martinez 30907 706-210-2875 Most insurance plans accepted

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

Karen L. Carter, MD 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com

Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

DERMATOLOGY Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Augusta 30904 706-733-3373 www.GaDerm.com

Ideal Image 339 Fury’s Ferry Rd Martinez 30907 1-800-BE-IDEAL • www.idealimage.com Schedule a FREE Consultation

MEDICAL MASSAGE

Steppingstones to Recovery 2610 Commons Blvd. Augusta 30909 706-733-1935

EMPLOYEE BENEFITS

Group & Benefits Consultants Inc. 3515 Wheeler Rd, Bldg. C Augusta 30909 706-733-3459 Floss ‘em or lose ‘em! www.groupandbenefits.com

Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048

LASER SERVICES

FAMILY MEDICINE Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Thomson: 706-595-7825 Primary Care Rates

HOSPICE Alliance Hospice 3685 Old Petersburg Rd. Suite 145 Augusta 30907 706-447-2461

Medical Massage Stuart Farnell L.M.T. 803-646-1846 jsfarnell@att.net www.FarnellClinic.com

OPHTHALMOLOGY Roger M. Smith, M.D. 820 St. Sebastian Way Suite 5-A Augusta 30901 706-724-3339

OPTICIAN

PHARMACY

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

SLEEP MEDICINE Sleep Institute of Augusta Bashir Chaudhary, MD 3685 Wheeler Rd, Suite 101 Augusta 30909 706-868-8555

VEIN CARE

Murphy & Robinson Phil Harris 1571 Walton Way Augusta 30904 706-737-2020

...PHARMACY

O P T I C I A N S

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

PHC Weight Loss & Wellness Centers Medical Center West Pharmacy 246B Bobby Jones Expwy 465 North Belair Road Martinez: 706-868-5332 Evans 30809 Thomson: 706-597-8667 706-854-2424 Medical Services of America www.medicalcenterwestpharmacy.com www.phcweightloss.com Hospice 4314-E Belair Frontage Rd. If you’d like your medical practice listed in the Professional Directory, Augusta 30909 call the Medical Examiner at 706.860.5455 706-447-2626

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AUGUSTA MEDiCAL EXAMINER

AUGUST 22, 2014

Lost in the maze? Why enter in the first place?

We know the way. EMPLOYEE BENEFITS • COMPLIANCE • WELLNESS • CONSULTING • EXCHANGES • PARTNERSHIPS • TECHNOLOGY

RUSSELL T. HEAD, CBC, CSA-PARTNER • 706-733-3459 • E: RTHEAD@GANDBC.COM • WWW.GROUPANDBENEFITS.COM