Jan8 16 by Daniel Pearson

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Dear Advice Doctor, I love my wife dearly, but after ten years of marriage, I find her laugh is more annoying every day. When we were dating I thought it was cute, but now I despise it. I don’t want to leave her, yet every time she lets loose with her cackle — many times every day — it sets my teeth on edge. Sometimes I just want to choke her. Do you have any advice on how to handle this? — Husband on The Hill Dear Husband on The Hill, The situation you describe is potentially serious, and is what dentists call “bruxism.” That’s the word for grinding and clenching your teeth, and over time it can cause jaw pain, headaches, damage to tooth enamel, and even cracked or chipped teeth. Sometimes teeth are literally flattened, making chewing food difficult. For some people (like you), bruxism is a stress reaction; millions of others don’t even know they do it: they grind their teeth in their sleep. The solution to bruxism can be anything from counseling or therapy to treatment by a sleep specialist. Check with your dentist to begin. He or she may be able to supply you with a mouth guard to protect your teeth from further damage, and worn tooth surfaces can be restored using crowns. Oh, one more thing: don’t tell your wife any jokes. + Do you have a question for The Advice Doctor about love, life, personal relationships, career, raising children, or any other important life topic? Send it to Advice@AugustaRx.com. Replies will only be provided in Examiner issues.

SOME

WIN LOSE

ometimes the pursuit of a longer and better life is a matter of one step forward, two steps back. According to the latest figures from the Centers for Disease Control, Georgia is in just such a situation. Georgia is one of a steadily growing number of states (21, plus the District of Columbia) in which deaths from bullets outnumber traffic fatalities. Can you believe that? More people are shot and killed in Georgia than die in car accidents. This isn’t even breaking news. It’s been that way for a while now, the result of years of decreasing traffic deaths and gun deaths that aren’t decreasing. Ten years ago the situation was reversed: nearly 1,700 people would die on Georgia roads in 2006, compared with fewer than 1,200 shooting deaths. As one grim statistic kept dropping, the inevitable happened and bullets finally overtook cars as the more lethal of the two in late 2010. Since then the gap has only widened. In 2013, for example, 1,262 Georgians died by firearms (both murders and suicides) compared with 1,179 on the

IT’S TIME!

highways. The trend is likely to continue. Cars, after all, have lots of safety features they didn’t have years ago: seat belts, airbags, collision avoidance systems, anti-lock braking, rear view cameras, navigation systems, eletronic stability control, and energy-absorbing “crumple zones.” New cars are significantly safer than older cars. Highway design has also improved, and laws have been enacted to encourage safety by stiffening penalties for distracted driving and driving under the influence. On the other hand, as one trauma physician observed in a Washington Posat article, 9mm bullets still measure 9mm, just like they always have. Bullets still travel the same speed they did ten years ago. Everyone seems to decry gun violence, whether the event is a mass shooting event like San Bernadino or Sandy Hook, or just

JANUARY 8, 2016

one unfortunate victim. Even so, laws designed to reduce gun deaths always face a difficult uphill battle. Many have been passed only to be rescinded soon after. Georgia, in fact, was the first state to ban handguns. Kentucky was the first state to make it illegal to carry a concealed weapon. Kentucky passed its law in 1813; it was struck down by an appeals court less than ten years later. Georgia’s ban went into effect in 1837; it was deemed unconstitutional by the state supreme court soon after. Where do you stand on the issue? Do you support stricter handgun laws? Or do you view gun control as an infringement on personal freedom and a dangerous intrusion by government into private citizens’ constitutional rights? However you may feel, in the deadly race of guns versus cars, highway safety is a progressive field that is producing results. By contrast, gun safety feels like a runaway train. The brakes are inconsistent and ineffective. We never go many days without another massacre someplace, and there is little basis for any realistic expectation of change. As we said above, sometimes it’s one step forward, two steps back. +

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BETTER BUSINESS

HEALTHIER BUSINESS NEW YEAR, NEW REPORTING REQUIREMENTS

he Affordable Care Act (ACA) created new reporting requirements under Internal Revenue Code (Code) Sections 6055 and 6056. Under these new reporting rules, starting this year certain employers must provide information to the IRS about the health plan coverage they offered (or did not offer) to their employees in 2015. For many employers, this has meant scrambling to understand the requirements of the forms, and Russell Head to find a technology solution to assist with completing and dispersing them to employees and the IRS before the deadline. Who Must File The new reporting requirements apply to all Applicable Large Employers (ALEs), defined by the law as those employers with an average of more than 50 full-time equivalent employees (FTEs) during the preceding year, and to all employers who are self-insured. Employers with fewer than 50 FTEs and who are fullyinsured need not report. (Note that companies with common ownership have special rules and should consult a benefits attorney or knowledgeable broker for guidance.) ALEs who are fully-insured will report on the health plan coverage offered (or not offered) each month to full-time employees, whether the plan met the minimum requirements for qualified coverage (as defined by the ACA) and whether it was affordable to the employee (also as defined by the ACA). Additionally, all employers who are self-insured are required to provide information on who was covered by the

JANUARY 8, 2016 employer’s plan, including any dependents, and for which months. When the Forms are Due The first forms are due to employees no later than February 1 (normally January 31, which this year falls on a Sunday). Forms must be filed with the IRS no later than February 29 (February 28 being a Sunday) or March 31 if filed electronically. However, employers may receive an automatic 30-day extension of time to file with the IRS by completing and filing Form 8809, Application for Extension of Time To File Information Returns, by the due date of the returns. Employers should keep in mind that employees will need to receive their individual statements as early as possible in order to have the requisite information to correctly and completely file their income tax returns for that year. What if I Choose Not to File? In June 2015, President Obama signed the Trade Preferences Extension Act of 2015 into law, which increases the penalties for failure to file correct information returns or provide individual statements under either Section 6055 or Section 6056. These changes are effective for information returns and individual statements required to be filed or provided this year. Employers who fail to file in a timely manner could face fines up to $500 per employee form, up to $3 million. For 2015, the IRS has said that no penalties will be imposed for employers who file on time and who can show a “good faith effort” to complete the forms, even if some mistakes are found. However, employers who do not demonstrate a good faith effort to complete the forms, or do not file on time may find themselves wishing that they had. Where Can I Find Help? The IRS has published detailed Instructions for Forms 1094-C and 1095-C which can be found on their website. Some payroll providers are offering reporting services to their existing clients. As always, a knowledgeable benefits attorney or trusted broker can be helpful when navigating these and other requirements of the healthcare reform law. + Russell T. Head is President with ACHS Insurance, Inc., Augusta’s largest risk management and employee benefits brokerage. He can be reached at 706-733-3459 or rthead@achsinsurance.com. Visit ACHS Insurance at www.achsinsurance.com.

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JANUARY 8, 2016

AUGUSTA MEDiCAL EXAMINER

What’s your story? Nearly all of us — even doctors and nurses — are sometimes patients. Perhaps you were recently injured playing your favorite sport, or years ago you somehow got hurt without even leaving your favorite recliner. Maybe you were diagnosed with a dreaded disease, mugged in a dark and lonely parking lot, or you stubbed your toe in the safety of your own bedroom. On the other hand, perhaps you needed medical attention 5,000 miles from home. Whatever your medical experience, we’d like to hear your story for our Medicine in the First Person feature. It can be frightening or funny, ordinary or extraordinary, just a few paragraphs long or quite a lengthy tale, bylined or anonymous. We’ll publish your encounters with the medical profession as often as we receive them. +

One family of providers.

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Send your submissions for Medicine in the First Person to the Augusta Medical Examiner via e-mail: info@AugustaRx.com or to PO Box 397, Augusta, GA 30903-0397. (The Medical Examiner reserves the right to accept, reject, or edit any submission at its sole discretion.)

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Obviously the online edition of the Medical Examiner has just posted. Full color on every page. Clickable links. Read it 24/7. Go to issuu.com/medicalexaminer

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

(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net Opinions expressed by the writers herein are their own and their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., or its agents or employees take any responsibility for the accuracy of submitted information, which is presented for informational purposes only. For specific medical advice, diagnosis and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2016 PEARSON GRAPHIC 365 INC.

JANUARY 8, 2016

AUGUSTA MEDiCAL EXAMINER

#14 IN A SERIES

Who is this?

OLD NEWS +

POINTS OF INTEREST TO FORMER KIDS by Trisha Whisenhunt, Senior Citizens Council

WHAT’S YOUR NEW YEAR’S RESOLUTION?

his gentleman may be one of the most tragic figures in the history of medicine. Although a true pioneer, his ground-breaking discoveries were ignored or rejected during his life, which ended tragically and ironically. As if to underscore the point, it is extremely unlikely you’ve ever heard of him. His name was Ignaz Semmelweis. He was born in Hungary on July 1, 1818. On his 28th birthday he was appointed to a chief resident-like position at an obstetric clinic of Vienna General Hospital. In that era, the mid-1840s, such clinics were popping up across Europe to try to stop the killing of illegitimate children. They offered free care for mother and newborn, and in exchange the women would be subjects for training by doctors and midwives. In fact, the Vienna hospital established two clinics, which admitted patients on alternate days. The First Clinic had maternal mortality rates as high as 18 percent, while the Second Clinic’s were as low as 2 percent. The large disparity between the two clinics puzzled Semmelweis, but the only difference that could be identified was that the First Clinic was for training medical students, while the Second Clinic trained only midwives. That meant nothing until one day in 1847 when a colleague and friend of Semmelweis died after being accidentally poked by a scalpel during an autopsy. The autopsy revealed pathogens similar to the women who had been dying in the First Clinic. Semmelweis immediately made the connection: medical students could at times have what he called “cadaverous particles” on their hands. That would never occur with midwives, thus the difference in mortality rates between the two clinics. Semmelweis’ solution was simple: hand washing. It was so simple that the medical community of the day rejected it out of hand; disease transmission was much more complicated than that. Furthermore, it was an insult to even suggest that doctors could be carriers of disease. Undeterred, Semmelweis instituted a rigorous hand washing protocol at the First Clinic in mid-May of 1847. Its mortality rate in April was 18.3 percent; by June it was 2.2 percent; in July, 1.2 percent. And by March of 1849, Semmelweis was unemployed, his breakthrough unrecognized. In fact, he was forced to take an insignificant, unpaid position at another maternity clinic where he again virtually eliminated mortality from “childbed (puerperal) fever.” After his departure (following a six-year tenure), his successor abandoned the Semmelweis policy and mortality soared from 0.85 percent to 6 percent. Semmelweis was an annoyingly tireless (and tactless) promoter of his antiseptic policy, but lacked any scientific explanations for its success. He was increasingly strident in his attacks on his peers, even calling them murderers for ignoring his simple hand washing suggestions. He was tricked into visiting an asylum, where he died within two weeks from sepsis, ironically enough, days after a severe beating by guards. Of course, ultimately Semmelweis was vindicated, but by then he was dead. The term “Semmelweis reflex” describes the reflexlike tendency to automatically reject new evidence or knowledge simply because it contradicts established norms or beliefs. +

ost of us make New Year’s promises to ourselves, and I’m guessing only a small percentage of us keep them. Go on a diet, quit smoking, work less, more time with the kids; you know the drill. We value keeping our commitments to others but it’s easy to let the commitments we contract with ourselves to become void. Why is that? We give our very best to our employers, family and friends; why don’t we believe we deserve it personally? I am making two resolutions this year. One of them is to train myself to be good to myself. I am the only one in my family that I say “no” to consistently. I want to be able to lighten up enough to buy the things I truly want (and can afford), take more day trips to see the places and people I wish to see, and eat more Chinese take-out. I have never seen a panda bear close up and I am determined to change that.

Happy 2016! The zoo is within a couple of hours, so there is no excuse. These are a few of the many things I know will bring me joy, and I intend to whittle the list down this coming year. What’s on your list? You may be so busy with work and family that you don’t even realize what your list comprises. That is your first order of business - make some quiet time to figure out what is important to you, what is currently missing from your life that will make you happy. Women especially worry too much and sacrifice themselves to the point of

exhaustion. There is only so much water in the pitcher. The kids will be fine, your husband is capable of making his own sandwich and it’s ok to delegate some work at the office. Many men work too much, either at their jobs, at home, or both. You don’t have to be in control of everything all the time. Relax. If we could really retrain ourselves to treat ourselves better, our blood pressure will drop, we will have fewer aches and pains and the headaches will lessen. Imagine: just by treating ourselves to something we really want more often and having some fun we can improve our lives and become happier people. The process is more difficult for some than others, but it can be done. The key is practice. At first it won’t work, but keep at it. Soon you will find you can do it on occasion. With continued practice it will happen more often, and before you know it, it becomes part of your life routine and you discover you are smiling more, smoking less, dropping a few pounds, sleeping better. I can’t think of anything more important I can do for myself than this. No one else can do it for me. No one can gift it and my doctor can’t prescribe it. Self-improvement is difficult and takes desire and determination, but the reward is huge. We all deserve it. +

MYTH OF THE MONTH Cracking your knuckles causes arthritis. If it does, every concert pianist who does the little exercise seen here when they sit down at the keyboard — and they all seem to do it — is doomed to a shortened career and a painful retirement. Fortunately, however, this bit of folklore is just that: a bit of folklore without any medical evidence to support it. Having said that does not mean, however, that cracking knuckles is the best thing ever invented for digital health. Even so, one medical doctor cracked the knuckles of his left hand every day, but never the knuckles on the right. After doing

this for more than 60 years, neither hand showed any evidence of arthritis or other damage. That feat earned him the 2009 Ig Nobel Prize, a parody of the Nobel Prize. The cracking sound, called crepitus, is caused by the popping of a gas bubble formed by stretching the joint. The main side effect: you can’t re-crack that knuckle for about another twenty minutes. + — by F. E. Gilliard, MD, Family Medicine 639 13th St Augusta, GA 30901 706-823-5250

JANUARY 8, 2016

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW res? ABOUT THINGS I DO NOT LIKE

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do not like: • Microorganisms such as viruses, bacteria and fungi that cause infections. • Patients who exchange symptoms and complaints in the waiting room. It confuses me. • Any recorded phone greeting that begins, “Your call is important to us.” That means you’re in for a long wait and you won’t get to talk to a real human for quite some time, if ever. • Any phone greeting that says, “Listen carefully as our menu options have changed.” That means, again, you will not get to talk to the human anytime soon, if ever, and you’ll go through a series of a dozen or so selections that are designed to guide or misguide you to information that you don’t want before it refers you to a website. If I wanted the k

website, I would have gone there before calling the 800 number. • Misleading advertisements, such as one that says, “Nobody makes a better widget than we do.” That really means that there are 50 other companies that make widgets and they’re all exactly the same. • TV commercials that are louder than the program that you’re watching. I know that is designed to wake up someone who nodded off during the program, but I’m capable of making my own decision of when I want to wake up. As a matter of fact, I can wake up within 15 minutes of anytime I want to ... without an alarm clock ... assuming that I looked at the clock before I went to sleep. That is a little gift from God that has served me well for decades. • Drivers who weave in and FREE T AKE-H OME C OPY!

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t s e B out of traffic. I guess they are trying to get somewhere in a hurry, but at the next red light we’re all back even. • Hollywood movies, TV programs, or advertisements that indirectly promote or advocate sexual orientations, religious beliefs, political inclinations, or other subtle agendas. If I want to voluntarily find a support group or join a cause, I know how without your help. • Radio or TV programs that purport to dispense news when actually they are a running commentary for a given political agenda. Any such program or network that can be described as conservative or as liberal is no longer a news agency. • Negative political campaigns. I don’t need them

e n i c i d ME

telling me what someone else has done that is bad. I want to hear what they will do that is good for me and the USA. • Women who dress and present themselves provocatively, and then look with disdain upon men who look at them. If they don’t want to get looked at, they should dress like Friar Tuck and no one will look. Roseanne Barr comes to mind. • Severe weather conditions that cause destruction and death, although I realize that is part of nature and we cannot change it. • Men who yell at or bully women or children. • Anyone who shows disrespect for women or children. • People who have 20 items in the 10-Item Checkout Line.

BORN IN AUGUSTA

That’s rude. • People who don’t vote, and then complain about who got elected. • People who leave a failed culture or nation and come to the USA and then want to change this country to be like the one they left. • Politicians who pass laws that apply to you and me, but not to the politicians. • Hypocrites. • People who criticize without having a solution to the problem. Tell me something you believe will work. I have enough doubts of my own. Enough of that, Dear Hearts. May your new year be better than the last and better than you deserve. + Bad Billy Laveau is a formerlyretired MD who wields a pointed sense of humor and now, tongue depressors too. He speaks and entertains at events for audiences not subject to cardiac arrest secondary to overwhelming laughter and glee. BadBilly@knology. net or 706-306-9397.

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this surgeon knows who and trauma surgeon Fort, a French very ER physician on March It’s René Le who died man’s name. 30, 1869 and day for his 1901 on March to this was born is remembered facial fractures. Many 30, 1951. He system for main categories a classificationyou he discovered the Le Fort III creation of tell Fort II, and works will Le Fort I, Le say he created reference — still named will go so far as to patterns in of fractures it at that. Some examining fracture “Le Fort by — and leave this bold statement: cation system the the classifi book made skulls to see Ah, but one roof onto their cadavers. off a tavern he the face.” before. And tossed cadavers of fracture lines in had gone 9 natural pattern going where no man WHO? page Please see That is boldly

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AUGUSTA MEDiCAL EXAMINER

Part Five of an 8-part series

Looking for Likes in all the right places.

16 for ’16

With the end of one year and the beginning of another, it’s a fitting time to consider ways to start the new year in a better state of mind and body. Each installment of this series, now through February, will offer simple ways to do just that by cutting bad things and adding good things. To read previous installments of 16 for ’16, visit issuu.com/medicalexaminer. Tell your dentist you’ve been flossing every day when you haven’t, and he’ll spot your lie within ten seconds of peering into your pie hole. But let’s say you can pull off a few stories that your doctor believes 100 percent. Who benefits from that? Anyone? It’s actually rather puzzling why some people bother to go to their doctor in the first place. The people we’re referring to don’t follow doctor’s orders; they don’t fill their prescriptions, or if they do, they take their medicine haphazardly at best, not according to the label directions. Or, they take their medicine religiously while continuing the behavior which

+ #8 LOVE YOURSELF/LOVE

YOUR DOCTOR As every doctor knows all too well, patients lie through their teeth. “Do you smoke?” No. “Have you been taking the medicine as prescribed?” Absolutely. “Are you up to date on all your shots?” Every last one. Let’s see... that’s three lies so far. As you may know, your medical chart doesn’t say “Patient doesn’t smoke.” It says, “Patient denies tobacco use.” But don’t think you’ve fooled your doctor. Your average nonsmoker can smell a smoker from twenty paces — even while blindfolded.

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caused their condition and their need for the medication. If someone would just donate a dollar to the Medical Examiner for every patient in the CSRA alone who simultaneously administers chocolate cake and insulin, or a bottle of soda and insulin, or a bowl of ice cream and insulin... well, we could print this thing on fancy paper. The bottom line: if you’re not what is known as a “compliant patient,” you’re cheating yourself. And in the process you’re cheating things like your lungs, your pancreas, your heart, your family members, and even your insurance company that pays for worthless and pointless doctor visits and medications. The remedy: do your level best to follow doctor’s instructions and take your medication as instructed. Keep your follow-up appointments, too. + #9 GIVE IT A REST! One of the most neglected elements of good health is getting sufficient sleep every night. It’s increasingly recognized as an essential component in the prevention of chronic disease

(serious stuff like diabetes, depression, obesity and cardiovascular disease) and the promotion of good health. As in potential resolution #8, this is another instance where you aren’t really getting away with anything by cheating yourself out of needed sleep. Cheaters hurt only themselves. Sleep is a bit unusual among health pursuits in that others are involved: you might want to get to bed early, but you share the bed with a night owl or a 100-decibel snorer. Or perhaps you have the job of supervising the sleep habits of others: you have kids. There are some simple and effective ways for one and all to get sufficient sleep. It’s fun for the whole family! Start by establishing bedtimes. That can help eliminate nightly battles and debates with your kids — or yourself. In other words, you can’t tell yourself, “Oh! So-andso is on Jimmy Fallon tonight! So long early bedtime.” Do not go there. Go to bed on time. You can catch that segment tomorrow on YouTube. As for the kids and the Please see 16 for ’16 page 13

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Be it resolved...

re you a New Year’s resolution fan? Or a resolution hater? Both sides in this annual discussion have their valid points. On the negative side, by the time you read this many carefully made resolutions may have already slipped a little. Statistically, by this date (January 9) 25 percent of all resolutions have already gone down in flames; that many usually fail within the first week. By the six-month mark the failure rate is about half. And by this time next year, the wreckage of 88 percent of all those shiny new intentions of last week’s New Year’s Day 2015 will lie strewn across the landscape. On the plus side, that means a fairly decent 12 percent of all resolutions are achieved after a full year. Building on that positive note, making New Year’s resolutions is evidence of one of the finest aspects of human nature — that we continuously evaluate ourselves and constantly strive to improve, to be better husbands or wives, better moms and dads, better employees, better bosses, and just better human beings. The typical resolutions reflect those basic desires: the #1 resolution every year is always some form of better health. Lose weight. Get more exercise. Eat less junk food or fast food. Eat less, period. Quit smoking. Drink less, or quit altogether.

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You really can’t fault anyone for such noble goals. After all, health is the ultimate wealth. It’s the currency that makes every other endeavor in life possible. Speaking of currency, improving finances is, broadly speaking, the second most popular resolution category. Common examples include establishing and/or sticking to a budget; saving more; cutting impulse buys; getting a better job, a raise, or a promotion. The third-most common resolutions might be categorized as self-improvement: read more; temper control/ anger management; reduce or manage stress; watch less TV; get more education: learn a new language, skill, or hobby; improve your marriage and other personal relationships, and so forth. All of these are worthy goals. They are well worth pursuing, even if that means getting past occasional setbacks. Since failure is always an option, it’s good to expect it and be ready to keep making progress. There is nothing magical about January 1. If you haven’t made some kind of self-improvement goal, it’s never too late. If you’ve started and failed already, restarts are always allowed. Whatever you set your sights on, keep the letters shown below in mind, as well as what they stand for. Please see RESOLVED page 2

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AND CALL ME IN THE MORNING. Prefer paper? We’re all over town. If you prefer our digital version, we’re all over the world. The Medical Examiner is always available on your favorite device at ISSUU.COM/MEDICALEXAMINER or at the Medical Examiner blog (www.AugustaRx.com/news) on issue dates. Click directly from any Examiner page directly to websites listed in ads and articles. You can easily view back issues, too. +

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MEDICINE IN THE FIRST PERSON Everybody has a story. Tell us yours! 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. Tell us if you want it “by you” or if it needs to be anonymous. Thanks!

JANUARY 8, 2016

AUGUSTA MEDiCAL EXAMINER

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If you have been to PF Chang’s you may have had their amazing lettuce wraps. They have a vegetarian version, a gluten free version as well as chicken lettuce wraps on their appetizer menu. I wanted to try and create a healthier version at home but, keep all the flavor of the PF Chang’s dish. I played around a bit with some ingredients and different ideas and then I put this recipe together. It is Asian Wonderful-ness! I think this dish turned out pretty great and my husband agreed. I used all natural ground turkey, veggies, no sugar, minimal oil and gluten free soy sauce and of course..... the very healthy leaf lettuce in place of ice berg lettuce that most folks use for lettuce wraps. The dipping sauce was both sweet and spicy. This meal was full of flavor, healthy and clean..... and very filling. I was stuffed when we finished the meal. The recipe made the perfect amount for our dinner but, if you had 4-6 people you could use this dish as an appetizer also. Lettuce wraps are typically eaten with your hands rather than with forks and knives so you’ll need a few sturdy • 1 small can of water pour 1/4 Cup of soy sauce, napkins available. To help chestnuts, coarsely chopped honey and rice vinegar over the dripping situation we • 1 lb. of button mushrooms, the turkey/vegetable mixture spooned the sauce over the stems removed, cleaned and and stir well to coat the meat turkey mixture once we had chopped and vegetables. placed it on the lettuce leaf • 1 Tbsp. of fresh ginger, 5. Stir occasionally and keep and then we wrapped it up fi nely chopped or grated warm while you prepare the as tightly as possible before • 1/4 Cup of gluten free, low dipping sauce, carrots and eating. sodium soy sauce cabbage. Have a great start to your • 2 Tbsp. of honey 6. Wash and grate 3 carrots New Year and I hope you • 1 Tbsp. of rice vinegar and shred approximately 1 enjoy the recipe! • 1 bunch of leaf lettuce, cup of red cabbage. washed and leaves broken 7. In a small bowl, add 6 Ingredients: apart Tbsp. of soy sauce, 4 Tbsp. • 1-2 Tbsp. of extra virgin • grated carrot of rice vinegar, 2 Tbsp. of olive oil • shredded red cabbage honey, 2 Tbsp. of Dijon • 1 lb. of organic/all natural mustard, 1 Tsp. of sesame oil ground turkey For the sauce: and crushed red pepper to • 4-5 cloves of fresh garlic, • 6 Tbsp. of soy sauce taste. Whisk all ingredients crushed • 4 Tbsp. of rice vinegar together for the dipping • 3 scallions, chopped • 2 Tbsp. of honey sauce. • 2 Tbsp. of Dijon mustard 8. To serve, place 1-2 Tbsp. of • 1 Tsp. of sesame oil the turkey/vegetable mixture • 1 Tsp. of crushed red onto a lettuce leaf, spoon a bit pepper (or to taste) of the dipping sauce over. 9. Sprinkle carrot and red Instructions: cabbage on top, wrap the 1. Heat 1-2 Tbsp. of olive oil lettuce leaf around the meat in a large skillet over medium and enjoy. + ROLLED SANDWICHES • SOUPS • SALADS to high heat. 2. Place ground turkey in the Alisa Rhinehart writes the blog skillet and cook until lightly www.southerngirleatsclean.com browned. She is a working wife 3. Add garlic, scallions, water and mother living in Evans, Georgia. chestnuts, mushrooms and Visit her blog for sauté stirring often until more recipes and vegetables have softened. information on clean Approximately 5-8 minutes. eating. 4. Decrease heat to low and AVERAGE CALORIES IN OUR CHICKEN & TURKEY WRAPS: LESS THAN 300. IN OUR VEGGIE WRAPS: LESS THAN 250 CALORIES an a million people can’t be w

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Asian Lettuce Wraps

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OUR NEWSSTANDS Medical locations: • Children’s Hospital of Georgia, Harper Street, Main Lobby • Department of Veterans Affairs Medical Ctr, 15th St., Main Entrance • Dept. of Veterans Affairs Medical Center, Uptown Div., Wrightsboro Rd., main lobby • Doctors Hospital, 3651 Wheeler Rd, ER Lobby Entrance • Eisenhower Hospital, Main Lobby, Fort Gordon • George C. Wilson Drive (by medical center Waffle House and mail boxes) • Augusta U. Hospital, 1120 15th Street, South & West Entrances • Augusta U. Medical Office Building, Harper Street, Main Entrance • Augusta U. Medical Office Building, Harper Street, Parking Deck entrance • Augusta U. Hospital, Emergency Room, Harper Street, Main Entrance • Augusta U., Laney-Walker Boulevard transit stop, Augusta • Select Specialty Hospital, Walton Way, Main entrance lobby • Trinity Hospital, Wrightsboro Road, main lobby by elevators • Trinity Hospital Home Health, Daniel Village, main lobby • University Health Federal Credit Union/ University Hospital Human Resources, 1402 Walton Way, Main Lobby • University Hospital, 1350 Walton Way, Emergency Room lobby area • University Hospital, 1350 Walton Way, Outside Brown & Radiology/Day Surgery • University Hospital - Columbia County, 465 N. Belair Road, Main Lobby • University Hospital Prompt Care, 3121 Peach Orchard Road, Augusta

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

Plus... 800+ doctors offices throughout the area for staff and waiting rooms, as well as many nurses stations and waiting rooms of area hospitals.

JANUARY 8, 2016

AUGUSTA MEDiCAL EXAMINER

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

WHEN THE CURE BECOMES THE PROBLEM, PART 2 Gluten-free this, gluten-free that… *Eye Roll*. Just a hipster fad, right? Not if you have celiac disease or its cousin, a wheat allergy. Eating gluten can be as life threatening to those who have this disease as a peanut allergy or any other common food allergy. In general, we are becoming much more aware of the major food allergies – dairy, eggs, fish, peanuts, shellfish, soy, tree nuts, and wheat – with over 3 million cases per year. If you have a medication allergy, most people know to make sure your physicians and pharmacy are aware of the allergy. The same goes for a true food allergy. (This doesn’t mean if the Bang Bang Shrimp gives you heartburn you have to list it as an allergy. However, it’s a different story if your lips swell after you eat that dish.) Medications are made up of “active ingredients” and “inactive ingredients.” The active ingredient is the actual drug in question. For example, it might be levothyroxine – a medication used for thyroid disease. “Levothyroxine” is the active ingredient and will be the same no matter who makes it. It does not matter whether it is brand name or generic, that part of the medication is the same across the board. The part of the tablet or capsule that may differ slightly is the “inactive ingredients,” the ingredients that hold it all together. Some common ingredients include corn starch, talc, acacia, dyes, sucrose, povidones, etc. While for most people the inactive ingredients of a medication make very little difference in how the medication works for them, for others those same ingredients may determine whether a medication is safe to take. For example, a woman on hormone replacement therapy with a peanut allergy would need to avoid the medication Prometrium. It contains peanut oil - but there

are plenty of suitable hypoallergenic alternatives available. A person with celiac disease will look for any inactive ingredients that may contain wheat or gluten. Sometimes that may include an ingredient simply listed as “starch.” In the United States, “starch” is generally corn starch or the like, but if medications are sourced from other countries it can become a guessing game. Even a tiny bit of gluten can make a celiac patient very sick and potentially send them to the hospital. Drug manufacturers may change their processes, even after many years of making a drug. For example, AbbVie changed their process in making Synthroid (levothyroxine) and can no longer guarantee it to be gluten-free. For celiac patients there are other similar medications that are now better choices. For many years, there was a warning on Atrovent and Combivent inhalers regarding soy and peanut allergies. At that time the products contained soya lecithin, a natural food-grade emulsifier. They have since been reformulated, as have all inhalers, and they no longer contain that ingredient. As with celiac patients, those with peanut/soy allergies cannot be too careful. Even a little can be too much. The moral of this story: If you have serious food or medication allergies, ASK QUESTIONS. Make sure that the allergy information is on your chart in the physician’s office and do not assume that the pharmacy has that information just because the doctor does. It may save someone’s life in the process. +

Food aller gies can become drug allergies.

THE COLD WAR

(This is Part 2 of a 2-part article.) Questions about this article or suggestions for future columns can be sent to us at cjdlpdrph@bellsouth.net Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson (cjdlpdrph@bellsouth.net )

It’s not over. We’re still fighting it.

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ATTENTION NEW YEAR’S RESOLUTIONERS: HOW TO ENSURE YOUR 2016 HEALTH GOALS ARE SUCCESSFUL by Katelyn Metz, RD, LD Clinical Dietitian at Georgia Regents Medical Center goals are not too lofty. For example, if you typically go to the gym only twice a week, be honest with yourself: are you actually going to be able to sustain going to the gym every day, seven days a week? Something more realistic might be going four days per week. Maybe try a group fitness class, make some new friends who may be on a similar journey as you. Start there, and work your way up! Also, is losing 25 pounds realistic? It is as realistic as you want it to be, but remember life happens and you don’t want to get down on yourself if you are not able to lose that much weight. Maybe a goal of 15 pounds is more reasonable for the hectic schedule you have amongst your family and kids. • Time-bound: Spring Break. This is a good timeframe to work with; three to four months to incorporate lifestyle modifications is typically realistic. A nonrealistic deadline would be something like Valentine’s Day. Give yourself time to turn these goals into daily habits. Make sure you set aside enough time to see results and turn these goals into your new lifestyle. 2 - Understand that life happens and you will slip up. And that’s okay; do not get discouraged and do not give up. So you only made it to the gym 3 times this week? That’s okay. Do better next week! Do not take it personally, you are not flawed. Learn from this lapse and create a plan of action

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than treating yourself to a sugary milkshake once you lose those 25 pounds, opt for a healthier alternative.

pick you up before you even fall. Recruit an accountability partner and/or include your family/kids in your journey. Undertaking lifestyle changes is not easy, but if you have someone you can count on to be by your side for these goals, they can help hold you responsible.

Ask a Dietitian 1 - Set SMART goals. It’s okay to be ambitious, but it’s equally important to be realistic. So you want to start eating healthier, go to the gym every day, and lose 25 pounds in time for Spring Break. Ask yourself these questions, are your goals SMART? What do I mean by SMART? Are they: Specific, Measurable, Achievable, Realistic, and Time-bound? • Specific: Think about what is important to YOU. Using the above example: What do you mean by “healthier?” Turning your refrigerator into the Garden of Eden, incorporating a vegetable with your meal at lunch and dinner daily, or eating at Chick-fil-A two less times per week? Really think: what does healthy mean to you? • Measurable: How are you going to measure these goals? Perhaps keep a food and exercise diary. Weigh yourself biweekly. Track your progress, but also your slipups. See what triggers those slip-ups and brainstorm what you can do to mitigate further mishaps. • Achievable: Are these goals achievable? Will you make time to set yourself up for success? For example, are you willing to go be bed a half hour earlier so you can make time for the gym in the morning before heading to work? Will this work with you and your family’s daily routine? • Realistic: Setting goals is an excellent way to make positive changes, but it’s important to make sure those

AUGUSTA MEDiCAL EXAMINER

or strategy to promote success next time. As the Japanese proverb states: Fall seven times, stand up eight. 3 – Stay accountable. It is great to have someone by your side to help you stand back up if you fall down - or to

5 – Make it fun! Altering a lifestyle you’ve lived for years will be hard work, but there are ways to make it more enjoyable and increase the odds of success for you and all involved. Some examples may be: • Adding money to a vacation fund upon completion of goals; • Creating a sticker-chart for kids every time they try a new vegetable; • Setting aside 30 minutes to take a walk around the neighborhood with your family and catching up on each other’s day, the options are limitless! +

4 - Set non-food-related rewards for reaching your goals. Go get a manicure or pedicure, schedule a massage (perhaps with your accountability partner), or purchase those new running shoes you’ve been eying for months. Rewarding yourself with food can be extremely counterproductive. So rather

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Overhead Door Company of Augusta-Aiken 706-736-8478 803-642-7269

The Short White Coat H

ello, 2016! As we welcome a new year, it is common to feel a sense of hope and promise. Some of us believe that with a new year comes the possibility for change. Granted, most of what we would want to see change is beyond our hands: world peace, the end to hunger and homelessness, a healthier planet, a better economy, and an improved healthcare system. Nevertheless, I have learned that our words and actions do play a role in how our world is shaped. Our own personal resolutions for the New Year can make a difference; despite how small that difference may be, it is still essential to the big picture. Treating others with respect, showing gratitude, being generous and coming from a place of peace can all make a difference. In the grand scheme of things, it may feel as though we have little control. However, if there is one aspect of life we can indeed control, it is ourselves. The manner in which we carry ourselves, the habits we form and how we react to others gives us control. As a medical student, maintaining a healthy lifestyle is challenging at times. Below I have detailed 10 general goals to choose from and 5 tips that I believe to be beneficial in setting a clear and specific goal and reaching it. Ten Goals: • Being more active • Eating more fruits/vegetables

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Call (706) 860-5455 This space available. If interested, please call the number above.

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M.E.

THE AUGUSTA MEDICAL EXAMINER AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

• Drinking more water • Writing a book • Running a marathon • A restoration project • Improving a craft/talent • Quitting sugary drinks • Daily prayer/Meditation • Take up a new hobby (photography, painting, ceramics, etc.)

Five Tips to Keep Meet Your Goals in 2016: • Start Small: It is a common mistake to take on too much too fast, become overwhelmed, and give up on our goal. In order to avoid this, start small! My goal is to exercise 6 days a week, but I will begin with 2. This way, it is manageable. • Buddy System: The company we keep can push us toward the goal or pull us away. It isn’t always feasible to find a friend who wants to achieve the same goal, but it’s worth a try to ask around. There are also free websites for weight loss or completing a novel, for instance, allowing you to meet others who can motivate you on your new journey. • Organization: Set a schedule, put it in writing, set alerts and reminders, and put post-it notes throughout the house if that is what it takes! • Rewards: Rewarding behavior that helps us reach our goal is important. I like to come up with shortterm rewards to keep the carrot within reach. Choose something you enjoy and treat yourself to it every 7 or 10 days of meeting your goal. Also, choose a bigger longterm reward once you’ve met your goal (finished a book, or remained consistent with your new habit until 2017). • Journaling: Keeping an account or record of your progress will further

A med student’s notebook motivate you with the energy to keep working on it. This could be in the form of a written or photo journal. As a third-year medical student, my goals involve competitive board exam scores, excelling in my clinical rotations and volunteering to work with at-risk youth. These goals will allow me to further my career as a future physician. My ultimate goal is to help others achieve and maintain good health. As future doctors, we sometimes put our own health second in order to meet the goal of helping our future patients with their health; using energy drinks or eating fast food. However, I will also be using the tips listed above to begin healthier habits in 2016. It is common to lose sight of the big picture. Nevertheless, the start of this year allows us to look back at the 365 days of 2015 and refresh the lens to imagine the positive changes that we can welcome into our lives in 2016! Wishing you a year filled with love, peace, joy and positive change! Happy New Year! + by Jasmine Rivas, a third year medical student at University of Medicine and Health Sciences, who is currently in a Surgery rotation in Augusta. Feel free to contact her with questions or feedback: jrivas@umhs-sk.net

OUR NEXT ISSUE: JAN. 22

READ THE MEDICAL EXAMINER — AND MUCH MORE — AT THE MEDICAL EXAMINER BLOG (www.AugustaRx.com/news) +

JANUARY 8, 2016

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AUGUSTA MEDiCAL EXAMINER

From the Bookshelf The blog spot — Posted by Nina Shapiro, MD on Dec. 28, 2015 at kevinmd.com

DOCTORS AND NURSES NEED BETTER SUPPORT WHEN THEY MAKE ERRORS In September 2010, a seasoned pediatric intensive care unit nurse administered an accidental overdose to a critically ill baby, giving ten times the amount of calcium that was prescribed. Five days later, this baby, with an already tenuous heart condition, died. The nurse recognized her mistake immediately, informed her superior, and also told the family and physicians. She was, however, escorted out of the hospital, put on administrative leave, and fired soon thereafter. Six months later, she took her own life. The nurse clearly made a mistake; an avoidable one at that, and it may have contributed to this baby’s demise. We are all human, and we all make mistakes, but in medicine these mistakes can cost a life. Mistakes occur almost 200,000 times annually in hospitals throughout this country. These disastrous errors are oftentimes personinduced medical errors, either from carelessness, lack of adequate knowledge, or, in this case, inattention to rote procedures that seemingly do not require a seasoned health professional’s complete focus. Some events occur as a result of systems errors. While computer programs in hospitals now offer alerts to minimize dosing or treatment errors, such errors still occur. Just this year, a patient with active Ebola virus infection was mistakenly discharged from a Texas emergency room, due to inadvertent oversight of an electronic medical record entry. As part of the continuing effort to eliminate mistakes in the operating room, many hospitals now routinely perform timeouts before each surgery, whereby the entire staff in the room confirms patient identification, medical allergies, site of surgery, equipment needed, anticipated events, and personnel present. The operating surgeon then states that anyone should voice their concern at any time should there be an unnoticed event or potential error. It is literally a timeout where everyone stops what they’re doing, and listens. At the end of each surgery, all personnel participate in a debriefing, where they review whether or not all went as planned, and, if not, what measures were carried out to handle any changes. While many experienced surgeons and nurses balked at these timeouts and debriefings, surgical errors have indeed been reduced, and even the most skeptical have incorporated and welcomed these moments in efforts to minimize error. Even when all goes perfectly in medicine or surgery, bad things can happen in a medical environment. Many of us treat critically ill patients. Some will die no matter how heroic our efforts. Some die in our hands — literally. Trying to revive a dying child on his or her last breath is unforgettable. Most medical institutions have built-in counseling and support systems in place to help a grieving family — emotionally, spiritually, and even logistically. This is a good thing. But medical personnel are also human, and for us there is little or no built-in support system in hospitals for those closely involved in the death of a patient, be it from error or not. As a medical or surgical team, we have each other. And we have our families and friends. But while the institutional support for grieving families is a well-oiled machine, there is no such machine to mop up the tears of the staff. While robotic surgery has become the rage, we as physicians, nurses, staff, and students, are not robots, and we could use a post-mortem, supportive debriefing in the hope of healing our wounds and hopefully continuing to heal those of others. Maybe, with these support systems, we can save the next nurse (or doctor) who errs. +

Maybe we can save the next one who errs.

Nina Shapiro is a pediatric otolaryngologist. She is the author of Take a Deep Breath: Clear the Air for the Health of Your Child, can be reached on her self-titled site, Dr. Nina Shapiro.

VISIT THE MEDICAL EXAMINER BLOG DAILY • www.AugustaRx.com/news •

This book begins with a sweet and touching scene introducing us to Dr. Perry’s very first patient — and goes seriously sideways before the second paragraph ends. The stories in this book are all the more poignant since they are about the already damaged lives of young children. The number of children who need counseling and therapy is, unfortunately, astonishingly large. As the introduction points out, the triggers for emotional trauma are everywhere: during one recent year there were roughly 3,000,000 official reports of child abuse or neglect made to various child protection agencies. The actual number is undoubtedly far, far higher. An estimated minimum of ten million children are exposed to domestic violence annually; in 1995, 6 percent of mothers and 3 percent of fathers admitted to physically abusing their children at least once; each year, 4 percent of American kids under age 15 lose a parent to death. Imagine how many more lose a parent to rancorous divorces and

relationship breakups. Add it all up and conservative estimates are that 40 percent of all children have at least one potentially traumatizing experience prior to age eighteen. Added to all that are moments of trauma, some monumental — think hurricanes, floods, tornadoes, house fires, heavily reported terrorist attacks — and others that may never rate more than the briefest mention on local news — devastating automobile accidents, for example — or that may happen in secret: rape and sexual

abuse. Once upon a time, children exposed to these terrible events large and small didn’t need treatment — or so the mental health profession believed. Children were “resilient.” They “bounce back.” And that’s if they even remember the trauma in the first place. Oh, they remember. And they aren’t as resilient as medical science once believed. That isn’t to say they can’t be fixed, but with 20-20 hindsight there was no basis for saying that experiences which would cause life-changing physical and emotional trauma for adults would be simply shrugged off by children. This excellent book comes highly recommended (by the Medical Examiner) for anyone who regularly deals with children, an audience that includes counselors, therapists, teachers, physicians/ pediatricians and parents. +

The Boy Who Was Raised as a Dog — And Other Stories From a Child Psychiatrists’s Notebook by Bruce D. Perry, M.D., Ph.D. and Maia Szalavitz; 288 pages, published in 2006 by Basic Books

Research News Sugar: not so sweet after all The MD Anderson Cancer Center in Texas released a study earlier this week which discovered a possible link between high amounts of dietary sugar and an increased risk of breast cancer, and metastasis to the lungs. Researchers said this is a significant finding, inasmuch as per capita sugar consumption in the US has surged to over 100 lbs. per year. The growing popularity of sugar-sweetened beverages and of ever-larger serving containers are contributing to an epidemic of obesity, heart disease and cancer, said study authors. Previous research has suggested a strong link between sugar and development of existing cancer. Texas researchers said their study was the first of its kind to investigate the direct effect of sugar — specifically table sugar and high-fructose corn syrup — has on cancer formation. Although further research is needed, this study suggests that dietary sucrose and

fructose induced production of breast tumor cells. Race bias in the exam room? Physicians get lower marks in nonverbal communication when dealing with seriously ill black patients compared to their white counterparts. At least that’s what a small University of Pittsburgh School of Medicine study released this week found. Thirty-three physicians (the overwhelming majority of them white males) were involved in the study, which put them in realistic situations in which black and white actors portrayed patients (each with a “family member” at their bedside) with plummeting vital signs related to either metastatic gastric or pancreatic cancer. The “patients” all acted from identical scripts. The doctors were unaware of what the study was examining. Physicians, scored using a point system for their verbal and nonverbal skills in interacting with the patient and family members, averaged 7

percent lower scores for their nonverbal interactions with black patients than with white patients. Physicians were more likely to stand right at a white patient’s bedside and touch them in a sympathetic manner. Hidden camera images from the study show the same, as well as contrasting images, like a doctor standing near the door of a black patient’s room holding a binder in front of him. Body language, say Pitt researchers, is an important tool to build (or destroy) trust and confidence in the medical profession, and can have significant treatment ramifications. Building trust encourages patients to take a greater roll in decisionmaking on more aggressive life-sustaining measures, or end-of-life care. Doctors, say the authors of this study, can help patients’ families in these difficult situations by being careful to avoid communicating any unintentional biases. +

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JANUARY 8, 2016

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS +

by Dan Pearson

Did you enjoy Yes, but it was just too Have you ever Aleve? thought of taking visiting your family quick. There How would that help? a leave? over the holidays? wasn’t enough time.

You could visit for a few weeks, maybe a month.

I will definitely ask my pharmacist. Thanks!

The Mystery Word for this issue: BEERMMAN

EXAMINER CROSSWORD

PUZZLE

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

QUOTATION PUZZLE

T G H T A E L N U N H O N F Y E E T C Y Y U N E E E ’ W R U L A O G E V D R O A N O D O

Click on “READER CONTESTS”

Solution p. 14

— Eric Hoffer

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once. Black squares indicate spaces between words, and words may extend onto a second line. Solution on page 14.

X A M I N E R

8 9

7 2

3 3

U D O K U

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

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

1 2 3 4

4 1

5 2

6 1

7 2

H 2

3 I 5

1 2 3 4 5 6

1 2

1 2 3 4 — Margaret Mead

1 2 3 4

1.VBTILWWHHO 2.OOAAAFYEH 3.LARRRER 4.DUDKRK 5.INE 6.NE 7.GD

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

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

VISIT WWW.AUGUSTARX.COM 1

ACROSS 1. Packs tightly 6. Ochoa’s org. 10. Surgery reminder 14. Spinning part of a machine 15. Thermometer type 16. Division of a window 17. Farewell 18. Self-appointed law enforcement officer 20. Cut down, as a tree 21. Indiv. in an org. 22. Loudly mourn or lament 23. Dictatorial 26. Sound starter? 27. Up to, in short by Daniel R. Pearson © 2016 All rights reserved. Built in part with software from www.crauswords.com 30. See more on your screen 34. Bark sharply DOWN 31. Cold prefix 36. Student follower 1. Vine’s partner? 32. Washington _____ 37. Aiken’s ______ Line Road 2. Cowboy festival 33. Medical College on Telfair? 39. Realm of a British noble 35. They vary with light 3. Leaning 41. Group of two (technical) 4. Money (slang) 36. Type of post or room 42. Diaries author 5. Big CSRA employer 38. Word of surprise or fear 44. Sell 40. Lottery game 6. Roberts’ ex 45. ___-buster 7. Early election 43. Jet engine housing 46. Former Alaska governor 8. Order by a judge 47. Attractive woman 48. Lady doctor 9. Person used as one’s excuse 48. Neon and xenon 55. Ancient district in S Greece 10. Mass of eggs 49. Owner of a Lonely Heart band 58. Greek goddess of the dawn 11. Site of Jesus’ first miracle 50. Governor in Mogul India 59. Capital of Italy 12. Oxidant beginning 51.Environmentally friendly 60. Pedestrian zone 13. Spool 52. Halogen element 62. Gas is one 19. Meadow 53. Mixture of smoke and haze 63. Clair de ______ by Debussey 21. Jenkins County seat 54. Fax forerunner 64. Wheel shaft 24. Soothe; calm 55. Legal group 65. Grasp 56. Group of vineyards (French) 25. Sudden assault 66. Employs 27. Mr. Gurley 57. Sharpen 67. Alcoholic beverage 28. Image of a deity 61. Chopping tool 68. Sears on 15th St. now 62. Test men take (abbrev.) 29. _______ disease 30. HIV and others

WORDS NUMBER

THE MYSTERY WORD

JANUARY 8, 2016

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AUGUSTA MEDiCAL EXAMINER

THE BEST MEDICINE ha... ha...

hy did the library book go to the doctor? It needed to be checked out: it had an enlarged appendix. Why did the math book go to the psychologist? It had too many problems. What do you call a noisy Chinese dog? How-Ling What do you get if you cross a highway with a refrigerator? Killed.

It was nearing Christmas as a priest walked through his vacant church after services. He saw a note left behind in one of the pews. He picked it up and read, “Dear Jesus: I would like a bike for Christmas. Love, Billy.” The priest thought it was adorable, put it in his pocket and forgot all about it. The next Sunday after Mass he found another note in the same pew. This one says, “Dear Jesus, I have been a very good boy and would really like to have a bike for Christmas. Love, Billy.” The priest is moved by the innocence of children as he reads the note. Christmas comes and goes, and after another Mass the priest is walking through his empty church when he notices the statue of the Virgin Mary is missing. He rushes over to the barren pedestal and finds a note there. It says: “Dear Jesus, If you want to see your mother again, you’ll get me that bike I wanted for Christmas. Billy.” Moe: What’s that game German children play touching each other with bread? Joe: Probably gluten tag.

What do you call a dead fly? A flew. And a fly with no wings? A walk.

Joe: What did the minister call the atheist bone? Moe: Huh? Atheist bone? I give up, what? Joe: A blasfemur.

I bought my friend an elephant for their room. They said thank you. I said don’t mention it.

Chuck Norris was dropped twice as a baby. First on Hiroshima, then on Nagasaki. When Alexander Graham Bell finally finished inventing the telephone, he had three missed calls from Chuck Norris. Chuck Norris is actually dead...but death is too scared to tell him. +

Joe: I just invented a new word! Moe: Cool! What is it? Joe: “Plagiarism.”

Why subscribe to the Medical Examiner? Because no one should have to make a trip to the doctor or the hospital just to read Augusta’s Most Salubrious Newspaper.

16 FOR ’16… from page 6 grown-ups, there is no room in any bedroom for a TV, a laptop, a cell phone, a tablet or a computer — at least one that is turned on. But the better option is to make every bedroom a tech-free haven at all times. That means that parents may need to account for (sometimes “confiscate” might be the more accurate word) all cell phones, tablets, laptops, etc., before bedtime. Don’t forget the chargers, either. Many parents have tucked their kids in at a decent hour only to discover that their kids are still awake hours later, surfing the web, playing video games, texting — and worse. When should bedtime be? Preschool kids need 11 to 12 hours a night; school-age means at least 10 hours per night; teenagers should get 9 to 10 hours of sleep a night; adults: 7 to 8 hours. Good sleep habits — also known as “sleep hygiene” — include going to bed and getting up at about the same time each day. The room should be dark and quiet and relaxing. That last word might suggest going into “quiet mode” well before bedtime. Don’t expect to watch a gory slasher movie that ends at your bedtime and fall sound asleep ten minutes later. Get into a restful frame of mind and activity well before your bedtime, and make sure kids do the same. Getting enough sleep not only brings health benefits; you’ll also perform better and be more alert all day long. If sleep is a problem, talk to your doctor. Say you want sweet dreams and more of them! + #10 K.I.S.S. You know the KISS Principle: Keep It Simple, Stupid. The phrase originated with the U.S. Navy in 1960 as a principle of design: most systems work best when they are kept as simple as possible. And if the principle is observed, “Stupid” can fix them if they do break. The same principle has been expressed in similar ways: Leonardo da Vinci said “Simplicity is the ultimate sophistication.” Architect Mies Van Der Rohe famously said “Less is more.” When you think about 5-pound computer manuals back in the day, and that computers today are far more complex yet usually come without a manual, obviously someone was listening. The question is: are we? Some people think they can’t be happy without the latest gadget or the trendiest fashions or the newest car or the most exotic vacations or.... and the list goes on. Unfortunately, many of those people are slaving to pay for all their very un-simple choices, so much so that all their hard-earned money belongs to someone else before their paycheck lands in their hot little hand. Their life looks pretty amazing on Facebook and Instagram, but in 3-D it’s a lot less amazing. Why? Because it’s complicated. The solution: As an old saying goes, to have more, want less. You’ll be healthier — physically and emotionally and financially — and happier. Previous “16 for ‘16” suggestions are available at the web link below. +

MEDICAL EXAMINER IS ONLINE • issuu.com/medicalexaminer • + +

SUBSCRIBE TO THE MEDICAL EXAMINER By popular demand we’re making at-cost subscriptions available for the convenience of our readers. If you live beyond the Aiken-Augusta area or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house! NAME ADDRESS CITY

STATE

Serving the Medical, Dental and Education Communities since 1976

ZIP

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

Visit us at any of our 5 locations or at www.hccu.coop 706-434-1600

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JANUARY 8, 2016

AUGUSTA MEDiCAL EXAMINER

THE MYSTERY SOLVED The Mystery Word in our last issue was: ULTRASOUND ...cleverly hidden in the p. 10 ad for DANIEL VILLAGE BARBER SHOP Congratulations to AUBREY THOMAS II, who scores a coveted Scrubs of Evans gift card, 2 movie passes courtesy of Health Center Credit Union, and a $20 Wild Wing Cafe gift certificate. Want to find your name here next issue? The new Mystery Word is on page 12. Start looking!

The Celebrated MYSTERY WORD CONTEST ...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then 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. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher.

The new scrambled Mystery Word is found on page 12

EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC.

SERVICES

POND VIEW! Evans all-brick 2-story with solar panels. Avg. electric bill $170 in Northwood, 3,400 sqft. Call 1-800401-0257, ext. 0043 24/7 for price and details. HOUSE TO LEASE 2 bdrm, 2 full baths, fenced yard, hardwood throughout, screened porch, room for garden, sunny windows, close to Summerville and downtown campuses $750/mo 706-2317697 AUGUSTAGAHOMESEARCH.COM Foreclosures • MLS • Builders • Rentals (706) 564-5885

HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706.267.9947 BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673) F. E. GILLIARD, MD FAMILY MEDICINE Acute & Chronic Illnesses Occupational Medicine PROMPT APPOINTMENTS 706-823-5250

MISCELLANEOUS HOUSEBOAT FOR SALE Tradewinds Marina, 30 minutes from Augusta. Live at the lake - or have a second home there with NO grass to mow! Recently upgraded. $65,000 Text me at (803) 640-9732 for pics HILTON HEAD For sale: Hilton Head oceanfront timeshare, 2 bdrm, 2 bath, first week of March. $990 OBO. More info: (706) 738-2292

SUNSET MEMORIAL GARDENS Opening and closing at Sunset Mem. Gardens in Graniteville. Sale: $760 (Value: $1520+) Call 706-736-0596 KING-SIZED bed frame with rails, dark wood, some surface scratches but overall very good condition. $90 Call 706-3730193

WANT TO BE HEALTHY? (Energy, weight loss, mental clarity) Go to gethealthyat.le-vel.com See video and Facebook. Sign free as customer. BEING PAID WHAT YOU ARE WORTH? Then make more money! Watch movie all out interview: ExtraMoneyInterview.net CEMETERY SPACES (2) Sunset Memorial Gardens, Graniteville SC adjacent to lighted military flagstaff, includes granite bench with urn space, installation and inscription. All $4700 ($8600 value). Spaces only: $2700. Call (803) 295-3033 FISHING CLUB wants more grey-haired members. Meet 2nd Thurs of month at Harbor Inn Restaurant, 12 noon. “Adventure Before Dementia” Info: (706) 736-8753 or (706) 829-1729 PET CARE in Martinez-Evans area. Dogs to 40 lbs, $9.00. Cats (1-3), $9.00 For interview/information, phone 706-829-1729

Thanks for reading the Medical Examiner!

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(OURS IS COFFEE)

Augusta Medical Examiner Classifieds

ANTIQUE maple dinette set with buffet corner cabinet table with pull-out leaves. Four chairs with two captain’s chairs. Excellent condition. $300. Double bed early 1930s with mattress spring coverlet shams $150. Call (706) 860-2170

THE PUZZLE SOLVED C

W A

D G

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

W A

SEE PAGE 12

QUOTATION

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

QUOTATION PUZZLE SOLUTION: “You can never get enough of what you don’t really need.”

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

— Eric Hoffer .25

.50

.75

1.00

1.25

1.50

1.75

2.00

2.25

2.50

2.75

3.00

3.25

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The Sudoku Solution

COFFEE IS GOOD MEDICINE

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

Send this form with payment to:

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

VISIT DRUGOFCHOICECOFFEE.COM

WORDS BY NUMBER “I learned the value of hard work by working hard.” — Margaret Mead

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

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

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JANUARY 8, 2016

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AUGUSTA MEDiCAL EXAMINER

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PROFESSIONAL DIRECTORY DERMATOLOGY

ALLERGY

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

CHIROPRACTIC

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

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

Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

EMPLOYEE BENEFITS

FAMILY MEDICINE F. E. Gilliard MD, Family Medicine 639 13th Street Augusta 30901 706-823-5250 Industrial Medicine • Prompt appts. Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Thomson: 706-595-7825 Primary Care Rates

CALLING ALL M.D.S!

MEDICAL MASSAGE Medical Massage Stuart Farnell L.M.T. 803-646-1846 jsfarnell@att.net www.FarnellClinic.com

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

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

Group & Benefits Consultants Inc. 3515 Wheeler Rd, Bldg. C Augusta 30909 706-733-3459 Floss ‘em or lose ‘em! www.groupandbenefits.com

Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048

Ideal Image 339 Furys Ferry Rd Martinez 30907 1-800-BE-IDEAL • www.idealimage.com Schedule a FREE Consultation

OPHTHALMOLOGY

DRUG REHAB

COUNSELING

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

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

DEVELOPMENTAL PEDIATRICS

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

DENTISTRY

LASER SERVICES

PHARMACY Medical Center West Pharmacy 465 North Belair Road Evans 30809 706-854-2424 www.medicalcenterwestpharmacy.com Parks Pharmacy 437 Georgia Ave. N. Augusta 29841 803-279-7450 www.parkspharmacy.com

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

...SENIOR LIVING

Cornerstone Compassion Center 420 Warren Road Augusta 30907 706-228-5359 or 706-394-6518 Assisted Living • Personal Care

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

THERAPEUTIC MASSAGE Centered in Georgia Diane Young L.M.T. 4488 Columbia Rd Martinez 30907 706-251-2244

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

WEIGHT LOSS Medical Weight & Wellness Specialists of Augusta Maycie Elchoufi, MD 108 SRP Drive, Suite B Evans 30809 • 706-829-9906 YourWeightLossDoctor.com

SUPPORT YOUR PRACTICE - AND THE MEDICAL EXAMINER A simple listing in the Professional Directory is less than $100 for six months or less than $200 for an entire year, and puts your contact information in front of 30,000 readers a month. CALL 706.860.5455 TODAY AND BE IN THE NEXT ISSUE

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AUGUSTA MEDiCAL EXAMINER

JANUARY 8, 2016