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The Doctor-Patient Relationship by Dr. Raymond C. Bard Founding Dean of MCG’s School of Allied Health Sciences

veryone has participated in the doctor-patient relationship, probably with several kinds of doctors: physicians, osteopaths, cardiologists, neurologists, dentists, and dermatologists, to name a few. Most of these health providers are men, although women have joined the ranks in increasing numbers during the last several decades. The doctor-patient relationship is unique. Who else can tell a person to disrobe and is permitted to poke and probe that person’s body, to inquire about the most personal habits and thoughts, with no apparent limits? Reduced to the level of a retarded child, the patient feels defenseless and wholly dependent on the inquisitor and must be patient to tolerate such invasions of privacy. Who is this curiosity-seeker? The doctor. There is no other way to “practice” medicine if the doctor is to establish the source or cause of the patient’s ailment or complaint. When the situation is very serious or life-threatening, none of the procedures used in attempting to ascertain the nature of the condition is beyond limits, whether painful, disfiguring or dangerous. Treatments are attempted and applied to save life, to preserve limb, or other important body part. The goal is survival, improved health, and comfort. What rationale justifies less effort, less zeal? Thus, the doctor-patient relationship is extraordinarily complex. By and large, the patient is medically ignorant, aware primarily of the presenting symptoms, hoping and praying for the best. Action is begged for to relieve the illness and anxiety, no matter the course of action and the cost. The doctor, as the healer, is expected to respond to all aspects of the situation, never to create a doubt about his infallibility, his almost Godlike powers. This is what the patient prays for and expects. In the search for continuing good health, patients reach Please see DOCTOR-PATIENT page 11

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DOCTORS OF DISTINCTION Over the past year on these pages we have asked readers to tell us about the people they deem to be Augusta’s finest doctors. Rather than choose one person for individual honors, we’d like to share, in no particular order, some of the experiences our readers shared. We also repeat our invitation here: we’re always eager to hear your stories of medical excellence.

RICHARD S. FIELD, M.D.

Looking for an exceptional doctor -- believe me, I know one! DR. RICHARD S. FIELD, Augusta Arthritis Center, Inc. is unusual. I was a patient of his when he was at MCG. Once when I had an attack at home my family was unable to move me to a chair. My niece called him and he said “I will be there in ten minutes.” Not understanding what he said or thinking she misunderstood what he said, asked him to repeat himself. Again, he said, “I will be there in ten minutes.” He did arrive in ten minutes and called an ambulance to have me transported to the hospital. Years later when he was in private practice in 2001, I called to ask for an appointment, and having a full schedule, he told me he would see me at my home after 6:00 pm. When I had hip replacement surgery he visited me three times in the rehabilitation center even though he was not directly involved with my care. Falling while shopping I was taken by ambulance to the hospital. Upon hearing I was in the hospital, Dr. Fields came to see me. Previous to opening his current practice, he was a professor of rheumatology at MCG. This is an exceptional physician and I am privileged to know him and be his patient. — Carolyn Gardner

ANAND JILLELLA, M.D.

I would like to nominate DR. ANAND JILLELLA from the GRU Cancer Center. Dr. Jillella was my dad’s doctor when he developed lymphoma. After chemotherapy treatments dad went into remission, but about a year later he started having

VOTE problems again and began seeing Dr. Jillella. Dr. Jillella thought it best that dad have a stem cell transplant and then radical chemotherapy. Again he was in remission and everything was good. Then he began having problems again, this time leukemia caused by the chemo. Dr. Jillella was heartbroken. We knew this was a risk of the treatment. Dad was not strong enough for a bone marrow transplant (which is what he needed) due to diabetes and a heart condition, so he began a new drug regimen. About three months into treatment, Dad died suddenly. Dr. Jillella was out of the country at the time, but as soon as he heard the news he took the time to call my stepmother and me from abroad to give his condolences. He and my dad had a relationship that was not just doctor-patient. They shared a deep fondness of each other. I knew when I spoke with him that he was saddened by our loss. I could hear the tears in his voice. Dr. Jillella happens to be one of the top cancer Please see DISTINCTION page 2

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DISTINCTION… from page 1 doctors in our country and I know why. It is not just because he has so much knowledge; it is because he truly cares about his patients and their families. His bedside manner is also the best I have ever seen in a doctor. Dr. Jillella will always have a special place in my family’s hearts. Thanks to him we had six extra years with Dad that we may not have otherwise had. In memory of my dad, Donnie Chavous, our family feels Dr. Jillella is the best. — Donna Johnikin

MICHAEL SHLAER, M.D.

My late husband was under the care of DR. MICHAEL SHLAER during his treatment for stage 4 renal cell carcinoma or kidney cancer. Kidney cancer, I’m told, does not respond well to chemotherapy and often by the time it’s diagnosed the prognosis isn’t good and the life expectancy short. I was fortunate in that my husband lived for almost three years. Doctor Shlaer and his staff were absolutely wonderful throughout what was very often during the last several months a very frightening, stressful and difficult time. Dr. Shlaer was always responsive—immediately. He was quietly reassuring and positive at every step. Most importantly, he was infinitely knowledgeable and articulate in his explanation of every treatment option and protocol available, delivered in his quietly reassuring way. His “responsiveness” went above and beyond the call of duty to wit: One early Sunday morning (6:30 a.m.-ish) after a particularly difficult night, my husband and I were preparing to leave the house to meet Dr. Shlaer at the emergency room so my husband could be examined and likely admitted to the hospital. While in the process of dressing, my husband had a seizure that left him unconscious on the floor of the bedroom. After making sure he was breathing and attempting to turn him on his side, I called the ambulance and then immediately called Dr. Shlaer (I had his cell phone number). He instructed me to make sure his breathing wasn’t obstructed and then told me he was on his way. He beat the ambulance to the house. At the time I thought such a response was typical. I assumed any doctor would have done the same in that situation. Not so it seems. Several weeks later when I relayed the incident to a couple I know (he a neurosurgeon, she an RN) she said to me: “I’m so impressed by that. The truth is Sherry, if you had called [her husband the neurosurgeon] he would likely not have come to the house because of the fear of being sued.” And this couple were close long-time friends. I was stunned. Dr. Shlaer is a special man whose reputation in the medical community is that his patients come FIRST no matter what. The attitude and demeanor of his staff and the ambiance of his office confirm that reputation

• SKIN EXAMS • • MOLE REMOVAL • • PSORIASIS • • ACNE •

in a thousand ways. That is no accident. Sadly, doctors like him are rare in the context of medicine today. Augusta is very lucky to have him. — Sherry Foster

the person actually stops breathing several times in the course of the night. Dr. Chaudhary is a true gentleman indeed. My vote is for Dr. Bashir Chaudhary. — Julie Martinez

DRS. OETTING and PARFENCHUCK

HOWARD HUDSON, M.D.

I would like to nominate neurologist DR. GREGORY OETTING of Augusta Back and DR. THOMAS PARFENCHUCK of Orthopaedic Associates as two of the best doctors in Augusta. I was admitted to University Hospital on a Friday afternoon in September 2008 with a crushed vertebrae and inherited Dr Oetting. On Saturday morning Dr Oetting, along with Dr Parfenchuck, examined me and the decision was to schedule emergency surgery for Sunday morning. At the time I was sedated, but to have surgery on a Sunday morning I knew I was in trouble. After the surgery the plan was to be in the hospital for 4-5 days. Throughout the stay in the hospital, both these doctors were super-attentive and checked on me every day as if I was their only patient. Dr Oetting usually was there first thing in the morning, dressed like he were going out for the evening. We often think of doctors working 9-5 but I can attest to the fact that isn’t always true. They are there when you need them!!! GOOD JOBS need acknowledgement! — Jerry Knight

DRS. GREEN, AUSTIN and CHAUDHARY

This is a difficult choice for me because the three doctors I picked are all very special in my book. They have all touched my life in different ways. DR. MARGARET GREEN worked with me for years to get my eyes in the best shape possible and built in me a self confidence when at the age of 16 I was finally able to wear contact lenses. DR. JACK AUSTIN was the chief of Medicine at University for years. I got to know him very well through his stops at our office to sign off on records. He has a wonderful sense of humor and always took a personal interest in our staff. He was so special, my coworker kept a bowl of his favorite candy (Bit-O-Honey) in her office for whenever he would stop by. One year I was so sick but couldn’t leave work. Without any hesitation, I called Dr. Austin’s office to see if he could see me. I was not even one of his patients, but he immediately told me to come to his office. He gave me some samples of antibiotics and I was off on my merry way. DR. BASHIR CHAUDHARY is a true gentleman. He once brought me a bag of jasmine he had picked from his garden. He volunteered his time to serve on our CME (continuing medical education) Committee for several years and gave several CME medical talks for our staff. I could always count on him to be a stand-by speaker for me as well if I had a cancellation. On a personal note, he diagnosed and treated my husband for sleep apnea, a serious condition where, without proper treatment,

• SKIN CANCER SURGERY • • RASHES • • WARTS • • ITCH RELIEF •

I would like to compliment DR. HOWARD HUDSON and his staff at Orthopaedic Associates of Augusta. From my initial visit to one week post surgical follow-up, their service was seamless, timely and efficient. Although my surgery was fairly simple, he and the staff were so gracious to address my questions in a very professional, straightforward manner. Pre-op and financial sessions with the staff were always at the appointed time. As a long time health care professional, it is refreshing to see that there remains a spot of class and professionalism in the local health care setting. — Elise Faulkner, Physical Therapist

DRS. KENNEDY and BLANCHARD

I enthusiastically nominate DR. THOMAS KENNEDY and DR. AMY BLANCHARD, jointly, for the Augusta Medical Examiner’s best doctor honors. Both of these fine doctors are pulmonary specialists at Georgia Regents Medical Center, and provided care to my wife, Deborah Watts, who passed away the day after Thanksgiving last year, while visiting family in south Georgia. What I learned from Dr. Kennedy and Dr. Blanchard last fall better prepared me for the overwhelming loss that I would face in November. Debbie, was admitted to GRMC just before Labor Day, 2012. She presented with complications that included pneumonia and diabetes. Drs. Kennedy and Blanchard provided care to Debbie when she was transferred to GRMC’s Medical Intensive Care Unit. Dr. Thomas Kennedy Debbie’s medical care at Georgia Regents was provided in a teaching environment. Dr. Kennedy is a great doctor because he took the time to explain Debbie’s illness. Every substantive test that Debbie’s care team ordered was explained to our family in detail. When lab tests were sent to Utah to be read, I understood why they were sent there. Dr. Kennedy coordinated this process during his time as her attending physician. After being in the MICU for a couple of days, the doctors were concerned over x-rays of Debbie’s lungs. Although she had been making slow progress earlier, it seemed that her pneumonia was becoming noticeably worse. X-rays of normal lungs should look dark and fairly clear. Instead, Debbie’s lungs looked like cotton candy or a snow storm. Immediately, Dr. Kennedy spoke to Debbie about the possibility of going on a ventilator. This conversation was doubly difficult because Debbie had initially declared her status to be DNR—Do Not Please see DISTINCTION page 6

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FEBRUARY 21, 2014

AUGUSTA MEDiCAL EXAMINER

EVERYTHING YOU NEED TO KNOW TO BE A DOCTOR YOU LEARNED IN KINDERGARTEN Okay, maybe not quite everything. There’s a great deal of anatomy, physiology, pathology, pharmacology and a couple of other additional details Ms. Love didn’t get around to teaching my classmates and I. (And just in case you are asking yourself, yes, my kindergarten teacher’s real name was Ms. Love.) Still, in a large part, serving the role of an effective physician comes down to the mere task of following directions. That’s right, simply following provided instructions. It may not be a person’s first thought when he pictures a doctor in his mind. After all, physicians are supposed to be the head honchos. So who, then, is giving them these directions? This is where all of the clinical research—including drug trials and record reviews—all come into play. Statistics are weighed, conclusions are drawn, and then other studies are done with the goal of reproducible results. Eventually, formal recommendations are adopted and circulated through the circles of doctors who put them into practice. It certainly sounds simple enough. Yet, as I approach completion of my first full year in clinical practice, this seems to be a major area of disconnect for patients. It’s something we can all sympathize with. Being sick is not fun. Thus, regardless of whether a diagnosis is a common cold or terminal cancer, it is a natural reaction for individuals to think that their case is different. Their case is unique, and if only the ol’ doctor would see this, he/she could alter therapy adequately

and put them out of their current discomfort. It’s a natural reaction. Yet, the whole thing about those statistics and recommendations is that they work best when applied to everyone. They are in place to benefit the most people in the grand scheme of it all. The guidelines are in place to maximize the therapy and relief healthcare workers provide, while minimizing the harm they inflict on patients and on communities. This is why your primary care physician won’t give you antibiotics when you have symptoms that point to viral illness, even when he/she sees that you are in a lot of discomfort. While you may mentally benefit just from taking something, antibiotics in this situation would not help you get any better and could ultimately have unintended negative consequences. Additionally, this wouldn’t be one of my articles if I didn’t mention that these practices attempt to cut down on waste. Though the vast majority of our old antibiotics are relatively cheap, over-prescribing them when a benefit is not shown ultimately leads to wasted healthcare dollars that could be allocated elsewhere. While that example makes sense to a lot of people, consider this one. These guidelines are the same that tell us to stop screening for cervical cancer in females over the age of 65, pending appropriate screenings and a history of normal findings. The disconnect comes from this and similar guidelines being applied to both “young 65 year olds” and what I can

Ross Everett is a 3rd year medical student at the Medical College of Georgia. He grew up in Buford, Georgia and graduated from the University of Georgia in 2011. In addition to his coursework, he is interested in health policy, health systems and health management. Please contact him at wideeyedwhitecoat@gmail.com and Like him on Facebook at Wide-Eyed White Coat.

Looking for medical service providers? Consult our Professional Directory on page 15 +

PROFESSIONAL DIRECTORY

SEE PAGE SIX

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.)

THE MONEY DOCTOR: FISCAL HEALTH ON PAGE 11

There’s always more good reading online. WWW.AUGUSTARX.COM/NEWS AUGUSTA

by Ross Everett

only assume is “normal 65 year olds.” The terms were new to me when I started medical school. Yet in practice, people often expect different treatment based on their own predictions of how much longer a senior has to live. While they may have an argument to make, the guidelines, once again, give us the tools to do the most good for the most people. They allow us a way to discern black from white in clinical areas where we would otherwise constantly be in grey areas. This is why we have checklists in the Operating Rooms. Yes, real checklists that are run through just like a pilot before takeoff. This is why we have flowcharts for working up and treating various illnesses. This is why I make the claim that a good doctor needs just to follow the directions being provided to him/her. Unfortunately, we do still live in a world with a lot of grey in it. Not every question has been answered with observable, measurable and repeatable clear outcomes. Additionally, a guideline can’t teach a surgeon how to operate or oncologists how to properly empathize. I suppose these constitute some of the reasons that medical training is so long. Even so. it is impossible to know it all. It never ceases to amaze me just how little I know when I have worked so many hours for so many days for almost three complete years now. So it is reassuring to know that even after many more years of hard work, when the answer isn’t clear to me, I can still do the best for my patients simply by thinking back to my kindergarten days with Ms. Love. +

MEDICAL EXAMINER

AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

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

(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net Opinions expressed by the writers herein are their own and their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., or its agents or employees take any responsibility for the accuracy of submitted information, which is presented for informational purposes only. For specific medical advice, diagnosis and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2014 PEARSON GRAPHIC 365 INC.

FEBRUARY 21, 2014

AUGUSTA MEDiCAL EXAMINER

Hope...Compassion...Politics

Helen Blocker-Adams

ome people are amazed, but I’m not, by the outpouring of love and compassion shown toward others during times of distress. The ice/snow storm that Augusta and the CSRA just experienced was the worst event, from most people’s recollections, ever to hit this area. Augusta Fire Chief Chris James said last Friday at a press conference that opinion is because of the significant number of people all over the city directly affected by the storm. 57% of the residents of Richmond County had power outage – some for as long

as four days. Seems a little surreal doesn’t it? I lost power on day one for about an hour and then the cable went out and stayed off until late Saturday. I lost power a second time on Thursday at 4:30 p.m. And it didn’t come back on until 11:30 Friday morning. What does one do when it’s dark and cold and all you’ve got is candles? Well, I wasn’t sleepy after it got dark, so I read a book by candlelight. Over the four day event, I read two books actually. I stayed as connected to people and the community as I could during the power outage by keeping my phone charged in my vehicle. I received first-hand updates from a variety of sources and made them available via social media. I shared information with other media outlets and elected officials on updated information that I received. I provided an update after attending the press conference, did some troubleshooting for several people, encouraged others, checked in via phone, text and email to others and did

everything I could without leaving home. I was careful to listen to the emergency officials to stay off the road. They didn’t have to tell me that twice. The outpouring of love and compassion from so many of my Facebook friends was touching, hopeful, encouraging and exciting. I saw it from elected officials, young people, seniors, organizations, and individuals of all ethnic and political backgrounds. The good that I saw, read, observed and experienced is how I see Augusta. It’s why I am running for Mayor. I believe in the people and our city. I believe others do too. It was exemplified in random acts of kindness for four days. Yes, I know these type of activities take place regularly. Most people who do good or help others aren’t looking for the limelight. Those who helped during the great ice/snow storm of 2014 didn’t either. The sharing of information to alert others who might be in distress was a beautiful thing to see. Hope, compassion and politics can co-exist. One does

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Hope IS Possible

have to make a concerted effort to make it happen though. Certainly it is not easy to do or else it would happen more often. But what’s amazing is how people can have so much love and compassion for someone they don’t even know. That gives me reason to believe that the behavior we saw time and time again over the past few days can happen every day – visibly every day. When I wrote this there were still about 20,000 residents without power. That puts things into a whole new perspective, doesn’t it? Yes, it has been a challenging time indeed – more difficult for some than others. I want to challenge you to maintain and exhibit those qualities of love and compassion – every day – everywhere you go. Our people and our community will be better because of it. + Helen Blocker-Adams is Executive Director of the Southeast Enterprise Institute; mental health advocate; and youth advocate. You can email her at hba@hbagroup-intl. com or visit her website at www. helenblockeradams.com FREE T AKE-H OME C OPY!

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FEBRUARY 21, 2014

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW

trip to the pharmacy, if you hadn’t already noticed, can often give you a severe case of sticker shock. A month’s supply of a new wonder drug can often cost more than your car payment … or even your house payment. Why do new medicines cost so much? It is all about money and profit, of course. Drug companies are for-profit corporations. They have thousands of investors. They spend hundreds of millions of dollars each year on research. And advertising cost huge amounts as well. They must show a profit so they can finance the next new medicine. They expect to make money. And they do not want to get sued, which would take money away from the bottom line. A few years ago, I ran one of the Phase III clinical trials for a major new drug. I was one of 20 sites scattered across the country. Each site had a budget of about $200,000. That was a quick $4,000,000 the drug company spent, a minor expense when all is considered. If you had a vision that told you how to cure cancer, you would be elated. You would have the means to alter health

ABOUT EXPENSIVE MEDICINES

care worldwide. You would be a hero, a Nobel Prize winner. Right? Not so fast. First you need to get a patent on your product to protect your future. Then you need to raise a few hundred million dollars to support your upcoming battle with the FDA to get approval to market your drug in the US. We won’t bother with foreign sales considerations or foreign patents, etc. You will have considerable legal expenses. You must use FDA-approved manufacturing facilities. You will need Phase I trials. Then Phase II trials. Then Phase III trials. And you will need FDA approval for each and every step. And you’ll need peer review. Institutional Review Board approval. A national sales force. TV ads. Magazine ads. Considering all that and many other unplanned expenses along the way, you have to count on anywhere from $400 million to $700 million, and 5 to 7 years, to get from the day of your vision to the day you treat your first patient. So in the best case scenario, unless you just happen to have a half billion dollars under your mattress which you are willing to give away

Who:

CSRA Parkinson Support Group What: EXCEPTIONAL PROGRAM! Dr. Kapil Sethi, professor of neurology and Director of the Movement Disorders Program at Georgia Health Sciences University will be speaking on the latest news in Parkinson’s research and clinical trials. Don’t miss this chance to hear information from an expert in the field. When: Tuesday, February 25, 2014 at 6:00pm Where: St. John Towers dining room 724 Greene Street Augusta, GA Contact: Mary Ann Navarro (706) 364-1662 Note: This event is free and open to the public.

Best for the good of mankind, you must generate a profit of $400,000,000 (plus interest) to just break even. That is big number. Every new drug is a huge gamble by a pharmaceutical corporation. Sure, they say they do it for the good of mankind, a service to humanity. That sounds good. But they really do it make a profit. And we should have no problem with that. Without the potential for profit, there would be none of the new wonder drugs we have today. No new medicines for resistant bacterial pathogens. No new life extending antidiabetic drugs. No new heart drugs. Without a doubt the cost would be lower if the FDA was less bothersome. But then we chance a lower safety factor in the chemical we take into our body. So to evaluate the cost of

e n i c i d ME

an expensive drug, you must consider: Is the cost worth the benefit to you in your particular situation? Let’s say you have wrinkles on your forehead. They make you look older. Or worried. Is it worth $5,000 to get rid of them for 6 months? That depends upon who you are, and who is paying for your Botox injections. If you are movie starlet, then certainly it is. Facial wrinkles would not be becoming on Beyoncé. She may need Botox one day. Michelle Obama recently said she would “consider Botox injections.” But on Tommy Lee Jones? Who cares? Or on me? Nobody cares about that, so Botox is not worth anything to me. John Kerry had wrinkles galore as a senator and then presidential candidate. But his wrinkles are gone now that he is Secretary of State … and you and I are paying for his

treatment. So, should we reward for-profit corporations for their billion dollar risks in the medical field? I can’t answer that for you. Only you know the answer. If their product is cost-effective for you in your condition, then pay them. If not, don’t. It is up to you. That is what a free market economy is about. +

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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FEBRUARY 21, 2014

AUGUSTA MEDiCAL EXAMINER

DISTINCTION… from page 2

VOTE

WE OFFER OUR SINCERE THANKS TO THE READERS WHO SHARED THEIR PERSONAL STORIES IN OUR SEARCH FOR AUGUSTA’S FINEST DOCTORS. THANKS ARE ALSO IN ORDER FOR THE DOCTORS HERE RECOGNIZED FOR THEIR EXCELLENCE IN CARE AND COMPASSION. IF YOU HAVE A STORY TO TELL OF A DOCTOR OF DISTINCTION, WE ARE ALWAYS EAGER TO HEAR FROM YOU.

Resuscitate. Understanding the seriousness of the moment, Dr. Kennedy told Debbie that he did not want to risk having to perform a crash intubation during the night because those events usually did not produce positive outcomes. Faced with her imminent fate if she didn’t allow an intervention, Debbie relented and agreed. Dr. Kennedy said that we had an hour or so before they would place Debbie on the vent, and that she should discuss arrangements with her family, in case she did not survive the procedure. Another reason why Dr. Kennedy is a great doctor is because of the way he calmly and professionally prepared Debbie and our family for the possibility that she might not survive being on the ventilator. He said that, when she came off of the vent after several days, she would awaken to see one of their physicians; or if Providence intervened, she would be on the other side. This was the most professional approach to speaking of one’s fate that I had ever heard.

Dr. Amy Blanchard Dr. Amy Blanchard was the attending physician who followed Dr. Kennedy in the normal MICU Pulmonary rotation; her care of Debbie was stellar, and she had a special way of relating with Debbie’s mother during this difficult time. Since Debbie came off of the ventilator under Dr. Blanchard’s care, the successful outcome of Debbie’s stay last fall was the result of the combined efforts of Drs. Kennedy and Blanchard. Georgia Regents Medical Center operates on a Patient- and Family-Centered Care model. This means that families partner with the care team about issues pertaining to the patient’s care. The patient and those that they define as family are comfortable discussing care and treatment options. This openness promotes a better patient experience and more positive outcomes. One day I arrived at the unit after rounds and found Dr. Blanchard speaking with Debbie’s mother. Debbie was asleep, so it was just Debbie’s

81-year old mother speaking with Dr. Blanchard. It isn’t often that you find a physician taking several minutes to visit with a patient or family member—just having a chat. Dr. Blanchard is worthy of recognition because of the compassion that she shows her patients and family members. Summary Thank you for the opportunity to share the story of exemplary care that my late wife received from Drs. Kennedy and Blanchard. Unaware that Debbie’s pneumonia had returned, we lost her during the evening on the Friday after Thanksgiving. The concern that Dr. Kennedy had expressed to us earlier came true—Debbie was gone before bedtime. To me, Dr. Thomas Kennedy and Dr. Amy Blanchard are Augusta’s Doctors of the Year because they took excellent care of my late spouse, and because the care they provided helped me understand and accept the loss of my wife. + — Alan Watts

WE’RE BEGGING YOU We’re never too proud to beg. What we’re begging for is Medicine in the First Person stories. With your help, we’d like to make this a feature in every issue of the Medical Examiner. After all, everybody has a story of something health- or medicine-related, and lots of people have many stories. Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx.com. Thanks!

“The cause was a mystery for a long time.” “And that’s when I fell.” nearest hospital “He doesn’t remember a thing.” “The was 30 miles away.” “I was a battlefield medic.” “He was just two when he died.”

“OUCH!”

“It was a terrible tragedy.” “She saved “I sure learned my lesson.” “I retired from medicine my life.” “It seemed like a miracle.” seven years ago.” “We had triplets.” “It was my first year “I thought, ‘Well, this is it’.” NOTHING SEEMED of medical school.” “They took me to the hospital by helicopter.” TO HELP, UNTIL. . “It took 48 stitches.”

ambulance crashed.” “Now THAT hurt!” “The “My leg was broken “I’m not supposed to be alive.”

“This was on my third day in Afghanistan.” in three places.” “I lost 23 pounds.” “Turned out it was just indigestion.” “At first I thought it was something I ate.” “The smoke detector woke me up.”

Everybody has a story. Tell us yours. Here’s our “No Rules Rules.” We’ll publish your name and city, or keep you anonymous. Your choice. Length? Up to you. Subject? It can be a monumental medical event or just a stubbed toe. It can make us laugh or make us cry. One thing we’re not interested in, however: please, no tirades against a certain doctor or hospital. Ain’t nobody got time for that.

FEBRUARY 21, 2014

AUGUSTA MEDiCAL EXAMINER

Southern Girl Eats Clean

Southwestern Stuffed Peppers

Voted “BEST BARBER SHOP” by the readers of Augusta Magazine

Daniel Village Barber Shop 2522 Wrightsboro Road

736-7230

Stuffed peppers are a mainstay meal in Southern homes. They are the perfect “go-to” weeknight meal. I made them for years the traditional way. You know, ground beef, white rice and tomato sauce, but in this recipe the peppers are loaded up with beans and veggies and packed with nutritional value. I add long grain brown rice in place of the white “boil-in-bag” white rice that I used to use in my stuffed peppers. There is no meat in this recipe, but I assure you that you won’t miss it. Even though these stuffed peppers are vegetarian, clean and healthy, they are also flavor filled. I’m a huge fan of Southwestern food and the cilantro, chipotle and smoked paprika in this dish will make your palate happy. The bell peppers, veggies and brown rice will give your body the fiber, nutrients and antioxidants it loves. Another plus with this recipe is that it usually makes enough to freeze and have again the next week. I really like it when I can cook once and eat twice, don’t you? Serve sliced avocado alongside these peppers to add even more nutrition. If you’d prefer to to make this a vegan meal, just leave out the grass-fed cheddar cheese.

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Southwestern Stuffed Peppers

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Making the dish: Cut and seed peppers and place into a 9 x 13 baking dish. Cook rice or quinoa and set aside. (I use a rice cooker)

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What you’ll need: • 2 organic red bell peppers and 2 organic green bell peppers; cut vertically down the middle, core and seeds removed • 1 Tbsp. of grapeseed oil 4 cloves of garlic, chopped or minced • 1 small Vidalia onion or a sweet yellow onion • 2 cups of cooked organic long grain brown rice or quinoa • 1 can of organic corn, drained and rinsed (or use fresh, frozen) • 1 can of organic black beans, drained and rinsed • 1 cup of crushed tomatoes (I like Muir Glen brand) • 1 4 oz. can of chopped green chilies • 1 jar (24 oz.) of all-natural/ organic plain marinara sauce • 1 tsp. of Mrs. Dash Southwest Chipotle Seasoning • 1/2 tsp. of smoked paprika • 1/2 to 1 tsp. of cayenne pepper to taste • Sea salt and cracked black pepper to taste • 1/4 cup of fresh cilantro, chopped • 1/2 cup of grass fed cheddar cheese, grated

Wrightsboro Road

Daniel Field

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Heat the grapeseed oil over medium to high heat and sauté garlic and onion approximately 3-5 minutes or until onions are softened. Add the corn, black beans, tomatoes and green chilies. Cook 2-3 minutes until heated through. Reduce heat to low and stir in 1-1/2 cups of marinara sauce, Mrs. Dash, smoked paprika, cayenne pepper, salt, and pepper. Simmer 10-15 minutes, stirring occasionally allowing flavors to blend together. Add cooked rice or quinoa to vegetables and mix well. If a bit dry, add a little more marinara sauce, keeping in mind that the mixture should not be too moist. Remove from heat and stuff vegetable mixture into pepper

halves. Before placing into the oven, pour a small amount of marinara on top of each pepper, approximately 1-2 Tbsp. Cover with foil and bake in a 400° oven for 45 minutes. Remove from oven and add a small amount of cheddar cheese to the top of each pepper. Return to the oven, uncovered. Allow cheese to melt and remove. Top with chopped cilantro to garnish and serve immediately. + 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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OUR NEWSSTANDS Medical locations: • Department of Veterans Affairs Medical Ctr, 15th St., Main Entrance • Dept. of Veterans Affairs Medical Center, Uptown Div., Wrightsboro Rd., main lobby • Doctors Hospital, 3651 Wheeler Rd, ER Lobby Entrance • Eisenhower Hospital, Main Lobby, Fort Gordon • George C. Wilson Drive (by medical center Waffle House and mail boxes) • GHSU Hospital, 1120 15th Street, South & West Entrances • GHSU Medical Office Building, Harper Street, Main Entrance • GHSU Medical Office Building, Harper Street, Parking Deck entrance • GHSU Hospital, Emergency Room, Harper Street, Main Entrance • GHSU Children’s Medical Center, Harper Street, Main Lobby • GHSU, Laney-Walker Boulevard transit stop, Augusta • Select Specialty Hospital, Walton Way, Main entrance lobby • Trinity Hospital, Wrightsboro Road, main lobby by elevators • Trinity Hospital Home Health, Daniel Village, main lobby • University Health Federal Credit Union/ University Hospital Human Resources, 1402 Walton Way, Main Lobby • University Hospital, 1350 Walton Way, Emergency Room lobby area • University Hospital, 1350 Walton Way, Outside Brown & Radiology/Day Surgery • University Hospital - Columbia County, 465 N. Belair Road, Main Lobby • University Hospital Prompt Care, 3121 Peach Orchard Road, Augusta

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

FEBRUARY 21, 2014

AUGUSTA MEDiCAL EXAMINER

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

A NEW MEDICINE FOR DIABETES IS IN TOWN

here are many classes of medicines designed to treat diabetes, or increased blood sugar. We have talked previously about some of these, so let’s review, then talk about a new type of diabetes medicine. Previously blood sugar medications acted to stimulate insulin release from the pancreas or to regulate stored sugar’s breakdown and release by the liver. There was also insulin that was injected to provide an outside source of insulin. Other medicines regulate the cell’s response to insulin present in the body and allow insulin to be utilized more efficiently. Some medicines work to prevent the brakdown of incretin, a body-signaling chemical, so that more insulin is released. At the end of last year a new medicine came out to treat diabetes. It is called Invokana, also known by the generic name canagliflozin. The fact that this drug has a generic name does not mean it is available in the United States as a generic drug. Be prepared to pay brand name copay for this medicine. But hope abounds as there is a copay assistance card if you qualify. Patients on any government funded insurance plan do not qualify, but those with commercial insurance should definitely look into this savings offer. Invokana is a new class of diabetes medicine that increases urinary excretion of glucose. Typically glucose is reabsorbed in the kidneys and returned to the body to be reused. In diabetics the problem is too much glucose in the blood and therefore the body, so the kidney’s reabsorption of glucose only compounds the problem. By decreasing reabsorption of glucose and increasing the excretion or elimination of glucose, total glucose present in the body declines to a more desired level. Invokana is indicated only for type two diabetes (non-insulin dependent) and is not to be used for insulin-dependent diabetes mellitus or in patients who have diabetic ketoacidosis. Invokana has been shown to be more effective as part of a multidrug diabetic regimen than previous combinations that we had in the past. For example,

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Invokana combined with metformin and a sulfonylurea was studied and proved to be better in getting diabetic patients to their A1C goal of 7 percent than the same combination with Januvia. This is impressive because previously, Januvia was considered the best option available. Just to clarify, a sulfonylurea is a class of medicines that increases insulin release and includes glyburide, glimepiride and glipizide. Metformin was originally known as Glucophage before it went to being available as a generic drug. Invokana is initiated as a single daily dose of one hundred milligrams and may be increased if needed to a three hundred milligram single daily dose. Dosage is dependent on not only the inability to reach goal at the lower dose, but also on your individual kidney function level. Invokana is taken once daily before the first meal of the day. There is the possibility of a drug-drug interaction if Invokana is administered with digoxin, phenytoin and a few other drugs, so consult your physician and let him or her know of all medicines you take no matter which doctor prescribes it for you. Remember that all diabetes medicines are meant to be part of a comprehensive diet and exercise program, and will not replace healthy lifestyle choices nor compensate for poor ones. + Questions about this article or suggestions for future columns can be sent to us at cjdlpdrph@bellsouth.net

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FEBRUARY 21, 2014

AUGUSTA MEDiCAL EXAMINER

Ask a Dietitian

Q: I have a family history of heart disease. How can I prevent myself from having the same fate as my parents and grandparents?

Answer: February is American Heart Month, and heart disease is the leading cause of death for both men and women in the United States. Good nutrition plays a large role in heart disease prevention. The risk factors for heart disease we can target and control include high blood pressure, high total blood cholesterol, low HDL cholesterol levels, having good management of diabetes, being overweight or obese (especially with excess abdominal fat), physical inactivity, and smoking. The food choices we make affect many of these. Eating a high fiber diet can help with diabetes and weight management. Fresh fruits and vegetables are lower in calories compared to fats, meats, and starches. Dark-colored fruits and vegetables like berries and dark leafy greens have properties that may help with underlying inflammation, which may play a role in heart disease. Try for five cups daily. You can do this by filling half of your plate with fruits and vegetables. The soluble fiber found in whole grains can also help lower blood

cholesterol. Choose foods like quinoa, barley, oats, brown rice, and whole-grain pastas, breads and cereals. Look for “100% whole grain” on the packaging. Try for at least three servings every day. Choosing heart-healthy fats can lower your total blood cholesterol, lower your LDL cholesterol (the “lousy” cholesterol), and help increase HDL cholesterol (the “happy” cholesterol). You can do this by replacing butter and stick margarine with liquid vegetable oils, especially canola oil and olive oil. Include avocados and a variety of nuts and seeds in your meal plan too. Remember, these are calorie-dense foods. A serving of nuts, seeds and avocado is one ounce, or about 1/3 of a cup of nuts, and 1/5 of a medium avocado. Omega3 fatty acids help reduce inflammation. Eat eight ounces of fatty fish weekly, such as salmon, sardines, anchovies, albacore tuna, lake trout, and mackerel. Omega-3 fatty acids can also be found in walnuts, ground flaxseed, flaxseed oil, canola oil, soybean oil, and eggs. Limit unhealthy fats such as saturated fat, trans fat and

cholesterol. Saturated fat and cholesterol are found in animal products. Cutting back on these will also help with weight management. Choose lean cuts of beef and pork that have the words “loin” or “round” in their name. Remove visible fat

from meat before cooking, and remove the skin from poultry before eating it. Limit high cholesterol foods such as egg yolks, fatty meat, full-fat dairy, shrimp, lobster and crab, as well as processed meats like sausage, hot dogs, and bacon. Try reduced fat cheese, milk and yogurt. Trans fats are often found in stick margarine, shortening, and packaged foods made with hydrogenated oils. Look for words like “partially hydrogenated oil” on the label to

avoid these foods. Additionally, foods without trans fats will likely have it advertised on the packaging. Watch your portion sizes. The recommended portion size for meat and fish is three to four ounces per meal. This is about the size of a deck of cards for meat, and the size of a checkbook for fish. The average American easily eats twice that much. A high sodium diet can contribute to high blood pressure, so eat less salt. Use herbs, spices, garlic, and citrus juices to add sodium-free flavor. Cook at home to give you greater control of how much salt is in your food. Often the amount of salt in a recipe can easily be cut in half. Look for canned foods labeled as “reduced-sodium” or “no-added-salt.” Avoid any food with a sodium content of over 300 milligrams per serving when trying to follow a hearthealthy diet. Convenience foods and “instant” foods often have sodium as a preservative as well as a flavor enhancer, and should be avoided also. Aim for a plant-based diet. Swapping out beans, nuts, seeds, and soy for meat is a good way to swap out bad fats for good ones. Start out by designating one day per week to eat meatless. The “Meatless Monday” initiative was started in 2003 by the Johns Hopkins Center for a Livable Future to improve public health by reducing intake of saturated fat. According to the FDA, consuming 25 grams of soy protein per day may reduce the risk of heart disease. Adding edamame, tofu and soymilk to your meals can help you reach

this goal. Do you like tea? Give it a try. If sweetened tea is your preference, try a small amount of honey instead of sugar. The antioxidants in tea are good for the heart. Studies have shown that people who drink black tea have lower cholesterol levels, significantly lower blood pressure, and a reduced incidence of heart attack. Be mindful about how you’re preparing your foods. Baking, broiling, boiling, and steaming are all better than frying. Make these dietary changes in small increments for the best chance of long term success. Making an extreme change, such as from whole to skim milk, is often too drastic for most people. Reducing the risk of heart disease requires attention to the whole lifestyle, not just nutrition. Increasing physical activity can help lower cholesterol levels, lower blood pressure, and help maintain a healthy weight. If you’re overweight, losing 10% of your current weight can lower your risk factors for heart disease. If you smoke, quit as soon as possible. It’s a lot to think about, but heart disease affects 35% of the population of the US. You’ve got the right idea by planning for prevention. + by Patricia L Ward, RD, LD, CNSC Clinical Dietitian Doctors Hospital - Augusta

References: www.eatright.org www.heart.org www.CDC.gov Who.int www.jhsph.edu www.avocadocentral.com

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FEBRUARY 21, 2014

AUGUSTA MEDiCAL EXAMINER

Simple heart health tips from the CDC

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Plan for Prevention Try out these strategies for better heart health. You’ll be surprised how many of them can become lifelong habits. • Work with your health care team. Get a checkup at least once each year, even if you feel healthy. A doctor, nurse, or other health care professional can check for conditions that put you at risk for CVD that can go unnoticed. • Monitor your blood pressure. High blood pressure often has no symptoms, so be sure to have it checked on a regular basis. You can check your blood pressure at home, at a pharmacy, or at a doctor’s office. Get your cholesterol checked. Your health care team should test your cholesterol levels at least once every 5 years. Talk with your health care professional about this simple blood test. Eat a healthy diet. Choosing healthful meal and snack options can help you avoid CVD and its complications. Limiting sodium in your diet can lower your blood pressure.

Less

t ha n a m i l l

Be sure to eat plenty of fresh fruits and vegetables—adults should have at least five servings each day. Eating foods low in saturated fat, trans fat, and cholesterol and high in fiber. • Maintain a healthy weight. Being overweight or obese can increase your risk for CVD. If you know your weight and height, you can calculate your BMI at CDC’s Assessing Your Weight Web site. • Exercise regularly. Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. The Surgeon General recommends that adults should engage in moderate-intensity activity for at least 150 minutes per week. Incorporate exercise into your day in different ways: take the stairs instead of the elevator, or rake the yard instead of using the leaf blower. Exercising with friends and family can be a great way to stay healthy and have fun. • Don’t smoke. Cigarette smoking greatly increases your risk for CVD. If you don’t smoke, don’t start. If you do smoke, quit as soon as possible. Your health care team can suggest ways to help you. • Manage your diabetes. If you have diabetes, monitor your blood sugar levels closely, and talk with your health care team about treatment options. Visit CDC’s Diabetes Public Health Resource for more information. • Take your medicine. If you’re taking medication to treat high blood pressure, high cholesterol, diabetes, or another condition, follow the instructions carefully. Always ask questions if you don’t understand something. If you have side effects, talk with your health care team about your options. Together, we all can prevent and manage heart disease, one step at a time. +

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Take It One Step at a Time You can control a number of risk factors for CVD, including: • Diet • Physical activity • Tobacco use • Obesity • High blood pressure • High blood cholesterol • Diabetes

As you begin your lifetime journey to better heart health, keep these things in mind: • Try not to become overwhelmed. Every step brings you closer to a healthier heart, and every healthy choice makes a difference! • Partner up. The journey is more fun—and often more successful—when you have company. Ask friends and family to join you. • Don’t get discouraged. You may not be able to take all of the steps at one time. Get a good night’s sleep—also important for a healthy heart— and do what you can tomorrow. • Reward yourself. Find fun things to do to decrease your stress. Round up some colleagues for a lunchtime walk, join a singing group, or have a healthy dinner with your family or friends.

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Cardiovascular disease (CVD)—including heart disease, stroke, and high blood pressure—is the #1 killer of women and men in the United States. It is a leading cause of disability, preventing Americans from working and enjoying family activities. CVD costs the United States over $300 billion each year, including the cost of health care services, medications, and lost productivity. But CVD is a foe we can conquer.

FEBRUARY 21, 2014

The Money Doctor

The blog spot

Charitable Giving — The Tools

– Posted February 5, 2014 by Baylor College of Medicine pediatric gastroenterologist Bryan Vartabedian at 33charts.com

Will CVS stop selling chips and soda? What’s more interesting than the CVS decision to halt tobacco sales is the social chatter holding CVS up as a champion of better living. But to be a health organization, it takes a broader position than the proscription of cigarettes. Wander the aisles of CVS and see how their nutritional offerings fit within the framework of an organization pitching health. I can hear it now: Cigarettes kill, potato chips don’t. But I’m not so sure about that. You can’t make money peddling savory snacks while at [the same time] setting the pace for a healthy lifestyle. And condemning one vice works for the press release, but not as a brand offering health solutions. If CVS is interested in the [prevention of disease and death] they’ll need to move beyond cigarettes. +

“It was good for press coverage.”

Speaking of blogs, the Medical Examiner blog is found at www. AugustaRx.com/news. Visit soon!

DOCTOR-PATIENT… from page 1 out for all kinds of help: herbalists, homeopaths, naturopaths, and many others employing unconventional methods. A vast number of books, treatises, magazines and other writings are available, some making unfounded claims with testimonials to support their arguments. People with illnesses or handicaps are desperate, even terrified, and hence grasp for whatever offers hope. Sadly, they are to be reminded that the person who treats himself has a fool for a patient. Hopefully, the doctor-patient relationship is of long standing before its inevitable end. It is that long period of time that should provide frank exchange of information and development of

“

11 +

AUGUSTA MEDiCAL EXAMINER

effective communication. Trust must be established as close friends embark on a long journey. Questions must be asked and the best answers sought and applied. Too much remains unknown about human maladies, but each day more is being learned. Patients must feel free to ask questions, for there are no stupid questions, only stupid answers. Hence, the relationship is a two-way communication network, open at all times to provide answers, to allay fears, and to serve with love. +

his is our second article in a series on charitable giving. Our last article discussed setting goals and having a plan for your giving. Having a plan allows you to focus your time and money on the areas you are passionate about. It also makes it easier to politely say no to the requests you may get that are worthwhile, but ones that may not be a priority for you and your family. In this article we will focus on several of the common tools that are used for giving. The most common is writing a check to your church or charity. This is by far the easiest and most convenient way. There are other tools available for those that have appreciated assets, such as mutual funds, exchange traded funds, or stocks. You can give appreciated assets directly to a charity. Why would you do this? Giving the appreciated asset directly to a charity allows you to avoid paying tax on the unrealized gain in the asset and the charity receives the full fair market value of the property. For example, say you bought a stock for $10,000 ten years ago and now it is worth $20,000. You could sell the stock and pay around 20% in federal and state taxes or $2,000 on the $10,000 gain. This would leave $18,000. Rather than sell the stock, you can give it directly to a qualified charity or your church and avoid paying capital gains tax. You also get a tax deduction for the full fair market value of the gift, or $20,000 in this example. For stocks and mutual funds, this is a fairly simple process of transferring the shares from your current brokerage account to the brokerage account of the charity. Some key items to remember, the stock has to be held for greater than one year and this has to come from a non-retirement account. Funds held in an IRA or work retirement plan would not be eligible. As always, talk with your CPA to make sure the security you are donating qualifies before making the gift. One of our favorite tools are Donor Advised Funds (DAF), also called Charitable Gift Funds (CGF). A DAF is a program that allows you to make contributions to an account and become eligible for an immediate tax deduction. From the account, you can make gifts or donations to charities on your own timetable or let the funds grow within the DAF. It is very similar to a foundation, but with smaller minimums and less

Editor’s note: This article originally appeared in the Winter 1996 issue of the Brandon Wilde Journal and is reprinted by permission.

administrative burden. Two of the most popular DAF’s are the Fidelity Donor Advised Funds and Charles Schwab Donor Advised Funds. Who would use these? There are a myriad of uses for DAFs. Sometimes your favorite charity or church may not have the ability to accept direct stock gifts, so the DAF is a tool where you can make the gift to the DAF and then donate funds from the DAF to your church. DAF’s are also popular for year-end tax planning, especially for those that have a desire to give to charity, but are not sure right now on who they would like to give it to. DAF’s also accept assets beyond your typical stocks and bonds, including real estate, restricted stock, and other complex assets. We have used DAF’s in some instances like a small foundation. It can be a good tool for bringing children into the charitable giving discussion and a way to pass down family values from one generation to the next. For younger children, there are other ways to get them started, one tool is to have three clear jars labeled – giving, spending, and saving and have a portion of their allowance allocated to each of the jars. It is always more impactful when you can directly see the benefit of your gift, so consider finding an organization where you and your children can donate your time. You will find this can be a fun exercise for the family and it will have a significant impact on your children as they grow up. DAFs also have endowed giving programs where you can name several charities at your death to receive funds from the account as long as there is a remaining balance in the account. As always, anytime you venture beyond giving direct cash gifts to charity, you should consult with your financial advisor and CPA. Having a well thought out strategy can have a big impact in the areas that you are most passionate about as well as minimize your income taxes. + by Bill Cleveland, a Certified Financial Planner (CFP®) and CPA with Preston & Cleveland Wealth Management, LLC (www.preston-cleveland.com) in Augusta and Atlanta, GA.

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FEBRUARY 21, 2014

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS +

by Dan Pearson

My hands were wet so I Why did it take so was trying to undo my long at the doctor? watchband with my teeth.

Don’t ask me how, but I ended up swallowing my watch.

And?

That is crazy. The doctor made me sit Then what? there and pass the time.

ON S IC

The Mystery Word for this issue: PROSIMETTOT

EXAMINER CROSSWORD

PUZZLE

ACROSS 1. Satisfy 5. Type of treatment 10. Point of transition 14. Ravi Shankar’s brother 15. Place of safety; refuge 16. Rectangular pier 17. Tempo 18. Musical drama 19. Smoke combined with fog 20. Dishonestly use or spend 23. Like summer weather 24. Fire ___ 25. Command to a horse 26. Unexceptional 31. Old Persian for “king” 34. Seven follower? 36. Hem’s partner, sometimes 37. NBC in these parts 38. Heaps 39. Mr. Ballesteros 40. Atmosphere 41. Suckerfish 42. River in central Europe 43. Football field 45. Hosp. employee 47. Type of pill 48. Like most 48-Downs 51. Easily influenced 56. Disfigure; cripple 57. Winter drink 58. Indolently 60. Karenina or Kournikova 61. Overhead 62. Network of nerves (Anat.) 63. Repast 64. Compacted 65. Mild oath

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F E U A T D E T E O C E I T O R O G O T T C M E A N O F N H H L A H O Y R H P L O

46 49

32. Locks 33. Emperor Nero’s mother 35. Short name for a long car 39. Sky King’s plane 41. Ready to harvest or eat 44. Pertaining to the skin 46. Handheld computer (abbrev.) 48. House covers 49. Senior 50. Cabela’s neighbor 51. Muslim leader 52. Synonym for 32-D 53. Univ. located in Savannah and Atlanta 54. Lone 55. Image 59. However

DOWN 1. Informal greeting 2. 6th US president 3. Implied 4. Vision 5. Store owner 6. Glad 7. Above 8. King mackerel 9. Type of sack? 10. Broad Street building 11. Peerless 12. Springing gait; pronk 13. Leaf of a book 21. One on the links 22. Lead-in for check or dance 26. Gourd fruit 27. At any time 28. Make seawater drinkable 29. Talk incoherently 30. Pitcher or jug 31. Curtains hung in a drooping curve

— Mark Twain

X A M I N E R

1 1 5 9 8 6 5

5 2 5 3 6 9 5 2 7

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.

Use the letters provided at bottom to create words to solve the puzzle. All the listed letters following 1 are the 1st letters of each word; the letters following 2 are 2nd letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.

’ 1 2

1 2 3 4 . 1 2 1 2 3

1 1

2 2

3 3

H 1 2 3 4 5 6 T 1 2 3 4

1 2

1 2 W 1 2

1 2 3 4 1

— Anais Nin

1 . A A A AT T T W W W S S D 2 . E E E E E H H H O S S R R 3 . I N E E E E E E 4 . M N T Y 5 . G 6 . S

SAMPLE:

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

L 1

O 2

V 3

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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.

Solution p. 14

WORDS NUMBER

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

AVE

QUOTATION PUZZLE

K LE

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

THE MYSTERY WORD

THE BEST MEDICINE ha... ha...

What do you call a monkey trying to cross a mine field? A babboom. A Norwegian cross-country skier was shot with a starter’s pistol at the Sochi Olympics just as the competition began. Police think the shooting is race-related.

man left for work the day after a terrible ice storm with the expectation that a roofing crew he had called would pull the fallen limbs out of his house and replace his entire roof. They assured him they would be finished before he got home from work, but when he rolled up that evening, everything looked exactly like it had that morning. “What happened to the roofer?” he asked his wife as soon as he walked in the door. “He called right after you left this morning,” she replied. “He has shingles.” A man complained to his psychiatrist, “And another thing: I’m sick and tired of finishing crossword puzzles so quickly. It’s depressing.” “Try not to get two down,” advised the doctor. A huge new study was released last week with statistics about the most common way people walk when they’ve had too much to drink. It’s staggering. A man was accused of killing a man with sandpaper. In his defense, he testified he only meant to rough him up a bit.

A dog not only wears a fur coat, but also pants. Medical Examiner Dictionary definition of alcohol: “A crash diet.” Bob: I like people who are very open. Rob: I bet you would make a great surgeon. Bob: No, I think I’d prefer to be a historian. Rob: There’s no future in that career. A toothless old termite walked into a saloon and asked, “Is the bar tender here?” A ham sandwich walks into a bar and hops up on a stool. The bartender says, “Sorry, we don’t serve food here.” A man woke up in the hospital after a serious accident. He immediately began yelling for help, and the doctor rushed in. “Doctor, doctor, I can’t feel my legs!” the worried man said. “Of course you can’t, silly,” said the doctor. “We had to amputate your arms.” It was an emotional wedding: even the cake was in tiers. +

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.

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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

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AUGUSTA MEDiCAL EXAMINER

STATE

ZIP

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

The Patient’s Perspective by Marcia Ribble

here is a local woman who wandered away from her home, and who was just found a month later, despite many people who have taken their time and energy to look for her. She was a woman who contributed a great deal to our community. She deserved to be found, not just for her sake, but also for the sake of her family. Nobody deserves to get lost, whether due to Alzheimer’s disease or any other reason. While waiting for the ice storm to hit, I was thinking about them all, and praying that her family, friends, and people who knew a woman I’ve never met, but who will always matter. Just as all people matter. Waiting for the ice storm to arrive last week was an anxious time. I know the ravages a bad ice storm can visit on a community. One sunny Sunday, a rare February 29th, my Grandma died trying to lift herself up her front steps. The very next day it started to rain, an awful freezing rain that continued for the next three days. By the second day, trees began coming down, power lines came down with them, and I watched all night long as transformers exploded, wires arced and spewed giant showers of sparks, and it felt like maybe hell was arriving, or the end of the world. Our house, and most of the homes in our city went dark, and all I could do is check on my four children in their beds and pray that the storm would end. It did end, eventually. Eventually the trees were cut down and piled at the curb, and the lights were restored, along with heat and hot water, cars could drive down the streets again, and everything was made right again, even though some things would never be the

“

Talk is cheap. Not talking can be deadly.

same. Most people sensibly left the wires alone, most people found places where they could be safe, warm, and dry, and most people survived a little wiser and more willing to listen to the weather folks warning us to prepare, and even those people who were not prepared managed somehow or another. That is one of the benefits of growing older. It gives us a perspective we wouldn’t otherwise have. This helps us to know how to deal with life events with a sense of peaceful purpose. A long time ago when I was fretting about all the suffering in the world, my oldest daughter told me, “Mom, you can’t fix everything wrong with the world, so just pick out one little corner and go to work to make a difference there.” When storms end, we can all help to make things right again if each of us do a little bit to help ourselves and others. Eventually all our ice melted, the sun and flowers came out, and we could finally bury Grandma, who had spent the rest of that winter in cold storage. + Marcia Ribble received her PhD in English at Michigan State and retired from the University of Cincinnati. She taught writing at the college level and loves giving voice to people who have been silenced. She is now teaching again at Virginia College in Augusta. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.

Dreams are today’s answers to tomorrow’s questions. — Edgar Cayce

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FEBRUARY 21, 2014

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FEBRUARY 21, 2014

AUGUSTA MEDiCAL EXAMINER

THE MYSTERY SOLVED ON S IC

The Mystery Word in our last issue was: OPTOMETRIST

K adEfor ...cleverly hidden (upper left) in the p. 16L AV GROUP & BUSINESS CONSULTANTS E

Unfortunately, due to a glitch at AugustaRx.com, we were again unable to receive and view Mystery Word Contest entries for the Jan. 24 issue. We hope to have that problem fixed soon. We’re putting The Mystery Word on sick leave until we can get this repaired. Our apologies.

The Celebrated MYSTERY WORD CONTEST ...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then be the first to find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries you’ll score our goodie package: gift certificates from Wild Wing Cafe, Top Notch Car Wash, and movie passes from Health Center Credit Union! 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

EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC. FOR RENT 2 bdrm 1 bath unfurn upstairs condo. Carport, pool, outside laundry. Country Club Hills condos, Milledge Road near GRU/ASU. $700/mo + $500 dep. We furn water, you pay electric. 706-736-7167 Email: ronst79@gmail. com ROOMMATE WANTED! 3 bdrm, 2.5 bath house with pool, 2 minutes from colleges. Perfect for medical or grad students. $425+share utils. 706.993.6082 WEST AUGUSTA House for rent. 3 bdrm, 2 bath, 1500 sqft, 1-car garage, 3024 Sterling Road, located off Stevens Creek at Riverwatch Pkwy. $850/mo. Call 678467-7187. FOR SALE: GORGEOUS, immaculate, never occupied townhome located mins from Medical District. 2 bed, 2 bath, master en suite, walk-in closets, office. 1450 sq ft. hardwood floors throughout, fabulous upgrades, custom kitchen and baths. Floor to ceiling windows, fenced yard. Partially furnished! 120k OBO.

803-507-6621. Augustagahomesearch.com Foreclosures • Rentals • MLS Roman Realty 706-564-5885

SERVICES VIDEOS-FOR-THE-WEB SERVICE Documentary style interview or demonstration shot HD with pro audio and basic edits, 3-min. finished video uploaded to your account. Complete package $250. Please call David: 803-645-8370. Documentary Video Productions, LLC – Aiken, SC. BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673) FULL-SERVICE MOVER Anthony’s Professional Moving, 28 years serving the CSRA moving hospital equipment, offices, homes, apartments, etc. Estimates are FREE. Call 706.860.3726 or 706.814.8141

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

NOTICE! ATTENTION! If any current or past employer has failed to pay you min. wage or time and a half overtime

TELL A FRIEND ABOUT THE MEDICAL EXAMINER

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

(OURS IS COFFEE)

Augusta Medical Examiner Classifieds

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

THE PUZZLE SOLVED S

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QUOTATION QUOTATION PUZZLE SOLUTION: Page 12: “You go to heaven for the climate and to hell for the company.” — Mark Twain

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

SEE PAGE 12

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

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

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The Sudoku Solution 3

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COFFEE IS GOOD MEDICINE

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

Send this form with payment to:

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

VISIT DRUGOFCHOICECOFFEE.COM

WORDS BY NUMBER “We don’t see things as they are. We see them as we are.” — Anais Nin

Multiply by number of times ad to run: x Total submitted: $

The Augusta Medical Examiner publishes on the 1st and 3rd Friday of every month. Your ad should reach us no later than 7 days prior to our publication date.

Thanks for reading!

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FEBRUARY 21, 2014

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AUGUSTA MEDiCAL EXAMINER

Lightening the Load of Caregiving by Kathy Crist For many of the approximately 6 million spousal caregivers in the United States, the elephant is not just in the room, but overtaking the room. On many days, Kathy Crist the elephant of illness, disability and aging will not budge for the spouse who steps in as a home caregiver to help maintain the partner’s health. Caregiving for a loved one can be gratifying, yet at times daunting and overwhelming. As care needs increase and the length of illness stretches into months, years or even decades, a caregiver

is vulnerable to common stress-related conditions including anxiety, depression, headaches, backaches and sleep deprivation. The unrelenting responsibility fuels fatigue. Resentments also can build against other family members who are not as available to help. In a 2010 MetLife “Study of Working Caregivers and Employer Health Care Costs, 17 percent of female caregivers age 50 and older reported fair or poor health compared with just 9 percent of non-caregivers. Eventually, care for an ailing loved one can lead to burnout in which the caregiver is depleted physically, mentally and emotionally. Sometimes it’s just not possible for the caregiver to continue to ensure the level of care that the loved one needs.

A thorough care assessment from an agency such as Right at Home will determine if home care would be a practical option based on the current needs of a loved one. Securing the help of a professional home caregiver is not a sign of weakness or giving up on the ailing family member, nor is asking for at-home care being selfish. Instead, hiring a trained caregiving service is actually showing greater love and concern for the spouse receiving care. Home healthcare aides are becoming increasingly vital in our society as more and more seniors choose to age at home. From a few hours a day to overnight or round-the-clock care, home care providers offer compassionate expertise and

care tailored to the client’s needs. To encourage caregivers to allow professional in-home care support, other family members and friends may consider the following: • Ask, “How are you doing?” Many people ask about the welfare of a care recipient, but not about the well-being of the caregiver. • Reaffirm that it’s okay to recharge. Caregivers need to refresh their own overall health. Respite breaks are excellent for going to the gym, seeing a movie or having coffee with a friend. • Help investigate home healthcare options. It’s important to select a reputable, experienced in-home care company. Thorough screening and training of caregivers

is vital as well as matching caregivers to the individual needs and preferences of each client. • Involve the ailing loved one in care decisions. As much as possible, invite the care recipient to weigh in on professional caregiving choices. + Right at Home of the CSRA offers in-home companionship and personal care and assistance to seniors and

disabled adults who want to continue to live independently. Right at Home is locally owned and directly employs and supervises all caregiving staff, each of whom is thoroughly screened, trained and bonded/insured prior to entering a client’s home. To learn more about Right at Home, go to www.csra.rightathome.net or call 803-278-0250.

PROFESSIONAL DIRECTORY ALLERGY

DERMATOLOGY

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

CHIROPRACTIC Poppell Chiropractic Clinic 1106-A Furys Lane Martinez 30907 706-210-2875 Most insurance plans accepted

DENTISTRY Dr. Judson S. Hickey Periodontist 2315-B Central Ave Augusta 30904 706-739-0071 Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048 Evans Dental Group 4250-2 Washington Rd Evans 30809 706-860-3200 www.evansdentalgroup.com Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

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

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

DRUG REHAB Floss ‘em or lose ‘em!

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

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

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

HOSPICE

...PHARMACY

Alliance Hospice 3685 Old Petersburg Rd. Suite 145 Augusta 30907 706-447-2461

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

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

OPTICIAN

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

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

VEIN CARE

Murphy & Robinson Phil Harris 1571 Walton Way Augusta 30904 706-737-2020

Parks Pharmacy 437 Georgia Ave. N. Augusta 29841 803-279-7450 www.parkspharmacy.com

O P T I C I A N S

PHARMACY Medical Center West Pharmacy 465 North Belair Road Evans 30809 706-854-2424 www.medicalcenterwestpharmacy.com

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

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AUGUSTA MEDiCAL EXAMINER

FEBRUARY 21, 2014