Dec4 15 by Daniel Pearson

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DECEMBER 4, 2015

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When cars hit bikes Like many other bicyclists in the Augusta area, I am dismayed whenever I hear news of the latest car/bike collision, usually with disastrous results for the cyclist. I’m glad they don’t happen often, but even one is one too many. I have often thought with regret about how few safe routes there are for twowheeled commuters. If you want to ride from the south or west side to downtown Augusta or the medical district, there is no way to completely avoid some very busy and congested roadways full of speeding traffic. Whenever a serious accident involving a biker does happen, that always seems to be a theme of comments on social media, that we don’t live in a very bike-friendly city, unless you’re talking about communing with nature on the Greeneway or along the Augusta Canal. Road accidents are always the fault of the aggressive motorist, and to a greater or lesser degree, city planners who laid out these streets and highways long before most of us were born. A couple of weeks ago, however, I had an experience

I hope he reads this. which reminded that cyclists are not always free from blame either. I was driving my car south on Silver Bluff Road in Aiken, heading away from town. Not too far past the point where Pine Log Road branches off to the right, Silver Bluff Road goes from four lanes to two. As I approached that spot, I saw a cyclist in the right lane, the lane that was narrowing to merge with the lane I was in. Since there was no oncoming traffic, I crossed the center line as I passed the cyclist, even though there was plenty of room to spare in his lane, which was still almost at full width at that point. Just as I passed him, I heard some kind of unusual noise. My car radio was on so I didn’t hear it clearly, but it caused me to look in my rearview mirror. What I saw was the cyclist, angrily yelling and gesturing at me. He was also trying to put the pedals to the metal,

apparently to catch up with me and tell me off. While he was doing all that, he also veered sharply to his left so that he was in the middle of the now single lane. Three or four cars immediately backed up behind him, unable to pass on the now two-lane road. What this gentleman could possibly have been angry about is beyond me, and I’ve had two weeks to think about it. But he is far from the first cyclist I’ve seen who seems to think he has just as much right to the road as two-ton vehicles do. Pedaling down the middle of a busy road on a bicycle going 30 mph below the posted speed limit is not a great way to make the point that cyclists have rights too. In this age of distracted driving, however, it is an excellent way to become an accident statistic. Sir, whoever you are, I have no idea what I did to offend you, but I would remind you that road rage — even when unreciprocated, as in my encounter with you — is never a good idea, but it’s particularly foolhardy when you attempt it on a bicycle. — Anonymous Aiken, South Carolina

Part Three of a series

16 for ’16

As the end of one year and the beginning of another approaches, it’s a fitting time to consider ways to start the new year in a better state of mind and body. Each installment of this series, now through February, will offer simple ways to do just that by cutting bad things and adding good things. To read previous installments of 16 for ’16, visit issuu.com/medicalexaminer. + #5 UNPLUG!!! “I only access social media occasionally.” Sure.

So do we all. Like the girl in the artist’s illustration above. She watches YouTube videos a mere 2.5 hours a day (leaving a hefty 21.5 hours free); updates Twitter only every 3 hours or so, posts to Flickr 5 times a day at most, regularly goes more than a full half hour without checking Facebook, and doesn’t even average one review per day on Yelp. She is practically living off the grid with stats like that. Some people do far more. And what’s the harm in that? Please see 16 for ’16 page 6

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AUGUSTA MEDiCAL EXAMINER

BETTER BUSINESS

HEALTHIER BUSINESS ‘TIS THE SEASON — FOR CHOOSING AN INDIVIDUAL HEALTH PLAN

ne of the hallmarks of recent healthcare reform legislation is the requirement that individuals have minimum healthcare coverage or face a potential penalty come tax time. Known as the Individual Mandate, this feature has sent many individuals not covered by an employer plan in search of individual coverage. Russell Head While Federal and state marketplaces can be a great source of plan options, they sometimes fall short of fully explaining the options and helping individuals choose a plan that is a good fit for their budget and needs. Individuals who select a plan before fully researching its details could end up with a policy that provides little to no practical coverage. Open enrollment in the Federal marketplace is open through December 15 if you’re considering a January 1, 2016 effective date. If you or someone you know is looking for a private individual policy through the Marketplace (“on exchange”) or outside of the Marketplace (“off exchange”), the following are specific areas to consider.

Premium Cost While not the only factor, the monthly premium cost is a major consideration for most healthcare consumers. The Federal marketplace generally lists plans according to lowest cost to the consumer, taking into account any subsidies for which the individual may be eligible. As with many purchases,

DECEMBER 4, 2015

however, an extremely inexpensive price often reflects an insurance product that may not tell the whole story. A deeper dive into the details will uncover the actuarial metallic value for the plan and can prevent unpleasant surprises later on. There are at least three key factors that should be considered closely when looking at plan design. The co-pay amount is the flat amount the consumer will pay out-of-pocket for a specific service, such as a professional exam for a diagnostic office visit. There may be a larger co-pay amounts (such as a primary care office visit vs. a specialty office visit), or no co-pay at all if you have selected a Qualified High Deductible Health Plan (QHDHP). The second factor to consider is the deductible amount. This is the amount the consumer must pay for covered medical charges (such as complex imaging, surgery or hospital visits) before the insurance company will begin paying a coinsurance. Once the deductible is met for the year, the insurance company typically pays co-insurance toward future covered medical expenses. Finally, your Max Out of Pocket (MOOP) is perhaps the most important factor when considering a worst-case scenario of personal covered healthcare expenses during a calendar year. The definition of what is considered Max Out of Pocket changed during healthcare reform. It now includes co-pays, deductibles and coinsurance. For 2016, the new MOOP limit is $6,850 for in-network covered medical charges for an individual. Access to Providers Many plans attempt to contain costs by restricting the list of network physician and hospitals that are deemed preferred providers. Services from providers outside of the network are either paid at a much lower rate or not at all. Consumers shopping for a health plan should study the list of approved network providers to be sure they will have access to their primary and specialty Please see HEALTH PLAN page 5

DECEMBER 4, 2015

AUGUSTA MEDiCAL EXAMINER

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

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

DECEMBER 4, 2015

AUGUSTA MEDiCAL EXAMINER

#12 IN A SERIES

OLD NEWS

Who is this?

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

he somewhat disconsolate appearance of the gentleman above might change if he knew the stature of his name today, more than a century after his death. His name seems to pop up regularly in national news, and is also a fixture on the shelves of every supermarket and drug store in America. He never visited the U.S, however, spending his career in England and Scotland. Coming from a family of Quakers in Essex, England, he was fortunate to be accepted to University College, London, one of the few institutions of higher learning which accepted Quakers at that time. After graduation (in 1847), he entered the Royal College of Surgeons at age 26, and subsequently (in 1854) was named to the staff of the Edinburgh Royal Infirmary in Scotland. Have you heard people say that cancer spreads when the air hits it? Well, go back to the mid-1800s and people thought infections were caused by chemical changes when open wounds were exposed to air, particularly “bad air” or “miasma” such as might be found near a swamp, a hog farm, or the dank slums of a big city. This gentleman, building on the recent discoveries of Louis Pasteur, discovered a reliable method of reducing post-operative infections. According to some reports of the day, as many as half of all amputation patients died from sepsis (infections). With his antiseptic procedures implemented, the sepsis rate dropped to 15 percent within four years. He is regarded as the founder of antiseptic medicine. Prior to his advocacy of sterile procedures, surgeons would routinely go from one procedure to another without scrubbing in, even if one procedure was an autopsy and the next one was a delicate surgery or childbirth. Surgeons would proudly display their bloody surgical gowns as a professional badge of honor. By now you may have guessed his name: Joseph Lister. He instructed surgeons under his supervision to wear clean gloves and to wash their hands before and after all procedures with an antiseptic solution. Instruments were likewise regularly and systematically sanitized, another breakthrough in infection control. Today, Lister’s name surfaces regularly — probably a little more often than he would like — when infestations of the bacteria Listeria (identified and named in Lister’s honor in the late 1920s) break out in a food processing plant somewhere that was not following Lister’s guidelines. But it isn’t all bad. Lister’s name is also recalled in Listerine, a brand of antiseptic mouthwash developed in 1879 by chemist Joseph Lawrence in St. Louis, Missouri. He named it after Lister and had hopes that Listerine would be used as a mouthwash, general germicide, and surgical antiseptic. +

IS YOUR PET RUINING YOUR SLEEP?

am a pet parent to a Welsh Corgi dog, and for the first time ever, a cat. A Himalayan. They get along quite well. And they both sleep with me. Although I have a kingsized bed it doesn’t seem big enough because they take their half out of the middle. It does impact the quality of my sleep. It’s ridiculous not to put myself first, but I admit to letting them get away with it because they are adorable and I love them. According to a recent Mayo Clinic study, 18 percent of pet owners admitted their animal disturbed their sleep. Those in charge of the study believe the actual numbers are much higher, citing the fact that pet owners don’t want to admit to letting the pets take over the bed. The study’s co-author, Dr. Lois Krahn, says; “Putting up with poor sleep just because you love your pet can negatively affect things like your mood, memory and in extreme cases, even your heart.” A fidgety dog or a cat that hogs the blankets can

keep you from falling asleep or staying asleep the same way a snoring spouse can. The study found that even if you aren’t consciously waking up, your pet can cause “micro-arousal or mini-wake ups” throughout the night that disrupt the sleep cycle. Even though you may never actually wake up, these mini-interruptions can leave you constantly feeling tired and you can’t figure out why. (While reading about this, I wondered if they made any comparison as to whether women do this more than men. It’s an interesting question but not addressed in the article.) If this sounds familiar

in your bedroom, it may be time for tough love. The doctors who did the study recommend kicking the fuzzies out of the bed in exchange for a sleeping spot of their own. This is easier said than done if you have been snuggled up with them for years. The habit will be hard to break for both of you. But they say if it’s done right, your pet won’t mind. Buy them their own beds and reward them with treats and petting whenever they use them. You can place the pet bed next to your own and reach down and pet him so he knows he’s behaving correctly. If your dog is a loud sleeper - dreaming or scratching, get a gate and set his bed outside the room, but in a spot where he can see you. Cats are almost soundless (unless they are destroying something) but they love to be very warm and will snuggle in soft blankets. They tend to prefer a variety of places to sleep and you may have to get creative in order to offer your kitty other sleeping options. Of course, it’s easier to instill these sleeping habits if your pet is new to the family. I don’t hold out much hope for any real changes in my household, but perhaps you will have better luck. +

MYTH OF THE MONTH Milk: in sickness

and in health?

It’s a common belief in some circles that it’s a bad idea to let children drink milk when they have a cold. The reasoning goes that the milk will cause them to have more mucus and thus worsen the cold. Is that fact? Or myth? The truth is, there is nothing about milk that will induce mucus production. Drinking milk will not thicken existing mucus, nor will it cause or exacerbate chest congestion. In fact, when children have a fever they often refuse to eat. Fevers have a way of taking away appetite. In such cases, milk is a good

choice by providing a food that is easy to sip and which provides protein and hydration. You can make it even better by throwing in some honey or banana and blending the mixture into a healthful shake. The exception would be if a child is vomiting, in which case clear liquids are temporarily a better option than milk. + — by F. E. Gilliard, MD Family Medicine, 639 13th St Augusta, GA 30901 706-823-5250

DECEMBER 4, 2015

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW res? k good eno r skin can ugh cer? son.”

hen a baby is born, sometimes the baby turns yellow. This is neonatal jaundice. That is because the newborn’s liver cannot conjugate bilirubin. Prior to the birth, the mother’s liver did the job while the baby’s liver was developing. If the baby’s liver does not “turn on” and conjugate bilirubin at birth, the baby’s life expectancy is greatly shortened and for the time that it does live, mental retardation is almost a certainty. Decades ago we learned to place such a child under ultraviolet light in the nursery and give small doses of phenobarbital. The introduction of phenobarbital induces the liver to metabolize phenobarbital and simultaneously “turns on” the enzymatic pathway to conjugate bilirubin. Once k

ABOUT THE MECHANICS OF ADDICTION

the liver starts conjugating bilirubin, it stays “turned on” and does not need kickstarting again. While the body is able to heal itself from many disorders and injuries, other disorders are lifelong. Once someone develops diabetes mellitus, although we can manage it well with diet, exercise, numerous oral medications, and insulin, diabetes is permanent. In certain drug-dependent disorders (alcohol, nicotine, opioids, etc.), once the addiction process begins it is permanent. Modern medicine has ways to manage these disorders and help the patient return his life to near-normal. However, we do not have a cure. That is why many people who have had addictions or dependencies to alcohol, nicotine, pain pills, etc. are FREE T AKE-H OME C OPY!

MEDICAL EXAMINER

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t s e B prone to relapse. Proper medical management can help those with dependencies to stay clean. But just as diabetics must avoid overloads of sugar, patients who become dependent or addicted to certain drugs must avoid exposure to the same demon that possessed them prior to treatment. While it is the primary responsibility of the patient to maintain his own good health, it falls upon the family and friends to help keep such patients away from temptations and the pitfalls of re-exposure. Many years ago, a relative became addicted to alcohol at about age 50. She had never drank before, but encountered it in social settings with a new group of friends. She had a very responsible job in a financial institution. Eventually her work production suffered.

e n i c i d ME

I brought her to my house and kept her for two weeks of drying-out, which involved all sorts of shakes and horrors and hallucinations. She did not drink a drop of alcohol for two years. While at the beach one summer, her husband thought he was doing her a favor and handed her one beer with the strict reservation that she could only have one. With that one beer the demons of craving leapt from the darkness and seized her soul. The next week, she started having her yard man buy alcohol and bring it to her on the sly. Within a month her work levels were suffered again. I brought her to my house for a second round of drying-out. That was 30 years ago. She has not drank since. She is a strong person. Still, she is an alcoholic and will be forever. The demons are still lurking about.

Substance dependency or addiction, regardless of the specific name, is a lifelong disease in most cases. It must be treated as such. Frankly, this requires lifelong medication to prevent relapses. Such is the case in opioid addiction. Suboxone or Methadone can be used to control craving. However, after weaning somewhat off from Suboxone or Methadone, the relapse rate after two years is somewhere in the neighborhood of 80%. I do not have a solution to this problem. I wish I did. If you know someone who has a dependency problem, whether friend or family, be very supportive and help them all you can. Lord knows they need you. + Bad Billy Laveau is a formerlyretired MD who wields a pointed sense of humor and now, tongue depressors too. He speaks and entertains at events for audiences not subject to cardiac arrest secondary to overwhelming laughter and glee. BadBilly@knology. net or 706-306-9397.

HEALTH PLAN… from page 2 physicians as well as hospitals of choice. Remember, as a consumer in the individual health insurance market you can insist on choosing your preferred providers. Pharmacy Formulary For many consumers, prescription medications represent a large percentage of their medical expenses. Insurance carriers and HMO’s can vary widely in the amount they cover in the plan’s specific pharmacy formulary. Most carriers favor generics by either charging more (or not at all) for their name-brand counterparts. Some plans

restrict where prescriptions can be filled. Consumers should check to see how or if regularly used prescription drugs are covered in the plan’s formulary. The co-payment, tiered drug level, prior authorization and step therapy will inevitably effect what you pay at the pharmacy. + Russell T. Head is President with ACHS Insurance, Inc., Augusta’s largest risk management and employee benefits brokerage. He can be reached at 706-733-3459 or rthead@achsinsurance.com. Visit ACHS Insurance at www.achsinsurance.com. +

Clinically proven. Doctor recommended.

The

Thanks for reading the Medical Examiner!

Money Doctor Coming up in the December 18 issue.

DECEMBER 4, 2015

AUGUSTA MEDiCAL EXAMINER

16 FOR ’16… from page 1

Looking for Likes in all the right places.

Well, there are definitely bigger sins in life than always having your face glued to a screen. But there are better ways to stimulate the amazing thing called the brain than Angry Birds and tweets. Consider the person — and they are everywhere, just look around (if you can pry yourself away from a screen) — who is either at work, driving, watching television or looking at their phone, laptop or computer screen seemingly at almost every waking moment. At red lights, they are instantly looking at their phone screen. In conversational lulls at lunch with friends or co-workers, they are instantly on their social media accounts. It’s not that any of the individual moments are that contemptible, but in sum you have to wonder about these people: do they ever have extended quiet time to create and nurture their own thoughts, an extended period of time when someone isn’t funnelling pre-packaged

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“It keeps me from looking at my phone every two seconds.” thoughts into their brain? Unplugging, and doing so regularly, offers the opportunity to think, to evaluate, to plan, to go beyond the superficial demands of the moment and consider the more important issues in life, in short, the big picture. It’s not easy to do that while constantly being distracted by electronics. The simple remedy: unplug every now and then.

TAKE ONE TABLET

#6 GET A FLU SHOT What are the benefits of flu vaccination? While how well the flu vaccine works can vary, there are a lot of reasons to get a flu vaccine each year. • Flu vaccination can keep you from getting sick from flu. Protecting yourself from flu also protects the people around you who are more vulnerable to serious flu illness.

• Flu vaccination can help protect people who are at greater risk of getting seriously ill from flu, like older adults, people with chronic health conditions and young children (especially infants younger than 6 months old who are too young to get vaccinated). • Flu vaccination also may make your illness milder if you do get sick. • Flu vaccination can reduce the risk of more serious flu outcomes, like hospitalizations. • A recent study showed that flu vaccine reduced children’s risk of flu-related pediatric intensive care unit (PICU) admission by 74 percent during flu seasons from 2010-2012. • One study showed that flu vaccination was associated with a 71 percent reduction in flurelated hospitalizations among adults of all ages and a 77 percent reduction among adults 50 years of age and older during the 2011-2012 flu season. • Flu vaccination is an important preventive tool for people with chronic health Please see 16 for ’16 page 13

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Be it resolved...

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

-HOM E CO P Y! TM

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JANUARY 9, 2015

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Who is this? See page 3.

S Specific

M A Measurable

Achievable

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

Relevant

Time-specific

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MEDICINE IN THE FIRST PERSON Everybody has a story. Tell us yours! Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx.com. Tell us if you want it “by you” or if it needs to be anonymous. Thanks!

DECEMBER 4, 2015

AUGUSTA MEDiCAL EXAMINER

Southern Girl Eats Clean Pumpkin Squares — with no refined flour or sugar!

Pumpkin Squares This fabulous little treat is just perfect for the sweet tooth after a large holiday meal. These light, sweet and flavorful squares are SO yummy. Loaded with real pumpkin and almond butter, they are a nutritious too They will satisfy that craving for dessert, but without all the sugar, flour, butter or cream. I found this lovely recipe on an Instagram account that I follow: @consciouskrys1. Krystelle has a blog where she shares some amazing recipes. Check out Krys and her recipes at www.consciouscooking.com I think you will go crazy over these little bites of heavenly, melt-in-yourmouth, pumpkin squares. They are very simple to prepare and will be a great treat to serve at any holiday gathering. They are addictive, but it’s okay because there is nothing in the recipe that will compromise your clean diet. So enjoy! Ingredients • 3/4 cup of organic pumpkin puree • 1/2 cup of organic almond butter • 1/4 cup of local honey • 2 organic pastured eggs • 1 tsp. of cinnamon • 1/4 tsp. of nutmeg • 1 tsp. of vanilla extract • 1/2 tsp. of baking soda • 1/4 tsp. of salt • Coconut flakes to garnish if desired Directions Line an 8 X 8 baking dish with parchment paper. In a mixing bowl add pumpkin puree, almond butter, honey, eggs and vanilla extract. Stir until well blended. Add the cinnamon, nutmeg, baking soda and salt to the mixture and stir to incorporate into the pumpkin mixture. Pour the batter into the baking dish. Bake in a preheated 350 degree oven for 18-20 minutes or until a toothpick comes out clean. Remove from oven and sprinkle coconut flakes on top. Allow to cool and then cut into 2 inch squares. Serve immediately or store in an air tight container in the refrigerator for up to a week. + Alisa Rhinehart writes the blog www.southerngirleatsclean.com She is a working wife and mother living in Evans, Georgia. Visit her blog for more recipes and information on clean eating.

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If the answer to both questions is Yes, you may be able to take part in a clinical research study. The CREDENCE Study is looking at an investigational (study) medication (taken as a daily capsule) that may help protect the kidneys in people with type 2 diabetes. TM

We are looking for people who: • are 30 years of age or older • have a diagnosis of type 2 diabetes • have kidney problems related to their diabetes • are currently taking medicines to control their kidney problems If you choose to take part in the CREDENCE Study, you will be looked after by an experienced study team who will carefully monitor your health and support your diabetes management. You will continue to take your current diabetes medications. TM

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DECEMBER 4, 2015

AUGUSTA MEDiCAL EXAMINER

The Short White Coat T he leaves begin to change and the weather cools down. Suddenly it is the holiday season and we have reminders at every corner. From Christmas lights to store sales, we are not allowed to forget that the holidays are near. Memories of preparing Thanksgiving dinner and sharing a meal with family and friends run through our minds. Spending my first 25 years in the city of Miami offered this benefit. I was never left to wonder what anyone I was immediately close to was doing on the most special of days. We were all together. That all changed when I moved to Saint Kitts to study medicine. I still remember the first Thanksgiving I celebrated away from home. My classmates and I had a potluck dinner party in our temporary home of Saint Kitts. There has always been so much to be grateful for, but now there was something new and different: opportunity. The opportunity to make reality from a dream was before all of our eyes. As medical students, we are fully aware that not every holiday will be spent at home with family and old friends. This reality can be disheartening, perceived as

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a sacrifice by some and an inconvenience by others. As an international medical student who left her home in Miami to move to the West Indies, Portland, Maine and now Augusta, I am learning to truly soak in gratitude for the experience and leave little room for whining and complaining; and trust me, this is a challenge! Nevertheless, I am blessed and honored to be receiving the education and training I will need to become a medical doctor, to be trusted by complete strangers with their most prized possession. I hope to never walk into a hospital or clinic on a special day, be it Thanksgiving Day, Christmas Day, a birthday or anniversary and forget that I am privileged to be there to learn, assist and serve. It is sometimes easy to become distracted and lose sight of the big picture. We can be consumed by details of the day, be it a traffic jam, the news, or something hurtful someone said or did. Whether we are the patient waiting too long to be seen or the doctor overwhelmed by the amount of paperwork that follows each patient, the big picture is always filled with so much more peace and hope, the big picture that reminds us how

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A med student’s notebook awesome it is to be the person who can help a sick person feel better, or how wonderful it is to be a sick patient who was seen and taken care of by a caring doctor using all the skills and knowledge medical science has to offer. This holiday season may we be mindful of ourselves. May we remember that we cannot control the traffic or the person who forgot to think twice before being hurtful. All we can do is control our reactions. Despite where we are for the holidays or whom we are with, we can always find something to be grateful for. Happy Holidays! + by Jasmine Rivas, a third year medical student at University of Medicine and Health Sciences, who is currently in a Surgery rotation in Augusta. Feel free to contact her with questions or feedback: jrivas@umhs-sk.net

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DECEMBER 4, 2015

AUGUSTA MEDiCAL EXAMINER

‘TIS BETTER TO GIVE and RECEIVE!

Ask a Dietitian SETTING S.M.A.R.T. GOALS FOR THE NEW YEAR

by Amanda Hubbard, RD, LD Charlie Norwood VAMC, Uptown Division

nother year has come and nearly gone and with that we often spend time reflecting on what we accomplished and what we still need to improve upon. As you take time to reflect, were goals such as improving your diet or including more exercise on your list? Each year do you promise yourself that with the new year will come changes to a new and improved you? While you may start off really well with those changes, over time you find yourself slacking off, and by summer you are no longer on track with your goals. Who said it had to be that way? What if there was a realistic, S.M.A.R.T. way to make longterm changes to a happier and healthier you? One great way to help you stay on track with your goals is to create S.M.A.R.T goals. If you are not familiar with such goals, they are Specific, Measurable, Attainable, Relevant (or Realistic), and Time-bound. When setting your goals, begin by being specific with what you would like to accomplish. For example, if you drink 2-3 sodas daily, your goal may be two sodas per week. Goals should be as specific as possible; it helps to hold you more accountable. A goal of “I am going to reduce my soda intake,” however, is not very specific. There is no date or plan to help you reach this goal. Once you have specified your goal, set the date by which you would like to reach it. Assuming you are starting January 1, you may want to reach your goal by February 1. By setting a date, you are making the goal both measurable and time-bound.

As you set specific and time-sensitive goals, make sure they are achievable. Is it realistic for you to cut back to two sodas per week in approximately one month’s time? Perhaps six weeks is more realistic for you than four weeks, but keep in mind that you want your goal to challenge you, so giving yourself two months to reduce your soda intake may be too long. Once your timeframe is put into place the next step is to make a plan to help achieve that goal. One plan may be to cut down to one soda per day for the first week, then the next week cut down to just four sodas, the next week three sodas and by week four you have reached your goal of two sodas per week. By mapping out a plan your goal becomes result-focused and again measurable. By the end of the process your written goal would look something like this “By February 1, I will cut down my soda intake to just two sodas per week. I will do so by cutting one soda daily for the first week. During the second week I will have a soda four out of seven days. During week three I will have a soda three out of five days. By week four I will be to my goal of two sodas per week.” It helps to write down your goals and plans and place them an area you see daily, such as on your refrigerator or on a post-it note by your desk. S.M.A.R.T goals can be used to set both short term and long term goals. Many people set an overall long-term goal — such as “ I will lose 20 pounds within the next 6 months” — and then set smaller goals throughout the next six months to help reach the big long-term goal. These small goals also help to keep us accountable and on track to reach our long-term goal. We all want to make changes that will benefit us now and in the long run. Following the S.M.A.R.T pattern for each goal you set will help make those tough changes seem realistic and achievable. While it may feel like a tedious process at first, the more you do it the easier it becomes. It is a great method to set yourself up for success, so that next year all those unhealthy behaviors fall into the “accomplished” category instead of the “still needing improvement” category. +

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DECEMBER 4, 2015

AUGUSTA MEDiCAL EXAMINER

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When Al Gore invented the internet, he probably never dreamed that it would be the best delivery system the world has ever seen for two very different things — porn and cat videos. Since this column is entitled Pet Vet, you have three guesses which one we’re going to address in this space today. If you guessed cat videos, give yourself a gold star. The internet’s latest viral video craze — taking up so much bandwidth that even the Pentagon and the NSA have to be content with leftover bandwidth — is videos showing cats going bananas when they encounter a cucumber. If you have seen this, you’ll have to agree that cats seem to be utterly terrified of cucumbers. In fairness, however, some previous cat video crazes have shown cats going bananas over, well, bananas. In response, here

at Medical Examiner world headquarters we have used some of our vast research laboratories in past months to test cats and their reaction to bananas. From what we saw on videos, we expected the mere whiff of a sliced banana would be for a cat like a strong whiff of ammonia would be for a human. Our test results were a huge yawner. There was no reaction. And when we get the milliondollar federal grant to study cats and cucumbers, we expect the same results: nothing. Cats go ballistic when they see a cucumber in only one

situation: when it’s placed there by a sneaky human in order to surprise the cat. You will note that this is the situation in every case on the world-famous cat-cucumber videos that have millions of views. There are no videos of cats walking up to an inert banana or cucumber and then reacting like they’ve been set on fire; it’s always when they have had their face in a bowl of crunchy kibbles and then suddenly turn to see something that wasn’t there just moments ago. For the record, people have the same reaction to rubber snakes, plastic spiders and Scream masks. The experts say it isn’t all just harmless fun, however. Cats can sometimes be a little on the neurotic side to begin with, and a pranks like the ones seen by millions of us all involve what is supposed to be a safe place — Foodsville — and an experience — eating — that is supposed to be pleasant. In some of the scenes shown, it looks like the cat could easily be injured or break something, cause a heavy object to fall on it, or be traumatized for days or weeks. If cats being scared out of their minds by a cucumber is your thing, watch it happen on YouTube. Don’t put your cat through the experience. +

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DECEMBER 4, 2015

11 +

AUGUSTA MEDiCAL EXAMINER

From the Bookshelf The blog spot — Posted by Eki Abrams, MD on Nov. 29, 2015 at kevinmd.com

THANK YOU FOR HEALING A PART OF ME As I entered the exam room to meet my new patient, I initially thought of the orange-haired heroine in the animated kid’s movie, Brave. Although this middle-aged woman’s hair was not quite as orange, it was long, expansive and wavy. It seemed to engulf her petite frame. Her cheekbones were prominent, and the delicate skin between her collarbones had a sunken look. She was accompanied by another woman, her best friend of 45 years. The patient nervously conveyed a bewilderingly circuitous medical history, all while daintily perched on top of the exam table. When she revealed that she had been diagnosed several months ago with pancreatic cancer, her case made sense to me. Her waif-like frame confirmed that this malignancy was depriving her body of the nutrients she needed to survive. As my hands hovered over the keyboard while I tried to decide between laboriously typing the details of her diagnosis, failed alternative treatments and current plan, my eyes began to tear. I begged myself to pull it together and “stay strong,” but I was transported right back to the oncology appointments I accompanied my mother to. Just a few hours earlier on my commute to work, I had felt my mother’s presence as I heard Schubert’s Piano Impromptu No. 3 on the radio, for it reminded me of the compositions she would play. I looked at my new patient. Mortified, I felt the burning tears rolling down my cheeks. Her nervousness instantaneously evaporated, and her tone and facial expression immediately conveyed such concern and empathy that I felt as if our roles had reversed and I was the one in need of healing. She tenderly asked who I had known that suffered from cancer. I shared with her that it was my mother, and I expressed the inner discordance of remaining shielded and professional versus being vulnerable and wanting to connect. Part of me wanted to remove the symbolic white coat and share that I could empathize with her. With outstretched arms, she enveloped me in a warm hug. We hugged for what seemed like forever. Despite feeling the physical frailty of her exterior in my arms, I detected the internal strength that radiated from her core, elevating her to a level of dignity, beauty and strength. For a moment, it seemed surreal: How could this marvelous person contain within her such a beastly dysfunction? After we disengaged from our embrace, she and I held hands through out the rest of the hour. She talked about how she worried about her youngest son being alone and her becoming a burden to the loving friends who were helping to take care of her. Unbelievably, in the midst of all this, her precious time had been consumed trying to find new doctors because of health insurance issues, and thus she was seeking me as her new primary care physician. As an internist whose focus is mostly on preventive medicine, the paradigm shifted within me to be the best physician I could be for her in this phase of her life, which would most likely soon entail hospice care. She had recently attended a consult appointment at a large academic tertiary care facility, and the oncologist never took the time to look into her eyes. This was clearly a disheartening experience for her, so today she was so joyous and appreciative of the connection we had made and would continue to nurture. I thanked her for helping to heal a part of me that is continually grieving, and for helping me reaffirm why I chose to become a doctor. Doctoring is not so much “practicing medicine,” the term I equated in my pre-med days to being a physician, as it is being a healing person. The difference is subtle, but after four years in practice, I feel the internal shift between doing and being. The latter resonates within me and is the reason I chose primary care, a specialty that allows for creating and maintaining such intimate healing moments. I never did see this lovely woman again. I soon received word that she had lost her battle to cancer, but I shall never forget her spirit. +

Our roles reversed. The patient was healing me.

Eki Abrams is an internal medicine physician.

If this book’s author — Siddhartha Mukherjee — sounds familiar, it isn’t your imagination. He also wrote the much-acclaimed Pulitzer Prizewinning book The Emperor of All Maladies published in 2010. That book weighed in at 592 pages. This one, however, was based on a TED talk, so it only fills 96 pages cover to cover. But good things come in small packages, as they say, and this book fits that description. It’s a thoughtful and thought-provoking book. Judging from the title you wouldn’t necessarily expect to find this sentence on its pages: “I had never expected medicine to be such a lawless, uncertain world.” That’s because science — as in “medical science” — is generally viewed as an arena where strict and unvarying laws apply. In physics, for example gravity is gravity anywhere in the universe. In chemsistry, two substances in the same circumstances will always react to each other in the same way. Ah, but “biology is the most lawless of the three basic

sciences: there are few rules to begin with, and even fewer rules that are universal.” The lifelong smoker never gets lung cancer, while the lifetime non-smoker occasionally exposed to second-hand smoke does. Living creatures bend the already thin rules of biology to their near-breaking point. Think of the freedom that gives us! But think of the complications it entails for doctors. As Mukherjee writes, medicine asks doctors to make perfect decisions with imperfect information. Medical science has amassed a tremendous wealth of knowledge in the past 75

years, but what to do with that information and how to apply it to individual cases, that has been the challenge. What if the standard wisdom does not apply to this patient with this history in this particular crisis? That quandary presents itself to doctors in the lawless world of medicine every single day. Reading this book instills not only an appreciation for the practice of medicine and all its myriad complexities, but also for the book The Youngest Science — Notes of a Medicine-Watcher, witten by Lewis Thomas, he of Lives of a Cell, and published more than 60 years ago. Lewis’ vintage book was of great interest to Mukherjee as a medical student and plays a starring role in this book. If you buy The Laws of Medicine, you might as well go ahead and get The Youngest Science while you’re at it. By the time you finish one you’re going to want the other. + The Laws of Medicine, by Siddhartha Mukherjee, MD, 96 pages, published in October 2015 by Simon & Schuster

Research News Save your knees Fortunately, medical science has devised ways to replace many body parts, something that a mere hundred years ago would have seemed to be outlandish science fiction. But before you get that knee replacement surgery, consider this: University of California at San Francisco researchers have discovered that losing a large amount of weight slows the loss of knee cartilage in obese people. 500 overweight or obese people with mild to moderate osteoarthritis participated in the study and were randomly divided into three groups over the 4-year duration of the study: one which lost no weight, a group that lost a little weight, and a third group which lost more than 10 percent of their body weight. It’s perhaps no surprise that weight loss protected against the loss of knee cartilage and cartilage degeneration, and also reduced the risk of osteoarthritis.

But one interesting discovery was that those in the middle group — who had 5 to 10 percent weight loss — had almost no difference in knee cartilage degeneration compared to those in the group with no weight loss. In other words, for those targeted by the study (overweight or obese people with mild to moderate osteoarthritis) 10 percent is the minimum weight loss for benefits to become apparent. And although it might seem counterintuitive at first glance, moderate exercise is one of the best ways (along with weight loss) to prevent osteoarthritis. What they don’t know won’t hurt them — or will it? Whenever a pregnant woman is seen smoking in public, most people probably think, “Well there goes the Mother of the Year.” It turns out that your kids know whether you smoked while you were carrying them — at least, they can if they have friends who are researchers at

the Johns Hopkins Bloomberg School of Public Health. There, health scientists discovered that blood drawn from children as old as age five shows molecular evidence that the mother smoked during pregnancy, markers that are not present in the blood of children whose mothers did not smoke during pregnancy. The finding suggests that for all of us, newborn or adult, our bodies can potentially be affected years after we’re exposed to anything that is less than healthful. In previous studies, researchers have established that smoking during pregnancy has a demonstrable effect on childhood conduct problems, and that smoking has discernable transgenerational effects, meaning that today’s children could have risk factors for various health problems because their grandparents smoked, or that mothers who smoke today could create negative health consequences for their children and even their grandchildren. +

+ 12

DECEMBER 4, 2015

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS

THE MYSTERY WORD

by Dan Pearson

Ah, this time it’s actually Have you heard the something good. What’s They want to rename latest from Augusta That crazy bunch? the proposed new name? Tobacco Road. commissioners? What is it this time?

E-Cig Road

The Mystery Word for this issue: GURONSE

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. 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, former Brave 26. Inner prefix 28. Jane’s ex 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 one 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

9 15

QUOTATION PUZZLE 30

53 58

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

Click on “READER CONTESTS”

VISIT WWW.AUGUSTARX.COM

— Edward Abbey

64 66

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.

65. Kelly of note 66. Throw 67. Makes leather DOWN 1. Ear _____ 2. _______ Minor 3. Command to a cat 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. A or C, for example 10. Resolve differences (with “out”) 11. ______-killer 12. Common conjunction 15. World’s longest river 21. Natal start 23. Ancient tower 25. Mr. Hogan 26. Vote for 27. Recently 28. Stroke abbrev.

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. Copenhaver, to friends 50. Downtown backstreet 51. Joseph (in Juarez) 52. Capital of Yemen 54. Greek goddess of the Earth 55. Uniform 56. Clarets 57. Type of war? 59. Gunk 60. Ernie of the PGA

X A M I N E R

1 6

7 8 6 9 4 3 9 1 7

2 6 3 9 9 7 5 1 1

9 3

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 3 1 2 3

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

O 1 2

1 2 3 4

H 1 2 3 4

1 2 1 2 3 4 5 6 7 8 9 5 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:

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 4, 2015

13 +

AUGUSTA MEDiCAL EXAMINER

THE BEST MEDICINE ha... ha...

Knock knock. Who’s there? Ash. Ash who? Bless you! Knock knock. Who’s there? Doorbell repairman.

man was driving down the interstate when he heard the unmistakable thumping of a flat tire. So he eased his car over to the shoulder of the road, carefully and safely got out of the car and opened the trunk. He took out two large cardboard cutouts, unfolded them and stood them at the rear of the car facing on-coming traffic. The cutouts were two men who looked so lifelike, drivers thought they were real They were dressed in open trench coats that exposed their nude bodies and private parts to the approaching drivers. Naturally, cars started slowing down to look at the cardboard cutouts. And of course, traffic began backing up. It wasn’t long before a state trooper pulled up. He got out of his car and walked toward the driver. He was not a happy camper. “Care to explain what’s going on here?” “My car has a flat tire, obviously,” the driver calmly replied. “I can see that, but what about those obscene cardboard men behind your car?” The driver was shocked that a state trooper wouldn’t know something so basic. So he said, “Helloooooo, those are my emergency flashers.”

Moe: I’m looking for a new computer. Any suggestions? Joe: What do you plan to use it for? Moe: Playing music mostly. I want a computer that sings. Joe: In that case I’d get a Dell. A wealthy man died and left his entire fortune to help the blind. Unfortunately, they never saw a penny of his money. A Mexican man is trying to book a flight to Australia with a travel agent. “I can book you a flight on Quantas Airlines,” she says, looking at her screen. “I think one would be plenty,” says the Mexican. What can think the unthinkable? An itheberg. I asked an attractive young homeless woman if I could take her home. She said yes with a big smile. But the look on her face sure changed when I walked away with her cardboard box. +

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.

16 FOR ’16… from page 6 conditions. Vaccination was associated with lower rates of some cardiac events among people with heart disease, especially among those who had had a cardiac event in the past year. Flu vaccination also has been shown to be associated with reduced hospitalizations among people with diabetes (79 percent) and chronic lung disease (52 percent). • Vaccination helps protect women during pregnancy and their babies for up to 6 months after they are born. One study showed that giving flu vaccine to pregnant women was 92 percent effective in preventing hospitalization of infants for flu. • Other studies have shown that vaccination can reduce the risk of flu-related hospitalizations in older adults. A study that looked at flu vaccine effectiveness over the course of three flu seasons estimated that flu vaccination lowered the risk of hospitalizations by 61 percent in people 50 years of age and older. That’s a lot of pro-flu-shot ammunition, and it all comes from the well-respected halls of the Centers for Disease Control, our Georgia neighbors right down the road. So you know it’s legit. + Want to check out earlier installments of 16 for ’16? Visit issuu. com/medicalexaminer for the world’s largest collection of Examiner back issues. “16 for ’16” began with the Nov. 6 issue. Topics covered in previous issues: 1. Driving safety 2. Goal setting 3. Tobacco use 4. Walking

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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

MEDICAL EXAMINER IS ONLINE • AugustaRx.com/news • -OR-

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

+ 14

DECEMBER 4, 2015

AUGUSTA MEDiCAL EXAMINER

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

...cleverly hidden (in the grass on the sandal) in the p. 3 ad for SOUTHERN COMFORT SHOES Congratulations to WILMA TSOPANARIAS, who scores a coveted Scrubs of Evans gift card, 2 movie passes courtesy of Health Center Credit Union, and a $20 Wild Wing Cafe gift certificate. Want to find your name here next issue? The new Mystery Word is on page 12. Start looking!

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

The new scrambled Mystery Word is found on page 12

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EXAMINER CLASSIFIEDS oceanfront timeshare, 2 bdrm, 2 bath, first week of March. $990 OBO. More info: (706) 738-2292

HOMES, APARTMENTS, ROOMMATES, LAND, ETC. POND VIEW! Evans all-brick 2-story with solar panels. Avg. electric bill $170 in Northwood, 3,400 sqft. Call 1-800401-0257, ext. 0043 24/7 for price and details. HOUSE TO LEASE 2 bdrm, 2 full baths, fenced yard, hardwood throughout, screened porch, room for garden, sunny windows, close to Summerville and downtown campuses $750/mo 706-2317697 AUGUSTAGAHOMESEARCH.COM Foreclosures • MLS • Builders • Rentals (706) 564-5885 FOR LEASE-3 bdrm, 1 bath, double lot, fireplace,hardwood floors, ample parking,off Wrightsboro, near Daniel Field. For appt. 706 738 3107. HOUSEBOAT FOR SALE Tradewinds Marina, 30 minutes from Augusta. Live at the lake - or have a second home there with NO grass to mow! Recently upgraded. $65,000 Text me at (803) 640-9732 for pics

SERVICES HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706.267.9947 BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673) F. E. GILLIARD, MD FAMILY MEDICINE Acute & Chronic Illnesses Occupational Medicine PROMPT APPOINTMENTS 706-823-5250

MISCELLANEOUS FOR SALE An elipitical in excellent condition. Asking $100.00. Please call 706-306-4666 KING-SIZED bed frame with rails, dark wood, some surface scratches but overall very good condition. $90 Call 706-3730193

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QUOTATION PUZZLE SOLUTION: Page 12: “Growth for the sake of growth is the ideology of the cancer cell.” — Edward Abbey

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COFFEE IS GOOD MEDICINE

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

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

SEE PAGE 12

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CEMETERY SPACES (2) Sunset Memorial Gardens, Graniteville SC adjacent to lighted military flagstaff, includes granite bench with urn space, installation and inscription. All $4700 ($8600 value). Spaces only: $2700. Call (803) 295-3033

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(OURS IS COFFEE)

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BEING PAID WHAT YOU ARE WORTH? Then make more money! Watch movie all out interview: ExtraMoneyInterview.net

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WANT TO BE HEALTHY? (Energy, weight loss, mental clarity) Go to gethealthyat.le-vel.com See video and Facebook. Sign free as customer.

HILTON HEAD For sale: Hilton Head

WHAT’S YOUR DRUG OF CHOICE?

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ANTIQUE maple dinette set with buffet corner cabinet table with pull-out leaves. Four chairs with two captain’s chairs. Excellent condition. $300. Double bed early 1930s with mattress spring coverlet shams $150. Call (706) 860-2170

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PROFESSIONAL DIRECTORY DERMATOLOGY

ALLERGY

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

CHIROPRACTIC

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

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

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

EMPLOYEE BENEFITS

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

CALLING ALL M.D.S!

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

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

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

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

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

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

OPHTHALMOLOGY

DRUG REHAB

COUNSELING

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

DEVELOPMENTAL PEDIATRICS

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

DENTISTRY

LASER SERVICES

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

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

...SENIOR LIVING

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

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

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

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

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

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DECEMBER 4, 2015