Dec19 14 by Daniel Pearson

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Road trip! W

hat can you do with the kids during their Christmas vacation? Well, you could park them in front of the TV for a mindnumbing week or two. Or you could take our suggestions that follow and hit the road for an educational, enlightening — and salubrious — field trip. It’s a day trip, and with gas being sold at giveaway prices these days, you’ve got no excuse not to go. And by the way, kids are not required for either of these destinations. Adults will find them to be educational, enlightening and salubrious too. The Long Journey First, let’s head to Jefferson, Georgia. According to Google Maps, all you have to do to get there is 1. Leave your driveway; 2. Drive to the corner; 3. Turn... wait. Let’s forget that and use MEPS, the Medical Examiner Positioning System. Step one: drive to Athens, home of the

Georgia Bulldogs. Try (and possibly fail) to resist the temptations of Lumpkin and Clayton Streets in downtown Athens and get on Prince Avenue. Stay on Prince and it will magically become Jefferson Road (aka US 129), your reminder that you’re heading for Jefferson. Stay on 129 until it T’s with Lee Street in Jefferson. Take a right, go two blocks, then turn left onto College Street. The Crawford W. Long Museum will immediately appear on your right. Travel time from Athens: about 30 minutes. Your destination is also

known as the “Birthplace of Anesthesia.” Yes, Dr. Long is the guy who made sedation dentistry possible; made childbirth (pardon the pun) bearable; and prevented simple procedures like appendectomies from becoming agonizing ordeals. Before anesthesia, “elective surgery” was virtually unheard of. Here you pay homage to the man who made painless surgery possible, and while you’re here you can take a fascinating and non-anesthetized journey from the 1840s up to today’s anesthesiology technology. You can even scoop up a “Got ether?” t-shirt or two from the museum’s gift shop. When you’ve explored anesthesia to your heart’s content, enter “1600 Clifton Rd NE Atlanta GA 30329” into your MEPS device and in less than 45 minutes you’ll be at Exit 89, N. Druid Hills Please see ROAD TRIP page 2

DECEMBER 19, 2014

Medical EXAMINER

Healthy SOUP hy is chicken noodle soup considered to be good for you when you’re sick? Is there any science behind it? Or is it an old wives’ tale? The answer is surprisingly simple: it’s Soup recipes, page good for you because your mother said so. s 7 & 10 But beyond that, traditional chicken soup, the homemade variety especially, is chock full of tasty medicinal ingredients: healthful vegetables; curative garlic; carrots rich in vitamin A; and the star of the show, chicken, rich in protein, thiamine and other B vitamins; all swimming in a tasty broth that promotes (re)hydration. Generally speaking, soup is a healthful, nutritious, low calorie, low cholesterol, low-fat food. That’s a mouthful, considering there are about 52,000 varieties of soup. On the other hand, if we were going to stereotype soup —and stereotypes are often negative Please see SOUP page 10

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ROAD TRIP… from page 1

One of the display rooms at the Crawford W. Long Museum in Jefferson, Georgia. Road (Exit 89), mere minutes from your destination. The CDC Museum Officially, it’s the David J. Sencer CDC Museum, operated in association with the Smithsonian Institution. The Story of the CDC is a permanent exhibit, but (through Jan. 2) the The CDC Museum in Atlanta. temporary exhibit is “What’s Cooking, Uncle Sam? The Government’s Effect on the American Diet.” It might not be a topic you’ve The Crawford W. Long Museum considered before, 28 College St but there’s actually Jefferson GA 30549 a lot of Uncle Sam Hours: Tue-Fri, 10 am to 5 pm in our food, from Saturday: 10 am to 4 pm the farm all the Closed on major holidays way to our kitchen Admission: Adults, $5; Over 65, tables. There are $4; Miltary & Students, $3; 5 and government regulations that encourage under, free farming and large-scale food production and that promote food safety. The David J. Sencer CDC Museum Uncle Sam has also tried, with 1600 Clifton Rd NE varying degrees of sucess, to shape our Atlanta GA 30329 everyday eating habits. There were major Hours: Mon-Fri, 9 am to 5 pm campaigns during wartime to encourage except Thursdays, 9 am to 7 pm home gardening and food conservation. Closed on weekends and federal The CDC Museum is not holidays recommended for small children. We Admission: free thought this was perhaps because the Important security notes: A food exhibit might feature broccoli or government-issued photo ID beets or something, so we asked. As it (drivers license, passport photo or happens, the exhibits are a little over other state-issued photo ID card) the heads of the daycare or elementary is required for all visitors over age school set. 18. Security officers will ask you Middle school, to open the trunk and hood of high school and your car for inspection, and will adult visitors will also conduct a quick scan of the get the most from undercarriage of your vehicle. The the displays. CDC says the entrance process Happy travels, will take at least 15 minutes. and remember Reservations are not required for to wear your groups of 9 or fewer. + + seatbelt. A war-era poster

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“DO LESS HARM”

o maybe that’s not how Hippocrates chose to phrase it in his famous oath for physicians that young medical graduates still take to this day. Still, throughout the history of medicine, that’s what we’ve had to aim for. Last week, an unusual headline in the Washington Post caught my eye. “Hospitals are killing tens of thousands fewer people,” it read. Now, how is that for a heading? The problem of medical errors came into clear focus in 1999 when the Institute of Medicine (IOM) released its report, To Err is Human: Building a Safer Health System. In its report, the committee estimated that medical errors were killing between 44,000 and 98,000 people in the United States each year. To put that into perspective, the committee

went on to note that even the more conservative estimate meant that more deaths are attributable to medical errors than breast cancer, AIDS, or highway accidents. The higher estimate would approximate two full 737s crashing every day. Fifteen years later, there is excitement and hope that these numbers are significantly decreasing. In fact, as the Washington Post concluded, the number of deaths attributable to medical errors may have declined by many thousands. Citing a new report released by the Agency for Healthcare Research and Quality (AHRQ), a division of the Department of Health and Human Services (HHS), this reduction could be as high as 50,000 fewer deaths over the last three years. The report compared the

rate of Hospital-Acquired Conditions (HACs) during 20112013 and compared it to the rate from 2010. This term “HACs” is really an umbrella term that covers numerous measures, ranging from surgical site infections to falls in the hospital to pressure ulcer development. The report found a steady decline in the rate at which HACs occurred, totaling to a 17% decrease overall during the last three years. That’s 1.3 million fewer HACs that patients in the hospital had to experience over those 3 years. Subsequently, in avoiding the additional treatment that would be required for these HACs, the healthcare system saved close to $12 billion dollars over the same time period. Sounds great, right? But now you might be asking yourself the same question that I had. “What changed?” Unfortunately, the answer is not very clear. The hope would be, of course, that such improvements were always occurring. With constant improvements in health technology, better drugs and fancier surgical instruments, one might expect that the decline in HACs has been fairly Please see WIDE-EYED page 6

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AUGUSTA MEDiCAL EXAMINER

DECEMBER 19, 2014

OLD NEWS

wait times in the reception area. I also heard comments regarding bedside manner. + Waiting is tiring but long waits for an exceptional POINTS OF INTEREST TO FORMER KIDS doctor seems to be the norm these days. My suggestions by Trisha Whisenhunt, Senior Citizens Council are to bring a book, a snack and a bottle of water. Dress RETINA DETACHMENT IS AN EYE OPENING EXPERIENCE comfortably. Complaining about the wait time or late in coming: prescriptions here is a small window mentioning your age at the were given to me after of opportunity for the front desk to garner sympathy surgery and required a trip correction of a detached retina. isn’t going to speed up the to the pharmacy. There was Depending on the type of process. the long wait to be filled and detachment, this window can As for the manner of my by that time, I was behind the be as much as a week or as doctor, I don’t need him to be curve and they were useless. little as a couple of days. I just my best friend. What I need I was a mess the first night went through this experience, and expect is a surgeon who but around 5:00 a.m. the and I was lucky; I had a little takes his time, is focused, nausea began to subside. time to play with. We are all gives me his undivided The wait time for followfortunate to have some of attention, answers my up appointments is long; the best eye doctors in the questions without making me three hours for my second nation right here in Augusta, feel rushed, and is pleasant appointment and just over Georgia. and gentle during the process. two for my third. There was I had no idea what to I am here for the restoration of grumbling about the long expect. I knew it could be my sight, so I am not offended corrected, but I thought I if he doesn’t make small talk was going to walk out of about my children. the surgical care unit being More than four months able to see and go about later I am still in recovery; still my business. on some medications. I have Recovery is not quick. had some complications. I had There are limitations; to have a cataract removed you can’t sleep flat for and a laser procedure was quite a while. As would be required. expected, prescriptions are Currently, the vision in the required as well as several affected eye is better than it follow-up appointments. has ever been and I am able Depth perception is gone. to get back to enjoying the The post-op headache things in my life which are and nausea were the important to me. I am amazed most severe I have ever by the technology and experienced. Medications Area of retinal grateful to both of my doctors to end those were of no detachment and their staff for their skill help because they were too and empathy. +

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BE FRUITFUL

There’s nothing better than fresh fruit, and we’re entering peak season for all the delicious natural bounty our beautiful earth gives us. The Medical Examiner asked the members of the Augusta District Dietetic Association — they’re registered dietitians — for their favorite nuggets of fruit info. Here are a few of their tasteful thoughts: To prolong the life of ripe strawberries, rinse them in a mixture of 1 part vinegar to 10 parts water and then drain and store in the refrigerator. Kathy Belinski, RD, LD If you picked too many blueberries, make your own syrup for pancakes or to put over angel food or pound cake 2 cups of fresh blueberries 1/4 cup orange juice 1/4 cup water 1 Tablespoon cornstarch 2 Tablespoons sugar 1/8 teaspoon ground nutmeg 1/4 teaspoon grated orange peel Combine all ingredients in a saucepan and cook and stir over medium heat for 5 minutes or until slightly thickened. To freeze blueberries for later use,, place dry berries on a cookie sheet in a single layer and freeze. Once frozen, transfer the berries to a plastic bag or freezer container. This way you can take out as many or few as desired for future use and they won’t be all frozen in one clump Jeanne B. Lee, MS, RD, LD Augusta Area Dietetic Internship University Hospital

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Quick fruit snack ideas: 1) Banana with peanut butter. Bananas and apples are another delicious combination.

2) Yogurt with berries and some granola or flax seed on top 3) Sliced banana with nuts 4) Dates stuffed with almonds 5) Low-fat crackers, cheese and wedges of fresh plums 6) a mix of dry plums, apricots and nuts Pamela Brisky RD LD Clinical Dietitian Georgia Regents University “Fruit is nature’s candy. The best energy bar grows on trees; pick a fruit for hours of energy instead of the supplements aisle.” Andy Yurechko, MS, RD, LD Dietitian Georgia Regents Medical Center & Children’s Hospital of Georgia • If you want to get a child to eat and apple, try cutting it up in slices and dipping it in dry jello. It is not only appealing to look at, but delicious to eat! • You don’t have to peel a kiwi to eat it. Try eating with the peel on. Your body will love the extra fiber. Donna S. Martin, EdS, RDN, LD, SNS Director School Nutrition Program Burke County Board of Education Strawberries are the only fruit which grows seeds on the outside. Bananas will turn black in the refrigerator. There are over 1 ,000 different kinds of apples. Amy Culberson, MS, RD, LD Dietitian/Private Consultant ++

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DECEMBER 19, 2014

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW ABOUT DRUG PRICING

AUGUSTA

ecades ago sildenafil was prescribed to lower blood pressure by dilating the blood vessels. It was classed as an antihypertensive drug. It sold for about 25¢ per tablet. Later it was noticed that in a different dosage, it caused engorgement of the penis and was helpful to aging men with sexual dysfunction. To get FDA approval for a new indication as a treatment of erectile dysfunction, Pfizer spent a huge amount of money and many years on clinical trials to prove to the FDA what they already knew: tt works. Once it was finally approved, it was marketed as Viagra ... but not at 25¢ per tablet. Now it was $8 a pill. Soon it was up to $12 to $15

a pill. The last quote I heard from a local chain pharmacy was $35 a pill. In my book, an increase from 25¢ a pill to $35 a pill is a something like a 14,000% increase in price over a few decades — for the same drug! For many years Vicodin (Hydrocodone 10 mg and acetaminophen 325 mg) was prescribed for pain. Now we have a “new formula” called Vicodin HP 300. It contains hydrocodone 10 mg and acetaminophen 300 mg. That is right: they kept the same 10mg of hydrocodone and reduced the acetaminophen by 25 mg. HP stands for High Potency. I checked with a local chain pharmacy. The price for 60 tabs of Vicodin HP 300 was $485.

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That’s $8.08 per tablet. I was taken aback. Thinking there might be a mistake, I call another chain. Sure enough, they had a better price: 60 tabs for $458, $7.63 a tablet. Then I asked, “If prescribed in the generic version of the “old Vicodin” (10 mg of hydrocodone and 325 mg of acetaminophen), what is the cost of 60 tablets?” $58! A mere 96¢ per tablet. If the recipient suffered from chronic pain (as in spinal stenosis, degenerative disc disease, or cancer pain), at the proper dose of 1 tablet four times a day using the old formula generic represents a savings of about $30 a day. That multiplies out to $11,000 a year for the remainder of the patient’s life.

e n i c i d ME

Triazolam (Halcion) 0.25 mg is a hypnotic that helps insomniacs drift off to sleep. Since it last only 4 hours, crosscountry or transcontinental airline passenger sometimes use it during flights so they can arrive rested and ready to work. For years, 45 tabs cost less than $20 dollars. A few months ago, without additional research or expense to the manufacturing drug company, the retail price jumped to $45. This month it cost $51. That is an approximately 155% increase in retail cost without any appreciable cost to the drug manufacturer. I don’t begrudge the drug companies their profits. Without a profit, there would be no new research and no new drugs. Think where we

would be without all the new drugs of the past two decades. However, in the case of older established drug treatments, it is clear that you should shop your prescriptions for the best pricing. And you should always consider the use of generics when it is appropriate. Don’t be bashful. Talk to your doctor. Talk to your pharmacist. Talk about cost and efficacy. After all, it is your health. And your bank account. And just because you have insurance does not mean you should use the more expensive brand name. The more your health care costs your insurance company, the more likely your insurance rates will increase. + Bad Billy Laveau is a retired MD with a pointed sense of humor. Bad Billy speaks and entertains at public and private events for audiences not subject to cardiac seizure secondary to overwhelming laughter and glee BadBilly@knology. net or 706-306-9397

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DECEMBER 19, 2014

AUGUSTA MEDiCAL EXAMINER

The Money Doctor Giving in 2015

We are fortunate to live in one of the most charitably inclined regions of the country. In the latest study (full results can be found at philanthropy. com), South Carolina ranked 5th at 6.4% and Georgia ranked 8th at 6.2% in the percentage of discretionary income given to charity. The data used for the survey was published from IRS data in 2008. Given the many worthy causes and organizations that are asking for support, how do we go about deciding who to donate our time and money to?

read an interesting article several weeks ago by Andrew Blackman in the Wall Street Journal. The title of the article was “Can Money Buy Happiness?” It is a fairly long article, but one I would encourage you to check out on the internet. There were several major takeaways: • Giving money (or time) away to causes where donors can see a direct impact on others lives makes people happier than spending it on themselves. • When they do spend money on themselves, people are a lot happier when they use it for experiences (like travel) than for material items. This article is about point one, but I also found the second point very interesting and he goes into some detailed research. We tend to neglect spending money on experiences because of what we spend on material, tangible things. The article suggests we may be happier with lower material expenses and increased spending of time and money on experiences.

Set annual goals It does not need to be an elaborate plan, but I recommend families having a one or two page template that guides your decisions in the causes you want to support. It should start with your family mission, goals and values, and include what is important to you. Your family’s plan should answer the question, Do we support several large organizations or many organizations with smaller gifts? Consider ways to get your children involved. Let them have some input in defining the

family mission and values and give them some flexibility in deciding which organizations they may want to support as well.If you have older kids, maybe this plan is discussed and implemented during Thanksgiving each year when everyone is home. How much and to whom? Create a list of the organizations you have supported in the past. List the amount donated to each organization. After the amount, put “Why?” If it is not something that is near and dear to your heart and supports your family mission, then consider redirecting those dollars to something else. Also, how good is the charitable organization at minimizing overhead costs and maximizing the use of your gift for its intended purpose? You will find having a charitable plan in place makes it easier to politely say no when that is the appropriate answer. This is the

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hardest thing for many of us to say. This is difficult because there are so many worthy causes, but there are only so many we can support. The full discussion on how we give is beyond the scope of this article. Direct cash gifts are the most common, but tools such as giving appreciated stock to charity, donor advised funds, and setting up private foundations are some of the tools that we help clients with to implement their charitable goals and objectives. Your time Most organizations appreciate your money, but probably more valuable to them and possibly more valuable to you is supporting them with your time (or “experience”). How many hours are you going to donate each year and to whom? This will be different for everyone – from a local homeless shelter, to church, to volunteering in school, coaching sports, mentoring young people… I expect that you, like many I have talked with who give their time to an organization they believe in, will walk away feeling like you have received much more than you have given. One of my favorite passages in the Bible is Mark 12:41-44. It is the story of a poor widow

that came to the temple and gave two small copper coins worth only a fraction of a penny. Calling his disciples to him, Jesus said, “I tell you the truth, this poor widow has put more into the treasury than all the others. They all gave out of their wealth; but she, out of her poverty, put in everything – all she had to live in.” One takeaway I get from this passage is Jesus was saying that you do not have to have significant financial wealth to have an impact in someone else’s life. It is important to support organizations with our money, but just as importantly with our time. If we think back over our lives, many of the most memorable gifts we have received were not toys or presents, but the precious time that a family member, friend, coach, or teacher spent with us. Giving is a very personal, private, and sensitive topic for many. I hope you will find that if you provide some structure and focus to your charitable giving plans, it will make it more enjoyable for you and your family and provide a tool to discuss items of importance to you with your children. + by Bill Cleveland, a Certified Financial Planner (CFP®) and CPA with Preston & Cleveland Wealth Management, LLC (www. preston-cleveland.com).

WIDE-EYED… from page 3 constant. However, that does not seem to be the case. It is possible that we have only recently acquired the needed understanding to implement effective counter measures. As more research is done on these problematic HACs we may finally be able to definitively account for such the drastic change of the last few years. Though the exact reasons remain unclear, most point to changes in the way that hospitals are paid. In recent years, hospitals are being paid less and less to manage episodes and conditions that they could have likely prevented in the first place. Public payers, such as Medicare, are largely responsible. Additionally, provisions of the Patient Protection and Affordable Care Act have likely played a role. For example, the healthcare law from 2010 introduced the rollout of a new type of insurance plan, called an Accountable Care Organization (ACO). These models continue the push away from fee-for-service models towards managed care that also emphasizes quality. Another provision has provided bonuses for Medicare Advantage plans that provided high quality care. Regardless of the reasons for the shift, this latest trend is a good thing, but there is still a long way to go. This latest report estimates that 12 out of 100 hospitalized patients will still experience some sort of HAC. As I alluded to previously, the carrotsand-sticks approach is likely taking effect. New knowledge and understanding of these conditions will always help. A lot still rests on the shoulders of the providers, however. I urge providers to take note of this 12% rate and to do their part. Many times it comes down to individuals. Wash your hands. Run through the checklist. Ask that extra question… We will never be able to truly “do no harm,” but we can continue to do less of it. + Ross Everett is a medical student at the Medical College of Georgia. He graduated from the University of Georgia in 2011. Currently, he is taking a year of leave from medical school to pursue a Master of Public Health degree in Health Systems and Policy from Johns Hopkins University. Please contact him at wideeyedwhitecoat@gmail.com

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AUGUSTA MEDiCAL EXAMINER

Southern Girl Eats Clean

Carrot Soup with Spinach

How do carrots, potatoes, onions and spinach strike you? If you are a fan of veggies, as I am, I know you will love this hearty and nutritional soup. This beautifully colorful soup would be perfect as a starter for your holiday meal or as a main course served with crusty whole wheat bread. I got this recipe idea while on a trip to Edisto Island, South Carolina at the end of September. After we arrived on the island, we realized that the Edisto Island Shrimp Festival was planned for that weekend. We rode over on our bikes to check it out and see what the festival was all about. I came across one of my favorite things - a cookbook. I am addicted to them. I simply can’t help myself. I have a serious problem. The Edisto Island Yacht Club published a cookbook of favorite recipes, some of which were new, some borrowed and some handed down from generation to generation. Of course, I purchased this cookbook because I love and blend until smooth... then • 2 tsp. of peeled fresh ginger, recipes that are rooted in pour back into the saucepan.) minced Southern history, tradition Add the lemon juice and and flavor. In the soup section • 1 tsp. of green curry paste green curry paste to the soup Juice of 1/2 lemon of this cookbook, a very and stir well. If mixture is too different recipe caught my eye, • 1-1/2 cups of spinach thick, dd more broth to thin. leaves thinly sliced using the “Carrot Soup with Spinach Stir the thinly sliced Chiffonade technique* Chiffonade.” I simply had to spinach leaves into the • Sea salt and cracked black give this soup a try. saucepan and allow to I changed the recipe a bit, as pepper to taste. simmer 1-2 minutes. • Goat cheese crumbles to I usually do. I added several Season with salt and garnish other ingredients and omitted pepper to taste. the yogurt as the garnish. It Garnish with goat cheese Directions: was SO tasty! The spinach crumbles if desired. Begin by tying on a cute gave texture and another in a tidy kitchen. Serve immediately. apron level of flavor. I topped my Then place 4 cups of soup with a bit of goat cheese chicken or vegetable broth, *The Chiffonade technique is crumbles, but you could leave carrots, potato, onion, garlic used for slicing leaves such as that off if you prefer or use a and 1/2 tsp. of ground ginger spinach or basil. Simply stack dollop of plain yogurt. into a large saucepan and the leaves on top of each other Enjoy! bring to a boil. and roll the leaves up. Then Reduce heat, cover and slice the rolled leaves very Ingredients: simmer until vegetables are thin. The end result is small, • 4 cups (or more) of organic very tender. Approximately thin strips of the leaves. + chicken or vegetable broth 30-40 minutes. • 1 lb. of organic carrots, Add the minced fresh Alisa Rhinehart writes the blog peeled and sliced www.southerngirleatsclean.com ginger to the saucepan. • 1 8 oz. russet potato, peeled She is a working wife and mother Using an emulsion blender, and coarsely chopped living in Evans, puree until all the vegetables • 1 medium organic sweet Georgia. Visit her are smooth. (If you do not yellow onion, chopped blog for more recipes have an emulsion blender, • 2-3 cloves of fresh garlic, and information on you may place the vegetable crushed clean eating. mixture into a regular blender • 1/2 tsp. of ground ginger

Carrot Soup with Spinach

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OUR NEWSSTANDS Medical locations: • Department of Veterans Affairs Medical Ctr, 15th St., Main Entrance • Dept. of Veterans Affairs Medical Center, Uptown Div., Wrightsboro Rd., main lobby • Doctors Hospital, 3651 Wheeler Rd, ER Lobby Entrance • Eisenhower Hospital, Main Lobby, Fort Gordon • George C. Wilson Drive (by medical center Waffle House and mail boxes) • GHSU Hospital, 1120 15th Street, South & West Entrances • GHSU Medical Office Building, Harper Street, Main Entrance • GHSU Medical Office Building, Harper Street, Parking Deck entrance • GHSU Hospital, Emergency Room, Harper Street, Main Entrance • GHSU Children’s Medical Center, Harper Street, Main Lobby • GHSU, Laney-Walker Boulevard transit stop, Augusta • Select Specialty Hospital, Walton Way, Main entrance lobby • Trinity Hospital, Wrightsboro Road, main lobby by elevators • Trinity Hospital Home Health, Daniel Village, main lobby • University Health Federal Credit Union/ University Hospital Human Resources, 1402 Walton Way, Main Lobby • University Hospital, 1350 Walton Way, Emergency Room lobby area • University Hospital, 1350 Walton Way, Outside Brown & Radiology/Day Surgery • University Hospital - Columbia County, 465 N. Belair Road, Main Lobby • University Hospital Prompt Care, 3121 Peach Orchard Road, Augusta

Around town: • Barney’s Pharmacy, 2604 Peach Orchard Rd. • Birth Control Source, 1944 Walton Way • GRU Summerville Student Bookstore • Blue Sky Kitchen, 990 Broad Street • Columbia County Library, main branch lobby, Ronald Reagan Drive, Evans • Enterprise Mill (North Tower), 1450 Greene Street, Augusta • Daniel Village Barber Shop, Wrightsboro Road at Ohio Ave. • Hartley’s Uniforms, 1010 Druid Park Ave, Augusta • International Uniforms, 1216 Broad Street, Augusta • Marshall Family Y, Belair Rd, Evans • Mellow Mushroom, 12th and Broad Streets, Augusta • Parks Pharmacy, Georgia Avenue, North Augusta • Southside Family Y, Tobacco Road, Augusta • Surrey Center, Surrey Center Pharmacy, Highland Avenue, Augusta • Top-Notch Car Wash, 512 N. Belair Road, Evans • Wild Wing Cafe, 3035 Washington Road, Augusta

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

DECEMBER 19, 2014

AUGUSTA MEDiCAL EXAMINER

Very little if anything about healthcare is inexpensive, and that includes medicine. Tiny pills can command large prices. Over-the-counter medications may be less expensive, but are they also less effective? Find the answers to lots of your drug store questions in this column written by Augusta pharmacists Chris and Lee Davidson exclusively for the Medical Examiner.

HOW DOES THE NEW YEAR AFFECT MY INSURANCE?

he start of a new year is quickly approaching, so let’s look at how that might affect your pharmacy insurance. If your insurance plan is changing effective the first of the year, then you should be acting now to prevent problems in 2015. There are be several reasons why insurance plans change, and you may or may not be able to do anything about it. A good rule of thumb is to plan ahead and get all the paperwork associated with any change as early as possible. This allows the new company to get your new insurance cards to you and have your information loaded into the computer before your start date. A business may change insurance and the employees are left to figure out who is administering their new coverage. If this is your situation, you cannot control when the paperwork is sent to the insurance company. As a result, you may start the year without new insurance cards. Without this you may be forced to pay for medical services until the paperwork is done up the ladder. A simple solution is to contact your human resources office at work and get the new billing information for your pharmacy and medical coverages. Yes, an employer may have one provider for medical insurance and another company providing the pharmacy coverage. Human resources should have at least a temporary card that contains your company’s group number and instructions on billing new claims. For pharmacy claims, in addition to the group number and your member identification number, the card needs to have a BIN and PCN number. These two numbers identify the insurance company’s online profile to the pharmacy so that a claim can be submitted. Whether you chose your insurance or an employer or government agency made the choice for you, the result is the same. Pharmacies must submit an exact match of the information contained in the insurance company’s computer system to receive a paid claim. This includes personal

information such as name, address and date of birth, in addition to personal identification numbers. The more information that matches, the easier job your pharmacy will have in getting your medicines covered. For example a pharmacy can call a certain insurance company to get your identification number but if your address on file with your pharmacy does not match the one the insurance company has, then no information can be retrieved. So take the opportunity at the end of this year to make sure everyone has the latest and correct information. Also get your point of contact to give you as much information as they have available before the effective date of the new coverage. Despite your best efforts to be prepared for the New Year, remember that others will not be. This can mean longer processing times at your local pharmacy and longer waits. The pharmacy is trying to accommodate all of their patients and is working as hard as possible to keep wait times to a minimum, so please be patient. Sometimes all your efforts go for naught if your new insurance company is running behind loading data into their system: Acme Insurance Company will have picked up a lot of new business, but does not have the processing capability for the new workload. This is puzzling from a pharmacy point of view because each insurance client comes with a known number of transactions, so why not have your computer ready to process the said number of transactions? Some pharmacies still cringe when they think about the Tricare debacle of many years past. It took up to two weeks for the new processor to be able to process claims. Let’s hope this year we avoid any such catastrophes. +

JANUARY

Rudolph’s

Questions about this article or suggestions for future columns can be sent to us at cjdlpdrph@bellsouth.net Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson (cjdlpdrph@bellsouth.net )

nose is red?

Send him over; we carry a complete array of cold medications.

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DECEMBER 19, 2014

AUGUSTA MEDiCAL EXAMINER

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

Food as medicine

lu season is already in full swing and the peak months of January and February have not even hit yet. As if the season isn’t long enough, the clinics and drug stores of the world start bombarding us with get-your-flu-shot messages in September. Don’t get me wrong, you should definitely still get your flu shot, but there are foods that you can incorporate into your diet that just might help protect your body from the flu. A number of researchers are exploring how factors such as diet, exercise, stress and age effect the body’s immune function. Listed below are some foods you might want to have in your grocery cart, especially during “flu season”! And it should be noted that these are healthy foods that can be included in your diet yearround, not just when these nasty viruses are waging war. Carrots — We all know that carrots are good for our eyes but the beta-carotene in carrots is important for our immune systems, as it helps protect the mucous membrane of the nose that traps germs. The richest sources of beta-carotene can be found in orange, yellow, and green leafy fruits and vegetables. Try snacking on a cup of raw carrots or have a salad with kale as the main ingredient. Some other excellent sources of betacarotene are spinach, tomatoes, sweet potatoes, broccoli, and cantaloupe.

Garlic — By consuming garlic in the winter months you can ward off the flu — and

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WebMD.com has listed 15 Immune Boosting Foods in a colorful slide show that you can view. These foods are: elderberry, button mushrooms, acai berry, oysters, watermelon, cabbage, almonds, grapefruit, wheat germ, yogurt, garlic, spinach, green tea, sweet potatoes and broccoli. Along with that important flu vaccination, washing your hands, getting enough rest and eating healthy are all important components of an effective strategy for trying to avoid those nasty flu viruses. Are you planning a holiday dinner for the New Year or on making a resolution to improve your diet in 2015? Try consuming the immuneboosting foods as listed above a few times a week. Remember, a healthy diet may aid in keeping your body healthy, free of colds and flu. + Sources: http://www.ucdenver.edu/about/newsroom/newsreleases/ Documents/VitaminDStudies/Ginde_ArchIM_2009%20(v itD%20and%20URTI).pdf -- Colorado and Vitamin D http://www.tandfonline.com/doi/abs/10.1080/07315724.20 07.10719634 -Florida and Green Tea http://www.ncbi.nlm.nih.gov/pubmed/22280901 --garlic and NIH http://www.webmd.com/cold-and-flu/ss/slideshow

— by Jennifer Goodman, Dietetic Intern in the Augusta Area Dietetic Internship, University Hospital

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Nonfat Greek Yogurt — This type of yogurt has 3 times more protein that regular yogurt. Protein is an important part of your immune cells which play that critical role of defending your body from infection. Yogurts have live and active cultures which some researchers also believe helps boost the immune system. These cultures also aid in digestion. Try mixing 1⁄2 cup of yogurt with 1⁄2 cup of fruit for a filling snack.

Green Tea — Many researchers believe that green tea is one of the healthiest things we can drink. It is not heavily processed before being served, so it is rich in catechins, which are antioxidants that fight against cell damage. A study at the University of Florida found that people who consumed 2 cups of green tea daily for 3 months had 32% fewer colds than individuals who did not. If you are not a fan of green tea try adding a splash of 100% juice to your green tea to give it a more appealing flavor.

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Salmon — Salmon is another food that will boost your body’s immune system. Fish, especially salmon, are rich in omega-3 fatty acids, which are essential to our health and well-being because they help with blood clotting and building membranes in the brain. But salmon also provides 1,000 IU of vitamin D in each serving. A study at the University of Colorado-Denver found that upping your intake of vitamin D in the winter months will help ward off colds. Try having salmon 1 or 2 times a week during the winter season. Grilled salmon on a kale salad will give you two flu fighting foods in one delicious meal!

vampires! Garlic contains a compound called allicin that defends against bacterial, viral, and fungal activity in the body. An NIH study found that people who took a daily garlic supplement had 36% fewer colds over the course of the year than those given a placebo pill. Allicin also can help with lowering lipids and blood pressure. Garlic also attacks H. Pylori, which is the bacteria associated with some stomach ulcers and stomach cancer. If you are not a big fan of the flavorful garlic plant, garlic supplements are available at the local drug store.

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NOW AVAILABLE AT AMAZON.COM Proceeds from the sale of this book benefit dementia research

+ 10

DECEMBER 19, 2014

AUGUSTA MEDiCAL EXAMINER

SOUP… from page 1 — the bad rap stereotype on soup would be that soup is high in sodium. A typical serving of your average store-bought soup can deliver 800 to 900 mg of sodium or more. To put that into perspective, the RDA for anyone on a sodium-restricted diet is 1500 mg per day. And here’s an insider tip: nearly every one of us should be on a sodium-restricted diet. As our contribution to fighting this disturbing trend, we asked Alisa Rhinehart, our resident recipititian (yes, that’s a word; we know because we just made it up) to give us a couple of delicious recipes for home-made soup. One is in her usual spot on page 7; the other is posted on the Medical Examiner blog (AugustaRx. com/news). As an added bonus, we also consulted the lovely and talented Kim Beavers of

WRDW/University Hospital and Eating Well with Kim fame for a couple of her favorite recipes. They are displayed below, ready to leap from paper or screen into your kitchen. And you’ll be glad to note they are lower in sodium than the canned soup in your cupboard by a third to nearly half. But we checked: they have approximately twice the flavor of their store-bought cousins. So please, enjoy soup season! +

BONUS RECIPE

TACO SOUP! AugustaRx.com/news + http://www.augustarx.com/news/2014/12/soup-week/

PET VET

COLD WEATHER PET SAFETY

ix months from now, this space may have an article about leaving pets in hot cars, but for now, it’s cold that we’re worried about. Fortunately, dogs and cats are wild animals at heart, covered in toasty fur, and by their very nature able to live outside in freezing weather. Right? Not according to the American Veterinary Medical

Rustic Bread Soup

Please see PET VET page 15

Chicken Alfredo Soup

(aka Ribollita) - from Eating Well with Kim

- from Eating Well with Kim

This soup is often classified as a soulful soup. That alone is enough to make me want to serve it at my table. It is traditionally made with leftovers so every batch is unique however it sounds much better to say it is a “soulful soup.” 2 tablespoons olive oil 2 medium onions chopped (about 2-1/2cups) 4 large carrots chopped (about 2 cups) 2 teaspoons basil 2 large stalks celery chopped (about 1 cup) 4 cloves garlic minced 6-7 cups chopped greens (I used green cabbage and kale) 2 (14.5 ounce) cans petite diced tomatoes and their juice 2 (14.5 ounce) cans Cannellini beans, rinsed and drained 1 “heel” of Parmigiano/Parmesan cheese (best not to omit this) 4-6 cups vegetable or chicken broth (reduced sodium preferred) 4 cups whole grain bread cubes Freshly ground pepper 1/4 cup chopped parsley Place a large stock pot or Dutch oven over medium heat and add oil. Once the oil is hot, sauté the onions and carrots for a few minutes until aromatic. Next add basil, celery, greens, garlic, tomatoes, the heel of the parmesan, beans and 4 cups broth; bring mixture to a boil. Add the cubes of bread, reduce heat and simmer softly for 1/2 hour; add more broth as needed to keep the soup from drying out. The bread needs to “melt” into the soup. Remove parmesan heel and serve soup with grated parmesan, fresh ground pepper and parsley. Yield: 14 cups/8 servings (Serving size: 1-3/4 cup) Nutrition Breakdown: Calories 310, Fat 8g (3g saturated, 3g monounsaturated), Cholesterol 15mg, Sodium 500mg, Carbohydrate 43g, Fiber 10g, Protein 17g, Potassium 369mg, Phosphorus 47mg. Percent Daily Values: 200% Vitamin A, 30% Calcium, 100% Vitamin C, 20% Iron. Carbohydrate Choices: 3 Carbohydrate Choices

Association. The AVMA says dogs and cats should not be left outside for prolonged periods in sub-freezing temperatures. Although there can be some variation from one breed to another, cats and dogs

are susceptible to frostbite and hypothermia. Among the aforementioned variables could be how long or thick their fur is, body fat stores, activity levels, and overall health. Some of the health factors that can affect how well a pet can tolerate cold include arthritis, diabetes, heart disease, kidney disease, and very young and very old animals. Body shape can also be a factor. Think about a Doberman frolicking in one of our rare Augusta snowfalls versus a Dachshund doing the same. The dog whose stomach is going to rub against

The heel of Parmigiano Parmesan cheese

Note: This is modified slightly from a recipe a friend (Nancy) of mine gave me. And I had recently read about this soup in the book “The Everlasting Meal.” As I began to research more about this soulful leftover soup, I noticed every recipe I deemed worthy included “heel of parmigiano.” The parmigiano makes it seem authentically Italian, so make an effort to purchase real parmesan for this occasion. It’s easy to tell real Parmigiano-Reggiano when you can see a piece of the rind, because it is embossed with its name over and over. +

The lemon juice is a key ingredient in this delicious soul satisfying comfort soup. 2 teaspoons olive oil 1 tablespoon butter 2 cloves garlic, minced 2 teaspoons flour 1 medium stalk celery, finely chopped 2 cups 1% milk 2 tablespoons reduced fat cream cheese 1 cup grated Parmesan cheese 4 cups reduced sodium chicken broth 4 cups chopped spinach Juice of one lemon (~4 tablespoons) 2 cups chicken cooked and shredded (8-9 ounces) 2 cups whole wheat penne pasta 2 tablespoons sundried tomatoes (optional garnish) In a large sauce pan or Dutch oven heat the oil and butter. Once the butter melts, add the garlic and whisk in the flour. Cook for about 2 minutes. Add the celery and cook an additional minute. Whisk in the milk followed by the cheeses. Once the cheese melts into the milk, add the broth, and noodles, bring to a very slight boil, reduce heat and simmer until the pasta is almost cooked (approx. 9 minutes). Add the spinach, chicken and lemon juice to the pot and cook until spinach is slightly wilted. Serve with optional garnish if desired. Yield: 8 servings (Serving size: 1-1⁄2 cup) Nutrition Breakdown: Calories 310, Fat 14g (6g saturated fat), Cholesterol 40mg, Sodium 600mg, Carbohydrate 29g, Fiber 3g, Protein 18g. Percent Daily Value: 15% Vitamin A, 4% Vitamin C, 10% Iron, 25% Calcium Carbohydrate Choices: 2 Carbohydrates Diabetes Exchanges: 2 Starches, 2 lean meats, 2 Fats

Kim’s Note: When I make a big pot of soup and plan to use it for leftovers I will make the grains separately and store them in a different container. This way the soup stays more soup like and the noodles or rice do not continue absorbing the liquid. In addition: When chicken breasts are on sale I will by a few pounds and either freeze them in marinade OR cook and shred them for quick meals later. Here is how I cook and shred chicken for future use. Preheat the oven to 450 degrees. Pound the chicken thin (I like to pound the thick side thin to create more even cooking). Rub with olive oil and season with a little garlic salt and pepper. Place in a baking pan and cook 8-10 minutes on each side or until the meat thermometer registers 165 degrees. Shred and mix with any liquids from the pan to maintain moistness, use or freeze immediately. Kim’s Idea; http://greatist.com/eat/healthy-zucchini-noodle-recipes?utm_source=Sailthru&utm_ medium=email&utm_campaign=daily_newsletter_2014-11-13_mails_daily +

DECEMBER 19, 2014

11 +

AUGUSTA MEDiCAL EXAMINER

From the Bookshelf The blog spot — Posted at kevinmd.com by Carolyn Messere, M.D. on Dec. 8, 2014 (edited here for space)

THE TIME I ALMOST GOT FIRED FOR SAVING A LIFE I was a fourth-year surgery resident on the transplant team. It was a difficult rotation because the doctor who ran it was sexist and got along better with you if you flirted with him. I had made it clear to him that I had no intention of playing along. It was a Saturday afternoon, and I was the senior in-house resident on call. A young woman in her 20s came in to the area of the ER where I was seeing a consult for transplant. The young woman was spitting blood everywhere. Her mother reported she had had a tonsillectomy the day before. From the bedside of the patient next to her I heard most of the history. As bad as it had been, she soon began to bleed in earnest — bright red blood pumping from her nose and throat. The nurses grabbed me and asked for my help. Thinking quickly, I got a wad of gauze and stuck it down her throat, putting pressure on the exposed tonsillar artery. This artery is connected to the carotid, and a woman her size and age could bleed out and die in minutes if the bleeding wasn’t stopped. In fact, it happened to one of my pulmonologist friends years later — he bled out at home from his tonsillectomy site and was dead before the ambulance arrived. Now I was stuck, because I couldn’t take my hand off the artery. It would not stop until it was oversewn in the operating room. Someone held a phone for me and I spoke to Dr. J., the ENT on call, urging him to come as soon as possible. He told me he was already in the car. Then we called the OR and told them we had an emergency coming down immediately. I climbed up on the stretcher, straddling the frightened woman, and off we went to the OR. Somewhere along the way, they outfitted me with a hat, mask and gown as best they could. Dr. J arrived just as we were rolling into the OR. They scrubbed my arm right and intubated her nasally. Once everyone was ready to go, I took my hand out of her throat. Dr. J. jumped right in and oversewed the artery. A life saved! During this entire episode, my pager was going off like crazy, but I couldn’t get to it. I was sure it was my attending — the flirting doctor I was working for that weekend. As soon as the bleeding was under control and my hand stopped being numb, I called him back. Beforee I could say a word, he let me have it — how could I be so irresponsible? How could I not answer my pager for nearly an hour? He told me in no uncertain terms to report immediately. My heart still beating from the adrenaline rush of saving a life, I slogged off to the transplant unit to meet my fate. Even when I explained what had happened, he was still angry. It wasn’t my responsibility to cover the ENT service, it was my responsibility to cover his service. Why couldn’t I at least have had someone call him to let him know? It’s true, I forgot about him. I was focused on the task at hand. He wrote me up, and on Monday I was told not to bother reporting for transplant. I was relieved of my chief duties. I was called down to the surgery chairman’s office to account for myself. It’s a very big charge to abandon your duties while on call. The transplant team wanted me fired. I won’t lie about it, I felt pretty angry. When did rote obedience become more important than patient care? In the end, I was not fired. I returned to the transplant team. I didn’t get a very good review from them. I won’t say I didn’t learn something from the whole incident. I had no idea at that time how to be assertive without aggression. It was back down and be walked on, or stand up and fight. There wasn’t much in between. Years ago when I interviewed for a surgery residency the interviewer asked me if I was aware that surgeons eat their young. I had no idea how true it was. +

“She could bleed out in minutes.”

If you were asked to name a few of the most dangerous occupations, what would come to mind? Maybe coal mining, ice road trucking, or skyscraper window cleaning. How about gardening? No, not the little patch in your backyard, but gardening as an employee of a large commercial agricultural operation. It wouldn’t be on many lists, but after reading this book you’ll clearly understand how it could be. It’s crazy to contemplate someone risking their life — correction, actually giving their life — to put a head of lettuce into your Frigidaire, but that’s exactly what the people profiled in this book have done. In truth, we very rarely if ever contemplate where that head of lettuce came from. Or the tomatoes or the apples or the celery or the strawberries. Where do they come from? The produce section of the grocery store, silly. And before that? Well, that’s the story of this book. And to be honest, it’s a tough story to read. If you

had to break it down to 1.) the kind of people who would want to read this book, and 2.) those who would want to avoid reading this book, you would describe both groups as follows: People who eat food. Group 2 might not want the curtain pulled back to reveal the backbreaking drudgery involved. They might not want to know that crop dusters spray fields with agri-chemicals while workers are in said fields. Group 1, by contrast, might actually want to know about the pesticides used in large scale farming.

Granted, much of this story of Florida farming is a look back at chapters of history that are now closed. We don’t spray DDT all over our farmland and our groceries-to-be anymore. Then again, when DDT was banned, it was replaced by families of chemicals that were subsequently banned themselves. And then those were replaced by chemicals that were replaced by the chemicals that are in use today. As the title suggests, maybe the higher price tags on those organic foods are worth it. Cheap food is like cheap anything: you get what you pay for. The cruelest of ironies, though, is that people actually died to provide cheap food. That makes cheap food very very very expensive. So yes, this is a book that some people won’t want to read. Then again, it might be nice to meet some of the people who made the ultimate sacrifice just to put a bowl of salad onto our tables. +

Fed Up: The High Cost of Cheap Food, by Dale Finley Slongwhite, 192 pages, published in May 2014 by University Press of Florida

Research News Vaping victim Police in Fort Plain, New York, say a 1-year-old boy there died last Tuesday (Dec. 9) after drinking liquid nicotine, what might be called the “active ingredient” in e-cigarettes. ABC News said the child may be the first U.S. fatality caused by e-cigarettes. Media reports there, quoting a local pediatrician, say emergency room doctors are seeing “skyrocketing” numbers of nicotine poisoning victims. The American Association of Poison Control Centers says there have been 3,638 cases so far this year (through Nov. 30) compared with 1,543 cases for all of 2013. In 2011, by comparison, there were only 271 nicotine poisoning cases nationally. It’s not all that surprising: nicotine is extremely toxic, so much so that skin contact is reason enough for an ER visit, and ingesting as little as half a teaspoon can be fatal to a child. Compounding the risk, ecigarette nicotines are flavored

(and labeled) with names like “Gummy Bear,” “Cotton Candy,” “Caramel Swirl,” “Candy Bar,” and “Chocolate Pudding.” They smell good and are packaged in bright colors that could be very attractive to young children. There are as yet no regulations requiring childproof packaging. Public health experts suggest parents keep e-cigarettes in a place that is completely secure from children. “Never too old to fight” That was the headline in this month’s Scientific American for an article profiling older adults — people in the 70s, 80s, and 90s — who are taking on cancer with all the vigor of people half their age. And they’re doing it with the blessing of their doctors. That is news. Twenty years ago, “few oncologists would have attempted aggressive therapies with 90-year-olds.” They were seen as too fragile for treatment, and predicted to die from other causes before cancer

would have time to do the job. That is all changing as the “very old” are described as the fastest-growing segment of cancer patients in the U.S. And they’re often getting the complete trifecta of treatment: surgery, chemotherapy and radiation, not just palliative care. Cancer treatment is gradually changing from its roots - treating a fatal disease - to an approach that treats it as a chronic disease, no matter what age the patients may be. Pre-natal exposure hurts IQ Researchers at Columbia University say a mother’s exposure to routine household chemicals can have an adverse effect on their children’s IQ. In brief, the Columbia study suggests pregnant women avoid microwaving food in plastics and avoid scented products as much as possible, including air fresheners and dryer sheets, and “not using recyclable plastics labeled as 3, 6, or 7.” The offending chemicals are DnBP and DiBP. +

+ 12

DECEMBER 19, 2014

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS

THE MYSTERY WORD

by Dan Pearson

I saw in the checkbook that you made a I wish I could have given more. donation to COPD.

I think that is highly offensive.

The Cleveland Ohio Chronic Obstructive Police Department? Pulmonary Disease. Really. Right now? Really?

Well it’s what I choose to support.

The Mystery Word for this issue: TARNIE

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

EXAMINER CROSSWORD

PUZZLE

ACROSS 1. NPR station named for Augusta College 5. _____ dirt 8. Delighted 12. Riverhawk’s league (abbrev) 13. Manila hemp plant 15. First female US Attorney General 16. Mets’ former home 17. Perry (miltary news consultant) 18. Members of a Maori tribe 19. Turtle 21. Walk like a duck 23. Center prefix 24. Son of Jacob and Leah 25. __________ Bash 28. What Richard III would trade his kingdom for 31. Before, in poetry 32. Paul ______ Theater 35. Well-known 37. Matures 39. Umbilical scar 41. Emperor of Rome 54-68 42. Twangy 44. “Daughters” singer 46. Nonexistent; 47. Native of Kathmandu 49. Former Central Ave art & coffeehouse 51. Migrant farm worker 52. Outer edge 53. “8-Mile” star 56. Pertaining to business, trade and industry 61. Monetary unit of Ghana 62. Intestinal obstruction 64. River in Switzerland 65. Ridge of coral 66. Attentive (Scottish) 67. Knot or burl in wood 68. Oldest son of Saddam

35 40

36 41

51 54

QUOTATION PUZZLE 29

39 43

Click on “READER CONTESTS”

VISIT WWW.AUGUSTARX.COM

23 26

P S R A E O Y O N T

DOWN 1. Intro for 43-D 2. Synonym for 5-D 3. Partner of Sonny 4. Stared fiercely 5. Synonym for 2-D 6. Play division 7. Another name for Jehovah 8. Football field 9. Obscene 10. Indigo plant 11. Quantity of medicine 13. Common analgesic 14. Weight-to-height ratio ltrs. 20. Mimics 22. River in central England 24. Walker start 25. Legume 26. ______ donor 27. Summerville campus library

— Rodin

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.

Hussein 69. Drunkard 70. Having a sound mind

U H N F E T T M S E E F E E U C G W I E A L W I O N E I S E I Y T I S I H X

29. Surgical _____ 30. Strange and mysterious 33. Local cabin owner? 34. Eggs (Latin) 36. Girl’s toy 38. Convert into soap 40. Biblical scourge 43. 1-D follower 45. Word preceding forest or date 48. Austin City _______ 50. Former Walton Way bakery 53. Beige 54. Reward (archaic, poetic) 55. Notion 56. MD for sore throat & sinusitis 57. Incision 58. Supernatural force (Polynesia) 59. Country W of Afghanistan 60. Cover with wax 63. Baseballers Mazzone or Durocher

X A M I N E R

4 7 3

5 7

4 6 5 1

8 7 2

4 2

2 6

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.

’ 1 2 1

1 2 3 I 3

5 ’

1 2 3 4 1 2 3 4

L 1 2 3 4 ’ 1 2 3 4

T 1 2 3 4 1 2

’

1 2 3 4 5 — Ray Bradbury

1 2

1.DIDDDYWILTY 2.FITHHOOOOOO 3.ANNUKUEI 4.TRENNTT 5.GE

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

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

DECEMBER 19, 2014

13 +

AUGUSTA MEDiCAL EXAMINER

THE BEST MEDICINE ha... ha...

Mexican magician performing in a nightclub tells his audience he will disappear on the count of three. “Uno,” he says. “Dos,” he says — and suddenly — POOF! He disappears without a tres. The math teacher was trying to reach the class troublemaker and make the lesson simple for him. “If you had ten chocolate chip cookies and I took half of them, what would I have?” she asked him. “A broken hand and a black eye,” he answered. “What are you planning to do about these excess pounds you’re carrying around?” the doctor asked the patient. “I just can’t seem to lose the weight,” the patient said. “I’m pretty sure I have an overactive thyroid.” “Actually, you’d be more likely to lose weight with an overactive thyroid, but the tests show your thyroid is perfectly normal,” the doctor said. “However, we do see some evidence of overactivity.” “Really? In what” “In your fork.” Why did the Mafia have Einstein killed? Because he knew too much.

Two friends who were not particularly bright rented a boat and went fishing every day, even though they hardly ever caught anything. But one day out of the blue they caught thirty fish. One guy said to the other, “This is great! Mark this spot so we can come back here tomorrow!” The other guy promptly painted a big red X on the bottom of the boat. “What’s that for?” asked the first guy. “I thought you told me to mark this spot.” “You moron. What if we get a different boat tomorrow?” All my life I said I wanted to be somebody. I can see now that I should have been more specific. What is the definition of minor surgery? An operation performed on somebody else. The bartender was astonished when a gorilla came in, took a stool and ordered a martini. The bartender could think of no legitimate reason to refuse to serve him, so he mixed the drink. Approaching the gorilla with the cocktail, the bartender was surprised again to see him coolly holding a crisp new twenty. He brought back six dollars in change and stood there for a moment, contemplating the amazing scene before him. Finally he said, “You know, we don’t get many gorillas in here.” “At fourteen bucks a drink, I’m not surprised,” replied the gorilla. “I never believed in Santa Claus because I knew no white man would be coming into my neighborhood after dark.” — Comedian Dick Gregory +

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.

The Patient’s Perspective by Marcia Ribble

y platelet count is still vacillating, but so far no treatments have been necessary, which allows me to shift my focus to the ongoing and gradual drop in temperatures outside as we head into winter. How delicious to wake up to these apple-crisp mornings, sometimes with frost icing the lawns and fields and rooftops. For many of us seniors, cold weather is uncomfortable for our hips, knees, and other parts affected by arthritis. As we feel the bones we didn’t feel all summer, we see the leaves have all fallen, revealing the bare bones of our trees. At this point we start hauling out our soup pots and filling them with many varieties of home-made soups, so warming to our insides. We snuggle up on the sofa with our fall magazines, picking out presents we can make for our loved ones. We go to games our grandchildren are playing in and cheer until we wake up hoarse the next morning. The weather is cool enough for walks through leaf-covered sidewalks, recalling trips to and from school when we were much younger. We might stop alongside a yard with a towering chestnut tree to retrieve nuts untouched by those greedy squirrels. My hair was the color of those chestnuts before it turned white, so holding one in my hand reminds me of when the sun burnished my hair to that awesome auburn glow. I also remember “borrowing” Dad’s jackknife to carve out the centers of chestnuts to make rings and necklaces. After cleaning his knife to

Talk is cheap. Not talking can be deadly.

as close to a state of pristine newness as anyone can make a twenty-year-old knife, I always returned it to its regal spot on his dresser. Every year the return of cold weather marks the beginning of baking season. This past summer the bottom element in my oven died a quick, unceremonious death. But I really didn’t need the oven all that much, so I allowed it to sit there unused and unrepaired until today, when the appliance company was called and by late afternoon that element had been replaced and the oven works to do whatever baking I will ask of it over the fall and winter. That was money wellspent! For me, the cool weather is perfect for creating a little blanket for my new greatgranddaughter expected any day now, maybe even on Christmas Day. How fun to be celebrating a new life as winter works to take hold of our world! + Marcia Ribble received her PhD in English at Michigan State and retired from the University of Cincinnati. She taught writing at the college level, most recently at Virginia College in Augusta, and loves giving voice to people who have been silenced. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.

+ +

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

TO OUR READERS AND OUR ADVERTISERS

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DECEMBER 19, 2014

AUGUSTA MEDiCAL EXAMINER

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

...cleverly hidden (on the doctor’s coat) in the p. 9 ad for PRUITT HEALTH Congratulations to DEANNA MERRITT, who scores a coveted Scrubs of Evans gift card, 2 movie passes courtesy of Health Center Credit Union, and a $20 Wild Wing Cafe gift certificate. Want to find your name here next issue? The new Mystery Word is on page 12. Start looking!

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

The new scrambled Mystery Word is found on page 12

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

Augusta Medical Examiner Classifieds

EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC.

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

CONDO FOR RENT 2 bdrm 1 bath unfurn upstairs condo; carport; pool; outside laundry. Country Club Hills condos, Milledge Rd near GRU/ASU. $750/$750 dep. We furnish water, you pay electric. (706) 736-7168; email:ronst79@gmail.com

MISCELLANEOUS

ROOMMATE WANTED! 3 bdrm, 2.5 bath house with pool, 2 minutes from colleges. Perfect for medical or grad students. $425+share utils. 706.993.6082 WEST AUGUSTA House for rent. 3 bdrm, 2 bath, 1500 sqft, 1-car garage, 3024 Sterling Road, located off Stevens Creek at Riverwatch Pkwy. $850/mo. Call 678467-7187. FOR SALE: GORGEOUS, immaculate, never occupied townhome located mins from Medical District. 2 bed, 2 bath, master en suite, walk-in closets, office. 1450 sq ft. hardwood floors throughout, fabulous upgrades, custom kitchen and baths. Floor to ceiling windows, fenced yard. Partially furnished! 120k OBO. 803-507-6621.

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

SERVICES HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706.267.9947 HEALTH CARE - CNA offering in-home care: companion/assist with daily activities, light housekeeping, meal prep, assist with ambulation, medication reminders, grocery shopping, Dr. appts, errands, etc. Since each person’s needs are different, I will consult with you one-on-one to discuss your needs. CALL 706.833.9787 BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673)

WHAT’S YOUR DRUG OF CHOICE?

W E S T

A C H E

B E A N

O R G A N

(OURS IS COFFEE)

E C R U

M E E D

.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

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

G L A A S R A P E P I R D E R E S I E S N S A L E P A L O K I I N E M D I I E F T A Y S

P A Y B A C A M I T H I N W L E A H M O N A V E L M A Y E I P E R E C O L E U S E N T Y O T

A V O N R A I N

G R I D I R O N

L E W D

A N I L

D O S E

S T E N S T M O M A A K N S A

E E R I E

D O L L

I R A N

C E R E

QUOTATION QUOTATION PUZZLE SOLUTION: Page 12: “Nothing is a waste of time if you use the experience wisely.” — Rodin

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:

C H E R

SEE PAGE 12

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

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

THE PUZZLE SOLVED

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

.25

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

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

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

VISIT DRUGOFCHOICECOFFEE.COM

8 5 1 4 7 2 9 3 6

2 6 4 9 3 8 7 1 5

9 3 7 6 1 5 2 8 4

6 4 2 8 5 7 1 9 3

5 7 8 3 9 1 6 4 2

3 1 9 2 6 4 5 7 8

7 9 6 5 4 3 8 2 1

4 2 5 1 8 9 3 6 7

1 8 3 7 2 6 4 5 9

WORDS BY NUMBER “If you don’t like what you’re doing, then don’t do it.” — Ray Bradbury

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

DECEMBER 19, 2014

15 +

AUGUSTA MEDiCAL EXAMINER

PET VET… from page 10 the snowy ground if we have more than an inch of accumulation is the one to worry about. Some people put out salt or other chemical de-icers (not that we would ever have an ice storm around here) on their sidewalks, so it would be a good idea to gently wash your pet’s paws when you get back home. Otherwise he may lick off those chemicals and in the process ingest things that aren’t meant to be ingested. Another AVMA suggestion is to make some noise before you drive off in your car. A warm engine from an earlier trip can be a great place to get away from the cold, so it pays to get into the habit of banging on the hood of your car as you walk to the driver’s door. One other aspect of pet safety in cold

weather is the safety of that tall twolegged creature at the other end of the leash. If your dog is one of those about whom people ask you, “Are you walking him or is he walking you?” it might be that some dog obedience lessons are in order. Most of us have at least some experience trying to stay vertical on snow and ice. It’s not all that easy under the best of circumstances, but when an 80-pound dog is tugging you along, you could easily fall and crack a bone, like the one right underneath your hat. The antidote is training your dog to obey, and that needs to be done long before there is ice on the ground. In fact, it would be a good idea on general principles, even if you lived in the tropics. It’s just being a good pet owner. +

Q A

Ask the Doctor Get an opinion here. Or a second opinion. Or a third.

Why are my toenails are getting thick and discolored?

Regular and through inspection of the feet and toes is an important part of good health maintenance. Diabetics are particularly prone to foot and toe disorders and feet should be examined at each physician visit. It is not uncommon for toenails to thicken in the later decades of life. This is not usually medially important and can be treated with benign neglect or pedicures. Discoloration, on the other hand, may be onychomycosis or fungal infection of toenail or nail bed. You should be seen by a physician. Onychomycosis is a stubborn infection and is frequently ignored or unnoticed because our toes are not commonly in plain view. + — by F. E. Gilliard, MD Family Medicine 639 13th St Augusta, GA 30901 706-823-5250

PROFESSIONAL DIRECTORY DERMATOLOGY

ALLERGY

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

CHIROPRACTIC

DEVELOPMENTAL PEDIATRICS

Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A Evans 30809 706-860-4001 Poppell Chiropractic Clinic 1106-A Furys Lane Martinez 30907 706-210-2875 Most insurance plans accepted

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

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

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

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

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

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

FAMILY MEDICINE F. E. Gilliard, MD Family Medicine 639 13th Street Floss ‘em or lose ‘em! Augusta 30901 706-823-5250 Industrial Medicine • Prompt appts.

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

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

HOSPICE

SENIOR LIVING

Medical Services of America Hospice 4314-E Belair Frontage Rd. Augusta 30909 706-447-2626

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

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

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

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

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

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

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

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 PHC Weight Loss & Wellness Centers 246B Bobby Jones Expwy Martinez: 706-868-5332 Thomson: 706-597-8667 www.phcweightloss.com

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AUGUSTA MEDiCAL EXAMINER

DECEMBER 19, 2014

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

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

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