Feb2 18 by Daniel Pearson

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FEBRUARY 2, 2018

AIKEN-AUGUSTAʼS MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

F Georgia and South Carolina each received a big fat F from the American Lung Association for their state’s tobacco control programs. Let’s take a look at the health and monetary impact on individual smokers and the states as a whole, and consider what we can do locally to reduce tobacco’s deadly impact.

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Cigarette smoking is the #1 preventable cause of death in the U.S., killing more than 480,000 people every year. You would think there would be an all-out war on the order of the Space Race of decades past against this scourge, but the national response as a whole is a lot more laid-back. The tobacco companies, meanwhile, are waging a pretty powerful pro-tobacco campaign: the five largest tobacco companies spent more than $22 million per day marketing their products in 2015. Last week the American Lung Association released its 16th annual State of Tobacco Control Report, giving every state a report card based on their efforts to discourage tobacco use through legislative means. Georgia and South Carolina had plenty of company in the roster of states who got a big fat F. How did they earn the failing grades, and what could they do differently? Georgia got failing marks for having the third-lowest cigarette tax in the country. For reference, New York’s tax is $4.35 per pack; in Massachusetts the rate is $3.51; in Alaska it’s $2.00. The national average is $1.72 per pack. The Georgia tax? 37 cents. That not only represents a huge loss of potential revenue (which could be used for tobacco cessation programs), but also a lost opportunity every time a pack of cigarettes is purchased to discourage tobacco use by increasing its cost to consumers. Nationwide, states collect more than $27 billion annually through tobacco taxes and tobacco industry settlement funds; they use less than 3 percent of that money on tobacco prevention and cessation programs. The CDC reports that spending less than 13 percent of that $27 billion (that is, $3.3 billion) on tobacco control initiatives would fully fund every state program at CDC-recommended levels. In South Carolina, (where the cigarette tax is 57 cents per pack), annual tobacco-related revenue adds up to $243.8 million, but the 2018 state budget for tobacco control programs is just $5 million, a fraction of the CDC’s recommendation for the Palmetto State, $51 million. Georgia’s picture is far worse in that department: its tobacco prevention and cessation budget for FY2018 is a paltry $930,159, a mere 3 percent of the CDC’s recommended level. That despite $385.6 million in tobacco-related revenue that lands in Peach State coffers every year. OUR MOST PUZZLING Can cash-strapped states afford to take tobacco money LOCAL PRIVATE SECTOR currently used for general budget expenses away and devote it to SMOKING ENABLER anti-smoking programs? The American Lung Association reports on the findings of a 2012 analysis of Massachusetts’ Medicaid Ironically enough, University quit-smoking program: in just over one year the state saved Hospital promotes and $3 for every dollar it spent. In a more long-term study in 2013, encourages smoking California’s tobacco prevention program was found to save the state $55 in healthcare costs for every $1 invested between 1989 by offering convenient and 2008. designated smoking areas for Both Georgia and South Carolina might be able to bring their employees, visitors, and even Fs to at least Ds by raising the minimum age to buy tobacco patients on its main Walton products to 21. Currently it’s legal in both states at age 18. Way campus. + Please see BIG FAT F page 3

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AUGUSTAMEDICALEXAMiNER M E DI C I N E

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It could be worse Back in September I got some potentially bad news. Bad news can come in so many forms. It could have been notification that I was yet again not under consideration for the cover of People magazine’s “Sexiest Man Alive” issue. It could have been worse than that: forget the cover; It could have been that I wasn’t going to be included in the issue at all (which is what actually happened.) The wealthy benefactor who underwrites my tuba lessons could have summarily discontinued them. I could have discovered that my real parents were midgets (or the more politically correct term these days, “Shetlands”) and my 6’3” height all these years was fake. But none of those things happened. Instead, a doctor told me, “You have suit.” “You mean I can sue the hospital?” I asked, confused but recalling that I did trip ever so slightly walking in. “No,” he said. “What I mean is S.U.I.T.” At that point I had to ask him to just give it to me straight. Let me have it, doc. “You have cancer,” he said. At fi rst, this sounds like it has all the classic makings of bad news, doesn’t it? We got down to specifics, and he told me that S.U.I.T. is a medical acronym for “Something Up In There.” In other words, colon cancer. Whew. That was a close call. So the news was not so bad after all. You see, just days before someone had told me that a guy he knows has breast cancer. Now that would have been bad news. No one —and I mean no one — should ever get breast cancer, and if I ruled the world no one would. Not one woman. And definitely no guys. What’s worse than potentially fatal? Uh, how about embarrassing? I think if I had breast cancer I would have to make something up to tell people. “It’s the worst case of Greenburg’s Cyto-Plasmosis the doctors have ever seen,” I might say to friends and wellwishers. Or maybe, “I’ve got Stage IV Spastic Windpipe.” Speaking of windpipes, when you undergo your basic colon surgery, every single doctor, nurse, resident, intern, orderly, housekeeper, priest, encyclopedia salesman, temperaturetaker, candy striper, florist delivery

person, strolling guitarist and jellobringer who entered my hospital room day or night wanted to know one thing and one thing only: “Have you passed gas?” Excuse me? The way I was raised, this was not something we discussed in public. Especially not with total strangers. Or ever. Go ahead, call me a prude. It’s okay. I’m not ashamed. Even so, I was faced with the constant dilemma of how to answer this simple question. By the 100th time or so, lying seemed like the best option. Specific, highly detailed and richly embellished lies. I eventually rejected that option with great reluctance. Well-taught manners can be pesky things, can’t they? But I had other problems too. My granddaughter came up to the room to visit me. The next day her teacher, knowing this was a rough time for her, asked how I was. She thought for a moment and then said, and I quote, “His hair looked flat.” Note to self: next time you’re unable to shower for a day or two while under treatment for a lifethreatening condition like Stage IV Spastic Windpipe, try to figure out a way to wash your hair. Not that I really have a lifethreatening condition. My doctors seem quite comfortable with my long-term prospects. Chemotherapy, once upon a time a lot like having a mixture of 200° turpentine, nuclear waste, and industrial strength Neet pumped through your body, is a lot more user-friendly these days. Mine is the new chunky style chemo with zesty Italian seasoning. The IV bag actually reads, “Now with zero trans fats!” I fi nd that very chemotherapeutic. All things considered, my prognosis looks decent, but I still can’t shake the regret that it happened in the fi rst place. My doctor told me that if they had discovered this even a week earlier, the diagnosis probably would not have been colon cancer. That was a surprise. Really? “If we had caught it earlier, I think it would only have been semi-colon cancer,” he told me. Just what I need: a stand-up comedian for an oncologist. +

“Have you passed gas?”

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EDITOR’S NOTE: The Medical Examiner is always begging readers to tell their stories for Medicine in the First Person, so I thought it only proper that I tell mine. Thankfully, it isn’t exactly new. The tale above describes events from well over a decade ago, the fall of 2006. A few months thereafter, this article appeared in Columbia County Magazine.

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AUGUSTAMEDICALEXAMiNER

FEBRUARY 2, 2018

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THE REAL COST OF SMOKING In January the financial information site WalletHub released the results of its study of the state-by-state lifetime costs associated with smoking. Its conclusion: “Smoking doesn’t just ruin your health. It can also burn a nasty hole through your wallet.” Their figures bear out the claim: The total economic and societal costs exceed $300 billion every year, which is in addition to the 20 million lives claimed by smoking-related illnesses since 1964 when the U.S. Surgeon General’s landmark report on smoking was issued. Here are the local numbers.

Total Cost Per Smoker

Out-ofPocket Cost

Financial Opportunity Cost

Healthcare Cost Per Smoker

Income Loss Per Smoker

Other Costs Per Smoker

GEORGIA

$1,156,444

$86,932

$730,268

$119,262

$208,231

$11,751

S. CAROLINA

$1,202,648

$92,517

$777,180

$129,717

$191,344

$11,891

How the figures above were calculated: Out-of-Pocket Cost is based on the cost of a pack of cigarettes per day during a lifetime of smoking, beginning at age 18, ending at death at age 69, the average age at which smokers die. Out-of-pocket cost, therefore, is the total number of days in 51 years multiplied by each state’s average cost of a pack of cigarettes. Financial Opportunity Cost calculates the value of the out-of-pocket cigarette expenditures if they had instead been invested in the stock market over the same 51-year period. The total is the historical market return rate for the Standard & Poor’s 500 minus inflation over the same 51 years. Healthcare Cost Per Smoker is from state-by-state data from the Centers for Disease Control on annual healthcare costs directly attributable to smoking divided by the total number of smokers in each state. Income Loss Per Smoker is a reflection of data showing that smokers experience income loss from a variety of factors, including absenteeism, lower productivity due to smoking-related health problems, and workplace bias. Overall the loss in median household income for smokers is 20 percent compared to nonsmokers, but a recent Federal Reserve Bank of Atlanta study found that only 8 percent of the loss is attributed to smoking and the other 12 percent to other factors. The figures shown above therefore reflect the 8 percent income loss. Other Costs Per Smoker involves a formula of calculations that include additional homeowner’s insurance costs for smokers versus non-smokers and healthcare costs for people with conditions caused by secondhand smoke. Total Cost Per Smoker (the first column) is the added total of all the columns to the right. Costs per smoker per year (based on similar formulas as above): Georgia - $22,675; South Carolina - $23,581 + — Source: WalletHub

BIG FAT F… from page 1 The American Lung Association’s recommendations for the state of South Carolina are as follows: 1. Increase the price of tobacco products through cigarette taxes 2. Increase the scope of comprehensive smokefree air laws 3. Increase funding for the state’s tobacco prevention program Their top three recommendations for Georgia are:

GEORGIA $3,182,695,641 TOTAL ANNUAL ECONOMIC COST 17.9% ADULT SMOKING RATE 20.6% ADULT TOBACCO USE RATE 10.8% HIGH SCHOOL SMOKING RATE 3.2% MIDDLE SCHOOL SMOKING RATE 11,690 SMOKING ATTRIBUTED DEATHS 1. Increase tobacco control program funding 2. Increase the scope of comprehensive smokefree air laws 3. Substantially increase the price of tobacco products

S. CAROLINA $1,906,984,487 20.0% 22.8% 9.6% 4.8% 7,230

through taxation, including electronic smoking devices Anyone and everyone can and should urge their employers to create and enforce no smoking workplace policies. +

Why don’t doctors get sick all the time? In the midst of this terrible flu season, that’s a logical question. The simplest answer is that doctors and nurses do not have some magical superhuman immunity from disease. They get sick from time to time, just like everyone else. But do they get sick as often? In most cases, the general answer is no. For one thing, since they’re seeing sick people all day every day (granted, not every branch of medicine deals with communicable diseases), they are as a group more conscientious than non-medical folks about such things as hand washing. A busy doctor might wash or sanitize his or her hands more often every day than most people do in a week. Doctors also know the symptoms of conditions most likely to cause problems and also how those sicknesses spread, and in such situations they take extra precautions, such as wearing gloves, gowns and masks. Healthcare providers are also more apt to be up to date on their annual vaccines and other preventive measures. For some hospitals and medical practices, vaccinations for everyone on staff is mandatory policy. The same is true for sick time. Showing up for work when sick with something communicable to patients is a violation of policy at many hospitals and medical practices. Then again, sometimes there is no such policy and medical personnel are expected to carry on. “You say you’re sick? That’s why we’re here. Come on in!” Some doctors swear that, beginning in medical school or early in their residency, they have been exposed to at least a mild case of just about every commonplace sickness under the sun, and as a result they have developed a certain degree of natural immunity. Finally, doctors and nurses are surrounded all day every day by co-workers with lots of medical training and experience. Someone might spot a co-worker’s earliest symptoms before their colleague is even aware himself, and in so doing take steps to head off the progression of the illness. +

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

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FEBRUARY 2, 2018

#60 IN A SERIES

Who is this? ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com by Marcia Ribble

ike most (if not all) of the 59 people we have previously profiled in this series, this man was a certified genius. Unlike most of them, however, he was not recognized as one for much of his career. Why? Just look at the picture. Percy Lavon Julian had the misfortune to live in an era of overt racism. The grandson of slaves (his grandfather, in fact, had two fingers cut off as punishment for learning to write), he was born in 1899 in Montgomery, Alabama, and became one of the 20th century greats in the field of chemistry. His work saved countless lives. His academic career began in 1916 when he was accepted to DePauw University in Greencastle, Indiana. Arriving there, he was warmly greeted by an upper classman at the train station. It was the first white hand he had ever shook. He graduated first in his class in 1920, but was discouraged from going on to graduate school for racial reasons. Instead, he took a teaching position at Fisk University, a historically black college in Nashville. There he was awarded the Austin Fellowship in Chemistry, allowing him to attend Harvard, where he earned a Masters degree in 1923. Still unable to find a major university where a black professor could teach white students, Julian taught at West Virginia State College for Negroes before becoming an associate professor of chemistry at Howard University. In 1929, Julian received a Rockefeller Foundation grant to study abroad, and earned his Ph.D. in Vienna in 1931. There he focused on organic chemistry and the study of soybeans. Returning to the United States and DePauw, Julian and colleague Joseph Pikl developed a process to synthesize a drug used to treat glaucoma from calabar beans. The discovery led to a position with Glidden as chief chemist for its Soy Products Division. (DuPont had offered jobs to both Pikl and Julian, but soon withdrew their offer to Julian, explaining they were “unaware he was a Negro.”) Glidden is commonly associated with paints and varnishes, but the company’s history includes acquisitions of companies (or parts of companies) as varied as Colgate-Palmolive and Durkee, the spice company. Soybeans were useful in the production of everything from plastics and paints to bread and margarine, all part of the Glidden portfolio. At Glidden, Julian developed a soy-based flame retardant used by the U.S. Navy that saved countless lives during World War II. Most notably, he devised a new process to synthesize estrogen, progesterone and testosterone from soybean oil in a technique he invented and patented (one of some 160 patents he held). The first pound of progesterone made in his Glidden lab, valued at $520,000 in today’s dollars, was shipped to the buyer, Upjohn, in an armored car. H also developed new methods of synthesizing cortisone, dropping the price from hundreds of dollars for a single drop to pennies. Although later years were kinder to the Julian family, his 1950 purchase of a home in the fashionable Chicago suburb of Oak Park (“a city,” Ernest Hemingway is alleged to have said, “of wide lawns and narrow minds”) was greeted with arson and a bombing, but several decades later the city named a middle school in his honor. Percy Julian was elected to the National Academy of Sciences in 1973, only the second AfricanAmerican to be so honored. He died of liver cancer in 1975. +

Today I listened to a recorded interview with a woman who worked for Health-eParadigm. HP is a provider of systems that collect medical information from all of a patient’s doctors in order to keep all of them equally informed about that patient. The reason for this is something that has concerned me before. Lack of knowledge of a patient’s conditions has led to medical decisions made without full knowledge of the patient’s conditions and needs that have been counterproductive for that patient. It can even be deadly when lack of knowledge leads to prescribing the wrong medicines, doing the wrong procedures, or otherwise putting the patient at higher risk than would have happened with more complete information. The program I heard was sponsored by the Medical College of Georgia in response to changes in Medicare’s MIPS (Merit-based Incentive Payment System) rules, particularly about value-based payments from patients and insurers. In addition to allowing patients and their insurers to lower the amount paid to practitioners, there are new financial penalties for non-complying doctors and hospitals who fail to achieve expected interoperability quality scores on the MIPS. Those are just a bunch of words that essentially say all of a patient’s physicians are on the same page, each having all the information about that patient, including allergies, procedures done, test results, and so forth, so they don’t make mistakes based on lack of knowledge. This was not so essential a generation or

two ago when our primary care doctors were more involved with our treatments and visited us in the hospital, acting as that information resource to our other doctors. But today, with hospitalists intervening between the patient and his or her treatments, and lacking complete information about patients, there is real danger for patients under medical care. This can result in patients being prescribed too much or too little of the medicines they normally take, or getting medication they are not supposed to take due to allergies or adverse effects. I have ITP, which in its simplest form means I have too few platelets to clot normally. If I was given even a small dose of anti-clotting medication, I could bleed to death. That I have ITP is something I could tell doctors if I’m conscious, but if I was unconscious after a bad accident, they might not have that information available to them. After surgery, it isn’t unusual for doctors to prescribe anticlotting medication to prevent patients from getting clots which could lead to pulmonary embolisms. For most patients, blood thinners are a normal part of many surgical procedures. For me, with already thinned blood, this could be a horrific mistake that could kill me, even if the surgery itself was successful. Even if it didn’t kill me, it could mean I would need infusions of clotting factors (platelets) to restore my blood’s ability to clot. Those platelets, in my blood type, may or may not be immediately available depending on how many patients have needed them and what blood product supplies are on hand. The interview I heard was on Top Docs Radio on November 28, 2017. +

MYTH OF THE MONTH The fresh versus frozen debate There are people who would almost rather swallow strychnine than knowingly eat foods that were frozen, not fresh. That choice is their right. But if the choice is based on a belief that frozen foods are not as healthful and nutritious as fresh, that is a belief that is, well, on thin ice. This is not necessarily a news flash, but the nutritional content of foods cannot be measured with a thermometer. If a food was

nutritious before it was frozen, it will still be nutritious when it is thawed out, prepared and served. Freezing doesn’t affect fats, protein, fiber, calories, carbohydrates, sugar, or most vitamins. Some foods go into the freezer crisp and thaw soggy, so there are definitely some good reasons to prefer fresh over frozen. But nutrition is not usually one of those reasons. +

FEBRUARY 2, 2018

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AUGUSTAMEDICALEXAMiNER

WHAT EVERYBODY OUGHT TO KNOW

ABOUT WHAT WE THINK WE KNOW

ifteen hundred years ago, everybody knew the Earth was the center of the universe. 1,000 years ago, everybody knew the Earth was flat. 500 years ago, everybody knew man would never fly. 200 years ago, everybody knew man would never go to the moon. 100 years ago, everybody knew that if you got pneumonia and were fat, you had a 90% chance of dying within the month. 100 years ago, everybody knew that if you had “sugar” (country shorthand for sugar diabetes) you would die within a few years. 50 years ago, everybody knew that if a middle-aged woman had pain in all four body quadrants and no other physical signs, she was a complainer who just wanted attention. But now we know science has changed all that. The sun is the center of our solar system, which is only a tiny part of the universe. The Earth is round, so you can’t sail off the end of the Earth and drop off into empty space. Man has walked on the moon. We even have pictures of Earth from the moon. Nowadays if you get pneumonia, most likely

you will be treated at home with antibiotics and various inhalants. If you develop diabetes mellitus, you can eat healthy, take various pills and insulin shots, and expect to live for decades. Fibromyalgia is medically recognized and has 17 various points of pain scattered over all four quadrants of the body. It is more common in middle aged women and difficult to manage. All those things that were “known” to be true were not true. They were the fake news of their day. Just think how many things we know today that ain’t so. Think how time and research changes things. Some still cling to the thought that we should never have gone to the moon in the first place. They say it cost too much just to find out the moon was barren and dry and not made of cream cheese like the childhood fairytales said. But had we not gone to the moon, we might not have computers, fiber optics, GPS in our cars and boats, flat screen TVs, cell phones, microwave ovens, arthroscopic surgery, cardiac caths, cardiac pacemakers, gamma knife surgery, cardiac

t s e B defibrillators, laparoscopic surgery, birthday cards that sing, or laser light halftime shows at the Super Bowl. But all that progress comes with a heavy price. Our world population has ballooned to about 7,600,000,000 worldwide. That means we need much more food, water, clothing, medicine, buildings, transportation, and energy. It means populations become desirous of the property and resources of others and try to get those resources however they can. That means more war, death, and famine. In the U.S. we set up a Social Security system to assist our seniors in their retirement. It was designed for a population which worked until age 65, retired, and died with a few years. It was designed when the life expectancy was in the low 60s. But today, life expectancy in the United

e n i c i d ME

States is the late 70s and steadily inching toward the 80s. The Social Security trust fund no longer exists. Instead, Social Security payments are a general obligation of the US Treasury. All of that is well and good, as long as our workers pay in more than retirees take out. But with ever-increasing longevity in the US, that will lead to a shortfall. That is another way of saying we will run out of money. So what can we do? We can’t take away the medical technology we have and cause life expectancy to decrease. No, we must depend upon science to produce new knowledge that will produce a healthier society who can and will continue working past age 65. We’re heading the right direction in that department.

We also must develop new energy resources that can and will support a greater production of food and goods at cheaper prices. Right now skeptics say that can’t be done. Let’s hope and pray that is one more “fact” that just ain’t so, just like the seven bits of “common knowledge that everybody knows” listed at the beginning of this column. As one of my medical professors used to say, it is better to not know so much than to know so much that isn‘t true. He also said that 80% of all inventions occurred in the past century. What we need is another century just like that, if not even better. I can’t wait to hear that some of the things we know as facts today turn out to be not true. Just remember, not all that long ago they designed elegant city districts so that horses were only allowed on alternate streets because ladies did not like to step in or smell horse manure. + Bad Billy Laveau is a retired Augusta MD who wields a pointed sense of humor.

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Southern Girls Eat Clean Savory Pepper Steak & Brown Rice Made with Grass-Fed Beef How do you feel about beef? Pepper Steak is a weeknight favorite in our home. My husband is the meat lover and even though I can take it or leave it, I have to say this is one of my favorite dishes made with beef. It has a lovely oriental flair and the veggies add color and texture to the dish. This meal is packed with flavor and your whole family will love it, and you can have dinner on the table in less than an hour. You may be wondering if beef is considered a clean food. Well, it is actually, but it’s because I use grass-fed beef instead of grain-fed beef. As I’ve mentioned before, we do not eat meat every day in the Rhinehart house. Sometimes we go two to three days without having meat at our evening meal. I try to stick to the rule of eating meat only once a day. If I have a meat at lunch then I don’t have it for our evening meal. Generally speaking, our goal is to eat less animal protein and more plant-based foods. However, we are not vegetarians (especially my husband) and stove top or in a rice cooker • Grass-fed beef is higher in we do enjoy animal protein and set aside. vitamin E, which has been a few times a week: beef, 2. Heat oil in a large sauté proven to lower the risk of chicken, turkey and fish. I pan over medium to high heart disease and cancer. simply try to purchase the heat. Vitamin E is a very strong cleanest possible option no 3. Add sliced sirloin steak antioxidant and can have antimatter which animal protein I to sauté pan and brown the aging benefi ts. Most of us are serve. steak, stirring often. defi cient in Vitamin E. Check out the differences in 4. Once steak is browned, add So go ahead and enjoy some grass-fed beef versus grain-fed: garlic, onion, red and green beef occasionally.....just try to • Grass-fed beef is much lower pepper and mushrooms, fi nd grass-fed beef whenever in fat. A sirloin steak from a toss with meat and cook possible. It will make your grass-fed steer has about 1/2 vegetables until tender crisp. body happy. to 1/3 the amount of fat than 5. Reduce heat to medium/ I hope you enjoy this recipe! the same cut from a grain-fed low, add beef broth and steer. It actually has about simmer. Ingredients: the same amount of fat as a 6. In a small bowl whisk • 4 cups of organic short or skinless chicken breast. together soy sauce and long grain brown rice • Grass-fed beef is much garbanzo bean flour. Pour • 1-1⁄2 lbs. of grass-fed sirloin leaner, and when meat is this steak, trimmed and sliced thin into sauté pan with meat and lean it actually lowers LDL vegetables. (Have your butcher cut the cholesterol levels. 7. Allow mixture to simmer meat for you) • Grass-fed beef is lower in until thickened, adding more • 1 Tbsp. of extra virgin olive calories too. Lower fat means broth if needed. oil lower calories. 6 oz. of grass8. Simmer for 10-15 minutes • 1 organic Vidalia onion or fed steak compared to 6 oz. of sweet yellow onion, cut in half on low heat. grain-fed steak has almost 100 9. Place a serving of rice and sliced thin fewer calories. • 1 organic red bell pepper, cut onto dinner plates and spoon • Grass-fed beef has extra Pepper Steak over rice. in half and sliced into strips Omega-3s, the most heart10. Serve immediately. + • 1 organic green bell pepper, friendly fats, 2-6 times more cut in half and sliced into good fats than grain- fed beef. * Information about the benefits strips NOTE: People who have of grass-fed beef was found • 1-1/2 cups of organic baby enough Omega-3s in their diet on the website http://www. Portobello mushrooms, sliced are less likely to have high americangrassfedbeef.com/ • 3 cloves of garlic, crushed blood pressure and they are grass-fed-natural-beef.asp and 50% less likely to have a heart • 1-1⁄2 cups of organic beef written by Jo Robinson, author broth (May need a bit more attack. of “Why Grassfed is Best.” to get the gravy to the right • The good fat in grass-fed beef (Omega-3s) lower the risk consistency) Alisa Rhinehart writes the blog • 1⁄2 cup of gluten free soy of cancer. Why does grass-fed www.southerngirlseatclean. sauce beef contain more Omega-3s? com She is a working wife • 1-1/2 Tbsp. of garbanzo Omega-3s are formed in the and mother living bean flour green leaves of plants. (Grass in Evans. Visit her is a plant!) When cows eat blog for more recipes Instructions: grass they have more Omegaand information on 1. Cook rice according to 3s, so in turn when we eat that clean eating. on the package directions meat, we benefit as well.

Savory Pepper Steak & Brown Rice

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NUTRITION Ashifa from South Augusta asks, “Is chocolate healthy?”

AUGUSTAMEDICALEXAMiNER With Valentine’s Day coming up, many people are wondering about chocolate. In contrast to what chocolate companies and their marketing and advertising campaigns want you to believe, chocolate is neither a food group nor a medicine. It is simply a confection. It’s a candy that can be enjoyed, now and then, for the pure pleasure of eating it. It tastes good, it smells good, it feels smooth and good in your mouth...but, it is not a “health food.” It is not a supplement for heart health, mood elevation, or a food to increase the antioxidant levels in your body. Yes, it is true that you can find evidenced-based factoids which show that certain chocolates have specific molecules in them. Looking at the forest rather than the trees, the presence of these molecules in chocolate are pretty insignificant when considering a person’s overall physical or psychological health. Chocolate is a high calorie, high fat, high sugar food and should be eaten in moderation, especially if you are overweight. Instead of soothing yourself with chocolate, adjusting your mood with chocolate, or using chocolate as a drug to increase the health of your heart...get your hugs, happiness and joy from your friends, from music, from art, or from playing sports. Don’t link your happiness to food. Food is to be enjoyed, it is to be shared, it is to be used to sustain. It is not to be used as a drug or as replacement for love or acceptance.

FEBRUARY 2, 2018

The typical American white or dark chocolate bar has approximately 230 calories per serving. 120 of those calories are from fat. That means the chocolate bar is over 52% fat. That also means, beware. When you are eating foods containing more than 30-35% fat, you should be eating these foods occasionally (or even better, eat them rarely), not every day. In addition, one candy bar has 9 grams of saturated fat, about 45% of all the saturated fat you should eat in a full day. Each serving of a chocolate bar can contain almost 22 grams of sugar. Do all these facts sound like chocolate is a health food? It is true that chocolate does contain stearic acid. Stearic acid happens to be a saturated fat, BUT, it is an exception to the rule. In the body, stearic acid is converted into the same unsaturated

fat found in olive oil (oleic acid), so it does not have that LDL cholesterolraising effect on your blood fats. Some chocolate (usually not the type you buy in supermarkets) even contains antioxidants. What is not true is the belief or expectation that, somehow, eating chocolate will make you healthier. It will not. A word of caution about eating raw chocolate or drinking beverages made from raw chocolate. Did you know it is very “in” these days to attend cacao ceremonies? However, do not be surprised if after consuming even just a small amount of raw chocolate or drinks made from raw chocolate that you experience a rush of rapid heartbeats. The active cardiovascular ingredient in cacao is theobromine, which is a compound related to caffeine. Theobromine has some beneficial cardiovascular effects at low concentrations, but at higher concentrations it may cause rapid heartbeats in some people. If your heart races after consuming cacao, avoid raw cacao and cacao ceremonies. What’s the “No-Nonsense Nutrition” advice for today? If you like the taste, smell and feel of chocolate in your mouth, then have some now and then. It is a delicious and fun food to eat. Just don’t expect “chocolate health miracles” to occur as a result. Happy Valentine’s Day. +

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

Dr. Karp

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AUGUSTAMEDICALEXAMiNER

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

THE SKINNY ON DETOXING by Meaghan Youngblood, MS-Dietetic Intern Every New Year is a time for new beginnings, new plans, and new diets, but are you also considering a detoxing diet or cleanse? During the holiday season, many of us can gain five to ten pounds from overeating and indulging in holiday sweets, but once the New Year arrives, the word “detox” may be on the minds of some. There is an overwhelming urge to undo all of the unhealthy habits done through the holidays as quickly as possible, to “cleanse” the body, and start the New Year off on the right foot. Everyone dashes to the gym and looks for the hottest new way to shed pounds fast. Companies sell cleanses and detoxes with promises of losing the undesired weight as quickly as possible, but is that the best longterm solution from a health standpoint? Are juice and soup cleanses or low carb diets the best way to nourish one’s body to achieve weight loss? Is there any scientific evidence proving that these methods of detoxification and weight loss are beneficial, or should these fads be avoided at all costs? According to a recent study published in the Journal of Human Nutrition and Dietetics, there is no scientific evidence on the efficacy of commercial detox diets,

even though companies may claim that these diets aid in removing toxins from your body and help you lose weight. The truth is that the human body already has the most efficient mechanisms of eliminating toxins effectively through the kidneys and the liver.

DETOX?

body of toxins and waste products that pose daily health risks. The liver is essentially the body’s fi lter system, converting toxic substances into less harmful ones and passing them along to the kidneys to be excreted in the urine to prevent toxins from accumulating. The gastrointestinal system, skin, and lungs also participate in these metabolic detoxifying processes, helping to rid the body of unwanted substances. The Academy of Nutrition and Dietetics suggests that eating a diet rich in fruits and vegetables, preferably five to nine servings per day, along with plenty of fiber from plants and whole grains, is a simple way to support the body’s natural detoxification processes. Maintaining adequate hydration is also crucial to support these metabolic pathways. Commercial detoxification trends can come with safety concerns that consumers may not be aware of and pose danger to the very organs that detox naturally. Most cleanses are extremely lowcalorie diets that are very restrictive, eliminating entire food groups. Juice cleanses promote the sole consumption of various fruit and vegetable juice blends and eliminate solid foods and many essential nutrients like fiber. The Lemon Detox Diet, for example, eliminates the consumption of solid foods for up to 10 days and instructs dieters to only consume a special lemonade beverage. According to the National Center for Complementary and Integrative Health, this extreme calorie restriction can lead to headaches, fainting, fatigue, dehydration, and malnutrition and can be harmful to people who

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Therefore, the best way to “detox” is simply to eat a variety of whole foods that provide optimal nutrients to support digestion, absorption, liver and kidney function. Of course, this may not sound quite as appealing as shedding any and all unwanted weight in a mere matter of days, but if eliminating toxins and feeling clean and renewed is the end game, then a balanced diet is the best medicine. The liver and kidneys play a starring role in ridding the

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nursing, or those with a history of kidney problems. The U.S. Food and Drug Administration has even taken action against several of these companies because their products contained illegal and potentially harmful substances. No scientific studies have confi rmed claims that these diets support weight loss, and those individuals who do experience weight loss from energy-restricted diets may not be successful in maintaining these results in the long-term, as it is often a result of water excretion. The calorie restriction and increased stress on the body can increase instances of appetite stimulation and binge eating.

What is the bottom line for commercial detox diets and cleanses? The health risks seem to greatly outweigh the benefits, if any, and a number of health and scientific organizations agree that cleanses and fad diets are best avoided. They more often than not include the elimination of vital nutrients your body needs to eliminate toxins and unwanted substances on a daily basis. For optimal health, maintain a healthy balanced diet and consult a registered dietitian nutritionist before trying any special diets to ensure they are safe, and promote overall wellbeing. A registered dietitian nutritionist is specially trained to help you with your health and nutrition needs. Visit www.eatright.org

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for additional information. + References: https://nccih.nih.gov/health/ detoxes-cleanses http://www.eatright.org/ resource/health/weight-loss/ fad-diets/whats-the-deal-withdetox-diets http://easacademy.org/trainerresources/article/cleanse-detoxmyths https://www.lemondetox.com. au/the-program.php Klein, A V, and H Kiat. “Detox diets for toxin elimination and weight management: a critical review of the evidence.” Journal of human nutrition and dietetics: the official journal of the British Dietetic Association., U.S. National Library of Medicine, Dec. 2015, www.ncbi.nlm.nih.gov/ pubmed/25522674.

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We’ve just added this shirt to the haul winners of the Mystery Word contest receive — in addition to gift cards from Wild Wing Cafe and Scrubs of Evans.

FIND THE WORD AND ENTER TODAY! Remember: the Mystery Word is always hidden. It is never in plain sight and it’s never in an article. See all the deets on page 14.

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FEBRUARY 2, 2018

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AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf — posted by Uzma Khan, MD, on January 24, 2018

BEING A DOCTOR ISN’T GLAMOROUS. BUT THIS PHYSICIAN KEEPS COMING BACK FOR MORE. My last clinic patient of the day was a frail, elderly man. I initially found him to be ornery. He had the air of someone who was chronically irritated. He was also incredibly hard of hearing. Due to the awkward setup of the exam room and computer, his wheelchair was positioned in such a way that we sat side-by-side. His wife sat sleeping in her chair, her pearls gleaming under the fluorescent light, red lipstick applied perfectly. Their caregiver stood between them. I asked him a few times before he finally heard me how he was feeling. With a disgruntled expression on his face, he said he had a back problem and couldn’t turn to face me. His caregiver and I clambered over the computer and gurney to wheel him around so we could sit face-to-face. We stared at each other. For all his frailty he was very well-dressed, someone who had been very successful professionally. His hairless head hovered between hunched shoulders. Eyeglasses sat atop his nose. Clear hearing aids were housed in each ear. He seemed a very serious man. “You’re a lady doctor,” he said. “Yes, I am. Surprise!” I quipped, my attempt at a polite answer to his assumption. “How are you feeling? What would you like to discuss today?” He paused and looked down. Then he looked back at me and said quietly, “Well, my wee-wee system isn’t working.” “OK. What do you mean by that?” hoping my question would open a floodgate of descriptions of urine color and stream strength. He didn’t answer. I knew I was going to have to prod a little more. I asked him many questions about his urine and his urinary habits. My next question elicited more of an answer and the true insight into what was bothering this man: “Tell me about your bowel habits.” He sighed deeply. “I’m having trouble. I haven’t gone in a week. I think that is the mess I’m in and it’s causing problems with everything.” His forehead was wrinkled, eyes intense. I told him not to worry, that I had some stuff that could help him. For the fi rst time in twenty minutes, his face softened, his eyes twinkled, and his mouth turned upwards in a half-smile. “Oh, good! You’re saying I’m full of crap?” He eyed me cautiously, testing my humor. “Well, yes probably. It sounds like you need to poop!” He finally laughed, and I joined him. He looked relieved. Well, emotionally relieved, at least. He didn’t want an enema. We created a plan together. I told him he could call me if the plan didn’t work. When I stood up to leave, I saw him try to kick one quivering leg off the foot stand of his wheelchair. His caregiver and I looked at him. “What are you doing?” she asked. “I’m trying to stand up and greet the nice doctor,” he insisted. I assured him he could thank me from his wheelchair. I held out my hand, which he grabbed and shook with both hands. As I left the room, I heard him say “Thank you for listening to me.” By no means do I consider my job to be glamorous. But I do realize the impact I can have on one individual person. And that’s what keeps me going back for more. +

The ornery patient finally smiled

Uzma Khan, MD is a hospitalist who blogs at meandmystethoscope.com

Editor’s note: With author Rebecca Skloot and the family of Henrietta Lacks in town for an event at the Imperial Theater (February 8 at 7:00 p.m.), this seemed like an appropriate time to revisit our book review from the August 6, 2010 issue of the Medical Examiner.

Have you ever heard of Henrietta Lacks? Perhaps, but probably not. Her somewhat obscure place on the pages of medical history should not be misinterpreted: the story of Henrietta Lacks is a complicated and riveting true story of, as Publishers Weekly says, “medical wonders and medical arrogance, racism, [and] poverty,” and that’s just scratching the surface of this truly fascinating and important story. How important? Every person walking around without cancer owes a tremendous debt of gratitude to Henrietta Lacks. Polio couldn’t have been cured without her. AIDS research is happening with help from Henrietta Lacks. Don’t get the wrong idea: it’s not like she worked in some research lab or something. In fact, she died young, a victim of cervical cancer. It was in death that she made her immortal contribution to medical science. And we’re not using that word “immortal” metaphorically: there are

billions of Henrietta’s cells thriving and multiplying this very second in labs around the world. They’re called HeLa cells in her honor. Scientists had been trying to keep cell cultures alive in laboratories for research purposes for decades, but sooner or later they always died — until Henrietta, that is. Her cells multiplied prolifically, and are still doing so today. They’re apparently immortal. Even though her family refused permission for the

routine original sample, it was taken anyway. The theft was something like stealing a rustedout Yugo, only to discover it contained billions of dollars worth of diamonds in its trunk. Henrietta’s cells were an inexhaustible supply of revenue to the tune of billions of dollars. But her family was never informed, nor were any funds ever shared with them. The story of the immortal life of Henrietta Lacks then, is more than just an inspiring story of a medical oddity that by chance contributed to mankind’s knowledge of diseases and their cures; no, it became a moral story, a true life lesson in medical ethics born of the racial climate of the era (she died in 1951). Skloot’s account of the entire story is scrupulously researched, yet reads like a novel — an engrossing and heartbreaking novel. Highly recommended. + The Immortal Life of Henrietta Lacks by Rebecca Skloot, 324 pages, published in February 2010 by Crown.

Research News Omega-3 = cancer fighter An article published last week in the Journal of Nutritional Biochemistry reports on research by professor David Ma at Canada’s University of Guelph. Ma was looking into existing evidence that omega3s from both plants and fish are protective against cancer. His goal was to see which one - if either - was more effective. Ma exposed laboratory mice to either plant-based or marine-based Omega-3s from conception, in utero. The mice were then given a highly aggressive form of human breast cancer (HER-2). Among the mice exposed to marine- or fish-based Omega3s, the size of the tumors were reduced by 60 to 70 percent, and the number of tumors was reduced by 30 percent. The same effect was observed using plant-based Omega-3s, but it took a much higher dose.

Based on his findings, Ma recommends that fish should be a staple in our diets two to three times every week. Flu virus kills pancreatic cancer cells A diagnosis of pancreatic cancer isn’t the death sentence it once was, especially if it’s caught early. Even so, it is a form of cancer that tends to develop and spread rapidly, often resisting treatment. Researchers have been looking for ways to make pancreatic cancer cells more responsive to drug therapy, and researchers at London’s Queen Mary University have discovered a promising approach. A genetically modified flu virus is designed to target and then bind to cancer cells. The virus then multiplies rapidly inside the cell, causing it to burst and die. As the virus replicates, it kills the tumor cells completely. The

researchers have further engineered the virus so that it can be administered through the bloodstream, tracking down and invading cancer cells that have spread anywhere in the body. The initial results have come from studies with mice; clinical trials with humans are planned within the next two years. The researchers say it takes about 5 years of follow-up to determine whether the therapy is safe and effective. Menopause worsens RA A study published Jan. 28 in Rheumatology suggests that women with rheumatoid arthritis experience greater declines in physical function after menopause. RA often shows changes coinciding with hormonal events like pregnancy and childbirth. Discovering why may help protect and maintain full physical function longer. +

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AUGUSTAMEDICALEXAMiNER

THE EXAMiNERS

FEBRUARY 2, 2018

THE MYSTERY WORD

by Dan Pearson

I need to take a break and close my eyes for a few minutes. For eye strain? That really won’t help.

Looking at the back Because when you do that of my eyelids? Why not? your eyes are still working.

The Mystery Word for this issue: LIPL

EXAMINER CROSSWORD

PUZZLE ACROSS 1. Exclamation by Scrooge 4. Worthless person 8. He wrote “Graceland” 13. Nothing 14. Forearm bone 15. Unify 16. Potpourri 17. Student follower 18. Beer mug 19. Overjoy 21. Chicago player 22. Trump VP 23. Hotelier 26. Former AU URL 29. Archives 33. Mess up 34. Peach add-on 38. Legal science 39. Female deer 40. Steam bath 41. Doc’s org. 42. Admiration 43. Strong current due to tidal flow 45. Impair 46. Suitable for Lent 48. William Faulkner’s home town 50. Official recorder 54. Bibb County (GA) seat 57. Cry of a cat 58. Type of circus 62. Decree 63. Composition in verse 65. Information concerning recent events 66. Willow twig 67. Italian bread 68. Short film excerpt 69. Guide 70. Each or every (Scottish) 71. Belonging to him

20 23

21 24

44 48 51

Click on “READER CONTESTS”

47 50

VISIT WWW.AUGUSTARX.COM

QUOTATION PUZZLE

25 29

58 64

E N B E O I G A T Y L O S D T S

B I O C

T T O K

F G D T G R H A A N E T E I R E O S P A — Thomas Helm

DOWN 1. Auditorium name 2. Operatic melody 3. Johnson, former chairman of the Augusta National 4. Prefix meaning lower or below 5. Radio starter 6. Unwarranted 7. Possibly 8. Punish with a temporary ban 9. Physician still in training 10. Manner, attitude, look 11. Of the ear 12. Hawaiian goose 13. Hollywood’s Saldana 20. Prefix meaning within 24. Profession of care 25. Luxury hotel (in Spain) 26. Decoration; award 27. He wrote and directed Jerry Maguire 28. _____Jackets 30. Seat of Georgia’s Wheeler

O M H D

County 31. _____ Building (in downtown Augusta) 32. Expanse of grass 35. It keeps pills in place 36. Humble dwelling 37. Black bird 43. Go back in 44. Test 47. Small medicated lozenge; pastille 49. Augusta’s ______ Market 51. Noted architect 52. Capital of South Korea 53. Emulate Miley? 54. Houses converted from stables (British) 55. Mine entrance 56. Quote a passage 59. BLT builder 60. Certainly (Archaic) 61. Viper 64. Extinct flightless bird Solution p. 14

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.

X A M I N E R

1 7

2 8

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 above. All the listed letters following #1 are the first letters of the various words; the letters following #2 are the second letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.

O 1 2 3 4

NUMBER SAMPLE: BY

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

O 1 2 3 4 5 6

1 2 3 4 5 6 7 8 9 10

M 1 2 3 4 P N 1 2 3 4 5 6

O 1 2 3

’

1 2 3 4 5 6

A 1 2 3 4

1 2 1

1 2 O 1 2 3 4

— Albert Einstein

1.THROATOEDFIST 2.SOHEVOONTHAIN 3.PECLEAAMRE 4.SYRPESTE 5.YONE 6.NTN 7.H 8.I 9.N 10.G

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

WORDS

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

FEBRUARY 2, 2018

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AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE

Moe: Well, fifteen years ago today I asked my high school crush out on our fi rst date. Joe: Aww. Moe: And yesterday I finally asked her to marry me. Joe: Aww. Moe: And both times she said no.

he Atlanta Falcons walk into a bar. To watch the Super Bowl.

Moe: Did you know the moon landings were all fake? Joe: Really? Moe: They were all Hollywood productions, every one of them. Joe: They sure looked real to me. Moe: That’s because the director was such a perfectionist he insisted they be shot on location.

Moe: What do you call a crying snake? Joe: A weptile. Moe: Are you still living the single life? Joe: Not me. Moe: I thought your girlfriend broke up with you when you stole her wheelchair. Joe: She did. But I knew she’d come crawling back to me.

We’ll, we’ll, we’ll, if it isn’t AutoCorrect.

Moe: I feel depressed today. Joe: You should do what I do. Moe: What’s that? Joe: I got a bumper sticker for my car that says “Honk if you think I’m sexy!” Moe: How’s that supposed to help? Joe: Whenever I’m a little down I just sit at green lights until I start to feel better.

Moe: Did you hear about the tragic accident at the fair? Joe: No, what happened? Moe: The Human Cannonball was killed. Joe: Oh no! I bet they’ll have a hard time finding another performer of his caliber. Moe: I used to be in a band. Joe: What was the name of it? Moe: Missing Cat. Ever see us play? Joe: No, but I’ve seen your posters all over town.

A man is washing his car one fine Saturday afternoon with his son. The son says, “Dad, why can’t you use a sponge?” +

Why subscribe to the MEDICAL EXAMINER? What do you mean? Staring at my phone all day has had no affect on ME!

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

SUBSCRIBE TO THE MEDICALEXAMINER +

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

Advice Doctor

Moe: What country has the fastest growing capital? Joe: Probably Ireland. Moe: Why Ireland? Joe: Because every year it’s Dublin.

ha... ha...

The

STATE

Dear Advice Doctor, Here’s the situation, doc: I’ve been a stay-at-home mom ever since the kids were born, but now I’m back in the workplace again. My husband gets home from his job a little after 4:00 o’clock; I don’t get home until after 6:00. I want him to cook supper and have it on the table when I get home. In return I’ll do the dishes and clean up the kitchen. He is fighting me on this. He says he’s tired when he gets home. Like I’m not??? I don’t think he has a leg to stand on in this argument, but he won’t budge. How can we solve this? — Kitchen Conflict Dear Kitchen, There really is no excuse for something like this to happen, especially these days. There are so many resources available for people like your husband who don’t have a leg to stand on. And let’s face it; living as we do near a major military base and hospital in a time of long-term war and terrorism, amputations are probably going to be an issue for the foreseeable future. Here are a list of resources, local and beyond, to help get you started: • Georgia Rehabilitation Services: (404) 232-3910 or www.vocrehabga.org • South Carolina Vocational Rehabilitation Department: (803) 896-6500; toll-free in-state: (800) 832-7526 or www.scvrd.net • Amputee Support Group of Augusta: (706) 823-8504 • limbsforlife.org • amputee-coalition.org (site includes global resources for amputees seeking assistance outside the U.S.) • abilitytools.org/resources/amputee-resources.php • nationalamputation.org (especially for “Links” and “Tips for New Amputees”) • heathermills.org (the ex-wife of Paul McCartney lost her left leg below the knee when struck by a police motorcycle in London in 1993; her website has some practical “tips and advice for amputees, their families and friends”) The major takeaway for any person who experiences the loss of a limb is that life does go on. It may seem like life will never be the same again, and while that may be true, those who have been through the experience often say life after an amputation isn’t necessarily worse, it’s just different. Humans are amazingly adaptable and resilient. + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will only be provided in the Examiner.

Why read the Medical Examiner: Reason #41

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

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+ 14

THE MYSTERY SOLVED The Mystery Word in our last issue was: DENTIST ...cleverly hidden on the scrubs in the p. 1 ad for INTERNATIONAL UNIFORM THE WINNER: BRYNN YON Want to find your name here next time? If it is, we’ll send you some cool swag from our goodie bag. The new Mystery Word is on page 12. Start looking!

AUGUSTAMEDICALEXAMiNER

FEBRUARY 2, 2018

THE PUZZLE SOLVED B Z E O L E L M E D A L

C R O W E

M E W S

A D I T

A R I A

H S O U O B T E I N N G E D U R O R E S E R I N T E N R E G C O N I C T T H E E E R

C L O C K

U N D U E

C H A U P T I M P E I

S E O U L

M A Y B E P A A R N A I D O T R W E M R O K A

S U S P E N D E X A M

I N T E R N

M I E N

O T I C

N E N E

A L A M F O R E D N E C L H I

L A M A R

S W A R D

I A W S I P S

SEE PAGE 12

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

WRITER WANTED

The only reason for time is so that everything doesn’t happen at once.”

The Sudoku Solution 6 9 8 2 7 4 5 1 3

3 2 5 9 6 1 4 8 7

4 7 1 3 8 5 2 6 9

1 6 9 7 5 2 3 4 8

7 3 4 8 1 6 9 2 5

8 5 2 4 9 3 6 7 1

2 8 7 6 3 9 1 5 4

9 1 6 5 4 7 8 3 2

5 4 3 1 2 8 7 9 6

QUOTATION QUOTATION PUZZLE SOLUTION: “My test of a good book is dreading to begin the last chapter.”

READ EVERY ISSUE ONLINE

— Albert Einstein — Thomas Helm

The new scrambled Mystery Word is found on page 12

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FEBRUARY 2, 2018

15 +

AUGUSTAMEDICALEXAMiNER

FIFTH IN A SERIES

The vitamin alphabet Right about now you might be thinking it’s time for a Letter to the Editor of the Medical Examiner, perhaps demanding a refund. After all, our previous issue profiled vitamin B3 and this one is looking at B5. What happened to B4? Good question. Once upon a time, there were so many vitamins in the B family that they started using numbers and letters. There was, indeed, a B4 back in the day, and a B8 and every other number through B17 — plus B20 and a bunch of letter Bs like Bf, Bm, Bp, BT, Bv, Bw and Bx. What happened to them all? They’re still around, but they’re like Pluto; it was initially considered to be a planet, but upon further review it didn’t fit the definition and was relegated to dwarf planet status.

Similarly, the substances that have been kicked out of the B family may still have the same beneficial and healthful properties they always had (in most cases), but upon further review they didn’t fit the definition of a vitamin. Hence the gaps in numbering. There is no vitamin B4 even though the substance once described as B4 (choline) is still an essential dietary nutrient. It just isn’t a vitamin. Another disinherited member of The House of B: pangamic acid, once called vitamin B15. Pangamic acid is basically whatever the seller of it decides it is. The FDA views it as “not an identifiable substance” and its many purported uses have led it

to be labeled as a “quack remedy.” You may have heard of PABA (or pABA), which is short for para-aminobenzoic acid, an ingredient often

used in sunscreens since it has UV-blocking capabilities. Well, PABA was once known as vitamin B10. No longer. But on to our story. Vitamin B5 is also known as pantothenic acid. It is an essential nutrient, found in nearly all foods, and its job is helping in the oxidation of fatty acids and carbohydrates. Certain enzymes which the body uses pantothenic acid to make are involved in metabolizing amino acids and cholesterol, among other substances. A vitamin B5 deficiency is pretty rare, but if and when it happens it can result in acne and parasthesia, the medical word you and I would call “pins and needles,” aka tingling, prickling, numbness or burning

sensations without any apparent cause. Well, the cause might be a dietary lack of vitamin B5. The history of this vitamin isn’t a long one. A biochemist named Roger J. Williams discovered it in 1933. We will see his name again in future articles in this series. His older brother, Robert, a noted biochemist in his own right, didn’t discover thiamine (vitamin B1) but in 1933 he was the fi rst to synthesize it. The following year Robert isolated 1/3 of an ounce of thiamine, but it took over a ton of raw materials (in this case rice polishings) to make enough thiamine for that third of an ounce. Roger considered Robert the inspiration for his career in biochemistry. Whole grains, egg yolks, sunflower seeds and liver are great sources of B5. +

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AUGUSTAMEDICALEXAMiNER

IT’S A QUESTION OF CARE How can I best show my love and care? by Amy Hane, a licensed Master Social Worker in South Carolina and Georgia, an Advanced Professional Aging Life Care Manager and also a Certified Advanced Social Work Case Manager.

In this month of love, February, we often contemplate the best way to show our love to those special people in our lives. In a prior column, I wrote about what love is: Love is a commitment, love is a decision, love is action. One way we show our love for those who are important to us is with our gift of time. This is particularly special to the elderly people in our lives. We live in a very busy time, when our attention is diverted between work, the road, screens, etc. We often don’t focus on the people right in front of us. The typical 90-year-old

person, if they live alone and are still somewhat independent, often does not leave the home much at all. They certainly do not work or volunteer the way they might have 10, 20, or 30 years prior. Typically when you’re in your 80s and 90s, every day feels the same. So to have someone come and sit with you for 45 minutes or an hour and share a simple meal or just talk about old times or current times is such a gift. They will be glad to share stories – yes, you may have heard them before, but just listen. Don’t even look at your cell phone or your tablet when you’re with them,

FEBRUARY 2, 2018

unless you’re using it to show them pictures. They will always appreciate you visiting them, or even calling them on the phone. If you don’t have a lot to talk about with them, you can play cards or a game. Just be sure you choose an activity that they can do and not feel frustrated while playing. Since their memory for past events is probably much better than it is for current happenings, another idea is to look through old scrapbooks together. You will not only be giving them a precious gift, you will find that you are blessed in return. +

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ALLERGY

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

AMBULANCE SERVICE

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706-863-9800

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

FAMILY MEDICINE

DENTISTRY

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

Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Floss ‘em or lose ‘em! Thomson: 706-595-7825 Primary Care Rates

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

DERMATOLOGY

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

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

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

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Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Parks Pharmacy Augusta 30904 437 Georgia Ave. 706-733-3373 N. Augusta 29841 www.GaDerm.com Vein Specialists of Augusta Resolution Counseling Professionals 803-279-7450 G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 3633 Wheeler Rd, Suite 365 www.parkspharmacy.com 501 Blackburn Dr, Martinez 30907 Augusta 30909 706-854-8340 706-432-6866 Karen L. Carter, MD www.VeinsAugusta.com www.visitrcp.com 1303 D’Antignac St, Suite 2100 Psych Consultants Augusta 30901 2820 Hillcreek Dr 706-396-0600 www.augustadevelopmentalspecialists.com Augusta 30909 Augusta Area Healthcare Provider (706) 410-1202 Your Practice Prices from less than $100 for six months www.psych-consultants.com And up to four additional lines of your choosing and, if desired, your logo. CALL 706.860.5455 TODAY! Keep your contact information in Steppingstones to Recovery this convenient place seen by tens of 2610 Commons Blvd. If you would like your medical practice listed in thousands of patients every month. Augusta 30909 the Professional Directory, Literally! Call (706) 860-5455 for all 706-733-1935 call the Medical Examiner at 706.860.5455 the details

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