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AUGUST 7, 2015

The Nepal Earthquake of 2015

The Tonsils

from Hell

“I was there.”

– by Alex Daitch

I had one kryptonite growing up: strep throat. Every year strep throat would come around and I would miss something major. I used to try everything to make myself sick so I could stay home from school, so much so that when I actually was sick, no one believed me. I was the girl who cried wolf. Strep throat, though, was one thing that everyone believed. I would have a high fever, cold sweats, bellyaches, swollen lymph nodes, and tonsils. I am now 23 years old and this past year I experienced a recordbreaking (for me) seven episodes of tonsillitis and strep throat. Seven times in one year qualified me for a tonsillectomy. Believe me when I tell you that my relationship with my tonsils had come to an end. Not to mention that my tonsils were huge. I don’t mean sort of big, or kind of huge, I mean colossal. So much so that everyone who looked at them was taken aback. Normally, kids with recurring strep throat have their tonsils removed at a younger age. Not me. When I asked my parents why they choose not to have them removed, they said that at the time, they were instructed by my pediatrician to keep them. That brings us to this year and getting a tonsillectomy at age 23. My ENT doctor, Dr. X, informed me that this surgery was no laughing matter. When adults get this surgery it takes them twice as long to recover. Okay, no offense, but I thought he was full of it. I am a tough cookie. I can handle this, right? We set the date and moved forward with planning the surgery. I planned to be out of work for a week and then be able to work from home or come into work part time. Surgery day came, and boy was I scared. I had never been in surgery before or under anesthesia. As I lay there in the prep room, the anesthesiologist and the doctors informed me that everything would go smoothly. I asked all the usual questions, like “What are the odds of death?” Please see TONSILS page 4

Photo for the Augusta Medical Examiner by Pritam Singh

Quaking in Kathmandu Editor’s Note: In June the Medical Examiner launched an occasional series called “World Medicine,” welcoming guest columns by any reader with a perspective of medicine and healthcare from beyond the borders of the U.S. Although Prakash Mishra has no connection to Augusta (he is a psychiatry resident in Cleveland, Ohio), he heard about the series and submitted this first-hand account of the earthquake which struck Nepal earlier this year. The article and photographs appear exclusively in the Augusta Medical Examiner. by Prakash Mishra Saturday morning, April 25, was a typical morning in Kathmandu. I was still lying in my bed that morning, awake and making my plans for rest of the day. I had to take care of necessary paperwork to start my residency training program in Psychiatry at the University Hospitals Case Medical Center in Cleveland. I had matched almost a month before in March, and to say I was ecstatic during those times would be an understatement. I was contemplating all these thoughts when I felt a shake,

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WORLD OF MEDICINE and before I could gather myself the ground started to shake so strongly that it felt that the whole house was about to come down on me. I panicked, but in an instant it occurred to me that I needed to run to save my life. Rushing outside, everyone I could see was shouting and charging to find an open space where buildings would not tumble down and crush them. I had never before experienced such chaos. The violent

shaking lasted approximately 45 seconds, and turned many houses into rubble. It later became known that an earthquake of 7.8 magnitude had hit central Nepal with the epicenter in Gorkha District of Nepal. Younger people and those on ground floors made it to safety earlier, but many were not so fortunate. Children and the elderly were trapped inside buildings and many lost their battle and were later found dead in the rubble. The extent of the damage was not evident for some time. Mobile networks Please see EARTHQUAKE page 3

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y a 5-4 vote, the Supreme Court of the United States Supreme Court in June narrrowly approved in Obergefell v. Hodges that all states must license same-sex marriages, and also must recognize same-sex marriages licensed in other states. For Georgia and several other states, the decision will mean a substantial departure from state laws which did not recognize marriages other than those of opposite-sex partners. Many of our clients have had questions over what impact this decision will have on their current and future benefits offerings. As with so many things, the answer is “it

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depends.” The following Q&A may help shed light on this complicated issue.

Q: I have a religious objection to gay marriage. What are my options?

Q: Must I offer spousal benefits to my employees’ same-sex spouse in the same manner that I offer benefits to my employees’ opposite-sex spouse? A: Probably, but not necessarily. While governmental employers are required to offer benefits to same-sex spouses on the same basis as opposite-sex spouses right away, private employers’ group plans are governed by other rules. For fully-insured groups, the decision will be determined by the carrier’s rules and state insurance laws. Most likely, one or both of these sources will require that all spousal and dependent coverage be uniform between both same- and opposite-sex spouses. Self-insured groups, however, have more freedom in designing their plans, including the definition of who will be eligible to receive benefits. As a result, a self-insured group plan may be designed to exclude benefits for same-sex spouses, but it should be noted that these plans may be at greater risk for discrimination lawsuits. Q: What is the timeline for enrolling newly eligible spouses? A: Little guidance has been offered as to the required timing of enrolling samesex spouses married before the court ruling. However, treating the new eligibility as a qualifying event is a safe route. Generally, the requirement to request enrollment is limited to 31 days following the event (in this case, June 26, 2015); however, some governmental employers are allowing enrollment of existing same-sex

A: Employers who do not wish to offer group benefits to same-sex spouses have limited options. As stated above, selfinsured groups may choose to design their plan to cover only straight spouses. Any group plan may choose to eliminate benefits to spouses altogether, eliminating any discrimination concerns. Q: What effect does this ruling have on payroll taxation of same-sex benefits? A: The costs of same-sex spousal benefits offered through cafeteria plans have been exempt from Federal taxes for some time. However, most states that chose not to recognize same-sex unions (including Georgia and, until recently, South Carolina) continued to tax the value of benefits for same-sex spouses. The court’s ruling will require states to exempt these amounts from state taxes as well. + For further explanation of information outlined in this article, please refer to the following resources: http://www.supremecourt.gov www.irs.gov www.healthcare.gov http://www.oci.ga.gov http://www.doi.sc.gov Russell T. Head is President/ Managing Partner with Group & Benefits Consultants, Inc., Augusta’s 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.

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EARTHQUAKE… from page 1

Photo for the Augusta Medical Examiner by Pritam Singh

What’s your story?

Photo for the Augusta Medical Examiner by Dr. Aakriti Goggireddy

Kathmandu, and the more traditional houses were completely destroyed in the quake. At around 12:56 PM on Sunday, April 26, there was another tremor of 6.8 magnitude, causing further damage, leading to additional trepidation and crises. I was in an open field and I was still scared to death. Many countries across the world extended helpful support to Nepal during this time of calamity. The Nepalese Army, volunteers, and numerous relief teams from foreign nations expedited relief work. The corpses were pulled out of the rubble. The silver lining was seen when an infant was pulled out of the rubble alive after multiple days. In a separate account, another woman was found alive inside of a badly destroyed building after more than three days. However, some were not so fortunate in their quest to survive and many lost their lives, limbs, and hard-earned properties. Many villages and towns in the central and eastern parts of Nepal had been ground to dust. Hundreds of thousands of people were made homeless. People continued to stay outside in tents. Schools and offices were closed. Hospitals were overcrowded and health professionals feared the spread of water and food-borne infections throughout the community due to open urination and defecation. After the third day the frequency of aftershocks had slowed. People started to move back inside their houses, but thousands had lost their homes and were in need of food and shelter. Many survivors voluntarily enrolled themselves into various organizations and started helping the relief teams to distribute supplies to the people in remote areas that had lost their source of income. My family and I Please see EARTHQUAKE page 6

Nearly all of us — even doctors and nurses — are sometimes patients. Perhaps you were recently injured playing your favorite sport, or years ago you somehow got hurt without even leaving your favorite recliner. Maybe you were diagnosed with a dreaded disease, mugged in a dark and lonely parking lot, or you stubbed your toe in the safety of your own bedroom. On the other hand, perhaps you needed medical attention 5,000 miles from home. Whatever your medical experience, we’d like to hear your story for our Medicine in the First Person feature. It can be frightening or funny, ordinary or extraordinary, just a few paragraphs long or quite a lengthy tale, bylined or anonymous. We’ll publish your encounters with the medical profession as often as we receive them. + Send your submissions for Medicine in the First Person to the Augusta Medical Examiner via e-mail: info@AugustaRx.com or to PO Box 397, Augusta, GA 30903-0397. (The Medical Examiner reserves the right to accept, reject, or edit any submission at its sole discretion.)

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were jammed due to the high call volumes being made to ensure the safety of loved ones. I tried to call my parents and sister relentlessly for three hours but could not connect with them. I was constantly praying for their safety. As I was gathering my composure, another shake occurred some 20 minutes later. This terrifying cycle continued throughout the day. Although not as violent as the first tremor, the aftershocks continued throughout that day, almost at regular intervals of 20 to 30 minutes. As news stations updated the death toll, rumors of an imminent and much bigger tremor than the first temblor began circulating. Hospitals were filled with the injured, mutilated victims, many of whom did not survive to see another morning. In the midst of disarray and fear, some decided to stay outdoors and began making arrangements to sleep in open-air tents. A few people returned back to sleep at their homes. The tremors continued to shake the ground and the survivors continued to pray for nature’s wrath to come to an end. I could not sleep the whole night, as the fear of another bigger temblor kept me awake. The next morning, news from surrounding districts reported death tolls to be close to 3,000. These districts were not as urbanized as

MEDICAL EXAMINER

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www.AugustaRx.com The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of news within every part of the Augusta medical community. Submit editorial content to graphicadv@knology.net Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com Augusta Medical Examiner photography: H + D Photography www.handdphoto.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397

(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net Opinions expressed by the writers herein are their own and their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., or its agents or employees take any responsibility for the accuracy of submitted information, which is presented for informational purposes only. For specific medical advice, diagnosis and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2015 PEARSON GRAPHIC 365 INC.

AUGUST 7, 2015

AUGUSTA MEDiCAL EXAMINER

TONSILS… from page 1 “What is the likelihood I will bleed?” They assured me that no one died under their watch having this procedure, and the bleeding percentage after surgery was only 5 percent. I was confident that everything was going to go flawlessly. The surgery took a total of about 20 minutes. Into recovery I went. When I awoke my mother graciously documented me saying my ABCs doped up on narcotics. I went to my parent’s house that day and began my medicine regimen. I felt okay, and honestly thought that I would only be under narcotics for three days, a week, tops. A week went by and I was feeling a lot better. I was off the heavy narcotics and decided that it was okay to go back to my own house. I was eating what I could and staying hydrated. Granted, if you have ever had this surgery as an adult, you can vouch for it being difficult as hell to drink or eat. But then at home one night I was lying on the couch when I suddenly felt as though I was going to puke. The second I lifted my head, I gagged and began spitting blood. The blood kept coming, flowing out of my mouth, scabs and mucus all dripping into the sink like the slimy scraps from an uncooked chicken thigh. Immediately my boyfriend called 911, and an ambulance showed up. By then I had gotten the bleeding under control. They informed me that I was rather calm considering my situation and that if I could drive or be driven to the hospital it would save me money. They then proceeded to discuss my furniture and home decor as I was sitting on the bathroom floor, bloodied towel in hand and blood-covered mouth hovering over the bloody toilet. Is it just me, or does that seem odd? I got a hold of my doctor and he informed me that drinking cold water would help stop the bleeding. It would restrict the blood vessels. If thirty minutes went by and the carnage continued, come into the hospital. Well, sure enough, after 15 minutes I was gagging blood again. As we arrive at the hospital — by now it’s 3:00 am — I feel worse and worse. I was having cold sweats, coughing blood into a towel and actually passing out in hospital chairs. When I got called back they immediately hooked me to an IV and had the doctors that were on call come in. They looked into my throat and realized that I had busted a blood clot. They informed me that they must go back in and cauterize the clot in order for the bleeding to stop. Lucky for me Dr. X’s assistant was on call, and the anesthesiologist was still there. They then informed me that the odds of bleeding after this would be only 1 or 2 percent. After surgery #2, I was not a happy camper. I was petrified. I went back to my parents’ house because I was once again on narcotics. That night I hardly slept and actually spat up blood again. There went the 1 to 2 percent. At this point I honestly wondered what else I could possibly go through. I was afraid to sleep; I was afraid to speak, or really even move a whole lot; I was afraid of bleeding again. I couldn’t eat and lost 15 pounds. Everything I ate made me sick or want to vomit. After another week (now we are at two weeks) I was still having trouble eating and talking. Another painful week went by and I could finally eat food other than soup. The first thing I went for was a cheeseburger from McDonalds. While eating the cheeseburger and realizing that I could actually chew and swallow with (relatively) minimal pain, I began to weep with joy. McDonald’s will do that to you sometimes. I had to go back to Dr. X’s office because even after three and a half weeks I was still having pain eating and swallowing. He informed me that chewing gum can help loosen the jaw muscles and help with the pain. If I had learned anything from this experience, it was that Dr. X was right, so I tried the gum idea. It worked! Unfortunately, in total it took my body over a month to recover from one surgery and one follow-up emergency surgery. All to remove the monstrous tonsils which resided in my throat. My only advice to those of you out there with kids who have recurring strep throat is, get their tonsils out earlier. Don’t wait till they are adults. It can be tragic. + — by Alex Daitch Augusta, Georgia

By this time it’s 3 o’clock in the morning.

READERS: Do you have a story to tell? Of course you do. Mail it to Dan@AugustaRx.com or, if you insist, to Medical Examiner, PO Box 397, Augusta GA 30903

OLD NEWS +

POINTS OF INTEREST TO FORMER KIDS by Trisha Whisenhunt, Senior Citizens Council

COLUMBIA COUNTY CITIZENS LAW ENFORCEMENT ACADEMY

ant to know what really goes on in the Columbia County Police Department? Then sign up for the Citizens Law Enforcement Academy, a free ten-week course open to all Columbia County residents age 18 or older. The program is designed to better acquaint the area’s residents with law enforcement and what the department has to offer to the general public. Some of the programs offered include the S.T.O.P.P.E.D. program. Parents can register their teen with the Sheriff’s Office through this program. If their teen is stopped while driving for any reason, the parents will receive a notification card with all the details concerning the stop. Another program is aimed at senior citizens who might want to volunteer with the Citizens Auxiliary Unit. This program uses community volunteers to provide assistance to the police department to help streamline efforts in providing public safety and promote peace of mind in the community. Other programs for seniors are the Senior ID Project, File of Life cards, and Senior Safety

Presentations. Once enrolled in the classes, you will be welcomed by Sheriff Clay Whittle and introduced to several of the members of the police force, including the K-9s. These dogs are amazing. Some of the tasks they are able to perform I wouldn’t have believed if I hadn’t seen it with my own eyes. Their energy level, dedication and loyalty is beyond words. I learned that almost without exception, our police and military dogs are trained in Europe and the officer in charge of each animal must learn to give him commands in the language in which he was trained. A tour of the county’s communications center revealed there is far more to dialing 9-1-1 than most of us realize. Each station has five computer monitors and each one contains a vital

piece of information. Once put together (in seconds), the station relays all the data for law enforcement personnel, fire department, or paramedics to be able to get to you in a timely manner. The operators receive ongoing training including secondlanguage courses and how to accommodate the hearing impaired. A reassuring note: any cell phone, as long as it can receive a signal, has the capability of putting through a 9-1-1 call. The companion tour of the jail was sobering. While the building is impressively clean, this isn’t a place you’d want to stay. Even visitation is harsh; there is no physical contact as inmates and visitors are separated by a concrete block wall with a small window. Meals are nutritious and calorie-correct. Showers, time out of the cells or outdoors and bedtimes are all strictly scheduled. There is a nurse on duty 24/7 and the “guests” are monitored around the clock. There are no weapons used within the jail, although the deputies are equipped with pepper spray. This course has something for everyone of every age. Much more is offered than I have outlined here. A wealth of information, free services and volunteer opportunities in the Sheriff’s Department are all offered. For more information visit www.columbiacountyso.org or call the Community Services Division at 706-541-2876. +

MYTH OF THE MONTH Giving kids too much sugar makes them go wild This is a wonderful myth when properly used because it shifts the blame for unruly children away from parents (if they aren’t the source of the sugar). Unfortunately, science does not support this one. In fact, a study published several years ago in the Journal of Abnormal Child Psychology was quite interesting. A group of children were given artificially sweetened Kool-Aid containing no sugar. Researchers told that fact to half the childrens’ parents; the other half were told the Kool-Aid contained sugar. The parents who thought their kids were riding a sugar rush reported them to be overactive

and uncontrollable. Every child, however, was wearing a sensor bracelet to monitor activity levels. They predictably showed no difference between the two groups of children. “I’ve seen this with my own eyes too many times,” counters an experienced mom. “Kids go crazy on too much sugar.” The study authors, probably parents themselves, explain that sugar overload often happens at parties and around holidays when rules are eased and excitement abounds. + — by F. E. Gilliard, MD, Family Medicine 639 13th St Augusta, GA 30901 706-823-5250

AUGUST 7, 2015

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW res?

k good eno r skin can ugh cer? son.” o

alph was a hospital orderly with purposeful thoughts. Hopefully, Jesus knew and understood him because most earthy beings did not think the way Ralph thought. Outwardly, he appeared to have only one toe over the line. He neither took drugs, shaved his head, nor grew a beard to advertise his uniqueness. The knowing look in his eye and the fact that he always spoke in italics gave him away. He knew every detail of the JFK assassination and said he was on first name basis with a mafia bagman and therefore had access to marvelous dark conspiracies that made The National Inquirer look pale and unimaginative in comparison. Occasionally, he whispered secrets in my ear. Being the mischievously jovial soul that I am, I felt compelled to stoke the fires of controversy. I ordered a pair of oversized clown shoes from a novelty shop and recruited Linda, the lady who ran the hospital laundry, as a co-conspirator. We cut the legs off one pair of white pants and sewed them onto the bottom of another pair of white pants, the biggest we could find. After starching and pressing them perfectly, we hung them in plain view above the clown shoes and attached a note: CLASSIFIED. DO NOT TOUCH!!! As if notified by the CIA, Ralph was waiting when the laundry opened at 6 o’clock the next morning, ostensibly to get new whites. Within seconds his laser eyes homed in on the giant pants, clown shoes, and the ominous note. “What’s that?” he whispered. Suspicion enveloped his voice. “Oh, that’s nothing to worry about,” Linda assured him. . Later Ralph yanked me aside. “I saw something in the laundry I wasn’t supposed to see. Something’s going on they don’t want us to know about. Something bad.” “What did you see?” k

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“Special uniform. For a giant. Special shoes with secret compartments. Eight feet tall. 450 pounds, I figure.” I barely contained my laughter. “That is probably just someone playing a joke. Go ask Linda. She’ll tell you.” “Already did. She’s in it up to her chin. Got her ass in a sling.” “Ralph, I think you’re blowing this out of proportion.” “Nope. Don’t think so. Most likely it has to do with that new off-limits construction area.” “That is our new ICU.” My belly jerked with hilarity. “Ok, yeah? They’re just telling you that so you won’t check it out. Tonight, I’m in there. Tomorrow, I’ll have the straight skinny.” “It is off limits for legal reasons. They don’t want a lawsuit from someone getting hurt during construction.” “Yeah. Right. Tomorrow. You’ll see.” “Ralph. Don’t go. You might get hurt. Or arrested. It’s just a joke.” He looked at me with a pitiful eye and was gone before I could breathe.

t s e B “Ralph, the Administrator gave me a key to the new construction site. Let’s go over there and I will show you there is no Russian spy.” “I already know there is nothing there. Checked it out myself.” “Good. I’m glad you figured out nothing is happening.” “The Russian spy is gone. Took his clothes and everything. They flew him out in a helicopter last night.” “You saw that?” “Nope. Girlfriend down at the Pancake House saw it. Sounded like one of them CIA Black

e n i c i d ME

Hawks.” “That was a MedEvac helicopter transporting a wreck victim to the trauma center. I helped load the chopper myself.” His eyes narrowed. Mental wheels spun. He made calculations and reached conclusions. With a sudden knowing look, he slowly backed away for me. “Damn. Would’ve never believed it in a million years. You’re in this, too.” Ralph never spoke to me

again except in job related situations. I miss him. Life is duller now that I screwed up a friendship. When you think someone is more than half a bubble off level, be careful what you do or say. You might lose a friend. You‘ll miss them more than they miss you. Besides, they think you are little off center, too. And they may be right. + Bad Billy Laveau is a formerlyretired MD who wields a pointed sense of humor and now, tongue depressors too. He speaks and entertains at events for audiences not subject to cardiac arrest secondary to overwhelming laughter and glee. BadBilly@knology. net or 706-306-9397.

Linda and I shared boisterous laughter as I reenacted my conversation with Ralph. She assured me she had told him it was all a joke. Then we laughed some more. Enough was enough. It had to end. We burned the clothes, shoes, and sign in the hospital incinerator. Ralph trapped me in a stairwell the next day. “Told you it was something special! They got a Russian spy in lock-up. One of my contacts takes him three trays of food each meal. He eats it all. Sleeps on two beds wired together. I’ll do some more research tonight. Fill you in tomorrow.” Poof. He was gone before I could get my tongue in gear. The next morning I was determined to undo the mess I had created.

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EARTHQUAKE… from page 3 reunited in the following days of the main shock and decided to help the victims in need. We established health camps using donated funds and tried our level best to support the sufferers. The tremors continued, but they were not strong enough to shake the faith of the people. But on May 12 at around 12:50 PM, another strong quake of 7.3 magnitude hit central Nepal with its epicenter near the Nepal-China Border. As we had done on April 25, we again ran for our lives. However, this time the major difference was that people were not taken by surprise, and though there was more physical damage to buildings and monuments, there was much less loss of life. This time around the impact was much more psychological. People who were trying to finally emerge from the ordeal of the first episode could not trust their surroundings any longer. People could not trust the ground beneath their feet. The casualty count increased to 8,857 dead and 22,304 injured in Nepal alone. Many relief workers lost their lives while attempting to rescue the victims, including a U.S. military helicopter crash that occurred on May 12. When I left Nepal on June 4 to begin my residency, the aftershocks were still shaking the ground. I put all my prayers

before my flight took off and sincerely hoped that peace, prosperity and stability comes back to my country. Now, weeks later aftershocks still continue to terrify the people. The frequency has decreased but the fear is still there and will be there for a long time to come. Children have started to go back to schools, but they have many questions that are still not answered. The impact that it will create on their mental development is beyond repair. People are trying to get back to normal life, but rumors of a much bigger temblor continue to petrify everyone. Victims and survivors are suffering from psychological problems such as anxiety, nightmares, insomnia, flashbacks, and depression. Many lives have been lost and many historically significant monuments irreparably damaged. Nepal is a mountainous country and agriculture and tourism are major sources of income. The impact from the damage is certain to effect tourism and tyhe overall economy. Many fear that Nepal has been pushed back economically by several years. One virtuous aspect that I can take away from such a tumultuous tragedy, is the resilience shown by the Nepalese. They have shown a tremendous ability to bounce back from this tragedy.

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Families have come together, and people are willing to help their fellow countrymen. Political instability may hamper progress, as politics have been volatile for nine years, since Nepal was declared a republic. Despite this, visionary Nepalese people are making preparations to be able survive a catastrophe of similar magnitude in the future. Nepal lies in a seismically unstable zone and a major earthquake has affected Nepal about every 80-90 years. Emergency preparedness plans need to be formulated and implemented to better protect us and future generations. Nepal is grateful for the support from concerned nations around the world to help us rebuild our nation. For me, I have started my residency at the University Hospitals. I am happy to have embarked on my new journey, as I am living my dream of being trained as a psychiatrist at one of the most prestigious programs in the United States. The earthquake indeed has changed my life forever in many ways that I don’t fully appreciate yet. I am learning the art of mental health, and I believe that from my own experiences during this tumultuous event, I will be better able to relate to the symptoms of patients who have

Photo for the Augusta Medical Examiner by Pritam Singh

undergone traumatic events in their life. It is never easy to come out of such ordeals, but then a positive outlook is always what carries one in the forward direction. I hope that the survivors and the victims in Nepal find enough courage within themselves and utilize this time of despair to build a stable and safer tomorrow for the future generations. +

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Who c ares? APRIL

18, 20

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Be it resolved...

re you a New Year’s resolution fan? Or a resolution hater? Both sides in this annual discussion have their valid points. On the negative side, by the time you read this many carefully made resolutions may have already slipped a little. Statistically, by this date (January 9) 25 percent of all resolutions have already gone down in flames; that many usually fail within the first week. By the six-month mark the failure rate is about half. And by this time next year, the wreckage of 88 percent of all those shiny new intentions of last week’s New Year’s Day 2015 will lie strewn across the landscape. On the plus side, that means a fairly decent 12 percent of all resolutions are achieved after a full year. Building on that positive note, making New Year’s resolutions is evidence of one of the finest aspects of human nature — that we continuously evaluate ourselves and constantly strive to improve, to be better husbands or wives, better moms and dads, better employees, better bosses, and just better human beings. The typical resolutions reflect those basic desires: the #1 resolution every year is always some form of better health. Lose weight. Get more exercise. Eat less junk food or fast food. Eat less, period. Quit smoking. Drink less, or quit altogether.

-HOM E CO P Y! TM

• MED

JANUARY 9, 2015

ICINE

• WEL

LNESS

Who is this? See page 3.

S Specific

M A Measurable

Achievable

You really can’t fault anyone for such noble goals. After all, health is the ultimate wealth. It’s the currency that makes every other endeavor in life possible. Speaking of currency, improving finances is, broadly speaking, the second most popular resolution category. Common examples include establishing and/or sticking to a budget; saving more; cutting impulse buys; getting a better job, a raise, or a promotion. The third-most common resolutions might be categorized as self-improvement: read more; temper control/ anger management; reduce or manage stress; watch less TV; get more education: learn a new language, skill, or hobby; improve your marriage and other personal relationships, and so forth. All of these are worthy goals. They are well worth pursuing, even if that means getting past occasional setbacks. Since failure is always an option, it’s good to expect it and be ready to keep making progress. There is nothing magical about January 1. If you haven’t made some kind of self-improvement goal, it’s never too late. If you’ve started and failed already, restarts are always allowed. Whatever you set your sights on, keep the letters shown below in mind, as well as what they stand for. Please see RESOLVED page 2

Relevant

Time-specific

New year. Old scrubs? We can fix that. (706) 364.1163 • WWW.SCRUBSOFEVANS.COM • 4158 WASHINGTON RD • ACROSS FROM CLUB CAR • M-F: 10-6:30; SAT: 10-4

MEDICINE IN THE FIRST PERSON Everybody has a story. Tell us yours! 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. Tell us if you want it “by you” or if it needs to be anonymous. Thanks!

AND CALL ME IN THE MORNING. Prefer paper? We’re all over town. If you prefer our digital version, we’re all over the world. The Medical Examiner is always available on your favorite device at ISSUU.COM/ MEDICALEXAMINER or at the Medical Examiner blog (www.AugustaRx.com/news) on issue dates. Click directly from any Examiner page directly to websites listed in ads and articles. You can easily view back issues, too. +

Read the Examiner — and lots more — online at AugustaRx.com/news

AUGUST 7, 2015

AUGUSTA MEDiCAL EXAMINER

Southern Girl Eats Clean Peach Granita... A Cool Summertime Treat

One family of providers.

Everything you need.

Peach Granita Peaches are plentiful in Georgia and South Carolina in the summertime. They are my absolute favorite fresh fruit, and one of the best ways to enjoy them in hot summer weather is in a peach granita. Granita is a coarse, Italianstyle flavored ice This granita is made with delicious peaches from just up the road in Johnston, SC. The variety that I prefer is the O’Henry peach. They are firm and not mushy at all, but very, very sweet. I decided that rather than making peach ice cream (traditionally Southern) that I wanted to do a granita or an Italian ice. Granita is a much lighter dessert and as a personal preference, I try to stay away from dairy as much as possible. This dessert was fabulous and it came together in no time. It is super-quick and an easy-peasy recipe for sure! This peach granita will be a fabulous light dessert for a summer barbecue or as a cool refreshing treat in the 90 plus Georgia heat that we’ve had the last few weeks. Enjoy! Ingredients: • 4 or 5 ripe peaches, peeled, pitted and coarsely chopped • 1⁄2 cup of filtered water • 3-4 Tbsp. of light agave nectar

• 1 Tbsp. of freshly squeezed lemon juice • A pinch of sea salt or Real Salt brand • 1 Tbsp. of finely chopped fresh basil Directions: 1. Place the chopped peaches, water, agave nectar, lemon juice and salt into a high speed blender. 2. Blend the mixture until smooth, approximately 1 minute. 3. Taste and add more agave if you prefer. (I used 3 Tbsp., but you may add more if you like it sweeter) 4. Pour the peach mixture into an 8 X 8 square baking dish. 5. Place into the freezer and freeze for 3-4 hours....scraping with a fork every hour. 6. The mixture should be light and fluffy. 7. Place the granita in 4 small serving bowls and sprinkle with chopped basil. 8. Serve immediately. + Inspired by a recipe I found at www.marthastewart.com 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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MEDICAL EXAMINER IS ONLINE • www.AugustaRx.com/news • Scroll down past blog entries to issue dates

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Pharma cy 4 11

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:

CAREERS IN PHARMACY

re you looking for a new career? Can’t decide what to do with your life? Maybe you should consider pharmacy as an occupation. Make no mistake, pharmacy is not an easy career. You must be very serious and attentive to detail. Remember, people’s lives are at stake and you must be accurate at what you do. Whether you are looking for a job as a pharmacist or pharmacy technician, there are jobs available in most geographical areas. Pharmacists are needed across the country in a variety of positions from retail and hospital pharmacists to insurance company employees. Pharmacies in retail stores and hospitals are in need of quality technicians. Training requirements can range from on the job training to a certificate or diploma program at a local junior college. These programs will give an applicant experience in math and drug information, among other topics. These are valuable skills to have for pharmacy jobs. People looking to attend pharmacy school should be prepared to apply to a school of pharmacy with a GPA at least in the 3.5 to 3.7 range during the two years of pre-pharmacy courses. Relevant extra-curricular activities are a definite way to set your application apart from the crowd. Usually candidates are required to have an interview to ascertain an applicant’s communication skills, so be prepared to make a showing and prove you are a “people person.” To be successful in pharmacy school you need to be comfortable with math and science courses. Courses include units on human anatomy, physiology and microbiology. So, with all the math and science, is pharmacy school worth it? If you look at entry level salaries the answer is a definite yes. The shortage of pharmacists and the subsequent demand have pushed salaries up in the past decade or two. While the salary range is not as large as some occupations, there is still room for pay raises after the high entry level salary. Another plus is that one can still have a positive impact on patient’s lives and can

THAT’S WHY WE’RE HERE.

ARKS

Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson. Questions, comments and article ideas can be sent by email to cjdlpdrph@bellsouth.net

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make a difference in people’s overall health even though you are not a physician. Many want to be pharmacy technicians, but few are serious enough to be good at the job. A pharmacy technician has tremendous responsibility even though their work is checked by a pharmacist before being dispensed to the patient. Technicians must be serious and attentive to detail. Technicians have a wide range of salaries depending on the position. Retail positions may start low, but a diligent and conscientious technician will be rewarded with a higher salary in the end because they can stay at one company for a number of years and salaries will increase over time. Hospital techs need intravenous admixture experience and can receive a higher salary for completing pharmacy technician courses. Hospital technicians generally have more varied experiences (IV, chemo, etc.) than do retail technicians, and they start at higher salaries as a result. If you want to pursue a pharmacy technician education program, be sure to check the reputation of the institution’s program. A degree means nothing if you don’t have the knowledge that should come with the degree. Pharmacy is a good choice for people to consider due to the high demand and the higher salary compared with other jobs at equivalent levels in other career fields. There are currently many available options in pharmacy. Whether looking at technician or registered pharmacist positions, there are the traditional options of hospital and retail jobs, as well as auditors and formulary advisors at insurance companies. Employers are often willing to be flexible in scheduling due to current shortages in staffing. For anyone who is interested in just putting a toe in the water, try to find an employer who will let you shadow or observe a position you are considering. +

Plus... 600+ doctors offices throughout the area for staff and waiting rooms, as well as many nurses stations and waiting rooms of area hospitals.

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.

• 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

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AUGUSTA MEDiCAL EXAMINER

Ask a Dietitian FOLIC ACID AND PREGNANCY by Deanna Shade, MS, RD, LD Georgia Regents University Medical Center

Having a healthy baby means having a healthy diet with sufficient amounts of folic acid. Folic acid, also known as folate, is a B vitamin that is essential for growth and development. Everyone needs folic acid, but it is especially important for women. Getting enough folic acid reduces the risk of birth defects in a baby’s brain and spine called neural tube defects. About 3,000 pregnancies are affected by neural tube defects each year in the United States. Some studies show that folic acid can even reduce the risk for congenital heart defects. Neural tube defects occur during the first 28 days of pregnancy, most often before a women knows she is pregnant. Since only about half of all pregnancies are planned, every women capable of becoming pregnant should take folic acid regardless of whether she is planning on becoming pregnant or not.

of becoming pregnant should consume 400 micrograms of folic acid per day (from supplements and/or fortified foods) in addition to normal dietary intake. The recommended dietary allowance (RDA) for pregnant women is 600 micrograms and the RDA for lactating women is 500 micrograms to cover the amount of folate secreted in milk. What foods are high in folic acid? Folate is found naturally in food, while folic acid is found synthetically in fortified

foods and supplements. Foods highest in naturally occurring folate include vegetables (especially dark green/leafy vegetables like spinach, asparagus, and Brussel sprouts), fruits and fruit juices, nuts, beans, peas, dairy products, poultry and meat (especially liver), eggs, seafood, and grains. Synthetic folic acid is found in fortified grains which include flour, rice, breads, rolls and buns, pasta, corn grits, corn meal, and noodle products. In an effort to ensure that women consume adequate folic acid, the Food and Drug Administration mandated folic acid fortification of all enriched cereal grain products in 1996. Take a look at the cereal in your cabinet and you will find folic acid on the ingredient list. It is important to note that the absorption of synthetic folic acid is 1.7 times greater than that of natural food folate. Scientists are still learning about the benefits of folic acid and in fact, they aren’t completely sure how folic acid contributes to the prevention of neural tube defects. They do know, however, that it is crucial for DNA synthesis and new tissue formation, making it a must for the health of both women and developing infants. + by Deanna Shade MS, RD, LD Completed Master’s thesis on intake of folic acid in woman of childbearing age. Pediatric Clinical Dietitian Georgia Regents Medical Center dshade@gru.edu

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HOPE Through Adversity by Helen Blocker-Adams

EDUCATION AND ITS IMPACT ON OUR MENTAL HEALTH

y the time this column hits the newsstands, our young people in Richmond and Columbia counties will have started the 2015-2016 school year. The children are asking, where did the summer go? Parents have probably been saying the summer didn’t pass fast enough. I have always been an advocate for pursuing an education – whether it’s a technical school, liberal arts college, a 2- or 4-year degree. As an instructor at an area career College, I am witnessing students with a variety of health and/or personal issues that negatively affect their ability to focus, learn, and sometimes, stay in school. The myriad of personal, family, financial and health problems facing people from all walks of life is staggering. Can you imagine making a decision to pursue higher education and then four weeks into the semester, a close family member unexpectedly dies? Not only is it hard to focus on school and study — at least temporarily — but for some it’s hard to recover even with the passage of time. Missing too many class days creates another set of problems that can be difficult to overcome. What if you woke up and didn’t eat breakfast at home and weren’t able to get to school in time to eat the morning meal

AUGUST 7, 2015

AUGUSTA MEDiCAL EXAMINER at school? Children all over the area are in that condition through no fault of their own. It’s hard to function on an empty stomach, wouldn’t you agree? Yet despite (or because of) life’s challenges, we have to keep pressing forward so we can reach our goals and objectives. According to a study from Child Trends, 1 in 5 adolescents (20%) has a mental health disorder, yet 60% to 90% of them do not seek medical treatment. That is another group of people with genuine health challenges that affect their ability to learn. As parents, educators, mentors, family members, friends, colleagues and everyone in between, we must have or develop a sense of empathy to effectively deal with the challenges facing young people today. We can no longer sit on the sidelines and think things will get better by themselves, because they won’t. This generation needs everyone to get on board. Whatever part you can play a part is better than not participating at all. Think about it: your mental health can be adversely affected if we don’t take care of the current generation. I hope in this upcoming school term, you will find in your heart to play a role in the mental health of a young person or two. Giving and serving from the heart is always a good thing. Our youth are depending on us. + Helen unBLOCKer Adams Educator, Life Coach/Mentor, Life Agent, Author, Transformational Speaker, Social Entrepreneur www.workinginlife.com www.twitter.com/hbadams www.facebook.com/helenblockeradams www.linkedin.com/ helenblockeradams

PET VET Y

PAIN MEDS FOR PETS: KNOW THE RISKS

our 9-year-old German Shepherd is limping, and you think that arthritis may be setting in. A trip to the veterinarian proves that you’re right — it’s osteoarthritis, a degeneration of cartilage and bone that affects joints. The veterinarian prescribes a non-steroidal anti-inflammatory drug (NSAID). NSAIDs are a class of drugs extensively used in both human and veterinary medicine for their anti-fever, anti-inflammatory and painrelieving properties, and they are the most commonly prescribed pain relievers for animals. Inflammation—the body’s response to irritation or injury—is characterized by redness, warmth, swelling, and pain. NSAIDs work by blocking the production of chemicals produced by the body that play a role in inflammation. NSAIDs are the cornerstone of osteoarthritis therapy in dogs,” says the Food and Drug Administration (FDA). Some NSAIDS are also used to manage pain after surgery in both dogs and cats. No NSAID has been approved for long-term use in cats. NSAIDs carry risks as well as benefits, however, and all dogs and cats should undergo a thorough physical examination by a veterinarian—including a complete discussion of the

pet’s medical history— before beginning NSAID therapy. It’s also important that you talk to your veterinarian about possible side effects, including those that could signal danger. Risks and Side Effects NSAIDS are associated with gastrointestinal ulcers/ perforations, kidney, and liver toxicity (damage done by exposure to medications or chemicals) and must be used cautiously in animals with pre-existing kidney or liver problems. Because most liverassociated toxicities occur during the first three weeks of use, it’s especially important to closely monitor the results of blood tests during the early stages of long-term NSAID treatment in dogs. Also, before starting long-term treatment with NSAIDs in dogs, blood tests should be conducted to establish baseline data, and those tests should be repeated on a regular basis. McLean recommends that you talk with your veterinarian about how often this blood work should be done. Some of the most common side effects of NSAIDS in animals reported to FDA are: • vomiting • decreased to no appetite • decreased activity level • diarrhea While your pet is taking NSAIDs, continuously

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monitor for these side effects, as well as looking for blood in the feces, tar-like stools, yellowing of the whites of the eyes, or yellowing of the gums. If you see these, call your veterinarian immediately. Other reported side effects include stomach and intestinal ulcers, intestinal perforation (a hole in the wall of the intestine), kidney failure, liver failure and death. Giving two NSAIDs at the same time, or giving an NSAID with a steroid, such as prednisone, can significantly increase the risk and severity of side effects, especially gastrointestinal toxicity. Risks associated with NSAIDs are detailed on the all package inserts and the client information sheets that accompany all FDA-approved veterinary oral NSAIDs. Are NSAIDs for People Safe for Pets? It’s not unusual for pet owners to want to give their animals NSAIDs or acetaminophen (Tylenol and other brands, which are not NSAIDs) straight from their own medicine cabinets. However, some over-thecounter (OTC) human pain relievers can be toxic, or even deadly, in pets. Check with your veterinarian first if you want to give your animal OTC human drugs. Similarly, pet owners should not assume that a medicine that is safe for one animal is necessarily safe for another. Communication with your veterinarian is essential. Before giving your animal an NSAID: • Make sure you know what the medication is being prescribed for, how much to give and how long to give it. • Discuss possible side effects and symptoms, especially those that require an immediate call to the vet. • Tell your veterinarian if the pet has a history of gastrointestinal problems, such as stomach ulcers, or surgery on the stomach or intestines. • Tell your veterinarian if your pet is on any other medications or supplements. + — Source: FDA.gov

Looking for something in a Medical Examiner back issue? “In times of rapid change, experience could be your worst enemy.” — J. Paul Getty

Visit issuu.com/medicalexaminer for the largest collection of Examiner back issues anywhere in the world.

AUGUST 7, 2015

11 +

AUGUSTA MEDiCAL EXAMINER

From the Bookshelf The blog spot — Posted by psychiatrist Allen Frances on October 6, 2014. Edited slightly for space.

HOW DO YOU TALK TO A PATIENT WITH TERMINAL CANCER? NOT LIKE THIS. A friend of mine has been living well with lung cancer for five years — working, running several miles a day, traveling, doing good stuff with his family, and generally enjoying the pleasures of everyday life. He knows the cancer will eventually kill him, but has been making the most of every remaining minute. Then, a month ago, things suddenly turned dramatically south. Severe shortness of breath, constant coughing, sleeplessness, fatigue, loss of interest, anxiety. My friend figured the jig was finally up — that he was going terminal. We all felt sad in the face of this inevitability. In our different ways, we began the painful process of saying goodbye. Then things seemed to get even worse. I accompanied my friend to visit his lung doctor — an amiable and thorough man who spent lots of time with us, took a good history, and did many tests. We gazed expectantly as the doctor came back into the consulting room and began gravely summarizing his findings. He brought what seemed to be terrible news: “I am really worried about you. Your oxygen saturation has dropped below 90 and your breathing is suddenly getting much worse. This kind of sudden deterioration can be caused by one of four things — pneumonitis from your previous radiation treatment, pulmonary embolism, pericarditis, or infection.” My friend had been as low as I could imagine before the visit. But now his face went white, his mouth sagged, he began to tear up, and the shortness of breath and cough became more palpable. Death seemed about to suffocate him. “Wait a minute, doc,” I said. “Are you saying the cough and reduced oxygen are not caused by the cancer.” “Right. I checked all the scans and the cancer hasn’t changed at all. It can’t be causing this.” “And how treatable are these four new possible causes?” “Very. We have to do some more tests to figure out which it is. Probably pneumonitis and that’s easy to treat with low dose prednisone. The other things are also very treatable. My guess is that he’ll be fine in a week or two.” With a new lease on life, my friend returned quickly from death’s door. The transformation was immediate and unmistakable. I have never seen a human being change demeanor so fast. Face filled with joy, he thanked the doctor for inspiring such confidence. There was a renewed bounce to his step as we left the office that I had never expected to see again. Even more remarkable, my friend’s cough and shortness of breath began improving almost at once. There is a strange healing power in a doctor’s words that has allowed doctors to help even when their treatments were ineffective or harmful. Reduced fear and renewed hope are wonderful medicines. The doctor had certainly done a lot of things very right — and one thing that was incredibly stupid. He should have entered the room with a bright smile and said something like: “Congratulations. Great news: It’s not your cancer causing these new problems. There are four different possible explanations, all of them minor and you should be feeling much better within a couple of weeks.” How could a smart and caring doctor say such a dumb thing to so vulnerable a patient? Simple. We overtrain our doctors on the overvalued technical aspects of medicine and under-train them in the undervalued relational skills that have always been at the heart of healing. +

The change was instantaneous.

Allen Frances is a psychiatrist and professor emeritus at Duke University. He blogs at the Huffington Post.

This may well be the perfect book for Medical Examiner readers. We imagine them — correctly, we’re pretty sure — to be of above average intelligence. After all, many of them are doctors and medical researchers, a definite repository of CSRA brain power. We have thousands of them around here. As for the rest of us, even though we can read this paper on our cellphone, tablet or computer, we really aren’t the type to stare at a cellphone screen all day, killing brain cells by the millions. No, we’re inquisitive types and we often ask the big questions, the important ones. Like what would happen if every person on Earth jumped up at the same time? Would the Earth’s sudden lightness affect its orbit? Would all of us landing a second later do the trick? Or what if everyone on Earth aimed their laser pointer at the moon at exactly the same time? Or this one that I was just pondering this morning: if I carry a penny in the coin tray of my car, how many miles would I drive before the extra weight of that penny cost me more

than a penny in additional fuel expenses? Simple enough to determine, perhaps, but what if that penny was found on the sidewalk? Was it worth my time to stop and pick it up? Spoiler alert. Assuming your time is worth $10 an hour, a penny is worth exactly 3.6 seconds of your time. If it takes longer than that to spot the penny, stop, bend down, pick it up, straighten back up and put it in your pocket, you’re losing money. Now we all know. Taking those facts from the Randall Munroe’s book (as I did), you can readily see that he doesn’t just shoot from the hip;

he doesn’t just wing it. As the subtitle of the book says, these are “serious scientific answers.” So if your child wants to end this hot summer with a pool outing on the last day before school starts — and he wants to do it in a spent fuel pool at SRS or Plant Vogtle — you can give him or her a scientifically accurate response. That’s because answers throughout the book are not only illustrated (very crudely, true), but they are derived from consultation with molecular biologists, astronomers, mathmeticians, NASA scientists, chemists, nuclear physicists — and the Commissioner of Baseball. Spoiler alert II. You can certainly go swimming in a spent fuel pool, even one containing spent fuel rods. But will you survive the experience? That depends. Better get the book and read the complete answer. + What If? — Serious Scientific Answers to Absurd Hypothetical Questions, by Randall Munroe, 320 pages, published September 2014 by Mariner Books

Research News Life lessons learned from cancer As we get older, age-related heart problems proliferate. Why? Heart cells aren’t as proficient at regenerating themselves as the years go by. Cancer cells, on the other hand, are the grand masters of proliferation. They don’t know when to stop. Why not use cancer cells to “teach” heart cells the tricks they used in years gone by? That is the oversimplified gist of research being conducted at San Diego State University. A growth enzyme extracted from cancer cells is being introduced into cardiac progenitor cells in mice. The working theory is that the procedure might help facilitate cell division which, in turn, could help heart cells rejuvenate themselves. Although researchers say balancing this cellular boosting with the risk of causing cancer is working on a razor’s edge, heart tissue is famously resistant to cancer. When was the last time you heard of anyone having heart cancer?

Music to sew by If you imagined you heard the strains of Bach, Beethoven or Bon Jovi during your last operation, you weren’t dreaming: surgeons often play their favorite music in the OR, and studies have demonstrated that it reduces their stress. However, there has been limited research into its clinical effect. Are surgeons so relaxed that their error rates go up? A small study conducted by The University of Texas Medical Branch at Galveston (published July 30 in Aesthetic Surgery Journal) found that listening to the surgeon’s preferred music improves efficiency, speed and quality of wound closure. Without being informed of the nature of the study, fifteen plastic surgery residents were asked to close incisions with layered sutures on pig’s feet obtained at a local grocery store (pig’s feet are widely used as being similar to human skin). In some cases their preferred music was playing; for others the lab was silent. The residents were then asked to repeat the

procedure one day later, but those who had music on day one had silence on day two, and vice versa. The expected result would be that the second day’s sutures would be better and more quickly done simply by virtue of practice and repetition. Instead, playing music resulted in a 7 to 10 percent improvement in speed and efficiency. Since some procedures involve a significant amount of suturing, greater speed, quality and efficiency through music can reduce adverse outcomes, costs, and reduce time spent under anesthesia. Start your day off right Although everyone knows that “breakfast is the most important meal of the day,” the number of people who skip breakfast is staggering. New research reveals those who do so at greatest peril: people with type-2 diabetes. Skipping breakfast triggers day-long blood sugar spikes and impairs insulin response throughout the rest of the day, says a study published in June. +

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AUGUST 7, 2015

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS

THE MYSTERY WORD

Your resume says you’re a preeminent cancer researcher.

by Dan Pearson

And yet this is your first job after college?

Correct.

Care to explain that for me?

Correct again.

I’m not eminent yet. I’m preeminent.

The Mystery Word for this issue: ENESEZ

EXAMINER CROSSWORD

PUZZLE ACROSS 1. Distasteful; nasty 5. Hurt 9. Apple music player 13. Author and poet (18981943) with an Augusta connection 15. Internal prefix 16. Female horse 17. Athletes from Aquinas 18. Heavy metal 19. Bread with a pocket 20. Establish (as a record) 21. Common lead-in to 23-A 23. Frequent follower of 21-A 25. Reznor group, for short 26. Last name of 48-D 27. Famous Jennifer 29. Soldiers 32. Mr. Sarazen 33. Squander 34. Exclamation of contempt 36. _____phone (recorder) 40. To be ill 41. The PGA’s Ernie 42. Second person singular pronoun 43. Headband 46. Acronym before 32-D 47. Squirtgun ammo 49. Word with tear or tape 51. Silk Tree 52. Masculine prefix 54. Squamous; dry and flaky 56. Big monkey 57. Indefinite article 58. Hogan’s nickname 59. Kill Bill star 62. Medicine 64. Norse god of thunder 66. Old Towne street 68. Urgent 69. Augusta painter Ed 70. Monetary unit of Lesotho

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”

QUOTATION PUZZLE

L T E P L R X M E I N E G O T D N H V I S G T T K E L A A S E E E E A A A A I V I H N N A N P L

— Medical advice from Dave Barry

71. _____ machine 72. Inquires 73. Greek goddess of the earth DOWN 1. Large wading bird 2. Cover with wax 3. Interlock loops of yarn 4. Affirmative reply 5. North Georgia tourist town 6. Concerning (archaic; poetic) 7. Nutritional label abbrev. 8. Lunar _________ 9. Mischievous child 10. College in Augusta 11. Red Sox DH 12. “Dizzy” baseball player 14. Follower of Jim or Ogle? 22. Faux add-on? 24. Ike’s or Langley _______ 26. Past tense of 63-D 28. I.M. ________ 29. It was, in short 30. August precipitation 31. Capital of Norway

32. Acronym following 46-A 34. Police route 35. Lou Gehrig’s letters? 37. “Cell” prefix 38. “Be on your _____!” 39. Migraine precursor for some 44. Eccentric 45. _____ mater 47. County Washington is in 48. First name of 26-A 50. Indication beginning (Med.) 51. Grand ____ 52. Time when showers occur? 53. Logical beginning (sometimes) 54. Acute circulatory emergency 55. Heals 56. Annexes 59. Forearm bone 60. Microscopic arachnid 61. Aboard ship 63. Acquire 65. Word on a towel 67. Augusta’s North ___

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.

X A M I N E R

8 8 5

6 7

3 1

1 9

4 7

4 1

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 above. All the listed letters following #1 are the first letters of the various words; the letters following #2 are the second letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.

H O 1 2 3 4 5 6 7 8 1

1 2 3 4 5

L 1 2 3 4 5 6

1 2 3 H O 1 2 3 4 5 6 7 8

O 3

V 1 2 3 4 5

1 2 3 4

1.TTCCEEOILS 2.HHHTWVEVFS 3.OOOSIIIE 4.OOSLLL 5.SSSLE 6.IRI 7.NN 8.GG

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

WORDS NUMBER

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

AUGUST 7, 2015

AUGUSTA MEDiCAL EXAMINER

THE BEST MEDICINE ha... ha...

man has applied for a job and during the interview gets the dreaded question, “What do you consider to be your greatest weakness?” “Probably my honesty,” says the man. “I don’t think you should view honesty as a weakness,” says the interviewer. “Well, you know what?” replies the man. “I don’t really care what you think.”

Three prison escapees were hiding in a barn when they heard the farmer approaching, so they quickly jumped into some burlap sacks and curled up in the corner. The farmer didn’t remember seeing the sacks there before, so he kicked the first one and heard, “Cluck, cluck, cluck.” Probably chickens in there, he thought to himself. He kicked the second bag and heard, “Baaa, baaa, baaa.” Oh, he thought, a lamb is in there. He kicked the third bag and didn’t hear anything, so he kept kicking it. Finally the prisoner jumped up, screaming, “I’m a bag of potatoes! What do you want me to say?” A small-town minister walks out in front of his church first thing one Sunday morning and

discovers a dead donkey on the church’s front lawn. He called Animal Control, but they said since it was a Sunday and would involve overtime, they couldn’t remove it without authorization from the mayor. The mayor is known far and wide as a first-class jerk, and he doesn’t disappoint, angrily ranting and raving at the minister for bothering him so early in the morning, and on a weekend. “And besides all that,” finished the mayor, “it’s your job to bury the dead, not mine.” “True,” said the minister, “but I always notify the next of kin first.” Bob: My ex-wife had weekly lessons with the devil on how to become even more evil. Rob: Seriously? Bob: Yeah. I still don’t know how much she charged him, though. Ella: I dreamed about a horse last night. Della: Was it scary? Ella: It was a real night mare. Joe: Have you ever tried to eat a clock? Moe: Eat a clock? That’s the most ridiculous question I’ve ever heard. Joe: But why wouldn’t you at least try it? Moe: For one thing I’m sure it would be very time-consuming. Wife: You know how the man next door always kisses his wife every morning before work? Why can’t you do that, dear? Husband: Sweetheart, I barely know her! +

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

STATE

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

13 +

Brown bagging it stress-free Stumped by what to pack in your child’s (or maybe even your) lunchbox? Maybe the school provides free or reduced-cost lunches, but you may feel like sending lunch at least a few days a week is a healthier option. But time is always an issue in the mornings. Is there a way to simplify the process? Sure, says the FDA. Read on. Tip 1: Plan Your Meals The key to filling a lunchbox with wholesome foods that are essential for healthy growth and weight maintenance is planning. Start by planning your family’s meals for the whole week. If that task is too daunting, start smaller by planning lunch for a day or two and progress from there. Duplicate that meal plan for the next week and build on it. The plan will provide the map so you can shop and have wholesome foods on hand. If you don’t plan, you become a victim of convenient foods. Start with the basic four: fruits and vegetables, whole grains for fiber (even if that means cutting off the crust because kids prefer the soft part), dairy, and protein. Get your kids involved in helping to pack their lunches and planning family meals. That helps them develop good habits that last a lifetime. Tip 2: Base Your Lunchbox on MyPlate Need help planning meals? MyPlate Kids’ Place (www. choosemyplate.gov/kids) has recipes and meal-planning information geared to different age groups and advice on making healthy meals, cooking at home and developing healthy eating habits. Parents should understand that it’s not what you say that matters, but what you do. Your kids are watching what you do. If you don’t eat your vegetables and if you don’t have a balanced diet, why would you expect your child to do any better? Add some fun. Studies show that children will eat more fruits and vegetables if you make it interesting for them. Give them fruits and vegetables they like; add some dressing for dipping. Replace French fries with a baked potato jazzed up with cottage cheese and cherry tomatoes on top. Mix unusual foods together, such as apples and peanut butter dip. Cut fruits and vegetables into bitesize pieces and fun shapes. The trick is to give your kids a variety of good foods that are good for them. An apple one day; a pear another; then an orange. Variety isn’t just the spice of life; it’s important for developing healthy habits. Tip 3: Cut Portions Kids need smaller portions. Think quarter-cups, tablespoons and half-sandwiches, depending on your child’s size, age and activity level. For a toddler, think tablespoons—not cups. Cut sandwiches in triangles, Beker says. That reduces the portion and increases the fun. What’s a reasonable portion? Think finger foods that are easily grasped by little hands: cut-up carrots and apples. Don’t expect your child to eat as much as you eat. If you do, they will get frustrated, and you’ll get aggravated. They will also be eating too much and won’t develop a healthy habit of eating to satiety. Instead, they will learn to eat by volume. Families should let children serve themselves at the table for better portion control. Tip 4: Read the Label Understanding the Nutrition Facts label is a big step toward a healthier lunchbox. When stocking your pantry, narrow down your choices based on the label. Read the ingredients and check for sources of fats and sugars in the food. When shopping for food, pick one item at a time to read the Nutrition Facts label. That way you can focus your choices on foods that provide healthier nutrient contributions to the daily intake. Next time you go shopping, check the labels of still other products. Just because something is low fat doesn’t mean it has fewer calories. Sometimes another food with a little more fat is a better overall choice because it’s more balanced. You don’t need to add extra fat or sugar to make tasty and healthy meals for your kids. But remember: You can’t make them without planning. +

+ 14

AUGUST 7, 2015

AUGUSTA MEDiCAL EXAMINER

THE MYSTERY SOLVED The Mystery Word in our last issue was: MEALTIME ...cleverly hidden (on the lettuce) in the p. 7 ad for WILD WING CAFE Congratulations to BRISEIDA GARCIA, who scores a coveted Scrubs of Evans gift card, 2 movie passes courtesy of Health Center Credit Union, and a $20 Wild Wing Cafe gift certificate. Want to find your name here next issue? The new Mystery Word is on page 12. Start looking!

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

EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC. HOUSE FOR RENT IN N AUGUSTA For Rent: House: two bedroom, one bath, kitchen with stove and refrigerator, bonus room, laundry closet with washer/dryer hook ups, basement, screened porch, handicap ramp. New carpet in bedrooms and living room. Nearly new vinyl floor in kitchen, double pane windows. Near North Augusta Public Safety and NA community Center. Within walking distance of Greenway. Ideal for students, a couple or single person. Handicapped ramp entrance. $650.00 per month, a security deposit of $650.00 is required with first month’s rent. No pets ! Rental Application required. Prefer 1 year lease. Call 803 599 0781 for appointment to see. ONE BDRM COTTAGE FOR RENT with off-street parking/carport in Hill area 2 blocks from college. Washer/dryer. We furnish water, you pay electric. $675/$500 dep. No pets. (706) 736-7168; email: ronst79@gmail.com Pictures avail. AUGUSTAGAHOMESEARCH.COM Foreclosures • MLS • Rentals • Builders 706-564-5885 FOR SALE: GORGEOUS, immaculate, never occupied townhome located mins from Medical District. 2 bed, 2 bath,

master en suite, walk-in closets, office. 1450 sq ft. hardwood floors throughout, fabulous upgrades, custom kitchen and baths. Floor to ceiling windows, fenced yard. Partially furnished! 120k OBO. 803-507-6621.

HELP WANTED PART TIME HELP NEEDED MATH AND SCIENCE TUTORS NEEDED: Local tutoring company seeking qualified math and science tutors. Please reply to: info@maeseducationcenter.com

SERVICES

MISCELLANEOUS WANT TO BE HEALTHY? (Energy, weight loss, mental clarity) Go to gethealthyat.le-vel.com See video and Facebook. Sign free as customer. BEING PAID WHAT YOU ARE WORTH? Then make more money! Watch movie all out interview: ExtraMoneyInterview.net CEMETERY SPACES (2) Sunset Memorial Gardens, Graniteville SC adjacent to lighted military flagstaff, includes granite bench with urn space, installation and inscription. All $4700 ($8600 value). Spaces only: $2700. Call (803) 295-3033

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

FISHING CLUB wants more grey-haired members. Meet 2nd Thurs of month at Harbor Inn Restaurant, 12 noon. “Adventure Before Dementia” Info: (706) 736-8753 or (706) 829-1729

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

PET CARE in Martinez-Evans area. Dogs to 40 lbs, $9.00. Cats (1-3), $9.00 For interview/information, phone 706-829-1729

F. E. GILLIARD, MD FAMILY MEDICINE Acute & Chronic Illnesses Occupational Medicine PROMPT APPOINTMENTS 706-823-5250

CEMETERY PLOTS Side-by-side cemetery plots for sale located at the Heart Section of Hillcrest Cemetery. $3600 for BOTH. (706) 798-8495

Thanks for reading the Medical Examiner!

The new scrambled Mystery Word is found on page 12

SENDING US A CLASSIFIED?

THE PUZZLE SOLVED

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

WHAT’S YOUR DRUG OF CHOICE?

Augusta Medical Examiner Classifieds

(OURS IS COFFEE)

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

T G

O R

W A

M O

W A M

M A

M A S

SEE PAGE 12

QUOTATION

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

QUOTATION PUZZLE SOLUTION: Page 12: “Never take a sleeping pill and a laxative on the same night.”

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

— Dave Barry .25

.50

.75

1.00

1.25

1.50

1.75

2.00

2.25

2.50

2.75

3.00

3.25

3.50

3.75

4.00

4.25

4.50

4.75

5.00

5.25

5.50

5.75

6.00

6.25

6.50

6.75

7.00

7.25

7.50

7.75

8.00

8.25

8.50

8.75

9.00

The Sudoku Solution

COFFEE IS GOOD MEDICINE

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

Send this form with payment to:

AUGUSTA MEDICAL EXAMINER, PO BOX 397, AUGUSTA, GA 30903-0397 Total ad cost by number of words as shown above: $

VISIT DRUGOFCHOICECOFFEE.COM

WORDS BY NUMBER “Choosing the lesser of two evils is still choosing evil.” — Jerry Garcia

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!

www.AugustaRx.com

AUGUST 7, 2015

15 +

AUGUSTA MEDiCAL EXAMINER

The Medical Examiner is what is known as a

This could be yyou.

GOLDILOCKS PUBLICATION.

The Medical Examiner can be delivered right to your door!

At 16 pages every issue, we’re just right.

Use the handy form on page 13

PROFESSIONAL DIRECTORY DERMATOLOGY

ALLERGY

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

CHIROPRACTIC

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

DEVELOPMENTAL PEDIATRICS

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

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

Resolution Counseling Professionals 3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866 www.visitrcp.com

DENTISTRY

EMPLOYEE BENEFITS

FAMILY MEDICINE Floss ‘em or lose ‘em!

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

F. E. Gilliard, MD Family Medicine 639 13th Street Augusta 30901 706-823-5250 Industrial Medicine • Prompt appts. Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Thomson: 706-595-7825 Primary Care Rates

CALLING ALL M.D.S!

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

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

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

Group & Benefits Consultants Inc. 3515 Wheeler Rd, Bldg. C Augusta 30909 706-733-3459 www.groupandbenefits.com

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

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

OPHTHALMOLOGY

DRUG REHAB

COUNSELING

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

LASER SERVICES

PHARMACY Medical Center West Pharmacy 465 North Belair Road Evans 30809 706-854-2424 www.medicalcenterwestpharmacy.com Parks Pharmacy 437 Georgia Ave. N. Augusta 29841 803-279-7450 www.parkspharmacy.com

SENIOR LIVING Augusta Gardens Senior Living Community 3725 Wheeler Road Augusta 30909 SENIOR LIVING COMMUNITY 706-868-6500 www.augustagardenscommunity.com

...SENIOR LIVING

Cornerstone Compassion Center 420 Warren Road Augusta 30907 706-228-5359 or 706-394-6518 Assisted Living • Personal Care

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

THERAPEUTIC MASSAGE Centered in Georgia Diane Young L.M.T. 4488 Columbia Rd Martinez 30907 706-251-2244

VEIN CARE Vein Specialists of Augusta G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 501 Blackburn Dr, Martinez 30907 706-854-8340 www.VeinsAugusta.com

WEIGHT LOSS Medical Weight & Wellness Specialists of Augusta Maycie Elchoufi, MD 108 SRP Drive, Suite B Evans 30809 • 706-829-9906 www.mwwsAugusta.com

SUPPORT YOUR PRACTICE - AND THE MEDICAL EXAMINER A simple listing in the Professional Directory is less than $100 for six months or less than $200 for an entire year, and puts your contact information in front of 30,000 readers a month. CALL 706.860.5455 TODAY AND BE IN THE NEXT ISSUE

+ 16

AUGUSTA MEDiCAL EXAMINER

AUGUST 7, 2015

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