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FEBRUARY 1, 2013
WEIGHT The
HISTORY
IN THE MAKING!
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AMERICA IS LEADING THE WAY. FOR THE
ST +
TIME
IN HUMAN HISTORY
OBESITY IS KILLING MORE PEOPLE •THREE TIMES MORE! •THAN
MALNUTRITION!
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OF THE WORLD
t’s amazing to consider the ramifications of the findings of the Global Burden of Disease (GBD) Study 2010, released in December by the British medical journal The Lancet. The study is described as “the largest ever systematic effort to describe the global distribution and causes of a wide array of major diseases, injuries, and health risk factors.” The news isn’t all bad; far from it: “infectious diseases, maternal and child illness, and malnutrition [...] cause fewer deaths and less illness than they did twenty years ago... Since 1970, men and women have gained slightly more See the than ten years of life expectancy overall.” Medical Examiner That alone — ten years of added life per person since 1970 — is an amazing testament to better blog for additional medical care and improved nutrition. information. On the other hand, you can have too much of AugustaRx.com/news a good thing: while deaths from malnutrition + have been cut by two-thirds just since 1990 (to less than a million in 2010), health scientists blame obesity for more than three million deaths each year worldwide. During the 40-year period of the study, that represented an 82 percent increase. Granted, every death is the result of a combination of factors. High blood pressure, smoking, inactivity, genetics, and obesity could all play a role in one death, and none of them may be the culprits in another. Weighing all the factors and data at their disposal, GBD authors say we have in a mere twenty years gone from a world where people weren’t getting enough to eat to a world now where too much food and unhealthy food — even in developing countries — is making us sick. The upshot is that millions of people are spending their extra years of life living with serious illnesses like heart disease and cancer, or otherwise not enjoying increased quality of life in their extra years. The United States has the dubious distinction of being the most overweight nation on earth by an unhealthy margin, but it’s sobering to think that obesity is even taking a toll in the developing world, “from Colombia to Kazakhstan,” in the words of the study. Yes, the fat American is a global stereotype, but it’s something of a shock to realize obesity is a problem all over the world. Please see WEIGHT page 6
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FEBRUARY 1, 2013
AUGUSTA MEDiCAL EXAMINER
Editor’s note: Healthcare is a whole new ballgame with the passage of the Patient Protection and Affordable Care Act (PPACA). How will healthcare providers be affected? What about patients? And how about employers who provide health coverage as an employee benefit? How will Medicare and Medicaid recipients be affected? Look to this column for the answers.
HEALTHCARE REFORM & YOU by Russell T. Head, CBC, CSA
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PRIVATE HEALTH INSURANCE EXCHANGES
n the last issue of the Medical Examiner, we talked about Public Health Insurance Exchanges and the timelines and regulations surrounding them. An alternative to Public Exchanges are Private Health Insurance Exchanges. I define these as an online store that individuals or employees can access to buy their Russell Head benefits. Many of the Private Exchanges are operated by insurance companies, benefit brokers or technology vendors. They provide benefits administration support, end to end transactional services and decision support for the user. A Private Exchange will often times include options to purchase lines of coverage in addition to a health plan. Life Insurance, Short and/or Long Term Disability, Dental, Vision and Pet Insurance are just an example of what is available. Private Exchange models: • Group Market Private Exchange – sells “group” insurance to employees of employers. • “Individual in Group Clothing”-sells individual market health plans to employees of an employer through an HRA. • Individual Market Private Exchange – sells health insurance to individuals and families in the individual health insurance market. This discussion will focus mainly on the Group Insurance market. A Private Exchange is typically offered by an employer as a defined contribution model, whereby the employer funds a
set dollar amount each month to all of their benefits-eligible employees. Each employee will have different coverage needs, so with the funding they receive an employee can buy a personalized package to protect themselves and their family. Any premiums over and above their defined contribution amount will be paid for by the employee through payroll deduction. For 2014 and 2015, the Public Exchanges will decide if they will offer the plans to groups of less than 100 employees or less than 50 employees. In 2016, all employers with 100 or less must be able to purchase benefits through the Public Exchanges. Note that beginning in 2014, employers with more than 50 workers may be subject to a penalty under ACA if they do not provide health coverage to their employees, or if the health coverage they offer is not affordable or does not provide minimum value. More on that in upcoming issues. Private Exchanges are open for business now and currently making a name for themselves. With the rising cost of health insurance, many companies are looking at this option as way to save money while still offering employees affordable coverage. Many Private Exchanges offer plans from several insurance carriers with choices of low deductibles, high deductibles, and many other costsharing provisions, some with little or no out of pocket expenses after the deductible is met. The cost differential between the low end and high end plans can reach up to 60%. By offering an array of plans, competition is promoted, employee satisfaction levels rise and people tend to take more ownership in plans they have Please see REFORM page 4
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FEBRUARY 1, 2013
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AUGUSTA MEDiCAL EXAMINER
ASK THE DOCTOR FUTURE DOCTORS ASK CURRENT DOCTORS
Do you get sick a lot? from Bryce W., 4th Grade, Martinez Elementary
T
his is a very good question, and shows that you are really paying attention to the world around you. Yes, it might seem like we would get sick often. We spend all of our days either in the hospital or in the office, and in both places we see lots of sick children. But remember, not everyone we see in the office is sick. And when we’re in the hospital, we are mostly seeing newborn babies. We pay careful attention to washing our hands when we see these newborns, and they are too young to have any diseases that we might catch. The hospital makes sure that the nurses and all other folks in the nursery stay healthy as well. One big thing that keeps us healthy is that we have had ALL our childhood shots, and even our adult shots. The shots that you get as kids really will prevent you from catching many severe diseases, so you wont get sick and spread the disease to other kids. Did you ever realize that when you stay well, it helps other kids stay well? This is why we believe that getting shots (childhood immunizations) are so important. Of course, every doctor knows you don’t like to get shots, and we don’t like giving them, but they
really do help! Remember, they only hurt for a few seconds, but they can keep you from being sick for a long time. Doctors also have been exposed over the years to many many different strains of germs that cause coughs, colds and runny noses. Our bodies are very effective at fighting disease, because once you have a cough or cold, your body develops antibodies to help prevent you from getting the same type of cough or cold in the future. These are specific things in your blood that help you prevent and fight infections. Of course, we wash our hands many times each day, and eat healthy and nutritious foods. All these help to keep us healthy so we can help you stay healthy! + Written by the physicians of Pediatric Partners, with offices in Evans and Augusta. They can be reached at 706.854.2500 and at www.pedpartners.com. TEACHERS! PARENTS! Send us your kids’ questions, whether they’re in high school, kindergarten, or somewhere in between. Mail them to Dan@AugustaRx.com or to Medical Examiner, PO Box 397, Augusta, GA 30903-0397
What’s your story? Nearly all of us — even doctors and nurses — are sometimes patients. Perhaps you were recently injured playing your favorite sport, or years ago you somehow got hurt without even leaving your favorite recliner. Maybe you were diagnosed with a dreaded disease, mugged in a dark and lonely parking lot, or you stubbed your toe in the safety of your own bedroom. On the other hand, perhaps you needed medical attention 5,000 miles from home. Whatever your medical experience, we’d like to hear your story for our Medicine in the First Person feature. It can be frightening or funny, ordinary or extraordinary, just a few paragraphs long or quite a lengthy tale, bylined or anonymous. We’ll publish your encounters with the medical profession as often as we receive them. + Send your submissions for Medicine in the First Person to the Augusta Medical Examiner via e-mail: info@AugustaRx.com or to PO Box 397, Augusta, GA 30903-0397. (The Medical Examiner reserves the right to accept, reject, or edit any submission at its sole discretion.)
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FEBRUARY 1, 2013
AUGUSTA MEDiCAL EXAMINER
Hope IS Possible
Self-preservation is so underrated
Helen Blocker-Adams
W
hen you think of the term self-preservation, what comes to your mind? An animal? Survival of the fittest? My fitness trainer/health specialist, T.J. Simmons with Champion Fitness & Nutrition, uses that term often either on my radio program or during our 5 a.m. workout sessions. He’s good at keeping the Morning Warriors motivated by letting us know that we represent a small group of people who have made a commitment to take care of themselves and develop and maintain a healthy lifestyle. Of course, it’s extra dedication for us because it’s so early in the morning when we meet three days a week. At 30 degrees or lower early in the mornings, it can be challenging to get out of the bed to go and work out. I have to admit, once I’m there, I am so thankful
that the little voice in my head pushed me to get up and go, despite the frigid temperatures. There are two definitions of self-preservation I want to explore and expand on. One, protection of oneself from harm or destruction; and two, the instinct for individual preservation; the innate desire to stay alive. What does this have to do with developing and maintaining a healthy lifestyle? Everything, actually. Think about it: when we eat healthy food, drink plenty of water, get plenty of rest, exercise, have a spiritual life, and make a conscious effort to take care of ourselves on a daily basis, we build our immune system, among other things, which protects us from getting sick. In other words, we are protecting ourselves from harm or destruction. I believe if you asked ten people the question, “How long do you want to live?’ they would say they want to live as long as they can. But frankly, if that is our answer, our lifestyles reveal something completely different. We say one thing, but we’re regularly eating fried food, too many sweets, far too much carbohydrates, and the most exercise some are getting is the walk from their car to the office.
We really must do better. As humans, we have an innate desire to stay alive and we can take a proactive approach to help make that happen if we do what we really know deep in our heart we must do. Some people made New Year’s resolutions by joining a health or fitness club last month. They went for one week and haven’t been back. Is that you? Health Guidance, an online health and fitness blog, had this to say about exercise and physical fitness: “Physical fitness has been shown to be significantly related to the ability to do physical activities such as household chores, work, sports and dance in an effective and safe manner. Less than one-half (40%) of the adult population exercise on a regular basis and only one quarter have done so for five or more years. However, over four-fifths (80%) of adults consider themselves as active or more active than other persons of the same age. The majority of adults are not knowledgeable regarding the specific requirements to strengthen the heart and lungs (frequency and duration of exercise and heart and breathing rate during exercise). A higher percent of younger adults engage in regular exercise.” A better way to say all
of this is that 60% of the U.S. population does NOT exercise regularly. Wow!! Let’s go back to the term self-preservation for a moment. There was a study performed in 2005 by an epidemiologist at Michigan State University which found that “most Americans do not do everything they can to lead a healthy lifestyle.” The study, published in journal Archives of Internal Medicine looked at four basic characteristics that are part of a healthy lifestyle. They are: • Being a non-smoker • Exercising 30 minutes or more five days per week • Eating five or more servings of fruits and vegetables every day • Maintaining a healthy weight with a BMI under 25 The results found that there is a low prevalence of healthy lifestyles in the United States adult population. The findings go against the notion that most people say they want: to live as long as possible. There is something wrong with this picture. Here is the individual breakdown, from the study, for the four healthy lifestyle characteristics: • 75 percent didn’t smoke. • 23 percent ate at least five servings of fruits and vegetables every day. • 22 percent exercised regularly.
• 40 percent maintained a healthy weight. Earlier I mentioned that an unhealthy lifestyle means more illness, and let’s not forget more expense to treat those illnesses. Poor health also means more time lost at work, less quality recreational time, and even shorter life spans (AKA self-preservation goes out the window). It’s not too late to reverse this. We, as adults, must be role models for our young people. You can start today, change and start living a healthy lifestyle. This can help lower your risk for cardiovascular disorders, diabetes, cancer, and other diseases. I certainly have enjoyed my journey since April 2012. I must admit being able to wear slacks three size smaller than what I was wearing last April is pretty good motivation for me to continue and be a role model for others to follow. I have no intention of going back! + Helen Blocker-Adams is Executive Producer/Host of “The Helen Blocker Adams Show with Co-Host Sammy Lilly”, which airs Monday through Thursday 1 p.m. – 3 p.m. on 103.7 FM/1600 AM WKZK The Spirit. She is also Founder of Unlikely Allies Emerging Leaders Conference. You can contact her at hba@hbagroup-intl.com or visit her at www.helenblockeradams.com
REFORM… from page 2 selected for themselves.. According to the National Association of Health Underwriters, these steps are proven to reduce health care spending. The regs have directives leading to financial subsidies being available for the Public Exchanges. The jury is still out on whether subsidies will be available for those choosing to buy benefits from a Private Exchange. Those of us in the health insurance business are continually digesting and interpreting PPACA regulations. Healthcare Reform has greatly impacted our segment of the insurance world.
As we move forward to 2014 when the exchanges begin, we will continue to learn more, keep our clients abreast of regulations that affect them and share that information in this publication. Stay tuned. + Russell T. Head is a Partner and Chief Visionary Architect with Group & Benefits Consultants, Inc., Augusta’s largest, privately held employee benefits consulting firm. He can be reached at 706-733-3459 or rthead@gandbc.com. Visit Group & Benefits Consultants at www.groupandbenefits.com.
www.AugustaRx.com/news
FEBRUARY 1, 2013
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AUGUSTA MEDiCAL EXAMINER
WHAT EVERYBODY OUGHT TO KNOW ABOUT WINNING WHEN YOU ARE SECOND
M
y wife’s car was almost out of gas. She sent me to buy some before it ran out. I was in scruffy, honey-do-list clothing that all us husbands wear from time to time. Two-day-old whiskers hid my wrinkles. As I retrieved the gas hose, a perky, slender blonde lady walked up and said, “Good morning, sir.” I know it is stereotyping, but one look told me she was neither panhandling nor merchandizing temporary pleasures. She exuded wholesomeness on a monumental scale. Not a single evil corpuscle coursed through her veins or haunted her mind.
She handed me a printed sheet paper. She said she wanted to do something to help mankind rather than just pray about good things and say Jesus loved me. She demanded nothing. She wanted nothing. She was giving, not taking. She said, “Good day,” and walked away. When I recovered from my surprise, I read the paper. She was from the Covenant: a United Methodist Faith Community on Washington Road near Gibbs Road. And even more astonishing, what seemed to be a $25 Kroger gift card was loosely attached to the paper. Should I call the cops and report a developing scam? Should I call mental health and report a lunatic on the loose? Should I act like it did not happen and go see if I could buy a few bottles of cheap wine to sooth my miseries? Heavens, no. I was the victim of a Random Act of Kindness by a friend of Jesus. Now, I know I couldn’t say that in a public
E
TH
Best school for fear of offending some atheist or any religious sect other than Christianity. But, correct me if I am wrong, I have not heard of any religious group, other than Christian based groups, handing out free money without wanting something back. So I say it here and risk the lances reserved for the politically incorrect. The lady walked away knowing she had done a good thing. I commend her for her resolve. And I commend those who worked hard to make the money, pay the taxes, Social Security, unemployment, Medicare, etc. to the Federal government, and then convert what little of their hard earned money was left into a Kroger gift card to provide benefit others. And they
GOT A STORY?
e n i c i d ME
do all that without asking anything in return or seeking recognition. She did not even ask or demand that I attend her church. That is how Jesus would do it. That is how she did it. The card suggested that if I did not need this, please pass it on to someone who does. I shall do that. And then I shall feel a little better about myself. The reason for telling you all this is best summed up in an old Brylcreem advertisement. (For those of you who don’t know, Brycreem was used on flat top haircuts for teenage guys back before Elvis changed men’s hair forever.) Just a Little Dab’ll Do Ya. Ain’t No Telling What Two Little Dabs’ll Do. Let this Random Act of
Goodness go viral. It caused me to do some good. And it will go one and on. Or at least I hope so. Unless, of course, the card eventually ends up in the hands of a dopehead who will swap it for a few puffs crack on their way down to the food stamp office where they can get some food stamps to exchange for some more crack so their last 5 teeth will fallout before the age of 30. What is the moral to this story? Laughter is the best medicine. But doing good deeds may be even better because it helps you and it helps those around you. You don’t always have to be first to win. + 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 706306-9397
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AUGUSTA MEDiCAL EXAMINER
FEBRUARY 1, 2013
Adventures in Administration
APART4-Room House II I The problem is undeniably big. And getting bigga.
WEIGHT… from page 1 to live an extra decade — and spend that extra time unable to enjoy it because of avoidable health issues? As part of the study, GBD scientists ranked the most significant risk factors (see the M.E. blog): obesity rose from 10th place to the 6thworst risk; alcohol abuse rose from 6th to 3rd; tobacco from 3rd to 2nd; hypertension rose from 4th to rst, accounting for some 9 FOR MORE INFO fimillion deaths around the world annually. Why it’s so important Considering the GBD Obviously, all of these most lethal risk factors are also report in its totality, there is eminently avoidable and more than ample reason to take significant steps to avoid preventable. It’s not like, say, finding a laboratory cure for cancer or the many negative domino effects HIV/AIDS; these are risk factors over which of excess weight. Since 1970, life each of us has a significant measure of control. expectancy at birth has gone up three to Let’s individually and collectively show four years every decade. That translates our appreciation for the gift of life by doing to an increase for males from 56.4 years everything we reasonably can to protect our worldwide in 1970 to 67.5 years in 2010; for health and prolong life. And not just for the females the jump was from 61.2 years to 73.3 sake of longevity, either. It’s only partly about years. Overall, populations in all but 8 of 187 quantity; quality is also important, as in countries surveyed in the GBD experienced quality of life. significant increases in life expectancy. As the worldwide leader in poundage, Another major health improvement has to borrow a line from the title of Bad Billy been the global drop in child mortality rates Laveau’s column this issue (page 5), this is (deaths under age 5). Between 1970 and 2010 that figure dropped by nearly 60 percent, from one arena where America would like to play 16.4 million to 6.8 million per year. second fiddle. If not third or fourth. But who wants to survive infancy and go on When we lose, we all win. +
If you take a moment to visit the Medical Examiner blog, you’ll see several graphics that illustrate the scope of the problem across the planet. We’ll also be posting some additional graphics that offer some food for thought, (so it’s thankfully devoid of fat, additional calories, etc.) that will help each of us avoid being part of the problem and, instead, be part of the solution.
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THIS PAGE IS PRESENTED IN LIVING COLOR IN THE ONLINE EXAMINER. THEY ALL ARE, ACTUALLY.
by guest columnist Bill Atkinson
n 1941 my family’s house burned to the ground. In 1961, 16 persons died in the most famous hospital fire in history. In 1962 I was appointed Chairman of the Fire and Safety Committee of the Ohio Hospital Association, . Here are three conceptions about fires: 1. Smoke kills (not fire) 2. Contents burn (not buildings) 3. Containment saves lives (not evacuation) Any seasoned fire fighter knows about the Hartford Hospital fire. Not because it was the most lethal. Other fires killed more. Not because it took place in the insurance capital of the world, Hartford, Connecticut, which it did. And not because of the many failures which contributed to it. The Hartford Hospital fire continues to be the most famous fire in hospital history because it created the foundation for fire safety that continues to protect us today. The Hartford Hospital fire fostered the model for how to build and manage all high-rise buildings. The fire started inside a trash chute. The trash, probably ignited by a smoldering cigarette, burned quickly, filing the chute with pressurized, poisonous smoke. Unabated increasing pressure will eventually explode somewhere. Something has to give. It did in Hartford when the trash chute doors on the ninth floor gave way and smoke jetted into a busy elevator lobby. All there perished. It had been previously assumed that the elevator lobby would contain the smoke, hold it at bay. Some aspects of the containment effort were working: e.g. doors of the lobby were closed. The mistake was that the false ceiling of the lobby was not intended to contain smoke and the smoke poured into the crawl space above. The elevator lobby walls did not go the floor above, failing to create containment and thus permitting smoke to billow over into the adjacent patient care corridors. The ninth floor nursing care unit was exposed. The results varied. Some tried to flee. Some sealed themselves off. Some fought the smoke. Survival was best accomplished by those who stayed contained. They plugged openings for smoke entry by using whatever they could find, and then stayed put. Stairwell doors, chute closures, patient room doors, elevator mechanisms, wallpaper flammability, and more were all challenged. The fire protection failures were being exposed and taught even as the smoke went relentlessly rolling down the corridors, killing on its way. Hartford Hospital’s leadership was castigated, then given credit for its aggressive use of this terrible experience to set the pace for making another such disaster unlikely. Even again this month on public TV the Hartford hospital fire was featured and re-told. The lessons of the famous Hartford Hospital fire are still being taught. As chair of the fire-safety program for the hospitals of Ohio, I telephoned the Hartford Hospital to ask if someone would come and speak to my association. Dr. Ernest Boetcher, senior person on duty at the time of the fire, fulfilled my request. Boetcher was in constant demand to write and speak about fire safety. He typified the aggressive effort by Hartford Hospital to use the fire to improve fire safety. A few years later Boetcher hired me to help him run St. Louis University Hospitals. From Boetcher I heard the story of the Hartford Hospital fire first hand and often. Then, several years later, as a JCAHO surveyor, I visited and inspected over 400 hospitals across the nation for fire safety. It might be asked, where was the JCAHO with its fire safety inspection in 1961. The JCAHO was formed in 1951 and was probably still gearing up. It was also an option on the part of the hospital to buy into and use the JCAHO’s services and reports. Hartford Hospital obviously did not buy in and heed the warnings. + Bill Atkinson is the former CEO of Trinity Hospital (then St. Joseph Hospital), and the author of the comprehensive 2009 Medical Examiner series on the founding of the Augusta area’s major healthcare providers.
FEBRUARY 1, 2013
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AUGUSTA MEDiCAL EXAMINER
Ask a Dietitian
T
here is an idiom which likens something running very smoothly to a well-oiled machine. A great example is the human heart; let it be welloiled and it will beat roughly 100,000 times a day for an average life span of 72 years. Throw in the monkey wrench of saturated and trans fats and the outcome is not so rosy. Take those fats out of your meals and suddenly, in the opinion of some, those aren’t so rosy either. Far too many people seem to be making the choice between enjoyment or longevity — as if it’s an either/or proposition — and far too many are knowingly following the path of enjoyment. The question I ponder is, why? Why would you continue to eat something demonstrated to be detrimental to good health when superior options exist? Especially when you can have both? Perhaps the answer is knowledge. As infants we squirmed in our seats over a jar of baby food; our limited knowledge telling us that this was so superior to formula. But
VOTE
then came table food and wasn’t it better! What followed was one new discovery after another as we transitioned from what we always thought was “the best” to what was actually even better. Eventually we arrived at adulthood with what we believed to be an understanding of good food as dictated by our discerning palate. The problem is that some palates never got to taste the next best thing, thus leaving them to operate at a lower level. The solution is easy – education – in the context of this article, that means trying some newer oils to see what you are missing in taste. You can’t have a well-oiled machine without oil, right? Before exposing your palate to a new oil, first be sure that it is one of the heartfriendlier versions; generally a mono or poly unsaturated fat. Also be sure that you don’t mistakenly add the new oil to your diet without first eliminating the saturated fat. To achieve heart health you need to replace saturated fat with
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unsaturated fat. Finally, be sure to educate yourself on the best use, proper storage, and distinguishing characteristics of the oil before adding it to your favorite dish. For instance, you would not want to pop corn or fry a turkey in olive oil because of flavor and expense. Oils also have unique smoke points; a temperature after which they begin to break down and become unpalatable and unstable to the point of fire. An oil to drizzle over a salad would be very different than one used for frying. In the first instance smoke point is inconsequential while in the second it may mean the difference between feeding the fire department and feeding your family. Oils also have unique storage requirements which if correctly followed will lengthen their shelf life and prevent rancidity – a really nasty off taste that you surely
don’t want in your food. This is of great importance when you consider cost: some of the “specialty” oils can be pricey. Keep in mind also that you are only using a little at a time. Now that you are armed with just the basics, here are a few to set you on your new educational adventure of exploration: Pecan Oil – This is an everyday use oil which is excellent in salad dressings and marinades but is also good for sautéing, stir frying, and braising. The smoke point is considered high at 470 degrees. Pecan oil is one of the few oils that may be stored refrigerated without clouding. Walnut Oil – This is an expensive specialty oil with a rich nutty taste which is not suited for cooking. Heat destroys its flavor, leaving a bitter taste. It is better used in salad dressing or as a finishing on a dish such as cooked pasta, fish, or roasted vegetables. Walnut oil has a short shelf
life of 6-12 months under appropriate storage in a cool, dark place or refrigerated. Almond Oil – This is a lightweight golden brown oil with a heart-healthy profile. This oil has a high smoke point which makes it suitable for high-heat cooking methods such as stir-frying and sautéing. As is the case with olive and some other oils, price is determined by grade. + If you are interested in seeing and learning more about these and other oils try visiting High Country Olive Oil located in Suite 2B in the LePavillion shopping center at 110 Pleasant Home Road, Augusta; Lucky Lady Pecans, Gifts, and More located at 220 N. Louisville Street, Harlem; or some other specialty markets in the area. Author Cindy Elia, M.S., R.D., C.D.E. is the Nutrition Specialist for the CSRA Area Agency on Aging, your gateway to aging resources. Got a question? Drop us a line: info@AugustaRx.com.
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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 • Doctors Hospital, 3651 Wheeler Rd, Employee Entrance (near the Joseph M. Still Burn Center entrance) • Eisenhower Hospital, Main Entrance, 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 • ASU 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 • 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 nurses stations and waiting rooms of area hospitals.
FEBRUARY 1, 2013
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.
HANDLING SOME MEDICATIONS CAN BE HAZARDOUS TO YOUR HEALTH
I
n the pharmaceutical world we all come in contact with many medicines on any given day. Some of these can be hazardous to certain people. As pharmacy employees we must protect ourselves — and so should you. Let’s look at a few situations where extra care should be exercised. Sometimes just being female can determine whether or not you can handle certain medications. The prime example is Proscar (finasteride) which is a medicine used by men to treat enlarged prostate. Women and children should not handle this medication, and if they come in contact with it the area should be thoroughly washed with soap and water. Imagine a wife laying out her husband’s medicine or filling his seven-day tray. If you are not pregnant, you may handle this medicine using common precautions so that you don’t come in contact with the pills or any powder for an extended period of time. Gloves or a good hand-washing immediately after the process is completed will be sufficient protection. If you are pregnant you should defer to another person in the family due to the risk of birth defects. This is especially important if you are carrying a male child or if the sex is unknown. This also applies to certain cancer medications and, in this case, the warning applies equally to men as well as women. Use gloves or good hand-washing practices when handling chemotherapy drugs. They should be kept in a light-resistant container with a tight lid to to protect the drugs’ potency and to ensure they aren’t touched by children. Women should look at medicines they come in contact with on a regular basis and question whether it is safe for them to handle. Any drug designed exclusively for men should be suspect, as well as any cancer medication. Another example is hormone medications such as testosterone for men. Women coming in contact with testosterone could have unwanted hair growth and other changes with their bodies. Your medical history should be considered as well when counting or handling medications. If you are highly allergic to a given medicine, then you should also defer handling this particular medicine, even if a family member is on it. I have
seen a person have a severe reaction in the pharmacy trying to count a drug using a tray and spatula so as to not come in contact with the allergen. Many people are allergic to sulfa antibiotics. These tablets are very powdery, so the person handling this medicine at home should wipe all surfaces down with alcohol after it has been put in a tray or in a pill cup for your family member. This will prevent powder from the allergic substance being transferred into another family member’s medications. Remember that a very small amount of medication can cause a reaction. So left over powder can be plenty to trigger an allergic reaction. Even a bit of powder inhaled from opening a new bottle of an antibiotic suspension in the pharmacy to be mixed for a prescription can trigger a reaction. Take that and apply it to your family: if we have to handle it with special precautions, then you should too. I have also had personal experience with a person breaking out in a rash because this person licked one drop of a sulfa antibiotic off their finger after giving it to a child. That one drop was not enough to treat or cure anything, but was more than enough for a person who was allergic to break out in a whole-body rash. Think back to a previous article about what a small amount of medication can be used to cause a positive effect in your body. Remember that a paper clip weighs approximately one gram. Medications are typically dosed in thousandths of a gram. If a few thousandths of a gram can spread throughout the body and still produce an effect at the target site, then think how little medication is needed to trigger the body’s immune system and start an allergic reaction. Everyone can relate to allergy season and how just the pollen from a few plants can cause allergies all over the area. That effect can be magnified many times over by today’s ultra-pure drugs. Be careful! + 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 )
We
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FEBRUARY 1, 2013
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AUGUSTA MEDiCAL EXAMINER
Let us now praise pancakes
is now
• Specialty Pharmacy • Home Infusion Ser vices • IV Nursing Same phone numbers! Same convenient location! 3630 Wheeler Road • Augusta, Georgia phone: 706.447.4343 • tollfree: 877.436.4584
www.ambienthealthcare.com
From hospital to home, quality of care continues Jonathon Azziz, 14, serves short stacks at the Washington Road IHOP on National Pancake Day 2012. Proceeds from this annual Children’s Miracle Network fundraiser go to the Georgia Health Sciences Children’s Medical Center. IHOP will serve free short stacks all day long on National Pancake Day in support of Children’s Miracle Network FEBRUARY Hospitals. All local proceeds TUESDAY will go to the Georgia Health Sciences Children’s Medical Center, the area’s only children’s hospital. More than 1,500 IHOP restaurants across the United States, including four in the Augusta-Aiken area, will invite diners to enjoy a complimentary short stack of IHOP’s signature buttermilk pancakes and to consider donating what they would have paid, or more, for Children’s Miracle Network Hospitals.
5
Participating local IHOPs include: • 2525 Washington Road, Augusta • 3125 Peach Orchard Road, Augusta • 4361 Washington Road, Evans • 180 Aiken Mall Drive, Aiken IHOP’s Pancake Day brought in more than $3,200 for the Children’s Medical Center in 2012. “Those funds were used by our respiratory therapy team to purchase specialized equipment for patients with asthma and other breathing issues,” said Catherine Stewart, CMN Development Coordinator. “The Children’s Medical Center is a not-for-profit hospital, so we are truly grateful for the financial support from our community we receive through special events like National Pancake Day.” +
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+ 10
FEBRUARY 1, 2013
AUGUSTA MEDiCAL EXAMINER
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MAKING THE MOST OF YOUR MEDICARE
D
o you sometimes feel you are not being heard by your physician or don’t know which questions to ask? According to Medicare’s official website, there are approximately 49,435,610 Medicare beneficiaries in the United States. That’s a lot of medical care being dispensed. Doctors can be overworked, or take it for granted you understand what they are talking about – especially if it appears that you do. Try not to be nervous when speaking to your physician. Taking
responsibility for your own healthcare and asking the questions you need answered is proactive and welcomed. You are not alone in being confused about medical issues. Most of us don’t know the details about diseases or how medications work in the body. Medicare wants you to make the most of the care available to you and that means asking about your condition and medications. In addition to your doctors, you can ask questions of the nurse, the technicians performing any tests, or your pharmacist.
These individuals are ready and willing to help you understand your health issues and educate you on the benefits and risks of your medications. Making a list of questions and concerns is always a good idea, since we don’t always remember what to ask, and even forget what we were intent on asking. Everyone gets caught up in the moment or rushed and forgets. Focusing on the following questions should prove very helpful: What is my main problem? What do I need to do? Why is it important for me to do this? If there is anything you don’t understand, let your medical provider know. You have a right to ask for clarification. Asking questions will get you the information you need to take better care of your health. Many people see more than one doctor. Make sure each knows all the medications you are taking. Some drugs can interact negatively and have dire consequences, while others can be made ineffective. Keep a current list of your medications along with the dosage and frequency in which you are taking them
in your purse or wallet. If your doctors are aware of all your medications, they can work together to ensure you are getting the maximum benefits of your medicinal routine. Remember to include any over-the-counter medicines, vitamins or herbal supplements. These can also play an important role in how prescription medications work and interact in the body. Other factors to question are when and how medications should be taken: Should the medications be taken before or after a meal? Is restricting alcohol intake important? What activities should be avoided? Is morning or evening a better time? At the end of your doctor’s visit, you may want to ask a final question that can catch anything you may have missed: What haven’t I asked that I need to know? This will give your doctor an opportunity to fill in any blanks. Good questions lead to good health. + Author: Trisha Whisenhunt, Certified Medicare Counselor, Area Agency on Aging Source: University of Georgia, Center for Health & Risk Communications
Voted “BEST BARBER SHOP” by the readers of Augusta Magazine
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There is only one. +
MEDICAL EXAMINER
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Visit danielvillagebarbershop.com today for your personal barber’s hours, local community news, information on the history of hair and haircuts, local art and music, and all kinds of fascinating and useful information!
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FEBRUARY 1, 2013
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AUGUSTA MEDiCAL EXAMINER
The blog spot — Posted by Polly Noble on Jan. 24, 2013 at drfranklipman.com. (Edited)
HOW TO DEAL WITH A HEALTH CRISIS There’s something annoying about getting sick. Whether it’s the common cold, flu-like symptoms or being hit with the cancer stick – it really is most inconvenient! I have never been one to do things by halves, it’s just not in my DNA. I went for 24 years without ever having to step inside a hospital and then in an instant, everything changed and my life revolved around scans, hospital waiting rooms and Mr. Oncologist. Yes, I got cancer. And that sucked. But then I got “better”. And then four years later I got it again and told it was “incurable.” That really sucked! During those four years I did a lot of reading, a lot of researching, and a whole lotta learning and now those golden nuggets are coming in handy as I have set about helping my body to heal naturally. Yep, these days I self-medicate with stuff that you can’t get in a bottle and that no one can manufacture. If you’re wondering what those things are, keep reading. But first, let me tell you that this is the stuff I wish I had known back then. During my first bout, I felt I had to ride the cancer rollercoaster journey alone and work out for myself how I could heal the “incurable” lymphoedema that had developed in my right leg after my treatment (which I did). I had to find more natural ways to relieve the constant constipation from treatment, deal with the diarrhea days, overcome the nausea, the extreme fatigue, and learn how to get the best out of doctors seriously lacking in social skills. All of this and more, I wish I had known. But most importantly I wish I had known at the beginning that I could have taken back the reins on my health at any time. It’s so easy to roll over and give your power away to your doctor. But there is always something you can do to move from feeling disempowered to becoming an empowered participant in your health and wellbeing. So what are these things I have learned along my path that allow me to feel healthier and happier than ever? • Understand your illness. Get the facts, learn what makes it tick and what stops it in its tracks so you can make better food and lifestyle choices. • Get support. Don’t be afraid to ask for help. The belief that we have to do everything alone is often more painful than the reality of the situation. Give yourself permission to be a little bit selfish for once. • Deal with the mind monkeys. The fear and uncertainty around your illness can be paralyzing, so it’s important to manage them and realize you are not your thoughts. Drop the fear-based thinking. • Take care of your emotional needs. Dealing with the emotional aspect of having an illness is like watching Little Miss Sunshine. Sometimes you’ll laugh, sometimes you’ll cry and sometimes you’ll have no idea what to feel but it’s vital to deal with the waves of emotions. See a therapist, write a journal or find a creative outlet in some form of therapy to ensure the emotion is released. • Practice stillness. Take time to notice the stillness that is omnipresent. Take time to tune in to it. In the stillness you’ll find that peace exists. • Eat consciously. A clean, green diet is where it’s at in terms of optimum wellness. Flooding your cells with vitamins, minerals, enzymes and super sexy oxygen boosts immunity, improves mental clarity, positivity, and improves energy levels. • Get moving! Exercise helps the body to flush out the toxins, kick-start the immune system, and get the lymph system pumping. Whether you are a yoga bunny, kick-boxing fanatic or just prefer a leisurely stroll, get your body moving! So whatever journey you are on and whatever health storm just blew into town, ask yourself what you can be doing to become an empowered participant in your health. Choose to think and act differently. Take positive steps to help your body heal and choose to become an empowered participant in your health. +
“ You can’t buy this stuff. ”
From THE Bookshelf If you’re the kind of person who cooks supper in Pyrex beakers over the blue flame of a Bunsen burner, have we got a book for you! On the other hand, since that describes a distinct minority among Examiner readers, let’s just say that lots of us wonder how they decaffeinate coffee, and why lemon juice keeps a sliced apple or banana from turning brown. As the subtitle of this book puts it, this is “kitchen science explained.” This is the kind of book Eugene would have loved. Eugene who? Just Eugene. They didn’t have last names back in caveman days. But Eugene was the Neanderthal who discovered fire, and therefore cooking. The city of Eugene, Oregon, is named after him. (Off the subject, but Norman, Oklahoma, is named after the guy who invented the wheel.) Anyway, let us exit stage left and leave you with a few words about this book from online reviews. (There is also a sequel to this book.) From Amazon: Why do recipes call for unsalted butter--and salt? What is
a microwave, actually? Are smoked foods raw or cooked? Robert L. Wolke’s enlightening and entertaining What Einstein Told His Cook offers answers to these and 127 other questions about everyday kitchen phenomena. Using humor (dubious puns included), Wolke, a bona fide chemistry professor and syndicated Washington Post columnist, has found a way to make his explanations clear and accessible to all: in short, fun.... With [recipes}, technical illustrations, tips, and more, the book offers abundant evidence that learning the whys and
hows of cooking can help us enjoy the culinary process almost as much as its results. From Publishers Weekly: questions and answers on food chemistry. Is there really a difference between supermarket and sea salt? How is sugar made? Should cooks avoid aluminum pans? Interspersed throughout Wolke’s accessible and humorous answers to these and other mysteries are recipes demonstrating scientific principles...Wolke is good at demystifying advertisers’ half-truths, showing, for example, that sea salt is not necessarily better than regular salt for those watching sodium intake. While the book isn’t encyclopedic, Wolke’s topics run the gamut. He tells it like it is: What does clarifying butter do, chemically? Answer: gets rid of everything but that delicious, artery-clogging, highly saturated butterfat. With its zest for the truth, this book will help cooks learn how to make more intelligent choices. + What Einstein Told His Cook by Robert L. Wolke, 368 pages, published October 2008 by W.W. Norton & Company
the
Clipping File As good an excuse as any Researchers at Hebrew University of Jerusalem have discovered that drinking a glass of red wine with a meal of dark or red meat can diminish the unhealthy effects of the meat by preventing the buildup of cholesterol. Antioxidants in the wine called polyphenols stopped cholesterol from being absorbed as food, and therefore prevented its entry into the bloodstream. The study, published in the January issue of the Journal of Functional Foods, helps to explain the oft-cited link between red wine and reduced risk of heart disease. Berry good news In a study that monitored the dietary habits of women, those who ate the most blueberries and strawberries had a nearly 33 percent reduction in their risk of heart attack compared to women with the lowest berry intake — once a month or less.
The reduced risk berry eaters enjoyed the benefits whether or not they had an othherwise nutritious diet, and were, in fact, independent of other risk factors like age, hypertension, exercise, smoking, family history of heart attack, and caffeine or alcohol intake. The study, published in the journal Circulation, credits high levels of dietary flavonoids in strawberries and blueberries. 93,600 women between the ages of 25 and 42 participated in the study. Mapping cancer treatment Specialists at London’s Institute of Cancer Research say all patients will soon have their tumor’s genetic code — its DNA — sequenced, enabling doctors to customize the exact prescription of drugs to keep the cancer at bay. This is another step in the direction of treating cancer as a chronic disease rather than the fatal disease it was once considered to be.
The sequencing approach also taps into the view that there are genetic triggers for cancer. DNA profiling holds the promise that in the future, those triggers can be defused or removed before they can detonate. On the rise: DWI No, we don’t mean Driving While Intoxicated. We’re referring to Driving Without Insulin. With the burgeoning population of diabetics, there are more and more drivers who face the threat of an accident when their blood sugar drops. Drivers have been arrested for DUI after erratic driving and slurred speech, only for officers to belatedly discover {sometimes after throwing the person in a cell without medication), that the problem was blood sugar, not alcohol. Drivers at risk for hypoglycemia have a responsibility to make sure their blood sugar levels are safe enough to drive. A prominent “Diabetic” ID bracelet is also a good idea. +
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FEBRUARY 1, 2013
AUGUSTA MEDiCAL EXAMINER
THE EXAMiNERS
THE MYSTERY WORD
+
How’s your cold?
by Dan Pearson
I took echinacea and zinc at the first sniffle.
Then I used my Netti-Pot.
Oh?
And boom! Two weeks later my cold was gone. Like magic.
And?
The Mystery Word for this issue: SIROOMFTDC
© 2013 Daniel Pearson All rights reserved.
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. _______ sample 6. Augusta’s Digital Journal rank 10. Make tea 14. Dried plum 15. Gimpy 16. Son of Jacob and Leah 17. Opposite of 13-D 18. By mouth 19. Capital of Yemen 20. Choose 21. Swing around (var.) 23. B-52’s home 25. Walter L. _________ 27. Raises, as a question 28. Unrestrained power 29. Early breast cancer detector? (abbrev.) 30. Extinct flightless bird 32. Author Harper 33. Regret 34. Boulevard that becomes 13th St. 35. DDE middle name 38. Cozy room 39. Twill-weave fabric 40. Andrews of Fox Sports 41. Male cat 42. Mongrel dog 43. Catch 44. Type of snake 45. Highest 49. Ascending and descending body part 51. Deportment 52. Pulsates 53. Bring up 54. Before in poetry 55. Prolific poet? 56. Mosque prayer leader 58. Monetary unit of Nigeria 60. Shine partner? 61. Thurmond, for example
BY
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Click on “Reader Contests”
QUOTATION PUZZLE 30
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VISIT WWW.AUGUSTARX.COM TO ENTER!
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U T E A P R E A T R G T H I N P T M I L E B O E E O U O O N G H T R A H L R
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by Daniel R. Pearson © 2013 All rights reserved
DOWN 1. Temp. regional tax 2. Derogatory wife adjective 3. Expulsion 4. Single unit 5. Diminished 6. Like hands making bread 7. Paddled; rowed 8. Kill Bill star 9. Backslide 10. Lethargic feeling 11. Savior 12. Vespers 13. Opposite of 17-A 22. Brunswick element 24. Lower digit 26. Name still found on some bumper stickers 29. Round bread roll
— Henry Rollins (1961 — )
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 only be used once. Black squares indicate spaces between words, and words may extend onto
by Daniel R. Pearson © 2013 All rights reserved. Built in part with software from www.crauswords.com
62. Lace protector 63. Smell 64. Toboggan 65. Hard candy (Brit.)
N T M D G S H E N
31. Consumed 33. Band from 23-A 34. -tology prefix 35. “Female beginner” (Fr.) at a formal (informally) 36. Spider 37. Vigorous in manner (Music) 38. ER bad news 39. Celestial 41. They’re often removed 42. Prolonged unconsciousness 44. Sponge___ Squarepants 45. Abounded (with) 46. Jennifer from Summer of ‘42 47. Booke of The Dukes of Hazzard 48. _____ of Verailles 50. Recluse 51. Male duck 52. Edible tuber 57. Grand ___ 59. Gone by
a second line. Solution on page 14.
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5 4 9 7
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8 1 9 7
by Daniel R. Pearson © 2013 All rights reserved. Built with software from www.crauswords.com
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 — one per dash — to create words to solve the puzzle. All the listed letters following 1 are the 1st letters of each word; the letters following 2 are 2nd letters of each word, and so on. Try solving short words and entering unique and minimal choice letters (such as 5 thru 7 in this puzzle). A sample is shown. Solution on page 10.
1 1
2 2
3
4 1
5 2
6 3
7 4
I ’ 1 1 2 3 4 M 1 1 2 3 4 5
1 2
2 3
3
R 1 2
4 1
2
1
— 1
3 2
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R 2 3 4
1
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1.TGMMBSTGLAAWIO 2.ORNSAOYUEEHAO 3.SLERMANTEST 4.TAENTKT 5.SGI 6.EN 7.G
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
by Daniel R. Pearson © 2013 All rights reserved
WORDS NUMBER
1
All Mystery Word finders will be eligible to win by random drawing. We’ll announce the winner in our next issue!
FEBRUARY 1, 2013
THE BEST MEDICINE ha... ha...
A
n elderly couple had been married for many, many years when one day the wife suddenly died. The husband arranged for the funeral at their church. Six young men carried the casket to the front of the church. The pastor gave the eulogy, and the six young men started to carry the casket to the side door. They had to go through an awkward, tight spot around a corner, and as they did so, the casket was violently bumped against the wall. Suddenly, the casket lid popped open and the wife sat up, alive and restored! The place went wild, and when things calmed down, the husband took his wife back home. Ten years go by, and the wife dies again. The husband again makes the funeral arrangements at their church. Again, six young men carry the casket down to the front of the church. Once more the pastor gives the eulogy, and again, the six young men carry the casket to the side door.
As they approach the tight awkward spot, the husband stands up and yells, “WATCH THAT CORNER, BOYS!”.” A husband and wife are getting dressed. The wife stands naked in front of a mirror looking at herself with a critical eye. “I look horrible. I feel fat and ugly.” Turning to her husband she says, “Please pay me a compliment.” “Well,” he replies, “Your eyesight is perfect.” Q: Why did the doctor take his nose to apart? A: He wanted to see what made it run. Patient: Doctor, everyone thinks I’m a liar Doctor: I can’t believe that! Patient: Doctor, doctor, I keep seeing double. Doctor: Please sit on the couch. Patient: Which one? Patient: Doctor, I’m on a diet and it’s making me really irritable. It’s so bad that yesterday I bit someone’s ear off. Doctor: Oh my, that’s a lot of calories. Did you hear about the Siamese twins? Everything goes in one ear and out the brother. +
OUR NEXT ISSUE: FEBRUARY 15
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The Patient’s Perspective by Marcia Ribble
T
he day for surgery arrived with me feeling not as prepared in many ways as I would have liked to be. But the surgery went forward, prepared or not. The day of surgery we weren’t hustling around too much because I didn’t need to be there until noon with surgery scheduled for 2:45 pm. At eleven, the hospital called. “Where are you and how soon can you be here?” Whew! Surgery had been rescheduled for 12 noon. And we all went into rush mode. As soon as I arrived they started to prep me for surgery, clothes off, gown on, onto the bed, onto the gurney, down the hall, and here we go! For me the worst part is the transfer from the bed to the gurney. I am always afraid that I am somehow going to fall off. I never have, but that doesn’t make that fear go away. “Can you sort of slide over?” they ask. I “sort of slide,” but it’s really more of a set of large and small lurches, while grabbing onto any solid thing I can get my hands on. Then there’s the maneuvering, “A little bit left, can you push yourself up higher in the bed, OK, keep your arms and hands in,” they tuck me in for modesty and off we go like a herd of turtles. They have already given me a nice little sleep aid, and I remember getting into the elevator, but nothing after that. I wake up a little in recovery, but not much, and was still pretty drowsy when they wheeled me into my room, with my kids peering at me anxiously as though they expected I’d come out with an extra head or something. But it was just me, with an IV and a leg wrapped from knee top to toe. There was nothing gross, no nasty bodily fluids, tubes down my nose or things like that. The person I was
Talk is cheap. Not talking can be deadly.
going into the OR was the same person who came out, minus a very defective knee joint and with the addition of a new knee that will work better. Within hours I was up and walking in my room, eating clear liquids and drinking ice water seemingly by the gallon. I am always thirsty in hospitals. They came in, told me that my potassium levels were too high, and took out the IV. I was fine with that. The only hitch was that the left side of my face had begun to droop, something only noticed by my kids when I got home. So I got back into the car and off to the emergency room to make sure I hadn’t had a stroke. No stroke! Bells Palsy. Nobody knew why. Bad luck? A silly coincidence? A result of the anesthesia? A virus? Eventually it will go away on its own, they tell me. So I have two things to recover from and both require exercises. I look at my droopy face, laugh when I try to eat or drink and food dribbles out of my mouth like a baby just learning to use her lips and tongue for eating. Might as well laugh. Growing old gives us plenty of things to laugh about. + Marcia Ribble received her PhD in English at Michigan State and recently retired from the University of Cincinnati where she taught composition. She taught writing at the college level and loves giving voice to people who have been silenced. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.
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AUGUSTA MEDiCAL EXAMINER
– Friedrich Nietzsche is by definition, a build-up of cholesterol and other fats in the blood vessels, causing them to harden and narrow in size; this process is formally known as atherosclerosis. The blood vessels that supply oxygen- and nutrient-rich blood to the heart (remember, the heart, too, needs blood) can be especially vulnerable to this atherosclerotic change. When narrowing of the blood vessels occurs, however, blood cannot flow as easily to the organs and tissues that it supplies, and this causes damage, as the tissues literally cannot “breathe.” When this happens to the heart, symptoms include feelings of chest tightness, “squeezing” feelings, and pain spreading from the chest to the arms and jaw. These symptoms, which can be very distressing, are collectively referred to as “angina pectoris.” It can occur
“All the knowledge I possess everyone else can acquire, but my heart is all my own.” – Johann Wolfgang von Goethe is when a person’s whole life, and the lives of the people who love him or her, can be completely devastated. It can be hard to stop this rolling ball called Coronary artery disease once it is in motion. But we can still try to slow it down, or perhaps even prevent it from rolling in the first place. While many of the risk factors associated with CAD are genetic or beyond our control (like hereditary high cholesterol or being born with a heart condition), many others are within our control. Bywords like “diet,” “exercise,” and “maintaining
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“One ought to hold on to one’s heart; for if one lets it go, one soon loses control of the head too.”
OR
ith Valentine’s Day being only a few weeks away, and my class’ intense study of the cardiovascular system for the past several weeks, I feel compelled to dedicate a discussion to the heart for my February article. The heart is our personal battery. It sends blood and energy throughout the body, revitalizes it when its nutrient and oxygen supply gets depleted, and tirelessly pumps like clockwork. Or, at least, it should. Unfortunately, though, the heart does not always function normally. Its rhythm gets thrown off, like a disco queen thrown into a Countrystyle boot-scootin’ boogie, or its muscles get cramped, like those awful charley horses that spring up in your leg at the most inopportune times. When the heart is involved, though, these scenarios are more frightening. I don’t know anyone who is not affected in some way by cardiovascular disease, either directly or through someone close to him or her. Whether it’s high blood pressure, high cholesterol, a heart attack, or something else, someone somewhere in everyone’s circle is suffering in some way. Cancer is another scary story, and we are all bombarded every day with recommendations on how to prevent it – sunscreen, breast self exams, colonoscopies, no more smoking, etc. But let’s not
during exercise – when the body needs more oxygen to supply its working muscles – or during total inactivity; it depends on how narrowed the arteries are. The worst part about angina pectoris, however, is that it indicates the heart is at risk for something much worse – a heart attack. A heart attack occurs when the blood supply to heart has been cut off for more than 30 minutes. This is when tissue death starts to occur with the heart muscle. Far worse, this is also when the person’s death can occur, especially if medical care is not given quickly. This
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forget another real major killer of Americans, one of the biggest serial killers of all time: heart disease. I want to focus on one form of heart disease that is the number one killer of American men and women: Coronary Artery Disease. CAD for short, this condition
CO
by Caroline Colden
DIS
The Short White Coat A med student’s notebook good health” seem universally applicable and perhaps a bit generic, but in this case they really do help. Enormously. Even simply cutting down on the greasy food you eat, taking the dog out for a run, controlling your diabetes, and cutting down on alcohol consumption can make a huge difference. And it’s worth it, too! Although there are medications out there to help lower cholesterol, as well as surgical techniques to widen some of those narrowed blood vessels, it is so much simpler to implement new lifestyle choices that include just a little more cardio, and a little less fat. While I am definitely not advocating giving up pizza and chili cheese dogs forever (because a life without pizza and chili cheese dogs for me would be no life at all), I do support the idea of cutting down a little, and adding more veggies. Maybe we can all become friends with those kids in the commercials who live in Hidden Valley, where people love eating vegetables. Or maybe we can just become better friends with our own bodies and indulge in a happier, healthier life. So Happy Valentine’s Day, and Happy February to all, and may we get more chances to “heart” ourselves just a little bit more. +
ROGER M. SMITH, M.D. OPHTHALMOLOGY
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