Jan11 19 by Daniel Pearson

MEDICALEXAMINER

HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS

JANUARY 11, 2019

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WHEN WE LIE TO OUR DOCTOR Ok, maybe not flat-out lie. But maybe we don’t always tell the whole truth. Important details are left out. And not by accident. Studies show the practice is more common than we might think: more than 50 percent of us do, according to one study. Why is this so common, and why is it a really bad idea?

WHY LYING IS DUMB: 1. Doctors have seen it all. It’s pretty tough to shock them. Plus, they’re doctors, not judges of morality.

WHY PEOPLE LIE: 1. We’re embarrassed by something we have or have not done. 2. We’re afraid getting a bad diagnosis.

2. A serious condition will not disappear if you ignore it. Which is worse: getting a bad diagnosis, or not getting treatment for a bad diagnosis? 3. It just might work. Then again, if it does, death is fairly inconvenient too.

4. We want to please the doctor.

4. Telling the doctor you don’t smoke when your clothes reek of cigarettes will not please the doctor. Telling the doctor you floss daily when the evidence is clear that you do not will not please the doctor.

5. We hope to score some drugs.

5. They’re on to you. They know.

3. We can avoid treatment that might be painful, expensive, or inconvenient.

Hiding facts or lying to the very person trying to help us is strange behavior, indeed. It can transform a manageable medical condition into a life-threatening emergency. As for doctors, they may sometimes lie too, minimizing problems they detect, offering overly simplified explanations, and failing to tell hard truths that patients need to hear. Honestly, we can all do better, and that’s the truth. +

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LOSE IT - OR, Well, NOT A phenomenon occurs in gyms across the country during the fi rst quarter of each year - increased memberships and attendance. In 2012, March was the contender for the highest gym usage, and January was second.1 What motivates us to hit the gym every New Year? It may be our New Year’s resolutions. Weight loss and fitness are top resolutions each year.2 However, by February 14th, a whopping 80% of us have abandoned our resolutions.3 When weight loss is a resolution, there is a lot to consider. The assumption that significant and permanent weight loss is easily achievable by everyone is faulty. It is not as simple as a diet plan, exercise, or willpower.4 The persistence with which significant and permanent weight loss is stressed and marketed in our society is confounding to some researchers. Esther Rothblum, a Rutger’s University scholar of Clinical Psychology with post-doctoral work in psychosocial epidemiology at Yale, challenges the conventional wisdom that permanent weight loss is highly achievable.4 Rothblum’s article (2018) attributes some of the reasons for outdated beliefs about weight loss to poor methodology of studies. It does not help that the weight loss industry is a multi-billion dollar publicity machine which can broadcast its own version of the “facts.”4 Commercial weight loss programs (the famous ones you see on television and in print ads) report inspiring results. The best case scenarios, from a pool of participants that completed the diet, are the ones touted. “Your results may vary” is in the fine print.Magazine cover stories tell us that you, too, can lose 18 pounds in a week by eating in a certain manner or by taking a supplement. Someone probably did. Someone. Also, researchers’ standards of significant weight loss may vary from a clinician’s. Simply put, clinical and statistical significances are different, and even small weight loss in a group may be statistically significant.4 In a review of commercial weight loss studies, it was found that the largest controlled trial of a wellknown commercial program yielded a 3.2% total loss of initial weight after 2 years. In many studies, participants who are in obese or overweight categories will not end up in a normal range during the trials.4 Make a resolution this year be kind to yourself. And realistic. Avoid fad diets and supplements, focus on improving health, and don’t fall for the headlines and gimmicks! +

JANUARY 11, 2019

NEWYEARNEWLAW Last summer, largely through the commendable efforts of BreathEasy Augusta, Augusta-Richmond County adopted a smokefree ordinance which went into effect January 1, 2019. The law opens with 19 “whereas” citations over three full pages. Each one cites a compelling reason for the ordinance, such as this one: “Whereas, according to the 2010 U.S. Surgeon General’s Report, How Tobacco Causes Disease, even occasional exposure to secondhand smoke is harmful and low levels of exposure to secondhand smoke lead to a rapid and sharp increase in dysfunction and inflammation of the lining of the blood vessels, which are implicated in heart attacks and stroke,” Or this one: “Whereas, Richmond County ranks 124 out of 159 Georgia counties in health.” Incidentally, did you know that Georgia counties with smokefree ordinances rank in the top 10, top 20, and top 30 in health measures? In brief, the new law mandates that all enclosed indoor workplaces and public buildings (that is, buildings open to the public, even if they are privately owned) are to be smokefree and vapefree. As for outdoor spaces, smoking or vaping may occur at a “reasonable distance” from a workplace or public building, and specifically at “a reasonable distance from outside entrances.” A good example of a violation of the outdoor requirements of the ordinance is this well-advertised smoking area at University Hospital (right). As the sign indicates, it is mere feet away from both the back and front doors of University’s Outpatient Center, as well as University’s pharmacy. Patients and their family members, as well as University employees, smokers and non-smokers alike, are routinely exposed to secondhand smoke at this location in what would seem to be a blatant violation of the ordinance.

“Doctor” Busbee is an Academic Librarian with a passion for multidisciplinary research. In the spirit of 19th century advertisements, medicine, and ensuing quackery, she would like to remind everyone to evaluate what you hear, see, and read before you believe it. And always have conversations with your doctors. Reference List 1. Kurtzelben, D. A Long Wait in Line for the Bench Press: Gym membership ramps up in January, but some gyms say traffic picks up later. https://www.usnews.com/news/articles/2013/01/03/its-gym-season-from-now-until-march. Accessed December 12, 2018. 2. This year’s top New Year’s resolution? Fitness!! Insights. https://www.nielsen.com/us/en/insights/news/2015/2015stop-new-years-resolution-fitness.html. Accessed December 12, 2018. 3. Mulvey, K. 80% of New Year’s resolutions fail by February — here’s how to keep yours. https://www.businessinsider. com/new-years-resolutions-courses-2016-12. Accessed December 12, 2018. 4. Rothblum ED. Slim chance for permanent weight loss. Archives of Scientific Psychology. 2018;6(1):63-69. doi:10.1037/ arc0000043.

Believe it or not, these are mostly healthcare workers. (Photo taken january 7, 2019)

Contrary to the belief of many, the law is aimed at more than bars and restaurants; it specifically includes health care facilities, naming “hospitals or other clinics,” nursing homes, long-term care facilities, and “offices of surgeons, chiropractors, physical therapists, physicians, psychiatrists, dentists, and all specialties within these professions.” The obvious question: will University Hospital finally do the right thing, ban smoking everywhere on all its campuses, and obey this law? +

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JANUARY 11, 2019

DEAR READERS,

As this new year begins, it’s a perfect time to thank each and every one of you for your enthusiastic support and affection for this publication. On an almost daily basis we hear from people who call, email, send cards and letters, and tell us in person how much they love the Medical Examiner. And yes, love is the word most often used. Thanks! It means a lot. As one of our house ads says, in addition to reading (which is much appreciated) one of the best ways to support the Medical Examiner is by supporting our advertisers. They like to know that you see their ads, so don’t be shy about thanking your favorite advertiser for making this newspaper possible. Or when you call one of our sponsors for any reason (to ask about their hours, for instance), please drop our name: “Yes, I saw your ad in the Medical Examiner and I was wondering when you close on Saturdays,” or “I saw your ad in the Medical Examiner and I’m calling to see if you carry...” Without readers, advertisers will disappear. And without advertisers, the Medical Examiner will disappear. You know advertisers are in the paper; you can see their ads. But they can’t see you unless you let them know you’re out there. Will you? Thanks in advance! +

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HOW SURVIVABLE IS HEART FAILURE? Heart failure sounds like the end, a fatal, non-survivable one-time event. You’re dead. Your heart stopped. It failed. That isn’t what it is, as the millions of people who have it know. Instead of being an event, heart failure is a condition, a chronic state of affairs. It might be compared to an appliance that doesn’t quite work as well as it once did, like a vacuum cleaner that over time no longer provides enough suction to get the job done. It still runs, but it doesn’t run well enough to accomplish its purpose. In the heart’s case, what that means is that blood isn’t being pumped adequately to meet the entire body’s needs. The causes vary. A heart attack can damage the heart’s ability to pump efficiently. High blood pressure makes the heart work harder, and if it isn’t controlled, over time the heart can’t keep up with the demand. Its weakened state results in heart failure. Vascular diseases like hardening of the arteries and high cholesterol and its resulting narrowing of arteries can similarly cause the heart’s workload to increase. As a result, people with heart failure often experience shortness of breath because oxygen isn’t being delivered as it should be throughout the body. Lung capacity has been compromised by an accumulation of fluid there (called congestive heart failure). Fatigue is another related symptom, along with dizziness and fainting. Speaking of fluid, people with heart failure often have swelling in their ankles, feet and legs. They’ll say they “retain water” (and they might, in which case diuretics can be prescribed), but the swelling is often blood pooling in the lower extremities that the heart isn’t strong enough to pump along through the miles of the circulatory system. Obviously, heart failure is serious business, yet many people ignore the various symptoms, hoping they’ll go away on their own. Heart failure is a chronic condition that can be treated successfully through a variety of strategies that can be as simple as improving diet and taking medications. By definition, a chronic condition is a survivable one. Being a good patient can mean the difference between long-term and short-term survival. So be a good patient. Live long and prosper. +

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JANUARY 11, 2019

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#82 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

ot cataracts? If your answer is, “Not anymore!” this is the man you have to thank for your clear vision. Charles Kelman (1930-2004) was a pioneering ophthalmologist who transformed cataract surgery from a medical ordeal into a procedure you could add to the middle of a busy day’s to-do list. Not everyone is old enough to remember the primitive early days of cataract surgery, but before Dr. Kelman introduced his revolutionary technique in 1967, cataract removal was a highrisk surgery followed by an average of 10 days in the hospital. Patients could not move, and were immobilized with sand bags to make sure they didn’t. Weeks of recuperation at home followed hospital discharge, and possible complications ranging from blood clots to blindness were numerous. Thick glasses followed successful outcomes. For all practical purposes, post-op convalescence lasted several months. Kelman transformed all of that into a 10-minute outpatient procedure. Patients could go back to work later the same day. The secret was going from what had been the standard incision in the cornea — which was 180° — to a 3° incision. A tiny ultrasonic probe is inserted through the incision (Kelman got his inspiration during an ultrasonic tooth cleaning in a dentist’s chair in 1964) which liquefies the cataract. The same probe suctions out the emulsified fragments of the cataract. Then a foldable intraocular lens is inserted through the tiny opening. It opens like a parachute, and vision is suddenly both crystal clear and 20/20. Some ophthalmologists can complete the entire procedure in five minutes flat. Recovery is almost immediate Kelman’s genius was not immediately recognized. Something of a showman (he was an accomplished amateur jazz saxophonist on the side who shared stages with Dizzy Gillespie and Lionel Hampton, flew his own helicopter, and appeared on The Tonight Show, Merv Griffin, The David Letterman Show and others), the academic surgical community treated him with overt contempt and hostility, shocked by his audacity in discharging patients on the day of surgery and clearing them to resume normal activity on the first or second day thereafter. One speaker at Kelman’s posthumous 2004 Lasker Award presentation estimated that it took almost 25 years for the ophthalmic community to come around and adopt his procedure — known as phacoemulsification — as standard practice. Today it is the most frequently performed surgery in many countries, improving the vision of millions of people every year in the United States alone and millions more each year around the world. Phacoemulsification was the very first surgical technique that could be described by a term we hear all the time today: minimally invasive. It opened the door for all the many, many other “keyhole” procedures now performed all over the body. With that in mind, phacoemulsification has helped millions of people around the world who have never had cataracts. Yes, even those with perfect vision are beneficiaries of the vision of Dr. Charles Kelman.

• I’m going in this morning for a CT scan, but first I need to drink two large bottles of nasty goo. Oddly enough, I am far less concerned about the test results than I am about ingesting the barium without tossing my cookies. I have been working to distract myself from even thinking about it. So far, I have used my watercolor pens to occupy myself, painting several complex pictures; run through posts on Facebook, and snuggled and petted the dog. I cannot eat or drink anything so that option is out, but I can go out and retrieve the newspaper and read it. I’m already dressed warmly to deal with the cold weather. I’ve taken out the trash container to the curb for pick up day. I need to call and cancel Meals on Wheels for this morning. Feeding the dog and making sure she has water is another small task to accomplish before I leave. • I drank the bottles of nastiness without throwing up and the CT was completed as scheduled. I still am having rumbles in my tummy, but I’ll live. It’s time to wait for the results. They should be available in two days. Now to catch up on the sleep I missed last night! • No news yet. It’s very early on Friday and I’m surprised at how little I’ve worried about the test results. There are two basic possibilities: one is a mass of some kind messing with my insides, and the second is scar tissue from surgery in 1984 that is also messing with my insides. At my age I have learned not to jump the gun and imagine all possible bad things that could conceivably

happen to save energy for what actually happens. Then I can deal with it as well as is possible. I’ve learned that panic is not an effective mode of operation. I’ve also learned that I am a very competent problem solver and very strong and tough when facing uncomfortable issues with my health or otherwise. I just ordered another set of watercolor brush pens to replace the ones I have now when they run out of juice. They were on sale, with a $160 pen set on sale for $44. Pen brushes have a pen shape and cavity for the watercolors, and a flexible pointed brush tip that allows for both fine and broader lines. This set also comes with heavy paper stock that makes more creativity possible; no patterns, just empty space waiting to be filled. I love painting, but it’s pretty messy. These brush pens will allow painting that is much neater because they require no cleanup. I just pop the top back on so they don’t dry out and I’m done. This allows me to paint whenever I have a bit of time and space in whatever space I happen to be in. The act of painting intricate patterns demands that I focus control and stay attuned even to my breathing, because calm bodies allow hands to function to their maximum efficiency. In addition, I need to pay attention to colors and their mutual effects on one another. Because these are watercolors they can run and blend with one another easily, allowing for shading and other effects not easily available in other mediums, and the colors are strong, too, not wishy-washy. Just like I try to be. +

I’M ON THE 3500 CALORIE PLAN WHICH WILL IT BE? If the headline doesn’t make sense, here’s the back story: For more than 50 years, it was an accepted fact [air quotes] that weight loss required cutting 3,500 calories (per week) for every pound of weight loss. Simply put, cut 500 calories every day of

the week, and you will also lose one pound per week. It stemmed from a 1958 article in the American Journal of Clinical Nutrition which stated, “3500 calories is the caloric value of one pound of body weight lost.” Actually, the 3500-calorie rule is theoretically accurate if you’re burning a pound of fat with a Bunsen burner in a lab. But outside the lab, real world humans don’t enjoy losing weight at the business end of a small blowtorch. Reflecting on this midcentury maxim and all the

people who tried it and failed to lose weight, it seems obvious that the rule was like lots of other claims in the world of weight loss: if it sounds too good to be true, it probably is. And if it sounds too simplistic, it’s not likely to work in all the millions of different human beings trying to lose weight. In debunking the 3500calorie “rule,” doctors and nutritionists are replacing it with a more realistic guideline: 7000 weekly calories cut will, over a year’s time, yield a loss of a pound per week. +

JANUARY 11, 2019

AUGUSTAMEDICALEXAMiNER

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

MEDICAL

INER

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JANUARY 11, 2019

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and things get really tough. Not only do I have at times written about the incredibly have to find a place for each of the pieces bad patient documentation I get from a of “documentation” I get from hospitals, local hospital. In truth, the documentation consultants, and old records, but I also need I get from everyone is terrible. Seldom does to sift through them and extract only the it tell me what I actually want to know, and bits of useful information and enter them as if there is useful information it is buried in “structured data.” an avalanche of yada yada. The main reason What, you may ask, is structured data? for much of the gibberish is our ridiculous Structured data is information that payment system, which requires us to generate is sorted so the important stuff can be notes that justify the obscure codes we submit gotten to easily. Some structured data are for money from the payors. That, combined numbers (like a blood pressure or blood with computers’ ability to glucose), some are words (like quickly and efficiently generate mammogram reports, heart Medical records drivel (see also: the entire exam findings, and pathology are typically a Internet) are the Miracle Gro reports), some are dates (date and hot house for meaningless teaspoonful of useful of last colonoscopy, flu shot, or words. Sprinkle the rules on a information buried office visit for diabetes), and computerized medical record some are images/documents in an avalanche of (like a picture of that rash you and stand back! Useless words yada yada. and codes will spew out at you had last July, or the video of like milk from the mouth of an the accident you had with the overfed baby. golf cart that got posted to When I started my new practice, one YouTube). Not all data should be structured which is outside of those rules, I was (it gets way more confusing that way), just excited about the possibility of actually the stuff you might need later on. documenting based on patient care. I asked, You see? Gluteus maximus acquires “what would a patient record look like if trauma and inflammation. It is really the only reason for it was for patient care?” hard to document things well, and human It was a compelling question; one which nature means that by the end of the day I undertook in earnest to answer over the you’ve spent your time doing things and past 18+ months. This endeavor has taught not documenting it all. It’s really hard to be me an important fact: documentation in diligent about this stuff and not require a itself, without the stupid rules, is still really double espresso Adderal latte with a valium painful and difficult. mojito chaser. Why? Imagine having to go through every I would be surprised if documentation day keeping track of every conversation you will ever become any more fun than have with people. Imagine trying to not only cleaning a cat’s litter box, but if we gain have meaningful interactions with people enough from the tool, we will use it better. and to make good decisions about important Right now medical records are caught up in things they tell you, but to make sure all the vortex of codes, ACO’s and meaningful of the facts were accurately documented use. Getting out of that vortex is only step 1 in the process. I’ve been busting my butt in a form that will be useful in the future. (more gluteal inflammation, sadly) to get Imagine that you had to do this with all of something that does even a small part your emails, phone calls, and text messages of this. I’m getting closer, but of course I you have with people. It’s is a real pain in had to build that new record system while the gluteus maximus! also seeing patients each day and properly Add to that the joy of patient documenting each encounter. confidentiality (and our dear friend HIPAA) Right now, I think I need to stand up for along with the gobbledygook we get from a bit. + other practices and hospital documents,

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Living with epilepsy

n April 5, 2015, my neurologist told me that for about three years I had been having petit mal seizures and didn’t know. At 15 years of age, I was heartbroken. She continued to say “ You have Epilepsy, and because it manifested so late in your life, you most likely will have it for the rest of your life.” Now at age 20, how has my life changed in the last five years? Back then I was a kid that zoned out a lot, but that wasn’t who I was, it’s what I did sometimes. Now I am a 20-year-old woman who lives in a 1-story house with her parents (and I’ll explain why in a moment), never got her driver’s license, and has grown from petit mal seizures to full grand mal seizures.

A day in my shoes Our house is essentially a 2-story house on its side with no stairs on the off chance that when I’m walking down them I’ll have a seizure and break my neck. For safety precautions, I am 20-yearold woman with a BABY MONITOR in her room! I would love to say that’s everything, but nope: at 9 o’clock in the morning I’m given medication that helps prevent seizures to a certain degree. Then most of the day I avoid anything that might “endanger” me. Just in case I might have a seizure, that includes the following: Taking a shower or going to the bathroom with the door closed (and especially with the door closed and locked),

cooking without supervision, and standing on a chair or ladder to get something off a high shelf. And if I get called to work...well..I’ve already had one seizure. If I get another while working, it’s not likely I’ll get called back. Then at 9 o’clock in the evening, I am given more medication. Medication that isn’t helping!!! You know those medication commercials that list 3 ways it helps and then 15 possible side effects? That’s me, constantly being changed from one pill to the next. I’ve lost count of how many different medications I been on. I do, however, remember the side effects: the first meds gave me suicidal ideations so bad I almost killed myself. The next medication gave

JANUARY 11, 2019 me permanent panic attacks and no desire to eat (lost 14 pounds in 1 week). I went on and off several more since one that has given me a permanent (but subtle) speech impediment. My doctor tells me to expect more of the same, including possible suicidal tendencies. I asked her about CBD oil (which contains no THC) because all the tweaking and adjusting becomes tiresome after five years of it. Even though I have epilepsy, I’m not “qualified.” I think a good next step is to get a seizure dog. They can detect an oncoming seizure and alert me or my family so I am kept safe. Since I now have grand mal and petit mal seizures regularly, I feel that a Seizure Dog will be beneficial to me in more ways than one. They would help me physically, so I know when I’m about to have a seizure. Which would in turn also help psychologically or emotionally. I wouldn’t feel like a 5-year old that needs to wear a leash at the store. I’d feel my age. I’d feel like a person again and not an illness. And for that... I’d give

that dog all the love in the world!!! My quest for a seizure dog has been futile!! In the past I didn’t have enough grand mal seizures to qualify. Another reason is time and money! I would have to wait two years to receive one. On top of that, it’s surprising how expensive it is to get a service dog. You have to put down a non-refundabledeposit to get on the waiting list. Then you have to travel out of state every two weeks to train with the dog (this is the bonding process). All out of pocket. The worst part is you have to submit a form to determine if you qualify and if you don’t qualify, that deposit is STILL non-refundable. What’s the Silver Lining? For people out there reading this who have epilepsy, I sincerely want to tell you and inspire you that there is a bright side to having epilepsy. I have no right to make you believe in something that you don’t. I can only tell you about my personal

ITʼSYOURTURN R N!

Please see FIRST PERSON page 15

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.

JANUARY 11, 2019

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I love the flavors in Greek foods, so when trying to create a simple wedge salad recipe I wanted to play off the classic Greek salad with a healthy spin. A wedge salad is typically made with iceberg lettuce, but I wanted to up my nutrition and flavor, so I used romaine lettuce for this greek wedge salad recipe. Romaine is readily available, and it’s easy to cut in half to make a wedge illusion. According to the USDA, each cup of shredded romaine lettuce has just 8 calories. It also has exceptionally high water content with each cup containing about 1.5 ounces. It is also very low in carbohydrates, sugar, and fiber. A large plate of romaine salad contains potassium, calcium, magnesium and phosphorous and for those trying to keep their sodium low, it only has 4 milligrams per cup. In addition to valuable minerals, romaine lettuce is also packed with vitamins. It contains high levels of vitamin K and betacarotene, which the body turns into vitamin A. The leafy green also contains good levels of folate, vitamin C, and molybdenum. Now don’t just associate romaine lettuce with dieting just because of its high nutrient density and low-calorie count. The nutrients and minerals in romaine provide benefits for anyone who eats it. Greek Wedge Salad For more information on the benefits of Instructions eating romaine lettuce be sure to visit my Combine chickpeas, cucumber, tomato, website at http://thelifegivingkitchen.com/ olives and red onion in a medium-size bowl. greek-wedge-salad-recipe/ In a glass jar add parsley, oregano, salt, pepper, vinegar, mustard, honey, and olive Ingredients oil. Seal with a tight fitting lid and shake • 1 cup chickpeas rinsed and drained for a minute until all ingredients are blended • 1 cup chopped English cucumber well. • 1 cup chopped Roma tomato Toss half of dressing with chopped • 1/4 cup halved pitted Kalamata olives vegetables in a bowl. • 1/4 cup finely chopped red onion Place +romaine halves on plates and spoon • 1/4 cup chopped fresh flatleaf parsley chopped vegetables over the hearts. Drizzle • 1 teaspoon dried oregano the remaining dressing evenly over romaine • 1 teaspoon pink Himalayan salt hearts. • 1 teaspoon black pepper • 6 tablespoons red wine vinegar by Gina Dickson, Augusta wife, • 2 tablespoons Dijon mustard mom and grandmother, colon • 2 tablespoons honey cancer survivor, passionate • 1/2 cup virgin olive oil about creating a community • 4 romaine lettuce hearts cut in half to help women serve healthy lengthwise meals to their family. Visit my blog at thelifegivingkitchen.com

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ASK DR. KARP

NO NONSENSE

NUTRITION Yvonne, an AskDrKarp Facebook friend from Montreal, Canada, writes “The New Year has me wondering, do we need to make any changes in our eating and lifestyle behaviors as we get older?” Yvonne, you ask an interesting and important question. Although there is a lot of information around about the nutritional needs of the elderly, there is relatively little information about changing needs as

you go from your 20s to 30s, to 40s, to 50s and 60s, etc. Although people like to compartmentalize “aging,” that’s not the way life works. It’s not, “you’re a baby, a child, an adult and then a senior.” Instead, life is a process of gradual but continuous change. Like life, you need to continually change and evolve in your attitudes and lifestyle behaviors, including eating. The New Year offers us an opportunity to reflect upon this and, perhaps, think about the changes we all need to make. Let’s talk about weight fi rst. If you eat the same at 50 as you did at 20 or 30, you will gain weight. No doubt about it. As you get older, your metabolism (basal metabolic rate or BMR) decreases. In order to stay the same weight, you need to eat less or move more, preferably, both. What most people do, unfortunately, is eat more and move less. What about all those gimmicky supplements that claim they will “boost your metabolism”? I always tell people to substitute the phrase “they make you sweat.” Fad supplements only cause temporary increases in metabolism, and have nothing to do with changing your basal metabolic rate and nothing to do with your health and your weight. In addition, these types of

supplements may be not be safe. By contrast, moving increases your metabolism much more effectively and has many other benefits. Maintaining or increasing your muscle tone is very helpful in keeping weight under control. Muscles are more metabolically active than fat tissue, and a person with a muscled body can usually eat more than a fatter person. Let’s talk about posture next. As you get older you get shorter, perhaps by an inch or more. If you are losing height, this may be due to some degree of osteopenia or osteoporosis, so that is important for you and your physician to know. Another possibility is that your posture is changing. Pay attention to your posture and do corrective exercises to maintain good posture as the years go by. A physical therapist may help you with this. One of the outcomes of poor posture is that you may start seeing that abdominal “pooch” as your spine changes shape, but your weight does not The third point to consider is the level of your physical activity. As you get older, changes in your joints and bones may necessitate changes in your daily exercise routine. You may see changes because of arthritis, joint wear or other factors. It may mean that

JANUARY 11, 2019 you can no longer do the same exercises and moving routines you did when you were 20. The mistake many people make at this point is they stop exercising altogether. Instead, all that may be required is simply lightening your weights, changing the resistance or the number of repetitions, or buying a more supportive pair of walking shoes. Or, it may mean that you need to change your moving routine completely and evolve into new exercise routines. You used to jog but now your knees hurt? You may have to take up swimming or biking instead of running down that canal nature trail. It may be that you need to be evaluated by a physical therapist who may suggest ways you can change your exercise routine to match your changing body and mind so you can keep moving, moving, moving. You may need to be evaluated by your physician for bone and joint issues. So, you see, there is a need for continual change and reevaluation of your nutrition and moving habits as you get older, whatever the age. Life is a work in progress, mentally, physically, physiologically and psychologically. You need to pay attention to changes occurring in your mind, body and spirit, and adjust your lifestyle behaviors, including eating.

What’s the “No-Nonsense Nutrition” advice for today? By keeping a healthy weight and moving, moving, moving, you will decrease your risk of unhealthy brain changes, heart changes, blood vessel changes and much more. Getting older probably means that your mortgage is paid off and your kids have finally graduated from college and moved out of your house (hurrah!). Being older can and should be one of the best times in your life and you need to enjoy this time as a healthy, active person. Happy New Year and Happy Life! +

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 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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9 +

AUGUSTAMEDICALEXAMiNER

Ask a Dietitian MAKE THE MOST OF THESE 10 MEAL PREP TOOLS YOU ALREADY HAVE

by Sohailla Digsby, RDN, LD, CPT Dietitian, Fitness Pro, Speaker and Author, Best Body Nutrition & Fitness, LLC How dinner gets on the table is different for everyone, and for many it just seems too difficult to get it on the table at all. Getting that “New-Yearperfect” meal plan feels daunting if you’re aiming for your kitchen to look like a Food Network clip where the counters are crumb-free, with no kids underfoot, and your apron doesn’t have last Monday’s dinner residue on it. Let’s instead work what’s doable into your reality. Progress in prepping meals doesn’t have to be perfect progress. Likely the person making it look easy has been cooking for longer than you have. So just take it one step at a time until you get into a groove that works for you. Whether you like to do a longer weekend block of preptime, or 10-minutes of multitasking prep-work here and there, make the most of these 10 tools you probably already have! Below are some suggestions to get you started (many of them from my cookbook, the Best Body Cookbook & Menu Plan.) You don’t have to do all of them at once, but start with a couple of the easier ones over the next few weeks and then add on.

dried beans on low each week (I alternate between black beans, white beans, pinto beans and lentils) – fill to the top with water and turn it on low for the day • throw veggies in with chicken and broth and plan to always have a soup or stew ready for leftovers and lunches (this is my secret to surviving busy weeks) • set up steel cut oats to cook overnight in the instapot or crockpot - ready for you to start your day strong! GRILL • once a weekend, fill the grill with lean meats and veggies for roasting (try these in a grill basket: baby tomatoes, onions, zucchini, and mini-peppers) • freeze grilled meat (cut into strips) in freezer-safe zipper bags FRIDGE/FREEZER • fi ll and flatten quart

CROCKPOT/PRESSURE COOKER • slow-cook a pound or two of

and gallon freezer-bags of aforementioned pre-cooked beans, soups, and meats and freeze • ready-to-cook frozen veggies • overnight oats ready in the fridge and a stocked veggie drawer for quick salad-entree’night CUTTING BOARD/FOOD PROCESSOR • what can you prep today for both today and tomorrow? (when you only have to clean up once) • finely chop spinach or kale to mix into sauces and smoothies • consider what produce you can buy that’s chopped for you GROCERY PICK-UP APP • this is a time-saver and helps with streamlining planning too (to save time, use the “Favorites” feature for staple items) • Prioritize lean protein and produce when building your list OVEN • double recipes for dishes that serve a crowd such as the Spinach Lasagna (photo left) from the Best Body Cookbook & Menu Plan (recipe, page 15). BLENDER • smoothies and slushies loaded with fruits and veggies Please see PREP page 10

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welp

PREP… from page 9 Find tongue ™

Organs

Glands

Near Augusta GA Bones

Joints

d Other

Tongue HHHHH

( *

13.1 million reviews

The organ of speech and taste Working now? Probably Take-Out Available? Only for Ellen Jamesians* (*obscure literary reference)

Good for: Talking, tasting

Phil H. Augusta, GA

H H H H H 1/4/2019 I have six words for you: tie twine to three tree twigs. If a tongue won’t work, what good is it? +

Franklin A. Evans, GA

H H H H H 1/4/2019 I love my tongue because I love to eat. My tongue is my taste buddy. I even named him: Bud. Thank you for your service, Bud! +

Jake T. Aiken, SC

H H H H H 1/4/2019 My tongue has gotten me in so much trouble during my lifetime, going all the way back to my childhood. Maybe I would slip up and say a bad word, so my mother would yell at me and say, “Watch your tongue, mister!” So then I would obediently stick it out so she could see that I was minding her and try to look down so I could watch my tongue. It’s hard to see down there! It would make her even madders, I guess because I couldn’t do it. +

Burton J. Clearwater, SC

H H H H H 1/5/2019 Sometimes a person makes a comment that is said to be tongue-in-cheek. My complaint is this: what comment does that NOT apply to? Isn’t every single word we ever say tongue-in-cheek? Do we even have a choice? +

Payton R. Bath, SC

JANUARY 11, 2019

(spinach and kale work well) • puree steamed broccoli slaw in the blender with water to add to sauces to pack more veggie-power STOVETOP • Boil half a dozen eggs to keep handy for use in quick breakfasts, lunches or snacks • make whole grain pasta and quinoa and store for during the upcoming days, and stove-pop popcorn for snacking MICROWAVE • steam-fresh type veggies (I love prep-free perfect broccoli in 3 minutes) • red potatoes and sweet potatoes (just wash, poke holes and put a couple in the microwave at a time – start with 5 minutes and check doneness by squeezing it gently while wearing and oven mitt) • when in a pinch, use the 90-second grains you can microwave – choose the plain ones for less sodium RESTAURANT • on which night or two of the week do you need/want to delegate cooking/cleaning the most? • plan restaurant meals in advance and try to cook at home as often as possible for better health (and to save money) These tools can be utilized on different days, or even simultaneously on a day that you have a larger chunk of time. You’ve got to prioritize planning and focused mealtimes just like you do other things that contribute to your wellness as a whole. Which tip can you incorporate this week? Try at least 1 suggestion each week until your kitchen time is streamlined and simplified. +

H H H H H 1/5/2019 This isn’t a rating, it’s more of a question: when someone really chews out another person bad, is that what’s called a tongue-twister? Or is a tongue-twister an actual storm, like a tornado? +

Terry T. Augusta, GA

H H H H H 1/6/2019 My uncle served in Vietnam and was captured during combat. He won’t talk about it. My mother says he’s tongue-tied. I guess that’s how he was restrained in captivity. Most people aren’t going to leave their tongue behind, even if it means freedom. You have someone’s tongue, you have them. +

Bobby B. Evans, GA

H H H H H 1/7/2019 I just saw the previous post. My cousin was in the Navy, and he won’t talk about his service in Vietnam either. I heard a cat got his tongue. What a brave thing to go through for your country! +

What will the new prize for winners of the Mystery Word Contest be?

Darnel D. Augusta, GA

H H H H H 1/7/2019 I know this guy who was in the Marines, and in boot camp he said they got a tongue lashing almost every day. That is so cruel. I don’t know what he did to deserve that, but he doesn’t seem to be affected by it too much. Well, come to think of it it he does have a bit of a lisp. +

Stay tuned for the big reveal.

Avery M. North Augusta, SC

H H H H H 1/8/2019 My wife has a whole branch of her family that she doesn’t like to be around. She says they’re creepy because they speak in tongues. I don’t get it. Doesn’t everyone? +

Thelma D. Augusta, GA

H H H H H 1/6/2019 In the doctor’s office the other day I overheard someone talking about a depressed tongue or tongue depressing or something like that. It’s sad whenever depression has gotten to where even individual body parts are depressed. When I was coming up, it was the whole person.

TELL A FRIEND ABOUT THE MEDICAL EXAMINER!

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JANUARY 11, 2019

11 +

AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf — posted at opmed by Rada Jones, MD, on January 3, 2019 (edited for space)

MURPHY’S LAW IN THE ER • Murphy’s Law as it applies to the ER: If something can go bad, it will do so in a hurry. If it can’t possibly go bad, it will still find a way. • Clock’s First Rule: All the patients will crash at the same time. Usually when the computer system goes down. • Clock’s Second Rule: The sickest patients will come just before shift change. • Haste’s Theorem: The healthier the patient, the more they insist on being seen first. Sick patients are not in a hurry. • Lefty’s Corollary: The patient who doesn’t ask “When is the doctor coming?” is probably dead. • Mass’s Law: Whenever a nonambulatory patient needs to be moved, he will weigh at least 300 pounds. • Law’s First Rule: Every drunk patient has a lawyer on speed dial. • Law’s Rule on Charting: The ONE case you documented poorly will turn bad and get you sued. • Sage’s Second Advice: Whenever a patient tells you: “You took care of my mom,” don’t ask how she is. She’s dead. • Urin’s First Law: The consultant you paged an hour ago will only call back when you go to the bathroom. • Urin’s Second Law: All babies will pee as soon as you remove their diaper. On you. • Urin’s Third Law: Whenever you need a urine sample, the patient has just peed. • The Law of Detrimental Location: The trauma victim was just sitting there minding his own business. • Middlesex’s Law on Gender: If you are female, you are a nurse. If you’re male, you are a doctor. • Prick’s Principle: The fear of needles is directly proportional to the number of tattoos. • Pain’s Rule of Furniture: Chronic back pain patients love to move refrigerators. • DeBeer’s Law of Correlation: The likelihood of a patient being suicidal correlates directly with the blood alcohol level. • Fahrenheit’s Law: Parents of unvaccinated kids don’t own thermometers. • Poor’s First Law: Smoking is inversely correlated with the ability to afford your antibiotics. • Poor’s Second Law: The number of tattoos is inversely correlated with being able to afford dental care. • Love’s First Law: The patient asking for your phone number is in the ER for an STD. • Love’s Second Law: The patient who hugged you before he left has scabies. • Love’s Third Law: The patient who shook your hand is positive for C Diff. • Pooper’s Rule: Patients with three weeks of diarrhea become constipated as soon as they step in the ER. • Luck’s Theorems: The likelihood of the computer crashing is directly proportional to the number of patients in the department. Multiply by five if it’s Monday night. • Lavoisier’s Dictum: When the patient comes to the ER, the med list stays home. • Child’s Principle: Toddlers can’t swallow pills. Unless they are at grandma’s. Then they’ll swallow the whole bottle. • Child’s Law of Location: Bleach must be stored under the sink in a Coke bottle. • Needy’s First Rule: Your patient will need you as soon as you leave the room. • Margarita’s Law: The ER goes to shambles as soon as the pizza arrives. • Margarita’s Corollary: Never order pizza in the ED. • Margarita’s Conclusion: To eat hot pizza you need to retire. +

The impossible will find a way.

Rada Jones, MD, MBA, FACEP, is an emergency physician

Here’s a book that is at the same time both trivial and educational. It’s great. It’s trivial in that it takes a detailed and scientific look at some seemingly insignificant issues: what about the 5second rule? Was George Costanza unfairly criticized for double-dipping? Is it really like putting your whole mouth in the dip? What about electric hand dryers? Do they blow bacteria everywhere? Is it dangerous to share a bucket of popcorn with your date? Is it bad that the chef in a 5-star restaurant tastes the sauce he’s preparing, then keeps stirring with the same spoon? Or does the heat kill any germs? Those are just a few of the food myths (or are they?) addressed in labs up the road at Clemson University that are then recorded in this book. As it turns out, there is no such thing as a 5-second rule, or if there is, it’s that germs aplenty can hitch a ride within 5 seconds of anything dropped on the floor. But then, you already knew that,

right? As for double-dipping, sure, it’s a violation. But how about this variation: you take a healthy scoop of dip using a huge chip, take a bite, then flip it around so the unbitten portion of the chip is used for the double-dip. Do you know if that’s pretty safe? Here’s a question you may have never considered: does blowing out the candles on a birthday cake increase the likelihood of spreading germs all over the cake? Spoiler alert: yes. But only by 1,400%. A compendium comprised only of such questions and answers might seem a bit

pointless and sophomoric. After all, many aspects of perfect hygiene are beyond our control, and no one wants to be grossed out by hypothetical scenarios. But the book actually bases everything on a pretty comprehensive lesson about bacteria. Call it Bacteria 101. Read it cover to cover and you’ll have a pretty good grasp of the world of microbes — and it’s quite a world. It’s right under our noses and all around us, but we can’t see it. Just one nugget from the book: the number of bacteria in and on one human being is greater than the total number of all humans who have ever lived. So yes, by all means read this book. Then go wash your hands. With bleach. + Did You Just Eat That? — Two Scientists Explore DoubleDipping, the Five-Second Rulle, and Other Food Myths in the Lab, by Paul Dawson and Brian Sheldon, 224 pages, published in November 2018 by W.W. Norton & Company

Research News An apple egg a day... New research from Finland released this week has found that an increased intake of eggs — one per day — can help lower the risk of type 2 diabetes compared to people who consume eggs less frequently. The study followed its participants for nearly 20 years and compared the health of those who ate on average an egg per day versus those who ate an average of two eggs per week. Blood serum samples found lipid molecules in the egg eaters linked to the blood profiles of healthy men who remained free of type 2 diabetes. Nutritional scientists have gradually been inching away from discouraging egg consumption due to cholesterol concerns and focusing more on the nutritional benefits of egg consumption.

A hearing aid can ward off depression Columbia University’s Irving Medical Center says in a new study that hearing loss increases the risk of depression symptoms; the greater the hearing loss, the greater the risk. The study found that, although most people over 70 have some degree of at least mild hearing loss, relatively few are diagnosed, much less treated. Hearing loss is also implicated in heightened risk of dementia and cognitive impairment. But hearing loss is easy to diagnose and treat, and the findings suggest it’s especially important, given the range of conditions that treating hearing loss can prevent. Evening exercise gets a green light Swiss researchers say the widely-held belief (even among sleep experts) that

exercise in the evening can have a negative effect on sleep quality is not universally true. In fact, the team at the Institute of Human Movement, Sciences and Sport in Zurich says that if sports in the evening has any effect at all, it’s generally a positive one. The study compared deep sleep times between those who participated in evening exercise against those who did not, and found the exercisers spent 21.2 percent of their night in deep sleep versus 19.9 percent for those who avoided an evening workout. While not a significant difference, it is significantly more than what the prevailing wisdom would have predicted. Based on this study, there is no reason to avoid evening exercise. The exception is vigorous exercise within one hour of bedtime. That did have a negative effect on sleep. +

+ 12

AUGUSTAMEDICALEXAMiNER

THE EXAMiNERS +

Problems?

by Dan Pearson

Right. You’re a hand specialist - and a very good one.

Well you know I recently joined a new orthopaedic practice, right?

When you Today I entered an exam were a cop? room and screamed at How so? the patient, “SHOW ME YOUR HANDS!”

Thanks. But my first job - a long time ago, true - keeps coming back to haunt me.

EXAMINER CROSSWORD

PUZZLE

ACROSS 1. Successor to VHS tapes 4. Capital of Yemen 9. Respiratory abbrev. 13. From a distance 15. Graven images 16. Entreaty 17. Significant life events 19. Islamic call to prayer 20. Pager 21. Average Joe’s last name 22. Christian’s name 23. Chronicle cartoonist 25. Shady recess 28. Meter prefix 29. Mischievous child 32. Middle name of Surrey Center restaurant 34. Purple _____ 35. Impair 36. Obamacare acronym 37. Listens and obeys 39. Before (poetic) 40. Become firm 41. Cold prefix 42. Georgia county named for the 14th US president 45. Reagan-era defense abbrev. 46. Harvest 47. Stoneworker 48. Footwear 50. Variety of football 52. Permit 54. Sleeve style 57. Like a lame excuse 58. Access controller 62. Roof overhang 63. Entertain 64. Bound 65. June 6, 1944 66. Mathematics 67. DDS’s org.

4 14

15 18

21 23

46 48

22 26

39 42

56 61

The Mystery Word for this issue: SCHMATO

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 Click on “READER CONTESTS”

We’ll announce the winner in our next issue!

E X A M I N E R

1 7 9 2 8 4 6 4

2 3

8 7

4 3

2 5 3 7 9 3

S U 4 D O K 6 U

DOWN 1. Thurmond, for example 2. Heart quivers, for short 3. Evans’ name 4. South Augusta call center company 5. Worship 6. Invasive beginning 7. Ginger beverage 8. Donkey 9. Room 10. Dementia 11. Quantity of paper 12. Monte follower 14. South African antelope 18. Surplus 21. Pelt 23. Alcoholic drink of fermented honey 24. Cordele’s County (GA) 25. Accumulate in large amounts 26. Ran swiftly 27. Capital of Slovakia

28. Before surgery, in brief 30. Rubio of note 31. Clean and straighten feathers 33. Wednesday’s number during Masters Week 38. Nestlings 41. Boast 43. Public perception 44. Young bird of prey 49. Corny 50. _____ Market 51. There are five Great ones 52. Impressed 53. Heavy metal 55. Capital of Western Samoa 56. Require 58. Leg (esp. female; dated slang) 59. MD’s org. 60. Egyptian pharaoh (in brief) 61. Nutrition label abbreviation

G R O O V E S U

E P A R G S R S

N I M C R E P C

E E Y E T A C A

S R G S T I B S

O C B A S R C J

J E H I L L O E

W V D O G L E G

A O R R E V I R

G L A D Y A A V

C R Y S T A L S

THREE LETTERS • Grant born in Augusta • Ernie of the PGA • Floyd of the PGA • GreenJacket stadium sponsor • Mr. Brown’s venue • Major SC jobsite • Augusta has two FOUR LETTERS • Heredity carriers • Aiken campus

QUOTATIONPUZZLE A H B I

V S A H I L N O H O L E H M S W T C L F E H A A F U O E E R I

D B B O S U L L I H S D E U S U W — Benjamin Franklin

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.

• Augusta’s ____ Section • Guitarist Feliciano • Davis of the PGA • Austin’s station • Palmetto util. FIVE LETTERS • Col. Co. venue • ____ Spirit • Savannah _____ SIX LETTERS • He said “I won’t bite”

• The 13th is one • Rut • US President Franklin SEVEN LETTERS • _____ River Water Park (now gone) • Daniel _______ • Charlie _______ • 5-star Aiken Hotel EIGHT LETTERS • Physician’s business ANSWERS: PAGE 14

WORD

THE MYSTERY WORD

DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.

Solution p. 14

P W I L L C O X

JANUARY 11, 2019

13 +

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE

The

Advice Doctor

Joe: They say you should never iron a 4-leaf clover. Moe: Why not? Joe: It’s pressing your luck.

ha... ha...

Moe: I’ve got a joke for you. What happens when potatoes smoke marijuana? Joe: What? Moe: They get baked! Joe: ...I thought you said you had a joke for me...

he man’s wife said, “It’s January! It’s over! If you don’t stop singing Christmas songs I’m going to kick you out of this house!” “But baby, it’s cold outside,” replied her husband

Bouncer: Sir, I’m going to have to ask you to leave. Customer: Why? Bouncer: Because I was on this trampoline fi rst.

Nurse: My phone just died. Doctor: We should call it.

Moe: I want to become a millionaire, just like my uncle. Joe: Your uncle was a millionaire? Moe: I called my wife earlier and asked her if Moe: No, but he wanted to be. she wanted me to pick up Burgers & Fries on my way home from work. Moe: I put a bunch of desks and a Joe: What did she say? blackboard in my living room today. Moe: I think she’s still mad that she let me Joe: What for? name the twins. Moe: To make it more classy. Moe: Instead of a swear jar, I have a Moe: The new guy at work forgot his lunch negativity jar. As of New Years Day, every time I today. have a negative thought, I put a dollar in it. Joe: The cannibal? Joe: How’s that working out so far? Moe: He’s the one. Moe: It’s currently half empty. Joe: So what did you do? Moe: I offered to lend him a hand. Moe: Somebody should learn to stock ATMs better. 9 out of 10 dermatologists agree: towels Joe: Why do you say that? Moe: I just went to four different ATMs to get are one of the leading causes of dry skin. + some cash and all four said Insufficient Funds.

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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.

Dear Advice Doctor, I have a situation at work I hope you can help with. Our sales team sometimes sold product that wasn’t available, or our plant manufactured product that wasn’t selling. A year ago I was assigned to create and develop a system to prevent this problem. I developed an app that makes sales, manufacturing and inventory virtually transparent. When I presented the finished product, management told me the project had been cancelled six months ago. No one told me! If I had known it was going to bite the dust I could have been doing something else this whole time. I’m tempted to take the idea to a rival company. Do you think I’ll be sued if I do? — Wasted Days, Wasted Nights Dear Wasted Days, Many people don’t realize how long this problem has been an issue. Believe it or not, Hippocrates was the first to describe the habit of biting (or eating) the dust, and there are references to it in medical texts as early as the late 1500s. Eating dirt — not its figurate meaning, to die, but literally eating dirt — has a very strong history right here in Georgia. People visiting or moving to a foreign country often experience diarrhea and other abdominal ailments. African slaves here experienced this, but found relief eating kaolin-rich Georgia clay. When the benefits were confi rmed scientifically, kaolin became the active ingredient in popular products like Kaopectate and Pepto-Bismol. Aside from biting the dust (or the clay), there are dozens of related compulsive eating disorders, including pagophagia (eating ice) and trichophagia (eating hair). Specifically, eating dirt is called geophagia, and to bite the dust is called coniophagia. Overall, the broad term for disorders characterized by compulsively eating non-food items is pica, a word that comes from the Latin word for magpie (Picave), a bird known for its habit of eating almost anything. A person with pica or a specific variation like geophagia should visit their doctor. While usually viewed as psychological disorders, some -phagias originate from dietary insufficiences. Correcting those can be a fi rst step to stopping a habit that can lead to serious complications from eating harmful substances. 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.

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

E U S S I T X E N : R E N N I W W E N

...cleverly hidden on the roof in p. 9 ad for OVERHEAD DOOR COMPANY OF AUGUSTA

THE WINNER: ANDREW FELAK 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!

JANUARY 11, 2019

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED D V D A F A R M I L E B E E B A R B O M A R K A C A S E T S D I S H A L L O W E A K E A V E D D A Y

S I S T P E A L R E T H C R R E O E W G A M

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

A L Z H E I M E R S

R E A M

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A P I A

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SEE PAGE 12

The Celebrated TheSUDOKUsolution MYSTERY WORD CONTEST 6 3 9 8 2 1 7 4 5 ...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.

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QUOTATION QUOTATION PUZZLE SOLUTION “If a man could have half his wishes he would double his troubles.” — Benjamin Franklin

JANUARY 11, 2019

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AUGUSTAMEDICALEXAMiNER

FIRST PERSON … from page 6 experiences. Since April 5, 2015, I found it initially difficult (and at times, still do), but I have learned so much. For example, I learned what it means to attain your goals despite trials. As my seizures increased I felt like a fragile porcelain doll that needed help with everything. But as time went by I noticed the bright side of that. When I finished high school at age 15, that felt like an accomplishment. I used to LOVE to read if it was a good series. I could read three books in three days, but sadly that love went away with certain medications. The bright side was that the love came back (just maybe not as fast). It felt like reading your favorite book again for the first time. I learned to look at things differently. Do I want a little more freedom? Yes, but I’ve also accepted that it’s ok to ask for help. Even being diagnosed with epilepsy, I still managed to get a well-paying Job. I’ve gone to school to

become a Certified Nursing Assistant. Did my epilepsy get in the way of my schooling? Yes, I stressed myself out so much I had a grand mal seizure (luckily at home), but did I let that stop me? No!!! I can’t tell you what your silver lining is because that’s something you have to find for yourself. It could be anything, but sometimes it’s what we least expect to happen to us that humbles us or inspires us in ways we couldn’t imagine. I can tell you here and now that’s my silver lining. Finding treasures where treasures are not normally found. Making goals and meeting them, despite having epilepsy. Whether you have epilepsy, arthritis, bi-polar, addictions of any sort, or any illness. I know that some way, somehow, you can figure out for yourself a silver lining. + — by Juleeza Perez Grovetown, Georgia

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Best-ever Spinach Lasagna Ingredients 1 16-ounce container low-fat cottage cheese 1 16-ounce container nonfat cottage cheese 2 cups part-skim mozzarella cheese, divided 1⁄4 cup Parmesan Cheese 2 eggs, beaten 1 teaspoon dried basil 11⁄2 28-ounce jars of pasta sauce 1 14.5-ounce can stewed tomatoes, juice reserved 1 14.5-ounce can diced tomatoes, juice drained 4 garlic cloves, minced 6 packed cups slightly torn fresh spinach (5 ounces) 1⁄2 teaspoon Greek seasoning (such as Cavendar’s) 1 9-ounce box oven- ready lasagna noodles (12–16 noodles) Instructions • Preheat oven to 425°F. • In a large bowl, combine cottage cheeses, 11⁄2 cups mozzarella cheese, Parmesan cheese, eggs and dried basil. Mix well. • In another large bowl, combine pasta sauce, stewed tomatoes with juice, diced tomatoes without juice, garlic, spinach and Greek seasoning. Mix well. • In the bottom of a 9x13inch baking pan, spread the following evenly: - 11⁄2 cups sauce - 4–5 noodles, spaced across the sauce - 1⁄2 of the cheese mixture - 1⁄3 of the remaining pasta sauce

- 4 noodles - all the remaining cheese mixture - 1⁄2 of the remaining pasta sauce - 4 noodles - all of the remaining pasta sauce • Wrap the lasagna tightly with a double layer of foil (spray the layer of foil that comes in contact with the food with cooking spray to keep it from sticking). Bake for 60 minutes. Uncover, top with the remaining mozzarella cheese, and return to the oven for 5 minutes to melt the cheese. After 5 minutes, turn the oven broiler on and standby watching as it cooks 6–8 inches under the broiler, removing it from the oven just when it begins to brown. Allow the lasagna to set for 30–40 minutes before cutting into 12 equal pieces. + — by Sohailla Digsby Total time: 1 hour 50 minutes (30 minutes prep plus bake/set time) Yield: 12 servings (serving size: 1 piece) Nutrient Breakdown: Calories 270 Fat 8g (4g saturated fat) Cholesterol 50mg Sodium 290mg Carbohydrate 30g Fiber 3g Protein 16g Plate Plan choices: 1 starch, 2 vegetables, 2 medium-fat meats

Call 706.860.5455. Let’s talk ads.

+ 16

AUGUSTAMEDICALEXAMiNER

IT’S A QUESTION OF CARE What if my parents are resistant to help and change?

1. Assure them that this change will maintain their health and safety. It’s helpful to explain to them that you, as the adult child, are beginning to spend a fair amount of time checking on them and working with them to make sure they are safe, healthy, and happy. You can explain that you, of course do this out of love, but you have a lot of obligations in your own life to which you must attend. Their willingness to consider assistance so that they are properly taken care of will help everyone involved. It will also make you feel more comfortable with their living situation. 2. Clarify that you will remain by their side during this process. This transition might be hiring help to come into the home, a move to an Assisted Living community or perhaps you might even offer for them to move

JANUARY 11, 2019

in with you if that works for you emotionally and financially. Whatever the case may be, assure them that you will be there to support and guide them through these changes. 3. Explain that you may hire professionals to help with this transition. You might employ an Aging Lifecare Manager or someone who specializes in downsizing so that your parent(s) feels comfortable with what they will be able to take with them if there is a move involved. Ease their worry about the other items stored in their home by pledging to give these belongings to family, donate them or sell them for their benefit. If a move is needed, you can assure them that they will be treated well and listened to when they voice their opinions about their options. If the choice is to bring help into

the home, then you can clarify that, if possible, they will be a part of choosing a caregiver with whom they can work well. 4. Work with them to manage finances accordingly. It’s also helpful to reassure them that you will work with them or their banker, financial planner, accountant or attorney to make sure their finances are handled well and their money will last as long as possible to pay for their care. You can also clarify that you will be working to ensure that if their money does run out, there is a backup plan in place. This will help them feel more comfortable with beginning to spend money on much needed 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.

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

DENTISTRY

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

IN-HOME CARE

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

DERMATOLOGY

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)

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. www.GaDerm.com N. Augusta 29841 Resolution Counseling Professionals 803-279-7450 3633 Wheeler Rd, Suite 365 www.parkspharmacy.com Augusta 30909 706-432-6866 Karen L. Carter, MD www.visitrcp.com 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com Your Practice And up to four additional lines of your choosing and, if desired, your logo. Keep your contact information in Steppingstones to Recovery this convenient place seen by tens of 2610 Commons Blvd. thousands of patients every month. Augusta 30909 Literally! Call (706) 860-5455 for all 706-733-1935 the details

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

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