Medical Examiner 12-6-19

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MEDICALEXAMINER

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HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS

DECEMBER 6, 2019

AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

10 Commandments Publisher’s note: The following are not the 10 Commandments. They are merely nominees (hence, there are more than 10) hoping to make the cut for a proposed amendment to the original 10 covering only the act of driving, a source of much sinful behavior not addressed by the original 10 Commandments.

• Thy horsepower shall not exceed thy IQ. • Thou shalt not use hand signals of fewer than two digits. • Husband, take not the advice of that strumpet in the GPS unit over thine own wife’s navigational wisdom, for why shouldst thou embrace the bosom of a foreign woman? • Wife, giveth not thy driving wisdom uninvited, lest thine own husband come to despise thee. • Show thyself respectful of grey-headedness, for it is a crown of beauty when found upon a reasonably capable driver. • Thou shall not parketh in a manner that taketh two spaces. • Remember the stop sign and keep it literal.

• Thou shall not send forth text messages while driving thy chariot, and it shall be a double abomination unto thee if done in the fast lane. • Shouldst I let thee merge into my lane, thy nod and thy wave they comfort me. • Anoint not the good land given thee and the public pathways with thine coffee cups, soda cans, plastic bags, and cigarette butts poured forth in profanation upon the land from thy windows. • Thou shalt not blow thy horn in vain. • Thou shalt not own a stereo worth double the value of the chariot in which it is installed. • Thou shall allow those who walk upon the land in the Please see COMMANDMENTS page 3

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PART 2 OF A SERIES BY JONATHAN MURDICK

Editor’s note: Our correctional nurse isn’t quite as fetching as the nurse on the cover of the pulp novel shown. Ours isn’t even a female. But our nurse has at least one exceptional advantage over the nurse in the picture: he’s real.

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lthough my first day as a prison nurse was harrowing to say the least (see last issue), another day dawned and I again braved the security checks, pat downs, and open yards full of prisoners. My first day left me confused, excited, and more than a little afraid. I again passed through the administration building and was greeted by the sight of the busy little multicolored ants in tan and pink scurrying this way and that across the yard.   Feeling more like a pro with that first day under my belt, I strolled unaccompanied across the yard to our little concrete medical bunker and banged loudly on the door. As soon as I did, inmates all around began throwing insults and slurs my direction. “Look at this [bleep]ing dude”, “We want to see the women, not your ugly [bleep]”. My confidence after yesterday’s congratulations evaporated instantly and I couldn’t wait for the door to open.   A guard let me in and I entered the safety of the unit only to find 50 angry faces staring at me. Today is sick call. The director yelled down the hall for me and as I entered her office she smiled. “I’m surprised you came back. Most nurses have never been through a day like yesterday and when they do, they usually never show for the second day.”   She then told me that there was no time to lose: the Nurse Practitioner (N.P.) had 50 patients to see that

SHOCKING TRUE TALES!

I Was a

Prison Nurse !

50¢ morning and she needed a nurse to help. That nurse was me.   When I entered the examination room, an inmate was stripped to the waist as the N.P. was examining him. She asked me to chart her notes and do the computer work as she ran through the list of issues the inmate was complaining of. I watched as she worked, moving patients through with remarkable efficiency. Inmates commented on her scrubs, her hair, her eyes, her butt, breasts, sexual preferences, and anything else you can imagine literally down to her shoelaces, and nothing phased her. Then they would look in my direction, tell me to shove some unmentionable Please see PRISON NURSE page 6

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DECEMBER 6, 2019

THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD by David W. Proefrock, PhD

Your 16 year-old daughter has become very secretive lately. She says she has a new boyfriend whom you haven’t met, and she doesn’t want to introduce you to him. Her circle of friends has changed and most of her girlfriends are older than she is. She has been buying new clothes and jewelry and seems to have plenty of money even though she’s working only part-time. What should you do?   A. It’s normal for adolescent girls to withdraw from parents.

Just keep an eye on her, but don’t do anything.   B. Sit her down and tell her you are worried. See if you can get her to open up and talk with you.   C. Tell her she has to quit her job and spend more time with the family.   D. These are serious signs that something is wrong. Keep her under direct supervision. Make sure she’s going to school, monitor her at her job, and don’t let her date or go out with friends until you are sure she is safe.

If you answered:   A. It is normal for both male and female adolescents to distance themselves from their parents at this age, but this is beyond normal. The situation is risky and calls for an intervention.   B. It almost never hurts to have serious talks with your kids, but this situation may be more serious than a talk.   C. This response is likely to lead to serious conflict and may, in fact, make the situation work. You need to make a more structured intervention.   D. You never want to think this could happen to your child, but there are at least five warning signs here of someone being trafficked for sex. If that’s the case, she is a victim and needs your help and protection.   Sex trafficking is far more common than we want to believe and, yes, it happens right here in the CSRA. Learn more at www.sharedhope.org. If you see evidence of sex trafficking, there’s a hotline where you can report it: (888)373-7888. + Dr. Proefrock is a retired clinical and forensic child psychologist.

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COMMANDMENTS… from page 1 crosswalk to fully cross before entering the crosswalk thine own self. • Tempteth not the Crown Vic. • Whine ye not upon receiving adverse judgement for thy sins lest thine own spouse, co-workers, and neighbors tell thee exactly how richly thou deservest them, and lo, that they are surprised that thou hast not incurred multitudes of summonses, fines and warnings. Hang thine head low, payest thou thy fines, and follow the commandments for generations upon generations to come, becoming a shining example to thine community. Go ye and sin no more. • Thou shall strap the fruitage of thy loins into car seats as Caesar proclaimeth, not heeding the cries of the fruitage of thy belly when they protesteth overmuch. • Shouldst thou maketh to overtake thy fellow upon the byways, thou shalt promptly defecate or leave the commode, as the ancient proverb sayeth, not taking thousand of cubits to complete thy pass. • Thou shall not leave thy turn signal on for many miles lest thou be made to wander 40 years. • Remember thy maintenance that thy days may be long in the vehicle that Detroit or Tokyo giveth thee. • If thou shouldst profane my words, thou car which art in heaven, totalled be thy name. + Note: These commandment nominations appeared in a previous issue of the Medical Examiner so old we couldn’t locate it in our archives. Some of them were borrowed from or suggested by listeners to National Public Radio’s erstwhile Car Talk program. For additional information about our deadly highway sins, see “Crash Course” on page 10 of every issue.

Proudly affiliated with Dr. John Cook of Southern Dermatology in Aiken

WHY DO WE SWEAT WHEN UNDER STRESS?   The short answer is that scientists just don’t know. There are only guesses and theories, lots of them wrapped up in evolutionary mumbo-jumbo. (Why “mumbo-jumbo”? Because evolution is a branch of science where anything too far beyond the broad brush of belief becomes the bastion of guesses and theories. Solid facts are sometimes in short supply, and many formerly solid facts are not considered to be current facts. And really, is it relevant that something allegedly dates back a few hundred million years?)   The reason for heat- or exercised-induced sweat, on the other hand, is no mystery. It’s a very efficient cooling system. Millions of sweat glands for this purpose are located just under the skin all over the body. These eccrine glands produce mostly water, salt and potassium. Through the process of evaporation, perspiration cools the skin very effectively.   Stress-induced sweat, on the other hand, is produced by apocrine glands. Their locations are limited to a few sites like armpits and the genital area where they are coupled with hair follicles. Triggered by stress-induced adrenaline, these glands when activated release a different kind of sweat. Like regular sweat, it’s odorless — at first. Its composition, however, is not as conducive to evaporation and it’s thicker or less watery compared with heat or exercise-induced sweat, so it stays on the skin longer. Apocrine sweat also contains plenty of nutrients that skin bacteria feed on.   Therein lies the main beef with stress sweat: it sticks around long enough to interact with bacteria, and that results in unpleasant smells very different from the odor of gym sweat.   The antidotes: all of us should work to reduce stress in our lives, and not merely to sweat less. Reducing stress has enough benefits of its own to fill its own QA article (and might do so). Beyond that, deodorants have ingredients that help deter those bacterial interactions, as well as fragrances to mask odors. Antiperspirants, as their name suggests, prevent perspiration in the first place. Those with excessive perspiration can get help from their doctor or dermatologist. +

MEDICALEXAMINER

M.D. John Cook,

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AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

www.AugustaRx.com The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of salubrious news within every part of the Augusta medical community. Pictured above (from left to right), John Cook, MD; Lauren Ploch, MD; Jason Arnold, MD; Caroline Wells, PA-C; Chris Thompson, PA-C

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DECEMBER 6, 2019

#104 IN A SERIES

Who is this? ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com Netflix and do some exploring.   My children and grandchildren will be   Tonight I figured out how to stream live TV surprised that I have entered a formerly on my computer. My big TV was out of sorts inaccessible realm, and they will tease me and I wanted to watch the news to see the because I will still be a troglodyte with my weather report on CBS. Given that I mostly kind nose just barely sticking above the primordial of squeak and cower in response ooze. That’s OK. They will to any electronics issues, the me when I am hopelessly Learning should be a rescue fact that I actually succeeded is lost in Modernity. The funny somewhat amazing. lifelong process, even with thing is they also enjoy the   When specialists talk with story-telling that carries them new technology. us about maintaining a healthy back into the past with me, mind, one thing they often especially stories they inhabit as mention is putting ourselves in positions children, not adults. where we learn new things. I learn a lot from   Together we form a sense of continuity, of watching the local and national news reports. linkages to the past and the present and the I also read the Augusta Chronicle daily. I do future. All of these linkages are essential to indulge in reading Facebook posts, but try to knowing who we are in the broader context be as discriminatory as possible to weed out of family life. Recapturing bits and pieces of the fake, the improbable, and the like. I rather memories as adults helps us all to solidify and enjoy the merely silly, funny, and even the ground ourselves in places, times, and people ridiculous. Laughing is excellent exercise. I which are part and parcel of our being whole. delight in scientific advances, often a long time The process is much like putting together a before they are able to be pragmatic instead stained glass window or a pieced quilt. of speculative. I sigh in pleasure over sunrises   At first they each begin as fragmented bits and sunsets, gorgeous flowers, cute animals, and pieces that may not fit very well together, and marvelous, magical scenery. like the start of a crazy quilt made from bits   As my 70s advance, new ideas and and pieces of clothes worn by family members. new adventures are so easy to come by Over time quilters organize those patches of electronically, and even those of us who are cloth, trying to find in their exquisite variety less than adventurous when it comes to new some way to compose a meaningful whole, technologies can still push ourselves further to see how the colors merge into one another, when a strong personal desire to learn a new how the textures create interesting patterns, skill presents itself. I suppose at some point how the quilting stitches overlay and intermix I may even join the worlds available through until the whole makes sense. Then beauty Netflix. Not today, and perhaps not tomorrow connects a unified reality between the quilt or even next week, but some day when there and the minds of its creators. is a movie I really want to see, but it’s too hot   What a lovely tool for a healthy mind-body outside or too cold, I may decide to get onto connection. + by Marcia Ribble

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his doctor has been dead for 275 years, but if his heirs have any sense at all, they’ll hire a screenwriter and a Hollywood agent on the double. His life story could be the next big screen blockbuster.   And we can film it where it happened: right here in Georgia.   But this doctor’s story spans the ocean, beginning with his birth in Portugal in 1668. There the family of Samuel Nuñez flourished even though they were living a secret double life that could eventually cost them everything.   The Nuñez family practiced Judaism in a country that had been in the grip of Christian fanaticism for parts of three centuries. The Portuguese Inquisition would burn at the stake any Jews they found who refused to convert to Christianity. Many Jews suffered this fate; others converted, whether willingly or reluctantly; still others, like the Nuñez clan, lived in disguise, saving their lives by the appearance of conversion while still secretly practicing their banned faith.   Hiding in plain sight, Samuel Nuñez (or Ribeiro Nuñez, as he was known in Portugal) became a prominent physician, counting the Portuguese Grand Inquisitor among his patients and patrons. In a Portuguese climate that calls to mind Nazi Germany of the 20th century, it was only a matter of time before someone discovered the Nuñez secret and informed authorities. That happened in 1703. Although Dr. Nuñez was prosecuted and tortured, the New Georgia Encyclopedia suggests his prominence led to a conditional reprieve, although it’s likely the family lost much of its wealth.   Even with a measure of freedom, life as a convicted criminal did not sit well with Dr. Nuñez — understandably so, when the “crime” was merely practicing his faith — and some sources recount an amazing escape to England: a lavish feast hosted by the Nuñez family and many prominent guests was arranged aboard a ship docked at the Nuñez mansion on the Tagus River. As guests were wined and dined (especially wined), the ship eased away from shore. Before anyone was the wiser, the vessel was en route to London, already too far from shore for anyone to safely swim to land. It is said that Dr. Nuñez paid return passage to Lisbon for all of his unwilling passengers.   From London, the Nuñez family immigrated to America, landing in Savannah in July, 1733, in the middle of an epidemic of dysentery, which Nuñez was able to successfully quell. Despite America’s promise of religious freedom, the trustees of the Savannah colony instructed Governor James Oglethorpe to promptly oust Savannah’s growing Jewish community (a third of the fledgling colony’s population), denying them settlement and granting them no land.   Oglethorpe had the backbone to ignore the trustees’ demands, and the result was a thriving Jewish community and one of the first synagogues in America, founded by Dr. Nuñez. +

The Medical Examiner is what is known as a

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


DECEMBER 6, 2019

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Musings of a Distractible Mind

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

MEDICALEXAMINER

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DECEMBER 6, 2019

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hen you approach a doctor - especially one you’ve never met before - you come with a knowledge of your disease that they don’t have, and a knowledge of the doctor’s limitations that few other patients have. You know more about your disease than most of us do. Your MS, rheumatoid arthritis, end-stage kidney disease, Cushing’s disease, bipolar disorder, chronic pain disorder, brittle diabetes, or disabling psychiatric disorder can be something most of us don’t regularly encounter. Even doctors who specialize in your disorder don’t share the kind of knowledge you can only get through living with a disease. It’s like a parent’s knowledge of their child versus their pediatrician’s.   You see why you scare doctors? It’s not your fault, but ignoring this fact will limit the help you can only get from them. I know this because, just like you know your disease better than any doctor, I know what being a doctor feels like more than any patient ever will. You encounter doctors intermittently (more than you wish, perhaps); I live as a doctor continuously. Even so, you have depth of knowledge that no doctor can possess.   So let me be so bold as to give you advice on dealing with doctors:   1. Don’t come on too strong. Yes, you have to advocate for yourself, but remember that doctors are used to being in control. All of the other patients come into the room with immediate respect, but your understanding has torn down the doctor-asgod illusion. That’s a good thing in the long run, but

few doctors want to be greeted with that reality from the start. Your goal with any doctor is to build a partnership of trust that goes both ways, and coming on too strong at the start can hurt your chances of ever having that.   2. Show respect. I say this one cautiously because there are certainly some doctors who don’t treat patients with respect - especially ones like you with chronic disease. These doctors should be avoided. But most of us are not like that; we really want to help people and try to treat them well. But we have worked very hard to earn our position. Just as you want to be listened to, so do we.   3. Keep your eggs in only a few baskets. Find a good primary care doctor and a couple of specialists you trust. Don’t expect a new doctor to figure things out quickly. It can take me years of repeated visits to really understand some of my chronic disease patients. The best care happens when a doctor understands the patient and the patient understands the doctor. This can only happen over time, but there is something very powerful in that.   4. Use the ER only when absolutely needed. Don’t expect emergency room physicians to really understand you. That’s not their job. They went into their specialty to fix problems quickly and move on, not to manage chronic disease. The same goes for any doctor you see for a short time: they will try to get done with you as quickly as possible.   5. Don’t avoid doctors. One of the most frustrating things for me is when a complicated patient comes in after a long absence with

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a huge list of problems they want me to address. I can’t work that way, and I don’t think many doctors can. Each visit should address only a few problems at a time, otherwise things get confused and more mistakes are made. It’s OK to keep a list of your own problems so things don’t get left out - I actually like getting those lists, as long as people don’t expect me to handle all of the problems. It helps me to prioritize with them.  6. Don’t put up with the jerks - unless you have no choice (in the ER, for example), you should keep looking until you find the right doctor(s) for you. Some docs are just not cut out for chronic disease, while some of us like the longterm relationship. Don’t feel you have to put up with doctors who don’t listen or minimize your problems. At the minimum, you should be able to find a doctor who doesn’t totally suck.   7. Forgive us. Sometimes I forget about important things in my patients’ lives. Sometimes I don’t know you’ve had surgery or that your sister comes to see me as well. Sometimes I avoid people because I don’t want to admit my limitations. Be patient with me - I usually know when I’ve messed up, and if you know me well I don’t mind being reminded. Well, maybe I mind it a little.   As a patient with a chronic condition you know better than anyone that we docs are just people - with all the stupidity, inconsistency, and fallibility that goes with that - who happen to doctor for a living. I hope this helps, and I really hope you get the help you need. It does suck that you have your problem; I just hope this might decrease the suckishness a little bit. +


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DECEMBER 6, 2019

PRISON NURSE… from page 1

I LOVE THE MEDICAL EXAMINER!

item where the sun doesn’t shine and then return to harassing the N.P.   Coming from a world of professionalism and customer service, I was appalled to hear such conversations in a medical unit. I was even further shocked to realize the guards and nurses didn’t seem to mind. How can you take this criticism and hatred every day while still providing care for these people?   Sick call continued for the better part of 2 hours, with patient after patient entering our little room, stripping down, receiving treatment, offering insults, and finally leaving while scowling in my direction. When we were finished the N.P. collapsed in her chair and sighed with relief. I turned to her and asked how she could do this every day and still actually care about these guys? She smiled a little and told me to be glad they liked me; they only pick on the ones they like. She then got up and left the exam room for the solitude of her office.   I sat in that chair charting for the next several hours, carefully inputting all the hastily scribbled notes I made on each of the 50 or so charts. I was startled from my work when a boom resounded from the small reinforced window in the exam room door. I turned to see one of the inmates that just yesterday was congratulating me on the care given to their companion. He smiled, yelled for me to go [bleep] myself and walked away. I found myself grinning as I let the insult slide off my back and instead realized that in his own twisted way, he was saying thank you.   What a sick call.

IT’SYOURTURN! Your turn for what? To tell the tale of your medical experiences for Medicine in the First Person. 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. See our “No Rules Rules” below. Thanks!

“My leg was broken in three places.”

“This was on my third day in Afghanistan.” “I lost 23 pounds.” “We had triplets.” “He was just two when he died.” “The smoke detector woke me up.” “It took “She saved 48 stitches.” my life.” “I sure learned my lesson.” “The cause was a mystery for a long time.” “The nearest hospital “They took me to the hospital by helicopter. ” “I retired from medicine was 30 miles away.” “I thought, ‘Well, this is it’.” seven years ago.”

“Now THAT hurt!” “OUCH!”

“Turned out it was only indigestion.”

“He doesn’t remember a thing.” “I’m not supposed to be alive.” “It was a terrible tragedy.” “And that’s when I fell.” NOTHING SEEMED “The ambulance crashed.” “It was my first year “At first I thought it was something I ate.” TO HELP, UNTIL... “It seemed like a miracle.” of medical school.”

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.


DECEMBER 6, 2019

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AUGUSTAMEDICALEXAMiNER

GARDENVARIETY

Healthy Vegan Peanut Butter Cookies Ingredients • 2 cups gluten-free flour blend. (I use Pamela’s Gluten Free All Purpose Flour Blend) • 1 teaspoon baking soda

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There is something about peanut butter cookies made with the classic crisscross fork marks that reminds me of warm childhood memories. My mom would make the dough, place the dough balls on the cookie sheet, and then it was my turn to carefully take a dinner fork and press an x mark onto each one. I wanted to recreate the same cookie but healthier so I could fully indulge this holiday season. This recipe does come with a warning; the cookies can be quite addictive.   Peanut butter cookies are not only satisfying but packed with protein, and I used coconut sugar for a lower glycemic index. I also have been trying Pamela’s Gluten Free All Purpose Flour Blend in some recipes since I can not eat fructans found in regular flour. It worked terrific in this recipe, so much so I am getting another bag to try with some more recipes. I’m excited to try other family holiday recipes that I otherwise would not be able to eat. To add a fun variety to this healthy peanut butter cookie recipe, you could sprinkle chopped peanuts on them before baking. Or, right after they come out of the oven, top each cookie with a dollop of jam such as strawberry or grape. For a real festive treat, place an unwrapped Hershey Kiss on the warm cookie; chocolate and peanut butter were made for each other.

PUT YOURSELF IN OUR SHOES!

Healthy Peanut Butter Cookies • 3/4 teaspoon salt • 1/2 cup butter flavor coconut oil. (I use Organic Nutiva) • 1/2 cup no-sugar-added chunky peanut butter • 1/2 cup coconut sugar • 1/4 cup maple syrup • 2 tablespoons unsweetened almond milk • 1 teaspoon vanilla Instructions   Preheat oven to 375°. Line a cookie sheet with parchment paper.   In a bowl mix together gluten-free flour, baking soda and salt. Set aside.   Add remaining ingredients to the bowl of a stand mixer. Beat on medium speed until creamy and smooth, about 2 minutes.   Add flour mixture, blend on low speed until well mixed. The dough will be smooth and form a large

ball.   Use a cookie scoop to creat uniform size balls. Place on cookie sheet and then mash flat with a dinner fork to create crisscross marks.   Bake for 10 to 12 minutes. Remove from oven, allow to cool a few minutes and then move them to a cooling rack. The cookies will firm up as they cool. Store in airtight container for up to 4 days. + by Gina Dickson, an Augusta mom to six and Gigi to ten. Her web site, intentionalhospitality. com, celebrates gathering with friends, cooking great healthy meals and sharing life together around the table. Also on Instagram @ intentionalhospitality

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NO NONSENSE

NUTRITION Steve from Savannah writes: “We just had our first baby. I know breastfeeding is good for our baby, but is it healthy for my wife?”

Yes, breastfeeding is healthy for your wife in many ways. I’m so glad, Steve, that you are asking about this as a man, a husband and a father. Successful breastfeeding requires the understanding and active support of the father, the family, the workplace, the community and the culture. We also know that the more support the mom, dad, baby and entire family get from those around them, the higher the success

rate for breastfeeding and the longer the baby will be breastfed.   It’s also important to understand that breastfeeding is an important nutritional and health issue. Breastfeeding is not, as some people argue, a political issue or a public decency issue. In the American culture, we need to support and encourage breastfeeding much more than we presently do. If the idea of a women modestly breastfeeding a child in public is a problem for you, then I suggest this is your own personal learning and maturational issue, not a breastfeeding issue. You need to have a clearer understanding of the importance of breastfeeding and you need to work on developing a comfort level around women and families who are breastfeeding. My wife used to breastfeed in public all the time in a very modest and appropriate manner. If a woman wears a button-down blouse and carries a little blanket with her, she absolutely can breastfeed in public without anyone feeling awkward or even being aware that she is breastfeeding. Simply unbuttoning a few buttons, putting a little blanket over the baby’s head…that’s all it takes. Believe me, we used to breastfeed in airports, on planes, on buses, and in restaurants. Many times, people around us were not even aware it was go-

DECEMBER 6, 2019

Australian senator Larissa Waters returned to work with daughter Alia after a 10-week maternity leave in 2017 and promptly made the point that breastfeeding can appropriately be done anywhere.

ing on. Remember, a woman’s breasts are there to nourish a baby; our society has sexualized breasts so much that people forget how important breastfeeding is for mother and baby. We need to start remembering.   People talk about all the benefits of breastfeeding for the baby. For example, breast milk is the ideal food for an infant. “Breastfeeding is best feeding,” as the saying goes. In addition, breast milk has many other advantages for the infant. It contains the mom’s antibodies and when a baby is breastfeeding, that baby is also getting some immunity benefits from the mom. Another interesting fact is that the distance between a mother’s eyes and a baby’s eyes during breastfeeding seems to also be the distance that a newborn

infant’s eyes can focus, so breastfeeding helps promote mother-infant bonding.   Besides nutrition, breast milk also contains what we call “signal molecules” which can help in the development of the baby’s brain and other organs. In addition, breastfed babies have a lower chance of developing childhood obesity, a very big problem in contemporary America as well as the rest of the world.   Getting back to your important question, Steve, what about the affect of breastfeeding on your wife? Is breastfeeding healthy for the mom, too? Absolutely. For example, women who breastfeed have a decreased chance of bleeding during the period immediately following birth, called the postpartum period. Secondly, women who breastfeed return

to their pre-pregnant weight much faster than women who do not breastfeed. In addition, the uterus at delivery is quite large, having contained a baby. After delivery, the uterus starts shrinking back to its normal size, about the size of a pear. This process is called “involution.” In women who breastfeed, the involution of the uterus occurs more rapidly. My wife always told me that when she breastfed, she thought she could actually feel her uterus contracting and involuting. How cool is that!   Women who breastfeed also have up to a 25% decreased risk of breast cancer, and have a decreased risk of ovarian cancer, too. Even women from high breast cancer-risk families, such as women who have a mother or sister who has or has had breast cancer, can cut their risk of breast cancer by breastfeeding. The more months and years a mother breastfeeds, the lower her risk of breast cancer, a factor called the “cumulative lifetime duration of breastfeeding.”   Concerning osteoporosis, women who breastfeed have up to a four times lower risk of developing post-menopausal osteoporosis, as well as a decreased risk of bone fractures. This is a very significant reduction. Breastfeeding moms also have a decreased Please see BREASTFED page 10

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

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DECEMBER 6, 2019

9 +

AUGUSTAMEDICALEXAMiNER

Ask a Dietitian THE WEATHER OUTSIDE IS FRIGHTFUL BUT THE FOOD INSIDE IS SO DELIGHTFUL

by Kim Beavers, MS, RDN, LD, CDE Culinary Nutritionist at University Health Care Co-Host Eating Well with Kim

The question is often asked, do we eat more in the winter? Research suggests that we do, by about 85 calories a day, give or take a few.   The next natural questions are, why do we eat more and what can we do about it? Anything nutrition- and health-related tends to be multifactorial. In this case it ranges from temperature and neurotransmitters to cultural expectations.   The desire to eat more in winter may simply be a matter of temperature. It has been concluded that hot weather suppresses appetite. It makes sense then that cooler weather would induce the opposite, the desire to eat more. When it is cold outside we tend to spend more time inside where more food is available to sample. In addition to a temperature drop in the fall and winter we experience a reduction in exposure to sunlight. Sunlight actually triggers the release of serotonin (a neurotransmitter that has been shown to boost mood). As sunlight exposure decreases so does serotonin release. Carbohydrate-rich foods (think mac & cheese and mashed potatoes) can boost brain serotonin levels. Reduced serotonin levels could certainly be one of the factors that leads to cravings of comfort foods.   Another possible explanation for our increased winter appetite is dehydration. It is simply harder to drink a tall cool glass of water when you are cold. Feelings of slight dehydration (headache, fatigue, lightheadedness) can be mistaken for hunger leading to cravings.   What about opportunity? The fall-to-winter seasons sure do present many eating and overeating opportunities. Our culture (especially in the south) begins eating at the first tailgate party in early fall right on through the Christmas holiday season.   Regardless of whether one Please see WINTER page 15

Lentil and Lemon Soup

This savory soup is finished with lemon and parsley to perfectly balance savory with brightness. Ingredients: • 1 tablespoon extra-virgin olive oil • 3 carrots, sliced • 2 ribs celery, sliced • 1 onion, chopped • ½ teaspoon Celtic sea salt • 1 teaspoon minced garlic • 1 teaspoon dried thyme leaves • 2 cups dried lentils, rinsed and drained • 6 cups reduced sodium chicken stock • 1 teaspoon grated lemon zest • 1 bay leaf • ¼ lemon juice • ½ cup chopped fresh parsley   Place a large pot or Dutch oven over medium heat and add oil. Allow the oil to get hot, then add the carrots, celery, onion, salt and garlic to the pot. Sauté over medium heat for 5 minutes or until the onion is tender. Add in the thyme.   Stir in the lentils, stock, lemon zest and bay leaf. Bring to a boil. Reduce the heat to medium and cover. Simmer for 35 to 45 minutes

or until the lentils are tender. Remove the bay leaf and discard. Stir in the lemon juice and sprinkle with parsley. + Yield: 6 servings (serving size: 1 ½ cup) Nutrition Breakdown: Calories 170, Fat 3g (1g saturated fat), Cholesterol 5mg, Sodium 140mg, Carbohydrate 26g, Fiber 6g, Protein 10g. Diabetes Exchanges: 1-1/2 Starch, 1 Lean Meat

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+ 10

AUGUSTAMEDICALEXAMiNER

CRASH

COURSE

More Americans have died on US roads since 2000 than in World Wars I & II combined REPLY TO “I AM A ‘BAD’ DRIVER,” PART 1   In our last issue, Bad Driver gave us 7 reasons why his bad driving isn’t so bad after all. Here is our point-by-point rebuttal to the first three points of his flawed reasoning:  “I drive fast” Bad Driver claimed that speed limits are designed for drivers with the lowest skill level, not hotshots like him. (Why do we assume he’s a guy? Because there’s a 99% chance we’re right.) One of many errors with that logic is that we all share the road. We all have a responsibility to every other driver on the road, no matter what their skill level is. Bad Driver also cited Germany, where “they don’t even have speed limits.” Not true. Only their limited-access autobahns do not have posted speed limits. But even if every road in Germany was a speed limit free-for-all, last time we checked this is the USA. One other point: it’s very, very difficult to convince yourself of this when you’re late, but speeding won’t really get you there any faster. If you had to go someplace 5 miles away with no

BREASTFED… from page 8 risk of diabetes and postpartum depression. Adolescents who breastfeed have a lower chance of conceiving a second child during their adolescence. In addition, data shows that these adolescent women stay in school longer. And let’s not forget about how much cheaper breastfeeding is. Formula is expensive. Breastfeeding is inexpensive, even after taking into account the cost of the extra calories a mom has to eat or drink to make the breast milk. And, with breastfeeding, you don’t have to sterilize bottles or nipples, you don’t have to make up formula, and you don’t have to warm up formula in the middle of the night when your infant needs to be fed.   In conclusion, I would be remiss if I did not mention the great support that lacta-

lights or stop signs and you drove 65 mph instead of the posted 45, you would possibly gain about 100 seconds. With traffic lights, speeding might make you catch red lights you might have otherwise sailed through on green

BAD DRIVER AHEAD  “I tailgate” Bad Driver and his ilk think tailgating is a great way to remind slowpokes to speed up. Tailgating is illegal, but it’s also idiotic. All that total stranger in front of you has to do is slam on his brakes and he will own your bank account for quite some time to come, and a good chunk of your insurance company’s too. Tailgating because you’re in a hurry is like telling Delta you can’t sit in row 38. “I have to get

tion consultants can provide for the breastfeeding family. A lactation consultant is a health professional who is an expert in the fields of human lactation and breastfeeding. In the United States, the organization that certifies lactation consultants is the USLCA, the United States Lactation Consultant Association. Lactation consultants are invaluable in educating and supporting the breastfeeding family about how to breastfeed, the different ways of breastfeeding, and preventing and managing different health issues that may arise as a result of breastfeeding. In addition, lactation consultants can help a mom and family manage the challenges of breastfeeding twins or triplets. Our area happens to have several very competent lactation consultants; I

there sooner! Give me a seat in row 28!” Dumb.  “I stay in the left lane” Bad Driver says he has a right to drive in any lane he chooses. Not true. He obviously can’t legally turn right from the left lane or left from the right. He can’t go straight in a left turn only lane. Speaking of tailgating (see above), it is not legal in Georgia to be in the left lane and not yield to a faster car approaching behind you. You could be zipping down Riverwatch at 95 mph in the fast lane, but if someone is tailgating you, by law you have to move over. To take a more realistic example, if two cars are driving down Highway 1 or Riverwatch or I-20 side-byside and traffic is stacking up behind them (not that that would ever happen), the driver in the left lane is breaking the law if he does not speed up or slow down and move over to the right lane. Both South Carolina and Georgia state laws require drivers to travel in the right lane except when passing. What’s the big deal about the left lane? Lane use laws are designed to promote smooth traffic flow and reduce accidents. Left lane slowpokes impede traffic flow, creating frustrated drivers, tailgaters, and traffic backups that lead to frequent lane changes by following drivers. All of that significantly elevates the risk of accidents. + In our next issue, the rest of our response to Bad Driver’s arguments

know some of them personally and, really, they are a great resource. One good way of finding a lactation consultant is to check with your hospital, your doctor, or your health department.   So, what is the no-nonsense nutrition advice for today on this topic? It is that breastfeeding has major advantages for the mom, as well as for the baby, for the family, and for society. Don’t let uneducated people turn an important nutritional and health issue into a political or public decency issue. If you have a personal objection about women modestly breastfeeding in public or in the workplace, then for your benefit and the benefit of society, you need to view that as a personal learning project and evolve your thinking. +

DECEMBER 6, 2019

HUMAN BEHAVIOR

How neuroscience works in everyday life

HOW HAPPY ARE YOU?

It’s been that kind of day. You got humiliated at work for missing a deadline, lunch was a vending-machine pack of by Jeremy Hertza, Psy.D. crackers, and after you got home, you realized you forgot to defrost the casserole for dinner. The kids are hungry, your spouse is upset, and oh yeah, there are a stack of bills you put away when you were tidying up—and they’re all late.   So—what are you grateful for these days?   On the worst, most stressful days—and we all have them— appreciating what’s good in the middle of everything going wrong can make the difference between thriving and merely surviving. A Framework of Gratitude   It’s not always easy, but being grateful for what you have has been shown to have many benefits, like boosting self esteem, helping you sleep better, improving physical health, protecting you from toxic emotions like envy or resentment, and making you resilient. OK, you say. But how can I start?   The first step is to put together what I call a “framework of positives.” Every morning and evening, go over a list of what you’re grateful for, so you’re bookending your day with positive thoughts. Don’t have a massive list, and don’t change the items around too much. You want a consistent message—consider it a mantra—where you’re repeating essentially same things to yourself. For example, you can think about what you’re grateful for in your marriage, with your family, with your friends, at your job, etc. That way, on those days when you’re struggling with your job, your marriage, your friendships or your kids, you can find comfort in the fact that this is just a momentary blip. When you consider the big picture, you are fully aware that you do have a great marriage, your children are healthy—or whatever your framework looks like.   At the same time, encourage yourself to be grateful for all the little things that happen throughout your day. Like, your boss sending you a nice email, or your child saying the funniest or sweetest thing, or getting an invite to a fun event with your friends. One way to remember is to keep a gratitude or happiness journal. It doesn’t have to be long; just a few sentences or bullet points are enough, but make sure to do this on a consistent basis— every day if possible.   Sometimes it can be hard to feel that gratitude unless someone else points it out to us. So another way to help you appreciate your life is to ask other people about it.   After a rough day, ask your spouse or a friend to point out what’s going well in your life. Ask your child what he likes about your family.   When you hear somebody else say something positive that reflects back on you, it can have greater meaning than when you say something positive. Think about it: When you look in the mirror and think that you look nice, isn’t it even better when your spouse notices and says something? Needing external reinforcement isn’t always necessarily a good thing, but sometimes we just need to hear it from someone else.   This isn’t the first time you’ve heard this, but often, the only thing in life we can control is our attitudes. So want to have a happier life? Your attitude can change a day where you screwed up a deadline and forgot to make dinner to one where you got the chance to fix the problem and show your boss how much you care about your job and where you and your family had a special night out at your favorite Mexican place. Try It   Developing the positive habit of gratitude doesn’t take long. Studies have repeatedly shown that it only takes humans about three weeks—to develop new habits. Today’s a great day to start. +

Jeremy Hertza, Psy.D., is a neuropsychologist and the executive director of NeuroBehavioral Associates, LLC, in Augusta. Contact him at 706-823-5250 or info@nbageorgia.com.


DECEMBER 6, 2019

11 +

AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf — posted by Monique Rainford, MD, on December 10, 2016 (edited)

THE TREATMENT THAT GIVES PEOPLE MORE TIME   I was about 13 years old when I heard that my former principal and my favorite teacher from elementary school had cancer. I went to the hospital to visit her. I don’t think she had reached her fortieth birthday. I was too young and uninformed to ask about any of the details. However what stuck with me and I remember so many years later is that on her dying bed her lament was she wished she had more time. There was so much more she wanted to do.   In the past few years, I have become aware of an area of medicine that could do just that: give people more time. Thanks to advances in medical technology there are procedures and medications that can delay death, but this one is different.   This treatment is safe and is essentially risk-free. It is lifestyle medicine. Its message is simple: improve your health by lifestyle choices such as eating healthily (increasing fruits and vegetables and other plant based food and reducing animal fat), exercising regularly, not smoking or abusing alcohol, building healthy relationships, actively taking steps to reduce stress and ensuring that you get adequate sleep.   This may sometimes mean making choices that seem difficult at first. For example, foregoing food that you initially enjoyed and finding healthy substitutes; spending a little time in the mornings or evenings to take a walk; climbing some extra steps in your day; deferring a TV show to get to bed earlier; or spending an extra 10 to 15 minutes per day in meditation or prayer.   I had a conversation with someone about making healthy choices and the person remarked that they would die anyway. The question is this: Do you want to cheat yourself of any of the extra time you may have had? If not yourself, how about your loved ones? Another question: how do you want your years to be? If you had a choice, wouldn’t you choose to be healthy in as many of those living years as possible?   A few years ago a patient came to see me. I always enjoyed her office visits and her vibrant personality. This time she was down and under a great deal of stress because her father was losing his battle with cancer. He was only in his 70s. She felt cheated because throughout his life her father had adhered to a healthy lifestyle. He exercised. He didn’t smoke. He was a vegetarian. How come he had cancer and not others who had smoked and abused alcohol?   However, she unknowingly revealed something else about her father. On more than one occasion the doctors told the family to say their goodbyes. He underwent a surgery with only a 20 percent chance of survival. He pulled through. He became gravely ill after chemo, but he survived. He was able to live to see another birthday. She remarked that he had a strong fighting spirit. I realized something as she shared these thoughts with me: the reason that her father had outlived the expectations of his doctors was likely because he took such good care of his health. Yes, it is unfortunate that he was not spared this terrible disease, and I am not pretending that a healthy lifestyle will guard against all medical ills. But his lifestyle gave his family a tremendous gift, perhaps the most valuable gift that any child can receive from a parent: more time. +

“Who wouldn’t choose this treatment?”

Monique Rainford is an obstetrician-gynecologist.

THE MONEY DOCTOR FISCAL HEALTH IN OUR NEXT ISSUE

If you have a body and you’re reading this newspaper — and we’re going to go out on a limb and guess that you probably qualify on both counts — you are going to like this book. There is no uncertainty.   For starters, you pretty much can’t go wrong with any book written by Bill Bryson. If you are among the uninitiated, you are in for many hours of reading pleasure. He has written a whole shelfful (that’s a word, right?) of books, and we here at Medical Examiner world headquarters have yet to read one that wasn’t thoroughly enjoyable and/or highly informative.   It’s not uncommon to hear people say the vast depths of the oceans are the last unexplored frontier left on earth.   Bryson wonders if it is instead the human body. “How many among us know even roughly where the spleen is and what it does? Or the difference between tendons and ligaments? Or what our lymph nodes are up to?”   Of course, answering those questions and a thousand more would be easy for medical professionals. But there are thousands more that even Nobel laureates can’t answer with anything close to certainty.   As Bryson notes early on in the

book, “You could call together all the brainiest people who are alive now or have ever lived and endow them with the complete sum of human knowledge, and they could not between them make a single living cell.” We are just a collection of inert elements, he says, the same stuff you would find in a pile of dirt, and yet we are living, breathing, sentient creatures. “That is the miracle of life.”   The mystery should be fully expected. After all, it takes 7 billion billion billion (7,000,000000,000,000,000,000,000,000) atoms to make up our 37.2 trillion cells, both numbers scooped up from the book, and

both numbers that any honest scientist will admit are just educated guesses. Our own composition, at least numerically, is virtually uncountable.   That goes for what goes on inside us. “Every second of every day your body undertakes a literally unquantifiable number of tasks - a quadrillion (and more) - without requiring an instant of your attention.”   In just the last second, for instance, the body has manufactured a million red blood cells and sent them off to work.   That’s the kind of gee-whiz facts that sprinkle this book in chapters that address everything from skin and hair to nerves, the immune system, digestion, the heart, lungs, and brain of course, and less mainstream topics, like how we maintain our equilibrium, and what happens when we get sick, even with something dreaded like cancer, and how medicine works.   But Bryson notes that the World Health Organization recognizes some 8,000 diseases that can kill us, and ultimately we defeat all of them but one.   That’s pretty good odds. + The Body, A Guide for Occupants by Bill Bryson, 464 pages, published in October 2019 by Doubleday.

Research News Off-limits foods increases exercise motivation   A Japanese study has found that limiting access to food increases the level of the hormone ghrelin, which in turn led to increased motivation to exercise.   Granted, the study was conducted with mice, but researchers feel the findings have application to humans.   Specifically, better diet control, such as strictly limiting food intake to mealtimes only, may help people seeking to lose weight to maintain a more regular exercise routine.   Strategies that may help promote adherence to mealtime-only eating include not purchasing snack foods, avoiding binge eating, and practicing habits that might tend to discourage eating, such as brushing teeth when the urge to snack strikes instead of eating.   The study was published in October in the Journal of Endocrinology.

Impossible Burgers? What about impossible-to-resist foods?   In the nutrition community, foods that are impossible to resist are known as hyperpalatable foods. These are foods that are formulated to light up the brain’s neural reward circuitry and overpower satiety mechanisms.   A recent study conducted by University of Kansas researchers made the point that food companies have very welldesigned and well-researched formulas for hyperpalatable foods to increase consumption. In other words, “Betcha can’t eat just one!” was far more than just a slogan. It was a challenge which that food company knew it would win far more times than it lost.   Amazingly enough, the Kansas study was undertaken because no previous research had conclusively identified a broadly accepted definition of hyperpalatable foods. The food industry’s trade secrets have

remained just that: secret.   Using detailed nutritional information coupled with precise computer analysis, researchers identified for the first times the exact specifics of what we’ll call here the unholy trinity of binge-inducing foods: the fat/sodium combo (think hot dogs and bacon), the fat/ sugars combo (cake, ice cream, brownies) and the carb/sodium combo (crackers, pretzels, popcorn).   Using their sophisticated tools, researchers say more than 60 percent of the over 7,750 foods in the USDA Food & Nutrient Database fall into one of the three unholy categories. Surprisingly, foods labeled as reduced or no fat, sugar, salt or calories made up 5 percent of hyperpalatable foods. The top group of the impossible-toresist foods (70 percent) were members of the high fat/high sodium combo.   Next up for the Kansas team is deciding on ways to give their data real-world applications. +


+ 12

AUGUSTAMEDICALEXAMiNER

The Examiners

DECEMBER 6, 2019

+

by Dan Pearson

A pound of dynamite? Are you serious? I really wonder about you I thought sometimes. you’d be happy.

I ordered a pound What was that package of dynamite for the that came today? gender reveal cake.

Happy? With a pound? You’re right. It is a There’s no way big cake. I’ll have that’s enough. them overnight five. © 2019 Daniel Pearson All rights reserved.

EXAMINER CROSSWORD

PUZZLE ACROSS 1. Criticize strongly 5. Intro for Gordon 9. Bob of This Old House 13. Pacers’ school 14. ____ Flu 16. Nation east of Iraq 17. Voice of Shrek’s Princess Fiona 18. Synagogue leader 19. Former Dawg Gurley 20. Monetary unit of Thailand 22. Dougherty County seat 24. Speedwagon starter 25. Sid, once a Brave 26. Inner prefix 28. Brother of John and Robert 29. Macon county 32. Malt beverage 33. Diarist Anais 34. Boston diamond 36. Chop 37. Prostate test abbrev. 38. Letters always associated with “bad” 39. Length of life 40. White of the eye 42. Anagram of 37-A 43. Take home 44. Bold, for instance 45. Lair 46. Thermometer type 48. Containing iodine 50. Synonym of 39-A 51. Johns, artist born in Augusta 53. Actor who died in 2008 from drug intoxication 57. Type of list 58. Pelvic exercise 61. Roof overhang 62. Secondhand 63. Intestinal bacteria 64. Requirement

BY

2

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4

5

13

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17

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20

6

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9 15

22

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30

35

38

41

39

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45

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49

47

50

52

53

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58

62

63

65

31

34

37

51

16

29

33

48

12

23

28

32

40

11

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27

36

10

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8

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61 64

66

DOWN 1. Ear _____ 2. _______ Minor 3. Improvised jazz singing 4. Certain lights on a car 5. Coen brothers film of 1996 6. Eggs (Latin) 7. ____ eye 8. Short coat (of the Middle Ages) 9. C or D, for example 10. Resolve differences (with “out”) 11. Type of bug 12. Common conjunction 15. World’s longest river 21. Natal start 23. Ancient tower 25. Mr. Hogan 26. Vote into office 27. Recently 28. Stroke abbrev.

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

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, DEC. 16, 2019

We’ll announce the winner in our next issue!

E X A M I N E R

2

S U D O K 4 U

7

1 6

7 8 6 9 4 3 9 1 7

7

2 6 3 9 9 7 5 1 1

9 3

by Daniel R. Pearson © 2019 All rights reserved.

DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.

67

by Daniel R. Pearson © 2019 All rights reserved.

65. Kelly of note 66. Throw 67. Makes leather

The Mystery Word for this issue: SIGNTECE

30. Master (in Africa) 31. Ring-shaped bread roll 32. Massage reactions 33. Ft. Gordon occupant 34. Fed. med. agency 35. Up until now 37. Before surgery, in short 38. M.D. asst. 41. Installment of a TV show 42. Not sweet, in wine terms 45. Type of deposit 46. Metal-bearing mineral 47. ________ Blvd. (near MCG) 49. Former Augusta mayor, to friends 50. Downtown street 51. Joseph (in Juarez) 52. Capital of Yemen 54. Greek goddess of the Earth 55. Uniform 56. Ohio team 57. Type of boat 59. Gunk 60. Ernie of the PGA Solution p. 14

QUOTATIONPUZZLE U O E R H O S A S H G S W D L T T N H I W W R E O E O D E U E I Y A T E N N F J M P O O O

2 3 8 7 U4 T1 N9 5 6

4 1 5 8 E9 L6 F3 7 2

9 6 7 5 2 3 8 4 1

— Roger Babson

by Daniel R. Pearson © 2019 All rights reserved

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once. Black squares indicate spaces between words, and words may extend onto a second line. Solution on page 14.

Use the letters provided at bottom to create words to 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.

1 2 3 1 2 3

I 1 2 3 4 5 I 1 2 3 4 5

O 1 2

3

4

1 2 3 4

H 1 2 1 2 3 4 5 6 7 8 9 5 1 2 3 4 C — Frederick 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 Douglass

1.CRRIWTTTTTT 2.SEEHHHHHHOA 3.IIBBUREEAA 4.SSEENNT 5.EEGGLL 6.LLS 7.II 8.OO 9.NN

SAMPLE:

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by Daniel R. Pearson © 2019 All rights reserved

WORDS NUMBER

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THE MYSTERY WORD

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DECEMBER 6, 2019

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AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

A

n anti-vaxxer dies and goes to heaven and is given the day one orientation, which includes meeting God one-on-one and asking any question they so desired.   “There’s one thing I’ve always wanted to know the real truth about,” said the new angel.   “Ask away,” said God. “Whatever it is, I know the answer.”   “Ok, here’s my question: once and for all, do vaccines cause autism?”   “You really want the truth?” asked God.  “Absolutely.”   “All right then. The truth is, no, vaccines have nothing to do with autism whatsoever.”   “Whoa,” said the anti-vaxxer in shock. “I cannot believe this. They got to you too.”  Moe: Do you like your new job?   Joe: Teaching? Yeah, I guess it’s ok.   Moe: You don’t sound very convincing.   Joe: It’s just that... well, you know how short I am. It bothers me that some of my students are taller than I am.   Moe: Why don’t you ask administration for a brighter, sunnier classroom?   Joe: How on earth could that possibly help?

The

Advice Doctor

Moe: Trust me on this: when you go into a brighter room, I promise you your pupils will get smaller.   A teenage boy is complaining to his friend that his widowed father has come out of the closet, and to make matters worse, his new boyfriend has moved in.   “I cannot stand the thought of having two dads,” he told his friend.   “You need to let go of your prejudice,” advised the friend.   “What prejudice?”   “It’s pretty obvious you’re prejudiced against gay people.”   “No way,” said the boy. “I just can’t stand the thought of twice as many dad jokes.”   Moe: All the animals came onto Noah’s ark in pairs, right?  Joe: Not the worms. They came in apples.   Moe: With everybody eating turkeys on Thanksgiving, I wonder what turkeys ate.   Joe: Nothing. They were stuffed.   Moe: I had the worst nightmare last night.   Joe: Did you remember it when you woke up?   Moe: Oh yeah. I was convinced there was a monster under my bed.   Joe: Sounds like pretty standard stuff.   Moe: This one was different. Turned out it was a can of Red Bull.   If I had a dollar for every time I didn’t know what was going on, I would be like, why am I always getting this free money? +

Why subscribe to theMEDICALEXAMINER? What do you mean? Staring at my phone all day has had no Effect on ME!

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

©

Dear Advice Doctor,   I am by far the best at what I do in our company in all its locations. As an added bonus, I love what I do. But there is one problem: I hate public speaking. I dread it. I am in terror days and sometimes weeks in advance of some event where I will have to speak in front of people, even if it’s a group of only ten or twelve. It’s my Achilles heel, but there’s no getting around it; it comes with the job. This irrational fear will eventually ruin my career. How can I overcome it? — Can’t Talk the Talk Dear Can’t,   Really, it’s a wonder more people don’t share your affliction. After all, the Achilles tendon is the largest or thickest one in the body, and we can barely make a move without it. What’s more, it bears tremendous loads in doing its job. According to research published in Medicine and Science in Sports and Exercise, merely walking subjects the tendon to a load stress 3.9 times body weight; during running that figure grows to 7.7 times. For someone who weighs 150 lbs, those numbers translate to a force of 585 lbs and 1,155 lbs respectively for each and every step we take.   No wonder heel inflammation or Achilles tendinitis is relatively common. Gradually building up leg strength through exercise is a good prevention strategy, as is stretching before running or other strenuous physical activity. Treatment for Achilles tendinitis is usually rest, ice, physical therapy and pain relievers. Complete tears or ruptures are less common and aren’t we glad - but are accompanied by lots of pain and extreme difficulty walking. The moment of injury might even be accompanied by a snapping sound, like a thick, strong rubber band (which is sort of what the Achilles tendon is) breaking (which is more or less exactly what just happened). Treatment is surgery, immobilizing the foot in a cast to promote healing, or both.   Clearly the best route to take, as with most health issues, is prevention. Heel health is protected by avoiding a sedentary lifestyle, high heels, and rheumatoid arthritis.   I hope this answers your question. Thanks for writing! + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in Examiner issues.

SUBSCRIBE TO THE MEDICALEXAMINER +

Why read the Medical Examiner: Reason #831

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

BEFORE READING

AFTER READING


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

...cleverly hidden on the thermometer in the p. 7 ad for C & C AUTOMOTIVE

THE WINNER: CAROL BRUNSON! Want to find your name here next time? If it is, we’ll send you some cool swag from our goodie bag. The new Mystery Word is on page 12. Start looking!

DECEMBER 6, 2019

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED B U D S

A S I A

E A L H E S C T J T O U S G E

S C A T

H F O A A V Z R A A N G R E O N D O T E N I W P S A L E R A Y P E D I O D I A S P E R D O K E E D E C N E T

R T I A N B B I A L B R E E D N F L D S P A E N C E L G E L O L I O S S

I R O N

L A A N D D Y

B W A N O R A R A E D G E A N E T A

B A Y G E E T L

B A B E L

V I T A M I N

E V E N

R E D S

SEE PAGE 12

The Celebrated TheSUDOKUsolution MYSTERY WORD CONTEST 2 4 9 8 5 1 7 6 3

...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.

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Love to stare at your phone? Visit issuu.com/ medicalexaminer and stare away.

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QuotatioN QUOTATION PUZZLE SOLUTION “Let him who would enjoy a good future waste none of his present.” — Roger Babson

WORDS BY NUMBER

“The thing worse than rebellion is

the thing that causes rebellion.” — Frederick Douglass

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READ EVERY ISSUE ONLINE WWW.ISSUU.COM/ MEDICALEXAMINER


DECEMBER 6, 2019

IT’S A QUESTION OF CARE Hosting your aging loved one at your home during the holidays by Amy Hane, a licensed Master Social Worker in South Carolina and Georgia, an Advanced Professional Aging Life Care Manager and a Certified Advanced Social Work Case Manager.

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AUGUSTAMEDICALEXAMiNER   In theory, at least, it is a great idea to invite all of the relatives to your house for a family gathering. However, if you are planning to host your aging loved one, consider these points to ensure that the visit is comfortable and enjoyable for you both.   Does your loved one need specific Durable Medical Equipment for comfort or safety? These items may include a recliner lift chair, wheelchair, cane, walker, shower chair, bedside commode, or temporary/suction grab bars in the shower. These can be either purchased or rented from a Durable Medical Equipment store. Do your homework before your loved one arrives to determine which of these they may need so that you are prepared.   If your loved one struggles with dementia, being in a place other than their normal environment may be disconcerting and you will need to be alert to make sure they are safe. Consider having them

sleep near you so you can hear them if they need you at night. If you have concerns about your loved one possibly wandering, you might put temporary alarms on the exterior doors of the home   Overall, you want your loved one to feel at home. Work to keep your loved one on as much of a schedule as possible, since that will help him or her feel calmer and in turn more able to visit and engage with everyone. Be sure that their medications are given correctly, and that all of their personal items are readily available so they do not have to search for them. You might even put signs on doors (pantry, bathroom, garage), so that they feel well oriented and can be helpful if you ask them to assist with tasks that require them to navigate around your home.   Have a great holiday, and an even better time connecting with those you LOVE and those who LOVE you. +

WINTER… from page 9

or all of these scenarios fits your winter eating habits it is important to maintain healthful eating all year long. Follow these suggestions to satisfy your winter cravings in a most nutritious way. • Begin each day with a large glass of water and continue drinking water throughout the day. For something warm try hot tea or herbal tea. • Aim to eat meals on time (to keep those serotonin levels up and cravings at bay) • Layer clothes for warmth, go out and exercise (this decreases eating opportunities, helps warm you up, and depending on the time of day exposes you to more sunlight • At festive holiday gatherings or football parties bring a delicious healthy offering • Keep plenty of vegetables at home and eat them regularly. A perfect way to get more veggies into your diet, increase hydration and provide warmth is soup! So be sure to try the recipe on page 9! + To find a local dietitian visit: www.eatrightaugusta.org.

PROFESSIONAL DIRECTORY +

ACUPUNCTURE

DENTISTRY

DRUG REHAB

Dr. Eric Sherrell, DACM, LAC Augusta Acupuncture Clinic 4141 Columbia Road 706-888-0707 www.AcuClinicGA.com

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

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

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

AMBULANCE SERVICE

Floss ‘em or lose ‘em!

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

DERMATOLOGY AMBULANCE • STRETCHER • WHEELCHAIR

706-863-9800

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

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

IN-HOME CARE Everyday Elder Care LLC Certified Home Health/Caregiver 706-231-7001 everydayeldercare.com Zena Home Care Personal Care|Skilled Nursing|Companion 706-426-5967 www.zenahomecare.com

LONG TERM CARE

Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) WOODY MERRY www.woodymerry.com Augusta 30904 Long-Term Care Planning 706-733-3373 SKIN CANCER CENTER I CAN HELP! www.GaDerm.com (706) 733-3190 • 733-5525 (fax)

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

YOUR LISTING Augusta Area Healthcare Provider 4321 CSRA Boulevard Augusta 30901 706-555-1234 CALL 706.860.5455 TODAY!

PHARMACY

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

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

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

YOUR LISTING HERE Your Practice And up to four additional lines of your choosing and, if desired, your logo. Keep your contact information in this convenient place seen by thousands of patients every month. Call (706) 860-5455 for all the details!


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