Feb8 19

MEDICALEXAMINER

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February 8, 2019

AIKEN-Augusta’s most salubrious newspaper • Founded in 2006

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Waiting for snow, hoping, praying by guest columnist Garrison Keillor

HALF OF ALL HEARTS WHAT ABOUT THEM? SEE PAGE 6

YOUR

It has snowed a smidge in Minneapolis and I went to church Sunday to give thanks for it and ask for more. The TV weatherman talks about who might be “hit by” a snowstorm and who might “escape,” as if the flakes carry an infectious disease, but snow is light, it does not hit anybody so that you’d feel it, and true Minnesotans love a snowstorm, the hush of it, the sense of blessedness, as Degas loved the female form and Cezanne cared about apples. I thank God for all three, apples, women, and snow, and also for my good health.

I am an old man chained to a computer and I get less exercise than your average statue in the park. Meanwhile I avoid vegetables in favor of peanut butter and bacon sandwiches, I seldom wash my hands and often rub my eyes, my daily water intake is less than that of a small lizard, and yet I feel pretty darned good, knock on wood, whereas certain people I know who lead exemplary lives of daily workouts and hydration and veganism complain of insomnia, sharp stabbing pains, exhaustion, gassiness, and memory loss, so where is the justice, I ask you. How is it that the wicked prosper and the righteous suffer?

Please see KEILLOR page 2

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AUGUSTAMEDICALEXAMiNER

February 8, 2019

KEILLOR… from page 1

the first 40 years are always the hardest

The answer is: I have an excellent doctor.

I searched high and low for one, eliminating those with WASPy names like Postlethwaite or Dimbleby-Pritchett and those with old names (Amos, Portia, Naomi, Elijah) who maybe don’t know about antibiotics. I scratched very young doctors (Sean, Amber, Jared, Emerald) who maybe don’t understand geriatrics. I eliminated doctors who, when I called to inquire about an appointment, I was put on hold and heard flute music. I nixed doctors who had tassels on their shoes or whose M.D. degrees came from schools in Tahiti or Tijuana. And by the time I found a doctor, medical science had taken great leaps forward in the treatment of sedentary dehydrated germ-ridden men like me, so here I am.

My advice to the young is: Don’t sweat exercise. Eat what you want to eat. Live your life. Follow your heart. And be sure to marry well. I did that a quarter-century ago and it took me a while to realize it but now I feel buoyant around her and without her I’m just going through the motions. With her, I’m Mr. Successful, and without her I’m an old guy with soup stains on his shirt.

Thoreau said to advance confidently in the direction of your dreams and you’ll be successful, but he could’ve been more specific.

He himself was a failure, as an author and as a lecturer and at finding a date for Saturday night. When he said, “The mass of men lead lives of quiet desperation,” he was talking about himself. His classic, Walden, would’ve been a better book if there’d been a woman living in the cabin with him, but he only had

E! R U T A E F W

a hard narrow bed and was more interested in mushrooms than in being a fun guy. And he was a Red Sox fan.

Scientists have pointed out that fans of losing teams experience a 20 percent drop in testosterone. A cruel thing. Your warriors go down to defeat and you get up from the TV and your wife comes and puts her arms around you and you think, “Oh no, not this again.”

I’ve been a fan of the Twins (78-84), the Golden Gophers (3-6), the Democratic Party (1 out of 4, counting the Supreme Court), and country music (he gets fired, his wife leaves him, he gets drunk, she runs off with a successful orthopedic surgeon) so I’m running low on testosterone, but there is hope. The lessons last Sunday in church said so. The prophet Isaiah said, “You shall be a crown of beauty. … You shall be called My Delight,” which nobody ever said to me before. The psalm was about feasting, and in the Gospel of John, Jesus did his magic trick turning water into wine at the wedding. I was absolved of my transgressions and I prayed for my daughter and for the infant Ida Rose, one week old, and afterward people around me reached over and shook my hand. I pulled out a five to put in the collection plate and saw too late that it was a twenty and the usher had seen it, so I let it go. Fifteen bucks for a sense of hope?

Cheap at the price. And now I look out and see snow falling. +

You happen upon a condom in your 12 year-old daughter’s room. You don’t think she is sexually active. She hasn’t seemed very interested in boys and she is not away from adult supervision for any significant periods of time. However, you are still concerned that she has it. What do you do?

Used with permission of the author, Garrison Keillor. www.GarrisonKeillor.com

B. You have to have a talk with her. There’s no need to play games with it and, perhaps, put her in a position of lying to you. Be direct.

“I get less exercise than your average statue in the park.”

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by David W. Proefrock, PhD

A. Don’t say anything to her about it, but keep it. She will know you’ve found it and eventually talk with you about it.

B. Keep the condom and after a day or two ask her if she’s missing anything from her room. That will force her to talk with you about it.

C. Confront her with what you found and put her on restriction from all of her friends.

D. Tell her that you found the condom and talk with her about relationships, sexuality, and responsible behavior.

If you answered: A. Most kids would never say anything to you about a missing condom even if they knew you had it. You would miss an opportunity for an important talk about life that you need to be having with her soon anyway.

C. This is not a situation that calls for punishment. It is a situation that calls for communication.

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M.E.

THE AUGUSTA MEDICAL EXAMINER Augusta’s most salubrious newspaper

D. This is the best response. This situation presents an opportunity for a frank discussion about relationships, adolescent sexuality, and responsible behavior that you probably should have already started by now.

The key in this situation is communication and guiding your child and preparing her, the best you can, through a stressful and very scary period of adolescent sexuality. It matters less where she got the condom unless it was given to her by an adult. If that is the case, you have a whole different and more serious problem that I’ll cover in a later column. + Dr. Proefrock is a local clinical and forensic psychologist

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February 8, 2019

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In one of the Medical Examiner’s past comic strips, the couple is talking about whether a certain carpenter is qualified for some home improvement projects. “Yes,” comes the answer, “He’s board certified.”

Ironically, carpenters are never board certified, but many doctors are. Yet plenty of doctors aren’t. What does it mean?

If a doctor is board certified, he or she chosen to take (and has passed) a rigorous test that reflects their commitment to practice at the highest level of their profession. It’s going above and beyond. As the old joke goes, they call the person who graduates last in their class at medical school “doctor.”

That isn’t the case with board certification.

Just to qualify to take it, a person has already jumped through many very challenging hoops, like getting a 4-year premed college degree, then going through medical school and earning a medical degree. Even that isn’t enough to practice medicine, let alone be board certified. An MD degree is followed by anywhere from three to seven years in an accredited residency program. That, finally, entitles a person to attempt to jump through the final hoop of gaining a state medical license.

For some doctors, that’s the final step. Board certification is an extra commitment, but it’s temporary. It expires. That means board certification is a patient’s assurance that their doctor is continuing to study and is keeping abreast of all the latest advancements in the ever-changing field of medicine.

Board certifications are awarded in two dozen specialties, like pediatrics, general surgery (plus separate certifications for neurological and thoracic surgery), urology, ophthalmology, and more. The tests of each examining board are different.

For a growing number of healthcare providers, board certification is a job requirement.

A doctor who takes a board test and fails can call himself “board eligible,” which sounds more impressive than it obviously is. Wondering if your doctor is board certified? Visit https://www.certificationmatters.org/ to find out. +

MEDICALEXAMINER

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February 8, 2019

AUGUSTAMEDICALEXAMiNER

#84 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

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here are so many interesting aspects and available side trips in the telling of this man’s story that it’s difficult to decide where to begin.

But to know that our subject, William Withering, was a botanist, chemist, and a physician is as good a place to start as any. Born in 1741 in Shropshire (UK), Withering heard about an old woman in the village, “Mother Hutton,” as the story goes, who practiced herbal healing. One of her concoctions for treating “dropsy” (congestive heart failure caused by swelling or edema) was a preparation made from foxglove plants.

Withering undertook a scientific study of the recipe, knowing the plants are toxic from their roots to their beautiful blossoms. In 1785 he published the first description in medical literature of foxglove’s active ingredient, identified

by Withering as digitalis. [Much of the plant’s identifiers are related to its appearance: its official name, digitalis purpurea, describes the “finger-like” appearance of its flowers (and their color); the common name arose from the first botanist to record the plant, the German Leonhard Fuchs in 1542, fuchs being the German word for fox; fuchsia plants are also named for him. “Glove” kept the finger-like imagery going.]

Publication of Withering’s paper launched a huge feud between him and Erasmus Darwin, Charles Darwin’s grandfather. Both were members of the Lunar Society, a dinner club and society for the learned elite that met monthly for many years beginning around 1765 in Birmingham, England.

Aside from Withering and Darwin, its members included such industrial and scientific heavyweights of the day as James Watt, Joseph Priestly and Josiah Wedgewood. The group’s name came, not from any particular interest in astronomy, but from its schedule of meeting on nights when a full moon made late night travels home safer in the days before street lights.

An entire chapter about the Society could be built around the events of 1791 alone. The group’s support of the French Revolution sparked riots in July of that year, often called the Priestly Riots, since Joseph Priestly, Society member and discoverer of oxygen, was one of the initial targets of rioters, who continued their rampage for the better part of a week. Priestly’s laboratory, extensive library and manuscripts were destroyed by rioters, who were said to have unofficial government blessing. Troops sent by King George III to quell the uprising took their time arriving, and the king said, “I cannot but feel...pleased that Priestly is the sufferer.” There is no record that Withering suffered loss or injury in the riots.

Although Withering’s discovery of the beneficial uses of digitalis in an otherwise toxic plant benefits cardiac patients to this day, the latest chapter in his story just surfaced about 90 years ago. Medical historians realized there are no references to “Mother Hutton” or any unnamed old woman in Withering’s papers. As it turns out, Mother Hutton was the creation of an artist for a 1928 ad campaign by Parke-Davis, the pharmaceutical company which marketed digitalis. Over the past 90 years she has grown from non-existent to an acclaimed genius whose research was stolen by Withering. In fact, the story of Mother Hutton is entirely apocryphal. +

by Marcia Ribble For many of us, parts of our past can be pretty gnarly, but also just plain funny.

Lately I have been trying to focus on recalling the funny parts of my past. I’m finding that with a little effort, more and more of the funny memories are walking back into awareness.

When I was about fifteen, my folks owned a bakery where we made and sold truly delicious pastries. Back in those days we used genuine lard in some of our recipes.

Lard came in large 200-lb. tins with tight fitting lids. When the cans were empty, we washed them out and sold them for $2 to customers who used them for a variety of purposes, like storing out of season clothes in the moth proof cans.

We kept a few of the cans out in the front part of the bakery to remind customers that they were available. To understand what makes this story funny, you need to know that my mother was a very proper woman who always behaved with the utmost dignity she could muster. You also need to know that our accountant, Mr. Tripp, was an even more proper gentleman who came in one afternoon a week to make sure my folks’ business dealings were all done very legally and thoroughly, from their paying of taxes on sales to their paying employees’ salaries.

One summer day, Mr. Tripp had finished his work in the bakery office. Aunt Helen and I were behind the counter waiting on customers. Mom was walking Mr. Tripp out of the store when he stopped to ask her a question. She stopped and, probably tired, sat down on one of the lard cans.

Lard cans with their covers on look solid

enough to sit on without a problem, but that appearance was deceptive. Let me also add that Mom was a slim 130 pounds at the time.

Nonetheless, the lard can’s cover folded itself in half and allowed Mom to fall, butt first, into the can. Her arms flew up and her legs flew up and there she was folded in half and stuck in the lard can.

Poor Mr. Tripp had no clue about what to do to help her out of that situation. Aunt Helen and I, meanwhile, were struggling — ­ and failing — ­ to control an overwhelming urge to fall out laughing. We were laughing so hard we could barely breathe, let alone help Mom out of the can. Finally we all came to our senses and helped her get out of the can. And that was that!

Looking at my 15 year old self, I understand how I found so much humor in my mom’s precarious position in the lard can. I am sure that at times I had sat on those cans myself without falling in. I’m equally sure that Aunt Helen had sat on those cans, too. As in most bakeries, there were no seats for employees in the store front or the bakery back. We worked from 7 am until 6 pm, so getting tired and wanting to get off our feet was normal. The humor came from the total surprise of the lid collapsing and Mom falling into the can, an absolutely unexpected outcome, especially since both Aunt Helen and I weighed more than Mom. I doubt we would have fit into the can like Mom did.

Remembering funny stories is good for us.

It can help us relax, elevate our mood and lower our blood pressure. It can also help to place our lives into better perspective rather than focusing on less happy aspects of our lives. +

BREAD IS A NO-NO on MY DIET

Which will it be?

Many people believe that grain products like bread, pasta, and rice are inherently fattening and should be avoided when trying to lose weight. And we’re close enough to New Year’s to still be in Weight Loss Season.

A moment’s contemplation on this common belief should be

quite revealing. It boils down to choosing to avoid an entire food group. That’s not a decision that should be undertaken lightly. It carries with it significant risk of missing out on major sources of vitamins, minerals and fiber that a healthy body needs.

In truth, grains themselves aren’t necessarily fattening or unhealthy - although they can be. Assuming a person is choosing whole grain products, not refined or enriched grains, they are getting healthful and salubrious foods. Examples of

the good stuff include whole wheat bread, brown rice, and whole grain cereals and pasta.

A related myth is that eating gluten-free foods means eating healthier. For good health, that restriction should be reserved for people diagnosed by a physician as having celiac disease. Gluten is a protein found in many grains, but a gluten-free diet is not a weight-loss diet. Avoiding products with gluten is another way to short-change yourself nutritionally. +

February 8, 2019

AUGUSTAMEDICALEXAMiNER

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Musings of a Distractible Mind

by Augusta physician Rob Lamberts, MD, recovering physician, internet blogger extraordinaire, and TEDx Augusta 2018 speaker.

Reach him via Twitter: @doc_rob or via his website: moredistractible.org

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February 8, 2019

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was talking with a few friends not long ago when one of them asked, “What do In a world where the patient is a participant you do when your patients don’t take the (and possibly “non-compliant”) here are the medications you prescribe?” rules I follow: I think he was expecting me to to be Dr. • The patient always deserves my respect, Furious and lash out against the patients who and should always perceive that respect. It’s don’t give proper respect for my authority. not enough to respect them, I’ve got to show Most people have heard how irritated many that I do. doctors get when patients are non-compliant.

• It’s their body, not mine. I can think it “Well,” I said, hesitating, “I guess I just ask makes sense to have surgery or take a medthem why they aren’t taking them. There’s ication, but they are the ones who have to got to be a reason for it, and I try to figure out get cut on or put the foreign substance in why. It could be that the prescription costs their body, not me. I cannot assume that just too much; it could be that they are afraid of because I prescribe or recommend something side effects; it could be that they heard somethat they will act on it without question. thing bad, or have some other bias against • I may know more about medicine than the medication for a reason I don’t know; or it they do, but they know more about their could be that they just don’t understand why own bodies. There is an old saying in mediI think they should be on it in the first place.” cine, “the patient will always tell you what is It is an important question: what happens wrong with them.” In other words, it is our when the patients don’t cooperjob to listen, to ask questions, ate? What does patient-centered to discuss things with them I don’t care if you and care look like with non-compliant so that we can know what is looked it up on going on. Many docs are far too patients? quick to disbelieve symptoms If you look up the word Google. the patient reports, and so many “compliance” in a thesaurus, the first synonym is “obedience to.” patients are afraid to tell of sympThis implies that non-compliant patients are toms that “don’t make sense.” This can lead disobedient patients. This is borne out by to mis-diagnosis. patients when they “confess” they haven’t • It’s more important to get it right than to be taken prescribed medications: they look guilty right. If the patient comes up with the diag— like they are expecting to be scolded. nosis then hooray. I don’t care how we come This flies in the face of the assumption that up with it. Who cares if they looked it up on doctors should be in control, and the patient’s Google? I look up my non-medical problems job is to obey what they’ve been told. Docon Google. Should plumbers, electricians, or tors, after all, give “orders” for things, and geologists be mad at me when I look up inforthe Rx on our prescriptions translates as “take mation in their areas? I could care less. It’s my thou.” We are the captains of the HMS health- pipes, my wires, and my...rocks. care, aren’t we?

• I want my patients taking responsibility for Perhaps this was the case before the Intertheir health. As I said before, what happens net, when doctors were often the only source between appointments is far more important of medical information. People could go to the than what happens in them. This means that library and look things up, but most didn’t my job is now one of teacher, interpreter, and take the time. Times have changed. Now all encourager. If I can’t explain why they need of the information I’ve got and knowledge I a medication, they shouldn’t take it. If they gained in my training and during my practice have questions, fears, or concerns, I want to is available to anyone any time. hear about them. Most of all, I don’t want This changes the whole dynamic of the repeople worrying about being scolded when lationship between doctor and patient. Many they come to my office. I’m not their mom. would say this is for the worse, but I disagree. In the end, it’s their choice. If after explaining, Doctors should welcome questions from our listening, educating, and even warning, peopatients; they might just point us in a direcple don’t follow my instructions, I’m OK with tion we hadn’t considered. With this mindset, that. My job is to let them know the risk of I’ve seen patients open up to me much more their choices. Once I’ve done my part, I don’t about things because they perceive that what lose any sleep about their choices. they say matters. I respect what they have to As it stands, I feel my patients are quite say about things, so they talk to me and don’t compliant with what I recommend. They hold back on their fears or concerns. This comply as long as I’ve done my side of the means that people are much less scared to agreement, and they tell me if they don’t do talk to me about important things like alcoas I recommend. I wish other docs would holism, depression, or their concerns about lighten up and stop thinking we are in the medications they are taking. All of these Marcus Welby world of prescriptive medicine. things allow me to give better care.

We aren’t, thank goodness. +

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HALF OF ALL HEARTS

Since our previous issue, the American Heart Association (AHA) has announced that nearly half of all hearts in America have heart disease.

This revolting development is partly artificial: it stems in part from the 2017 change in the definition of high blood pressure (hypertension).

Millions of people with exactly the same BP they had before the change are now considered to be hypertensive

even though they weren’t two years ago. (The definition of hypertension was 140/90. The new standard we want to be lower than is 130/80.)

That change alone meant that overnight, the prevalence of hypertension went from just over 30 percent to more than 45 percent. And overnight, 25 million Americans suddenly had heart disease.

The change was made to reflect just how important it is

the

Money Doctor

to keep blood pressure under control. Experts say about 80 percent of all cases of heart disease could be prevented by controlling blood pressure, high cholesterol and diabetes, along with stopping tobacco use.

But keeping the focus on blood pressure for one more paragraph, the AHA has some good news/bad news figures: if all the cases of high blood pressure were removed from heart disease statistics, the overall rate for Americans would drop from 48 percent to just 9 percent.

That’s how many people have hypertension.

While that sounds like pretty great news, 9 percent of all Americans still translates to more than 24.3 million people who have other causes for their cardiovascular disease (CVD).

The list of alternate culprits includes heart failure, stroke, atherosclerosis (hardening of the arteries), angina,

February 8, 2019 abnormal heart rhythms, and so on.

The various manifestations of heart disease are, in turn, the side effects of routine features of American life: lack of exercise, high-sodium diets, obesity, stress and anxiety, diets low in fruits and vegetables and high in fat-rich foods, cigarette smoking, and so on.

Such a lengthy list of things so common tells us our work is cut out for us. As one of the AHA study authors noted, “healthy” is not the default setting in this country.

Our communities are not built for commuting by bicycle or mass transit.

Walking is not always safe (more studies released last week say U.S. pedestrians have never been in greater danger of fatal accidents).

Processed foods and sugary drinks are far less expensive and more convenient than healthier foods like fresh fruits and vegetables. Even though smoking rates continue their steady fall, even healthcare providers (like University Hospital locally) encourage smoking by

offering convenient designated smoking areas for their employees.

So our culture, locally and nationally, may not be structured to make healthful change easy. But life and health are certainly worth the best effort we can give them.

And the encouraging news about heart health is that it improving it is within the grasp of literally everyone. Can you (can I?) do something physical for 30 minutes a day - even if it’s only for 10 minutes at a time? Can we work to reduce our stress level? Can we join the 21st century and give up cigarettes if we’re still among the dwindling few (the latest numbers: about 15 percent of adults still smoke)? Can we eat more fresh fruit every day? More vegetables? Can we make sure we know our BP and cholesterol numbers and work to keep them under control?

If all or even some of those answers are yes, that amazing machine inside us that beats 100,000 times a day just might reward us with a few hundred million more beats. Cool. +

IT’SYOURTURN! Coming up in our next issue.

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!

“My leg was broken in three places.”

“This was on my third day in Afghanistan.” “I lost 23 pounds.”

“We had triplets.” “He was just two when he died.”

“The smoke detector woke me up.” “It took “She saved 48 stitches.” my life.”

“I sure learned my lesson.”

“The cause was a mystery for a long time.”

“The nearest hospital “They took me to the hospital by helicopter. ” “I retired from medicine was 30 miles away.”

“I thought, ‘Well, this is it’.” seven years ago.”

“Now THAT hurt!”

“OUCH!”

“Turned out it was only indigestion.”

“He doesn’t remember a thing.” “I’m not supposed to be alive.” “It was a terrible tragedy.”

“And that’s when I fell.” Nothing seemed “The ambulance crashed.” “It was my first year “At first I thought it was something I ate.” to help, until... “It seemed like a miracle.” of medical school.”

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.

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AUGUSTAMEDICALEXAMiNER

GARDENvariety

It took me a while to be converted to back-eyed peas vs. my Hoosier navy beans I grew up with. But once I did, there was no turning back. That’s why I love this recipe where the south meets traditional hummus with a twist. Not only is it great tasting, it’s very nutritious.

For example, black-eyed peas help prevent anemia since they are an excellent source of iron. Iron is needed for the production of red blood cells which carry oxygen from the lungs to the rest of the body. When a person is deficient in iron, their body does not produce enough red blood cells and they become anemic For pregnant women, black-eyed peas should be a key part of their regular diet. They contain nutrients that are vital to a healthy pregnancy, such as fiber, protein, folate, iron, and more. Folate, or vitamin B9, is an essential nutrient for a healthy pregnancy. This vitamin plays a significant role in DNA synthesis, and research shows that folate deficiency raises the risk for spina bifida and anencephaly.

Black-Eyed Pea Hummus Another good reason to eat these tasty little beans • 1/2 cup virgin olive oil is they are a great source of protein.

One cup of black-eyed peas contain 13.3 Instructions grams of protein, which is 27 percent of Combine all ingredients in a food your recommended daily allowance. This processor, blend until creamy and smooth, impressive amount makes black-eyed peas a about one minute great substitute if you’re trying to cut back Place in a serving bowl, top with a few on animal protein, or if you’d just prefer to whole black-eyed peas and red pepper have more plant-based foods in your diet. flakes. Serve with soft pita bread or crackers. Refrigerate up to one week. + Black Eyed Pea Hummus Ingredients

by Gina Dickson, Augusta wife, • 2 cups canned black eyed peas, drained mom and grandmother, colon and rinsed cancer survivor, passionate • 2 tablespoons tahini about creating a community to • 1/4 teaspoon red pepper flakes help women serve healthy meals • 1 teaspoon apple cider vinegar to their family. Visit my blog at • 1 teaspoon pink Himalayan salt thelifegivingkitchen.com

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AUGUSTAMEDICALEXAMiNER

ASK DR. KARP

NO NONSENSE

NUTRITION Kaitlin, a Facebook friend from Dallas, Texas, writes “I know that high fiber foods are healthy to eat, but do I have to graze to have good nutrition?”

Yes, Kaitlin, eating foods high in fiber is a very healthy thing to do. However, unlike those Texas longhorns, you do not have to graze to have good nutrition. I like the way you asked the question. Many people have the mistaken idea that high fiber foods are tasteless, hard to chew, hard to digest, make

you very “gassy” and are practically impossible to include in your diet. This idea is further advanced by all those silly commercials pushing high fiber supplements, high fiber drinks, high fiber bars and high fiber cookies.

Seriously? It underscores the point that you need to get your nutrition information from scientific sources, not ads or commercials.

Last month (January 2019) some very important studies about fiber and health were published in the prestigious medical science journal The Lancet. These studies are extremely powerful science and you need to take them very seriously. What do I mean by “extremely powerful science”? The studies are based on people who were part of 185 prospective studies and 58 clinical trials. Wow, these are super-studies!

The studies found a very large decrease (15–30%) in heart attacks, heart disease, strokes (including dying from strokes), diabetes, and cancer when comparing people who eat foods higher in fiber to people who have a low-fiber diets.

In addition, people eating foods with more fiber weigh less, have lower blood pressures and have lower blood total cholesterols. The more high-fiber foods you eat, the

Lentils are a great source of fiber that offer an added prep bonus.

greater the effect. Be aware, however, that there is no reason to go “fiber-crazy.”

Remember that if the fiber in your diet is too high (more than 30-35 gms/day), the fiber can interfere with the absorption of some minerals and other nutrients. It is

February 8, 2019 never a good idea to simply focus on one specific food or nutrient in our daily diet.

Instead, look at your overall eating patterns.

About your “grazing” comment, yes, I know that those commercials give you the impression that it is impossible to get all the fiber you need from food, so you need to buy their products. I am sure that you’ve seen that lady walking around grazing on broccoli all day. It may be funny to look at, but it’s simply not true. If you eat fruits and veggies and whole grain breads and cereals, it’s easy to get lots of fiber each day.

For example, in the morning are you in a hurry? Take a pear or apple and eat it while you drive to work.

Don’t stop for a fast food sausage/egg biscuit. Do you actually have more time to sit down for a minute and eat in the morning? Have some low-fat yogurt with the pear, mix some berries in with the yogurt and maybe sprinkle everything with cinnamon or ginger. Have a slice of whole grain toast with olive oil margarine with this quick, easy little breakfast. This simple breakfast meal has all the food groups (protein, dairy, grain, fruits/veggies) and it is low fat, low salt, high fiber, high calcium, healthy and delicious.

Want a “fancier” Sunday morning breakfast? Make a mushroom, onion, garlic, broccoli, tomato, “Egg-Beater” type (or egg white) omelet, serve it with whole grain toast and put 4 strawberries on the plate for extra color, for taste and for fiber, too.

It’s a great Sunday breakfast.

Here’s a very easy thing to do for dinner: instead of serving a side of plain rice, mix the rice with some lentils when you cook it.

Chop up some red and green peppers and throw that in, too. Lentils are very high in fiber and they are so easy to prepare. Most beans have to be soaked before cooking, but with lentils, you can cook them just like rice and simply mix them in with the rice if you want, to add more interest. Make sure and chop up some scallions, cilantro or parsley (or all 3) and throw them on top before you serve your rice/lentil side. You can even sprinkle on some toasted almonds.

Once you start looking for fiber opportunities, they’re everywhere.

What’s the “No-Nonsense” advice for today? Yes, high fiber foods are extremely healthy, so you need to eat more of them. No, you don’t have to graze to have good nutrition. +

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 find 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 financial 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 meant to be used to diagnose, manage or treat any patient or client.

Although Dr. Karp is a Professor Emeritus at Augusta University, the views and opinions expressed here are his and his alone and do not reflect the views and opinions of Augusta University or anyone else.

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AUGUSTAMEDICALEXAMiNER

Ask a Dietitian FEBRUARY IS AMERICAN HEART MONTH

by Tracey Neely, MS, RDN, LD

“I can’t eat heart healthy with my busy schedule.”

Whether you’re single or have a family, finding time for a good meal seems to be at the low end of our priority list. Work, school, and paying bills get the most attention. While we like the idea of living healthy, few of us commit. We’re more interested in a short-term fad than a lifestyle change that includes being more active and eating well. But change is possible.

First, adjust your attitude.

Be optimistic. You CAN make changes and set goals that work for you. You run your life. It shouldn’t run you. Regain control of what matters.

Adjust your priorities. Your health should be at the top of your priority list. Small steps add up over time. Committing to a few changes can make a real difference.

Second, realize that you don’t have to be a great cook to pull together a “HEARTY” meal for you and your family. Heart health means reducing saturated and trans fat and sodium while increasing high fiber foods. We all need a few “go-to” recipes on hand that are easy, affordable and we feel good about eating. Here’s one you might enjoy. Note the small steps that make this a healthier dish.

Can be made ahead or be on the table in 30 minutes.

Store any leftovers in single serving containers for lunch later in the week. All ingredients for this recipe were purchased at local Augusta supermarkets.

Small steps: 1) The sodium content of canned beans is reduced by 41% when you drain and rinse them in a colander under cool water. If you want to reduce sodium even more, buy beans and canned foods with “no added salt” on the label. You won’t find added salt in this recipe because the canned items and broth do add sodium to this dish. 2) Choosing super lean ground turkey breast significantly reduces fat when compared to traditional chilis. 3) Adding the bell peppers ups your veggie intake for the day. Pack in as many veggies as you can to this dish. It’s great with diced zucchini too.

Ingredients • 1 1/2 Tbsp. canola • 1 large onion, chopped • 2 large sweet peppers, diced (any color red, orange, yellow, green) • 1 pound fresh ground, turkey breast • 1/2 tsp. garlic powder • 2 tsp. chili powder • 2 tsp. ground cumin • 1/2 tsp. pepper • 15.5 oz. canned, pinto beans (rinsed, drained) • 15.5 oz. canned, black beans (rinsed, drained) • 14.5 oz. canned, diced tomatoes (undrained) • 1-3/4 cups fat-free, low-sodium chicken broth • 1 cup frozen whole kernel corn (or canned corn, drained) • 8 oz. canned, all natural tomato sauce (Hunt’s) Toppings: • 4 medium green onions sliced • 1 bunch fresh cilantro, chopped Please see DIETITIAN page 10

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“Go-To” Turkey Chili A warm bowl of chili for dinner on a cold evening is so satisfying. This recipe represents several small changes to make a healthier dish.

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AUGUSTAMEDICALEXAMiNER

*

welp

Find thumb Organs

Glands

Near Augusta GA Bones

Joints

Other

Thumb HHHHH

5.7 million reviews

The first, shortest and thickest digit on each hand Working now? It’s probably holding this newspaper Take-Out Available? No Good for: Holding everything and hitchhiking

( *

Tom T. Augusta, GA

H H H H H 1/31/2019 I’m not famous by any means, but I share my name with a very famous person. It’s not easy, especially since I’m 6’4”. +

Bubba J. Evans, GA

H H H H H 1/31/2019 Listen, I’m not proud of this considering that I’m 5-foot-8 and I weigh almost 300 pounds, but here goes: my wife has me completely under her thumb. And she weighs 100 pounds soaking wet. +

Alice B. Aiken, SC

H H H H H 2/1/2019 Well, as long as people are making admissions, I still suck my thumb. And I’m 28 years old! +

Noel O. Edgefield, SC

H H H H H 2/1/2019 In my opinion, the thumb doesn’t often get the respect it deserves. When I was in college I used mine to travel all over Europe. Best time I ever had, and I owe it all to my thumb. + H H H H H 2/2/2019 Thumbs. They get my thumbs up. Two, in fact. +

Tam W. Wrens, GA

Elmer F. Evans, GA

H H H H H 2/3/2019 I’m not saying I’m old, but I remember when strength was measured in horsepower. The power of a mighty horse! You had something there. Now they talk about thumb drives. Really, what is this world coming to? +

Carter K. Augusta, GA

H H H H H 2/3/2019 I’m out of work because of my thumb. I can’t work. I’m a carpenter - or at least I was until a nail gun shot a nail right through my thumb. I thought it was just an ordinary nail, but apparently it was a thumb nail. +

Jolene S. N. Augusta, SC

H H H H H 2/3/2019 I am quite an art connoisseur if I don’t say so myself. I visit art galleries wherever I travel looking for thumb prints. The kind I’m looking for are pretty scarce, though. +

Thomas E. Aiken, SC

H H H H H 2/4/2019 I don’t like it when someone thumbs their nose at me. +

Hannah Z. Ft. Gordon, GA

H H H H H 2/4/2019 I do like to read, but who’s got time these days? I wish I could say differently, but with three kids and two jobs, all I can manage these days is to thumb through a book every now and then. +

Fred M. Augusta, GA

H H H H H 2/4/2019 Sorry, but I have nothing good to say about thumbs. I’ve been accident-prone all my life. I’ve broken six bones, had dozens of bad sprains and thousands of cuts and bruises. And do you know why? I’m all thumbs, that’s why. +

Tina V. Aiken, SC

H H H H H 2/5/2019

February 8, 2019

DIETITIAN… from page 9 • 5.3 ounce, Skyr or Icelandic (Siggi’s) yogurt Directions Add the oil to a large stock pot or dutch oven on stove top.

Heat over medium-high heat, swirling to coat the bottom.

Cook the onion and peppers for 3 minutes, or until soft, stirring occasionally.

Reduce the heat to medium. Stir in the turkey. Cook for 5 minutes, or until browned, stirring frequently to turn and break up the turkey.

Stir in the garlic, chili powder, cumin, and pepper. Stir in the remaining ingredients except toppings. Cook for 5 to 7 minutes, or until heated through, stirring frequently. Adjust seasoning to taste.

Serving: Serve in warm bowls or mugs. Top with a tablespoon of plain Siggi’s yogurt and sprinkle with green onions and cilantro.

Small step: Siggi’s is all natural Skyr (Icelandic yogurt) and was used as a substitute for sour cream. + Nutrition Facts Serving size: 1-1/3 cups = 347 calories, 34 gm protein and 10 gms of fiber *recipe adapted from American Heart Association Disclaimer: Tracey is not compensated by any food company, brand or organization mentioned in this article. She is sharing her personal preferences for specific or brand items that you might also enjoy.

Tracey Neely is a “Georgia Grown” registered dietitian/nutritionist specializing in Disease Management, Wellness and Nutrition Education.

NEXT ISSUE:

THE MONEY DOCTOR

To view my work go to: scscja.org, then click on resources, then merchandise - a ring comes up, then click on PDF link.

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February 8, 2019

The blog spot — posted by Alexandra Lackey on Feb. 4, 2019 (edited for space and content)

DO YOU KNOW WHY YOU’RE HAVING SURGERY TODAY? During my third year of med school, I completed a rotation in surgery. I was certain it would be horrible. I envisioned myself in the OR getting lightheaded, passing out and being yelled at by my attending physician. My parents, both physicians, warned that I’d just be holding retractors for hours.

I want to interact with my patients, not just hover over them while they’re anesthetized.

During the first week, my opinion changed only slightly.

I wasn’t passing out in the OR, but I certainly wasn’t in love with surgery.

Then, on preoperative rounds, I met Mrs. Smith.

A frail 82-year-old, she suffered from diverticulosis and recurrent urinary tract infections. Her CT scan had revealed a colovesical fistula, an abnormal passage between the colon and the bladder. It was slated for repair later that day.

She lay quietly in her hospital bed as I examined her and collected her history. Her husband sat nearby.

“Do you have any questions?” I asked her.

“I guess not,” she said. Tears welled up in her eyes. “I’m ready to get this done with so I can begin chemotherapy.”

“You have cancer?” I asked, confused.

Her tiny, frail hands reached into the bedside dresser and pulled out a large yellow envelope containing a stapled fourpage document: her CT report. I saw no mention of cancer.

“It’s spread to my kidney!” she exclaimed with a sob. Mr. Smith began to cry, too.

“Who told you that?” I asked.

“No one told me; it says it there on the paper,” she replied, a bit impatiently. My eyes darted to the section about her kidneys. It described normal renal anatomy.

“Mrs. Smith, do you know why you’re having surgery today?” I asked.

“To take the cancer out,” she said, now clearly annoyed.

“Would you mind if I sit by you on the bed?” I asked. She nodded, and I sat down beside her. “There’s no indication here of a cancer diagnosis,” I told her gently.

I went through each section of her CT report with her, emphasizing that the findings were normal and that her renal cyst was most likely a normal variant.

“Oh, that’s wonderful!” Mrs. Smith said excitedly. She was even more elated to hear that the surgery would resolve her symptoms and get her back to living the life she’d once enjoyed.

Through tears of joy, Mr. Smith embraced her. “I thought I was going to lose you too soon,” he whispered.

I was thrilled to help change Mrs. Smith’s life so much for the better — but upset to think that a member of her care team handed her the CT report without explanation.

At Mrs. Smith’s two-week follow-up visit, she was doing well. When she thanked me profusely for helping her, I once more felt humbled and fortunate to be part of a profession that touches lives in such an important way.

From then on, I began including: “Do you know why you’re having surgery today?” in my preoperative questions.

Often, as with Mrs. Smith, the patients’ answers led me to offer more explanations and illustrations.

I found myself enjoying getting to know each patient before surgery. As horrified as I’d once felt about surgery, I fell in love with its ability to so dramatically improve someone’s life within a matter of hours. Although I lacked surgical skills, I found that I did have the skill to communicate with patients.

Above all, I learned that what takes place in the OR is critical to a patient’s recovery — but so are the words that help patients to understand what’s happening to them, and what they might hope for. +

“Who told you that?”

Alexandra Lackey is a medical student.

11 +

AUGUSTAMEDICALEXAMiNER

From the Bookshelf A compendium of excerpts from reviews of this book: “[Au] has a quick eye for comedy and a wry wit that must at times have helped her get through the daunting responsibilities that come with the white coat. The emotional complexity of her work gets full weight in these stories . . . An engaging writer who knows how to entertain, she is also a young mom on a learning curve, a wife who has negotiated a complicated partnership with a professional peer, and a caregiver who has learned how much of compassion depends on sustained awareness that every patient has a story in which she is offered a small supporting role.”

- The International Examiner “A refreshingly witty memoir . . . she tells her story with real wit and wisdom.”

- Points North magazine “She is brilliantly funny, has enormous emotional wisdom beyond her years, and

displays honesty and humility that brings the reader to the center of her journey, rather than preaching from a false ivory tower of medicine . . . should be required reading for all women interested in medicine and/or starting a family.”

- Mothers in Medicine “Honest, irreverent . . . hilarious and heart-breaking . . . this memoir is not just about how [Dr. Au] navigated the medical world. It’s about the life she wanted beyond the four walls of the hospital.”

- StudentDoc.com

“In this treasure of a medical memoir, Au makes doctors seem fallible and funny. She opens her book with her attempt, as a third-year medical student, to retrieve a stool sample from a 300+-pound 85-year-old. After some epiphanies (“I hate working in the pediatric emergency room”), she switches from pediatrics to anesthesiology.

Meanwhile, her boyfriend (now husband), Joe, picks ophthalmology, seemingly a good-hours specialty, but one that actually requires being on call every night for two years. After a colleague says he is sure she’ll find a “mommy job,” she does land a manageable-hour position.

Au seems to strike a good balance between being a good mom, wife, and doctor, and stays humble in the process. Get ready for a new appreciation for the training and life of doctors.”

— Karen Springen, Booklist This Won’t Hurt a Bit (and other white lies), by Michelle Au, M.D., 336 pages, published in May 2011

by Grand Central Publishing +

Research News A little dab’ll do ya Last week the Centers for Disease Control (CDC) issued a warning about excessive toothpaste use among children between the ages of 3 and 6. At that age, kids tend to swallow as much toothpaste as they brush on. The problem there is that swallowing excessive amounts of fluoride toothpaste, especially in relation to the small body size of children, can cause a condition known as dental fluorosis, which is another way of saying tooth discoloration.

The CDC cited a study which found that nearly 40 percent of children aged 3 to 6 use more toothpaste than recommended, leading to more toothpaste swallowing than recommended. For the record, kids in that age bracket should have no more than a pea-sized bead of toothpaste on their toothbrush.

An excuse to skip the gym Actually, that is the last thing we want to accomplish in this brief article. But we are in that annual period where one or two New Year’s resolutions may still be hanging on by a thread. Going to the gym is often one of those.

What follows, therefore, is designed to make you an informed gym user, not someone who avoids the gym like, well, like the plague.

You see, a recent study

by FitRated, a company that conducts consumer reviews of fitness equipment, found that gym equipment is absolutely swarming with bacteria.

The company commissioned a laboratory to visit three average gyms, all members of national chains. At each gym samples were taken from three treadmills, three exercise bikes, and three sets of free weights. The firm then analyzed the results back in the lab. The results showed that gym memberships can

offer a lot more than visitors bargained for.

The findings were expressed in the numbers of colonyforming units (CFU) per square inch. CFU expresses the number of viable bacteria cells found.

Free weights were the cleanest, relatively speaking, showing an average of 1,158,381 CFU in the nine set sampled. To put that into perspective, a toilet seat averages 3,200 CFU, meaning the weights had 362 times more bacteria.

Exercise bikes showed an average of 1,333,418 CFU in the nine bikes sampled. By comparison, a reusable plastic tray from a cafeteria was measured at 33,800 CFU. The treadmill average was 1,333,432 CFU, compared to an average of 18,000 found on a typical water faucet.

The message? Don’t be shy about disinfecting machines before and after using them.

Ditto for your hands. +

+ 12

AUGUSTAMEDICALEXAMiNER

The Examiners +

What on earth I just bought will you do with a 1,000 hamburgers. thousand burgers?

I’m on my way!

by Dan Pearson

Jeff Bezos of Amazon got his start flipping burgers, Uh, I think maybe he and he’s a billionaire. did a different kind of flipping.

How many do you want?

How do you figure that?

Get rich reselling them, that’s what.

February 8, 2019

The Mystery Word The Mystery Word for this issue: MURICAN

© 2019 Daniel Pearson All rights reserved.

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

EXAMINER CROSSWORD

PUZZLE

1

2

3

4

5

6

7

8

9

10

11

14

15

16

17

18

19

12

13

20 21 22 23 ACROSS 1. Friday starter, sometimes 24 25 6. Bobby and Barry 26 27 28 29 30 31 32 33 11. Corn holder 14. Mad 34 35 36 15. Revolutionary path 37 38 39 40 16. Mineral spring 41 42 43 17. Stair part 18. Mother-of-pearl 44 45 46 47 48 19. Former soldier’s abbrev.

49 50 51 20. Exceptional or significant 22. Knight follower 52 53 54 55 56 57 58 24. Medical prefix 59 60 61 62 25. Skin eruption 26. Impurifier 63 64 65 30. Masters champ (‘04, ‘06, 66 67 68 ‘10), to friends 34. Kent’s girl

by Daniel R. Pearson © 2019 All rights reserved. Built in part with software from www.crauswords.com 35. Snakelike fish 36. Came up 33. Flat shelf DOWN 37. Of the ear 38. Bobbins 1. Word before ball or bug 38. Ostentatious 39. Another name for Aaron 2. Eye part 40. Mild oath 46. Existing in a specific place 3. Coarse file 41. Hebrew letter 47. Embarrassed 4. Part of Aiken’s triple crown 42. Imitate a 49-er 48. Lubricant 5. Three lines of verse 43. The Hague (in Dutch) 50. Dog type?

6. Walton Way landmark 44. On the ocean 52. Augusta rarity 7. By mouth 45. Rebellion 53. ____ Park neighborhood 8. WAGT network 49. Submerged 54. Tea type 9. Without delay; frankly 51. Swiss capital 55. Portico 10. Harsh 52. Protect 56. Promote 11. Area abbrev.

55. Evade 57. Ultimatum word 12. Store door word 59. WTC setting 58. Dock 13. Sheet of matted cotton 60. Shallow flat dish 61. Gehrig’s initials?

21. Wrath 62. Garlic-flavored 23. Censure, reproof mayonnaise 25. Once more 63. Lyric poem 26. Hilo greetings 64. Serf of ancient Sparta 27. Sees 65. Habitual drunkard 28. Join 66. Marry 29. Ages 67. Analyze a metalic 31. Masters legend Ben compound 32. Son of Abraham 68. Store door word Solution p. 14

by Daniel R. Pearson © 2019 All rights reserved. Built with software from www.crauswords.com

s 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.

QuotationPuzzle T T T S

O E S S R R A T O F E U K O P S B O E H E H H E S

A P R T Y P P E W H

A N E S S I Y I

— Martin Luther King Jr.

by Daniel R. Pearson © 2019 All rights reserved

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.

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

1

2

3

4

5

N 1 2 3 4 5 6

NUMBER SAMPLE: BY

e x a m i n e r

S 6 7

1 2

H 1 2 3 4

1 2 3

H 1 2 3 4

1 2 3

H 1 2 3

1 2 3 — George S. Patton

1 2 3 4 5 6

1.B B Y Y W I S H H H 2.O O O O O U H I S I 3.GUUUCTTWE 4.NNTCH 5.CEO 6.MES 7.S

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

by Daniel R. Pearson © 2019 All rights reserved

WORDS

Click on “READER CONTESTS”

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February 8, 2019

13 +

AUGUSTAMEDICALEXAMiNER

TheBestMedicine ha... ha...

A

n elderly gentleman with a reputation for being very frugal was quite sick. His doctors feared the worst and told the family to gather for their final goodbyes. The man opened his eyes and whispered, “Is my wife here?”

“Yes, honey,” she said, grabbing his hand.

“I’m right here.”

“Are all the children here?” he asked.

“We’re all here, Daddy,” they said.

“And all my other relatives too?” asked the man.

“The entire family is right here for you,” one of them said.

At hearing that, the man struggled to sit up in bed and asked, “Then why are the lights on in the kitchen?”

Moe: That sure was some frigid weather we had last week.

Joe: You’re not kidding. One morning my windshield was covered in ice.

Moe: What did you do? Nobody around here has ice scrapers.

Joe: The only thing I had was my Kroger card.

Moe: Did it work?

Joe: No, I could only get 10% off.

A single guy was living with his elderly father and running the family business. He realized he was going to inherit a fortune once his ailing father died, and decided it was time to find a mate to share his life.

One day at the bank, he spotted the most beautiful woman he had ever seen and made his move.

“I may look like just an ordinary guy,” he said to her, “But one day soon my father will die and I’ll inherit 100 million dollars.”

Impressed, the woman asked for his business card.

A month later, she became his stepmother.

Moe: What do you call a headless duck?

Joe: A duck that didn’t, I suppose.

Moe: A duck that didn’t? Didn’t what?

Joe: Duck.

Moe: They say smoking marijuana causes short-term memory loss.

Joe: They do.

Moe: Also, I wonder if smoking marijuana has any side effects.

Moe: I need to come up with a strong password for this program.

Joe: How about 12345678?

Moe: How is that strong? That’s weak.

Joe: You think 2444666668888888 is weak?

Moe: Hey, you know any good pizza jokes?

Joe: Just that it’s all in the delivery.

Moe: I made a chicken salad for lunch.

Joe: That’s nice.

Moe: But the stupid thing won’t eat it. +

Why subscribe to theMEDICALEXAMINER? What do you mean?

Staring at my phone all day has had no Effect on ME!

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

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The

Advice Doctor ©

Dear Advice Doctor, I have a close friend who is always in a panic about one thing or another.

It’s almost aways about things we have no control over. Is this going to be a cold winter, will next summer be hotter than normal, will a certain store come to the area, or will one already here close? I tell her don’t sweat it if it’s beyond our control, and 99% of the time it is. But reasoning doesn’t seem to be working. How can I help her break her habit of needless worry?

— Calm Down Dear Calm Down, Everyone should have a friend like you who is caring enough to step in and try to help during difficult times. You are to be commended, and I agree that this is a matter which should be addressed.

This situation is actually a very serious quality of life issue that can affect employment, emotions, personal relationships, and the basic ability to enjoy everyday life.

As you have discovered, reasoning is a completely ineffective treatment for excessive sweat, although I certainly don’t fault you for suggesting it.

The official term for it is hyperhidrosis, and your friend is by no means alone: an estimated 2 to 3 percent of Americans suffer from some variety of hyperhidrosis or another. In some cases the excessive perspiration is localized, effecting only hands or feet, armpits, groin, scalp, or other areas. But sometimes it is generalized, meaning it happens all over the body. Some people experience hyperhidrosis of their scalp, face or chest after eating certain foods. It can begin at birth or just pop up out of the blue at any point in life.

Fortunately, doctors can treat this silent handicap. Step one is trying to determine the cause, even though strictly speaking, hyperhidrosis has no known cause. In some cases, however, excessive perspiration can be a drug side effect, a symptom of diabetes, a result of extreme anxiety, or an indication of a thyroid gland disorder.

Depending on the cause identified (or even if no direct cause can be isolated), a variety of tools are at a physician’s disposal to banish this problem, ranging from topical creams to botox injections, prescription medications, and even noninvasive surgical removal of sweat glands. Help is dfinitely available.

I hope this answers your question. + 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 be provided only in the Examiner.

Why read the Medical Examiner: Reason #53

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!

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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

Before reading AFTER reading

+ 14

THE Mystery SOLVED The Mystery Word in our last issue was: SODIUM

...cleverly hidden in the right tail light in the p. 8 ad for OVERHEAD DOOR

THE WINNER: KAYLA SHARPE! 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!

February 8, 2019

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED F I R E

I R I S

R A S P

A L O H A

D A T E S

U N I T E

S N O W

H Y D E

I C E D

S T E E P L E C H A S E

T B O E O R R N A C I A L E R I T E R A E S H O P A N I N S A N K L D S P L A T H E L O A S S A

N D S B I T C R E E R A C N N T E L W Y U R G B E R I D E E A T S Y E

C S R R A E P H R O E G H A E N N S T I O O U N T

SEE PAGE 12

O P E N

B A T T

I S A A C

L E D G E

E L S E

P I E R

The Celebrated TheSudokusolution 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 for 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.

Love to stare at your phone?

Visit issuu.com/ medicalexaminer and stare away.

QuotatioN QUOTATION PUZZLE SOLUTION “The surest way to be happy is to seek happiness for others.”

— Martin Luther King Jr.

WORDS by NUMBER “Success is how high you bounce when you hit bottom.”

— George S. Patton

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February 8, 2019

15 +

AUGUSTAMEDICALEXAMiNER

Coming soon!

Advice Doctor ©

Will he ever get one right?

E

R

L

Winners of the Medical Examiner’s celebrated Mystery Word Contest will soon be sipping their tea and coffee (or some other salubrious libation of their choice) from these cool custom mugs.

When we’ve already used the word “soon” twice EDICA M so far, it unfortunately means it won’t be this week, or even next. That’s because these babies are custom XA made from the ground up. Literally. We have people MI NE out digging up clay as we speak.

In fact, this mug is merely a prototype, so the final prize might look exactly like this, or it might look slightly different. But no matter what the end result is, we guarantee it will be nifty and locally designed, built and fired.

If you’re a winner between now and delivery day, this mug will be like money in the bank. So please be patient. And please be on the lookout for the Mystery Word.

Details on pages 12 and 14.

The

Probably not.

+

Questions.

And answers.

On page 13.

MEDICALEXAMINER

TM

NOWWITH EASIER SUDOKUS!

Because really, how much fun is a puzzle you can never solve?

+ 16

AUGUSTAMEDICALEXAMiNER

IT’S A QUESTION OF CARE How do I know when my elderly parent needs additional care?

1. Observe the foods in their home.

Look in the refrigerator. Are there expired foods or open packages that look questionable? Look in the pantry as well: Are there random cans of food but nothing to put together to prepare a simple, but decent meal?

2. Investigate their mail and bills.

If you see mail that is unopened or stacks of bills that appear to be unpaid, dig deeper. Your parent might not be paying their bills on time, and instead they may be sending donations to every solicitation they receive.

3. Check their laundry and housekeeping skills. As people age and begin to decline cognitively, they will go through the motions of doing laundry but may fail to add detergent, so their clothes are not clean. They may claim they are performing housekeeping duties, but you notice their home is cluttered and dirty, and

February 8, 2019

you know this isn’t typical. This is common when they either cannot keep up the demands of the home, whether physically or cognitively. Often, their ability to judge an acceptable standard is compromised.

4. Look at their personal care habits.

If they were always fastidious about their hygiene and you note that they are not bathing regularly or brushing their teeth or combing their hair, there’s often a problem.

5. Seek feedback from others. You can attend social activities with your parent and inquire if the people there regularly see your parent(s). People who live alone or are beginning to experience symptoms of dementia may claim they are still going to church, meeting friends as normal or grocery shopping regularly when they are not. Asking others will help you know if they are still doing what they claim they are.

6. Assess their driving skills. If Mom or Dad insists on driving and you are brave enough, ride with them and observe for yourself! You can also ask neighbors what they have seen of your parent’s driving habits near their home. Are they driving 55 in a 25 mph residential zone or perhaps the opposite: 25 mph on a busy road?

If any of the checkpoints highlight a problem, it might be time to consider hiring non-medical in-home care or begin investigating assisted living. The decision should be based upon your parents’ needs and their financial situation, in addition to your availability and willingness to check on them and provide some of the help that they are beginning to require. +

by Amy Hane, a licensed Master Social Worker in South Carolina and Georgia, an Advanced Professional Aging Life Care Manager and a Certified Advanced Social Work Case Manager.

PROFESSIONAL DIRECTORY +

ALLERGY

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

AMBULANCE SERVICE ambulance • stretcher • wheelchair

706-863-9800

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

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

YOUR LISTING HERE Your Practice And up to four additional lines of your choosing and, if desired, your logo.

Keep your contact information in this convenient place seen by tens of thousands of patients every month.

Literally! Call (706) 860-5455 for all the details

IN-HOME CARE

DENTISTRY

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

Floss ‘em or lose ‘em!

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

Zena Home Care Personal Care|Skilled Nursing|Companion 706-426-5967 www.zenahomecare.com

LONG TERM CARE WOODY MERRY www.woodymerry.com Long-Term Care Planning I CAN HELP! (706) 733-3190 • 733-5525 (fax)

DERMATOLOGY

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

DRUG REHAB Steppingstones to Recovery 2610 Commons Blvd.

Augusta 30909 706-733-1935

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

TRANSPORTATION Caring Man in a Van Wheelchair-Stretcher Transports • Serving Augusta Metro 855-342-1566 www.CaringManinaVan.com

VEIN CARE

PHARMACY

Medical Center West Pharmacy 465 North Belair Road Evans 30809 Georgia Dermatology & 706-854-2424 Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) www.medicalcenterwestpharmacy.com Augusta 30904 Parks Pharmacy 706-733-3373 SKIN CANCER CENTER 437 Georgia Ave. ARKS www.GaDerm.com harmacy N. Augusta 29841 803-279-7450 www.parkspharmacy.com

DEVELOPMENTAL PEDIATRICS

SLEEP MEDICINE

P

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

YOUR LISTING HERE Augusta Area Healthcare Provider Prices from less than $100 for six months Call 706.860.5455 today!

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