Medical Examiner 7-17-20 by Daniel Pearson

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KEEPTHESHEEP JULY 17, 2020

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One of the hotly trending insults in this divided nation is “sheep,” along with its portmanteau, “sheeple.” Generally, these words are directed to people wearing masks by those who are not. The implication is that anyone wearing a mask is meekly

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swallowing the coronavirus Kool-Aid hook, line and sinker. People who are sheep — aka sheeple — are surrendering their freedom and willingly cooperating with sinister efforts to steal the constitutional rights of one and all. Naturally, these are not opinions shared by everyone. Perhaps they are shared by a minority, especially as the pandemic rages on unchecked, at least in the United States. But we have to ask: is being a sheep such a bad thing? If you’re a sheep, you are not defenseless. You’ve got someone looking out for you and

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keeping you safe. The job description of a shepherd is simple: ARE YOU A CHRISTIAN? If so, you know sheep are portrayed to watch out for you 24/7 even favorably in the Bible, and that you are if the threat is a cougar or lion. supposed to apply Bible principles in Shepherding is not a 9-to-5 job; your daily life. Here’s one to meditate on it’s around the clock. that applies to the pandemic. If you’re a sheep, you’re no The apostle Paul wrote that if eating fool. A stranger — a counterfeit meat offended his brother, he would shepherd — can call to you all never eat meat again. (1 Cor. 8:13) In day long and you’re not going to other words, he was willing to forego a respond. You aren’t even going perfectly acceptable personal right in to raise your head. You’re going order to avoid harm to another person, to keep grazing contentedly. You even if that “harm” was more or less all know who’s real and who is on in the mind of the other person. your side and who isn’t. As a Christian (if you are one), are The classic enemy in this age- you willing to apply this principle and put old analogy is the wolf, whose aside your personal rights (to not wear a objective is to kill sheep. mask, for example) out of consideration As all of this translates to for others? + people in this historic era, each of us should ask, “If I had to be described as one or the other, which would I be, a sheep or a wolf?” Wolves in a coronavirus analogy are just like wolves of the 4-footed variety: they are anything but harmless; they can kill. They view mask wearing as weak and foolish; hand sanitizing is unneccessary; distancing is for snowflakes. On the other hand, there really isn’t anything that comes to mind that literal sheep do which poses any harm or danger to other living things (except maybe grass). In a coronavirus setting it’s much the same: what sheeple do — wearing masks in public, practicing physical distancing, sanitizing their hands, etc. — couldn’t hurt a fly. To put it another way, if the sheeple are wrong and their socalled prevention efforts turn out to be completely unnecessary, what harm has been done to anyone? But if the wolves are wrong, their actions will contribute to the spread of the virus. Their actions will sicken some and kill others — sometimes not from the virus: In France last week, a city bus driver just trying to do his job enforcing mask-wearing rules was beaten by, well, angry wolves, and left brain-dead by the attack. If you’re not a sheep, if you are, in fact, antisheep, you have to ask yourself, what is the cost of cooperating with the recommendations versus rebellion? Is the price so high that I can’t pay it for the possible common good of all? +

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JULY 17, 2020

THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD by David W. Proefrock, PhD

Your three young sons have terrible table manners. They play with their food, talk with their mouths full, and don’t use the proper utensils. It seems that no amount of reminding, nagging, or threatening helps the situation. What should you do? Can you pick the best option? A. There’s not much you can do besides continuing to remind, nag, and threaten. They will grow out of it soon enough. B. Tell them that good manners will be the rule at your house. When you see them using bad manners, send them away from the table for about five minutes or so and then let them return and eat as long as they use their manners. C. Make meal times instructional. Demonstrate good manners and explain to them why manners are important. D. They should know better by now. You should be more strict. When one of them uses bad manners, they should be sent away from the table and not allowed to eat until the next meal. If you answered: A. They probably won’t grow out of their bad manners. Manners are taught and learned. They won’t gradually pick them up on their own as they go along. B. While this approach might work, it is just too stressful and disruptive. Mealtimes would probably become torture for everyone. C. This is a good solution. Good manners are taught, and parents should be the teachers. D. This solutions is too harsh. Mealtimes and the times between meals would probably become too negative to endure. Education is always better than punishment. Anytime you have an opportunity to teach your children, you should make use of it. + Dr. Proefrock is a retired clinical and forensic child psychologist.

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ere at Medical Examiner World Headquarters in Augusta, we don’t take kindly to crude speech of any kind. So when someone around here accidentally says, “Shut up!” someone else will invariably say, “Hey! We don’t use the ‘S’ word around here!” So please, forgive the illustration. We have violated our own policy. But you know what they say: desperate times... What is so desperate right now? You may have noticed that a pandemic is raging around the globe, and the United States, all 3.8 million square miles of it, is the world’s undisputed coronavirus hotspot. We’re #1! Notice that we did not put the word pandemic in quotes. We did not say a plandemic is raging across the globe. We did not say a hoax is circulating around the world. But there is a sizable and very vocal faction who believes all of this is a creation of the media. The virus itself isn’t fake, they say, but the size of it and the reactions to it have been hugely overblown by “the liberal media.” Another group loudly proclaims it has all been deliberately engineered by some unnamed supreme global agency with the specific intention of robbing people of their basic freedoms. Let’s stipulate before we proceed any farther that governments all over the world have a rich history of corruption and scandals of every kind. We are not here to say that governments are always innocent and above reproach. However, have you noticed who is disseminating information for the opposing sides? The pandemic faction is led by various public health officials and physicians all over the world, from local doctors in Aiken and Augusta to recognized experts at Harvard and Yale, the World Health Organization and the Centers for Disease Control. The plandemic/hoax faction is being spear-

headed by people who, frankly, should closely study the illustration above and take it to heart. These people have extremely questionable qualifications, at least when it comes to their favorite topic. For example, within the past week on Facebook (on the Medical Examiner page and others, like Pam Tucker’s), the entire medical establishment and basically everything it is telling us to do to minimize the spread of the virus has been attacked. This, of course, is a daily event all across the country. “Barry,” one such local vocal attacker, repeatedly touted himself as “a licensed pesticide applicator.” That’s how he knows so much about viruses. “Phillip,” another rabid mask opponent and protester against anything and everything anti-virus, apparently operates midway entertainment equipment. The phrase “stay in your lane, bro” comes to mind. It’s flashing in neon letters 30 feet tall. If you’re a pest control professional or an equipment operator at fairs and midways, what possible real and genuine expertise in epidemiology and medicine can you possibly offer? By contrast, the medical professionals trying their hardest to help us all (take notice: they aren’t trying to dictate how bug sprayers or fair workers should do their jobs) are specifically qualified to advise us. It is probably the exceptional public health official who does not have decades of experience. Are these medical professionals perfect? Not hardly. Have they made mistakes in trying to address this pandemic? Absolutely. But who do you think makes the most sense to listen to in the middle of a global pandemic: medical professionals with years of experience? Or random strangers on social media who are not even in the medical field? Although it pains us to use this kind of language, you uninformed rabble-rousers: please, shut up. +

3 +

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JULY 17, 2020

Let’s spend a few calm, quiet and rational minutes talking about everyone’s favorite subject, the coronavirus. (Part 8 of a feature of unknown duration.)

Here we are in the 8th installment of this temporary series, and we’ve never addressed the key word of the series title: reality. Normally differences in perceptions of reality are reserved for conceptual subjects that are matters of personal preference and opinion. For instance, “Isn’t this weather unbearable?” Response: “No, I love it. The hotter the better!” Or, “Didn’t you think childbirth was the worst pain imaginable?” Response: “For me it wasn’t that bad.” As regular readers know, every installment of this column has been about the coronavirus. From our perspective, it is extremely odd that this global outbreak is the subject of so much doubt, debate and skepticism. Yesterday alone in the U.S.,

73,311 new cases were reported. In one day! Worldwide there were more than 248,000 new cases yesterday alone. A quarter of a million new cases in a single day. How much more will it take for people to realize this is real? Granted, social media is the Supreme Repository of Human Ignorance, but with an expenditure of just a brain cell or two anyone can find posts that are truly bewildering: • the pandemic numbers are being exaggerated by the media for ratings purposes • the numbers are true, but they are nothing to be concerned about (Example from Texas: “We have only 8,000 cases in this county of half a million people!”) • doctors say wearing masks offers no protection • doctors say wearing a

mask causes oxygen deprivation • doctors say wearing a mask compromises the immune system of wearers • the survival rate is 99.96%, so what’s everyone so concerned about? There is not space enough in all 16 pages of this newspaper to debunk all of the false statements proliferating almost faster than the virus itself. But let’s at least address that last one. Dr. Anthony Fauci was quoted in USA Today in May stating that a 1% mortality rate would make the coronavirus 10-times more lethal than the regular seasonal flu. A 99% survival rate might sound promising, but the attending physician for Congress and the U.S. Supreme Court predicted early in the pandemic that 70 million to 150 million U.S. residents could contract COVID-19. A 1% mortality rate at that scale of infection among 329 million Americans would mean between 700,000 and 1.5 million dead. Think that sounds bad? The actual U.S. death rate is not 1%. It’s 3.8%. The global death rate is 4.25%. You deniers, wake up. It’s real. It’s time to perform a reality check on yourself. +

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Is “straining” dangerous? Straining? you say. Don’t act like you don’t know what we’re talking about. Everybody does it, and everyone strains sometimes. Is it dangerous? We have all heard that The King — Elvis, that is — died on the throne. Does that offer some evidence? In this case, no. Presley’s cause of death was the subject of some controversy, but the 14 drugs in his system at the time, “ten in significant quantity,” certainly played a role. An enlarged heart was also a factor. But straining during a bowel movement — officially known as the Valsalva maneuver (for more information, see page 4) — is associated with a number of health issues, some potentially serious. Topping the list is hemorrhoids. They may not be life-threatening, but still, nobody wants those, right? Straining in the first place is an indication of several lifestyle issues. It’s usually associated with constipation, which in turn is often blamed on not drinking enough water and on a diet short on fresh fruit and vegetables and other sources of fiber. A lack of regular exercise is also a possible cause (or contributing factor) in constipation. Straining can also affect heart rate and blood pressure, and if a person already has issues in that department, the Valsalva maneuver can make things even worse. The “bottom” line: try to avoid straining and the lifestyle factors that contribute to it. +

DEARREADERS

Many of you have contacted us to ask when the print edition of the Medical Examiner will return. We are as eager for that day as you are, but when it happens will be dictated by conditions largely beyond our control. It will happen as soon as it is practical and safe to do so, you may be sure. At the moment, COVID cases in the two-state region are breaking records almost daily. We hope they will plateau soon and begin a steady decline. In the meantime, thank you for continuing to support this online version and the loyal advertiers who make it possible. +

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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 salubrious news within every part of the Augusta medical community. Direct editorial and advertising inquiries to:

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#119 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

emember Glamour Shots? Back in the day they were in every mall, including Augusta Mall. Now there are only three locations left (one in Texas, the other two in New Jersey), so photographs like this one (right) aren’t as easy to come by as they used to be. We bring this up not because our profile subject, Antonio Maria Valsalva, had anything to do with the chain that popped up centuries after his death, but because his portrait (above) was the 17th century equivalent of Glamour Shots. Pretty swanky for its day, don’t you think? But that isn’t the only way in which Valsalva was ahead of his time. Born in Italy in 1666 and officially minted as a doctor in 1687, Valsalva was a maverick in his view of mental illness. Although the condition was dismissed by his contemporaries as “madness” and sufferers were often mistreated, Valsalva viewed mental illness the same as he would any other disease, and was an advocate for more compassionate and humanitarian care. Antonio Valsalva, however, is not known for his stance on mental health. His medical specialty was the ear. In fact, he named the Eustachian tube and described its function and structure. Valsalva’s magnum opus was De aure humana tractatus, or “Treatment of the Human Ear” if our admittedly sketchy Latin is correct. Originally published in 1704, the book was the definitive text on the ear used by physicians for more than a century, and was translated into Dutch and Italian. Valsalva was a highly skilled anatomist, which is logical for someone who was a student of Marcello Malpighi (16281694), known as the founder of microscopic anatomy. Valsalva is also noted for his discovery of the so-called Valsalva maneuver, a way to exhale forcibly with nose and mouth shut, like a person would do lifting a heavy weight or straining (see QA on previous page). People sometimes perform the maneuver when trying to equalize pressure in their ears during flight. Valsalva also did work in ophthalmology, rhinology, and vasal and tumor surgery, as well as pioneering work studying aneurysms. He married in 1709 at age 43. His bride was 17. They had six children together, three of who died in childhood. Valsalva discovered that cerebral stroke or trauma on one side affected the body on the opposite side. A stroke ended up taking his life in 1723. He was 57 years old. +

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When you look like Einstein with his finger in a light socket, you know you’re a year overdue for a haircut. My last haircut occurred a week before falling and breaking three ribs and my T11 and T12 vertebrae last July 12. I was only home from the hospital and rehab from that injury a couple of weeks when I fell again and broke my hip. The hospital and rehab from that took until December 24th of 2019. From that point until now I’ve been housebound and still recuperating with the wonderful assistance of home health care physical and occupational therapy. My Kindred at Home helpers have been truly awesome in their dedication to my recovery. But home heath care does not include haircuts and I’m not driving yet. In this pandemic world, going to get a haircut is no longer a matter of going in, sitting in a row of chairs by the window and waiting your turn. The latest rules mean sitting in your car and waiting until they call you. Unfortunately, there is no car to sit in and I cannot afford to pay someone to sit outside waiting with me. So I am wondering, with many hairdressers still out of work, why they don’t follow the practice of some dog groomers, and create a visit-you-at-home personal grooming entrepreneurship with their own company? They wouldn’t need the setup dog groomers use. Just their scissors, cape, comb, and clippers are all that would be needed, and their gloves and mask. A mask could, and should, also be worn by the customer. Of

course, we wouldn’t have that handy dandy chair used in beauty shops, but our chairs at home should suffice. I’d likely sit in my wheelchair. And they can use our own broom and dustpan to clean up the floor afterwards. Now some might say there are no overriding health benefits derived from getting a haircut, but I disagree. For many people, both male and female, looking good is an essential aspect of mental health. Currently, I do not look good. I look like what my mother used to call the cave person look, before combs and brushes were invented, before basic hygiene existed, before mirrors showed people what they looked like. I try to avoid looking into mirrors because my looks distress me. My wild hair, wild despite frequent combing, etc., looks like I don’t care about myself. It looks like I am in depression so deep that I have given up on basic life skills like self-grooming. That is not at all the case. Now some might say that I should simply cut my own hair. I do have in my possession some reasonably sharp scissors, combs, brushes, and etc, needed to cut hair. However, when I was junior high age, my hair was long enough to offend me, though not as-long-as it is now, so I followed my mother’s example and began to cut my own hair. One side was always longer than the other, so I kept cutting, and cutting, and cutting. It was eventually so short that the beauty shop operator my mother sent me to sent me to the barber across the street. The outcome was the invention of the pixie, twenty years before it was popularized. The don’t-cut-my-own-hair lesson took me only one time to learn. +

Do you struggle with moderate to severe unsalubriousness?

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For external use only. May be habit-forming. Take regularly; do not discontinue reading unless advised by a physician. Product not child resistant. Do not chew or crush. Not to be taken by mouth. May be taken (read) on an empty stomach, or with food. May be taken one hour before or after meals. And at any other time. Product may not be gargled. Do not drive a motor vehicle or operate heavy machinery while reading. Use in conditions of adequate light. Store in a cool dry place. Not to be used as a personal flotation device. Dispose of properly. Overeating, poor diet, cigarette smoking and excessive drinking may alter the effectiveness of this product. Do not use near spark or flame. Not dishwasher safe. If you become too salubrious, please read fewer articles.

JULY 17, 2020

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ADVENTURES IN

Middle Age BY J.B. COLLUM

rant and the menu, as he insisted this was the place he went to regularly and he knew what today’s special was, no matter what the menu, the signs, or anyone else said. Oh boy, I just barely managed to convince him to let it go and to sit down. I ordered all three of us the same basic meal with some slight variations. At this point, Mary took this opportunity to tell me what she wanted for lunch and

tarded boy work here?” I have no clue what made her say that, but if I had been agile enough to crawl under the table I would have, and then I would have crawled right out of the restaurant. I was grateful that the server was gracious enough to just ignore Mary’s statement. This would cost me later though. Next, Mary took a good look at her food and said it wasn’t what she ordered, though it actually was. I tried to tell her that, but she would have none of it, so she went to the counter to complain. I figured it was safer to stay at the table with Dad and Larry. It was also closer to the door in case we needed to make a run for it. However, Mary, surprisingly, came back to the table without incident and shortly after that, more food arrived for her. She didn’t like it either, though, and asked for something else again. Twice. Underneath the table started looking very tempting again, but I survived, we finished our food, and finally left, but not before I ventured over to the counter to leave a large tip as an apology on behalf of my hitchhiker. As I stuffed the money in the jar, I caught the eye of our long-suffering server, smiled, and shrugged my shoulders. She kindly just gave me a nod recognizing my second-hand embarrassment and act of penance. I then went back through the laborious process of getting dad and Larry back in the car again and buckled in while keeping one eye on Mary to make sure she didn’t get into even more trouble. Our next stop was the nursing home to visit Larry’s wife and I figured that not much could go wrong with that, but we are out of space, so I will reveal the folly of that thinking in our next installment. Until then, stay safe, and avoid hitchhikers. +

{

In the previous issue, I chronicled the first part of the trip with my father to visit his uncle in Charlotte. We now resume the story with us headed to lunch with my uncle’s octogenarian millionaire neighbor, Mary, who earlier had essentially given us no chivalrous choice but to let her hitch a ride with us. Once we pulled up to the Greek restaurant that Uncle Larry had chosen, Mary hopped out of the car with great alacrity and walked directly into the wrong restaurant, next door to the correct one. She was already getting us a table, so I suggested to Uncle Larry that based on my previous feeble attempts to change her mind, maybe it would be easier if we just ate there instead. But he insisted that we were going to the Greek place, so I hung my head and after getting Larry and Dad out of the car, pointed in the right direction and safely cruising at their usual pace toward the correct restaurant, I ran into the wrong place and retrieved Mary. She then ran ahead like a spry ten-year-old girl out of the wrong restaurant and into the right one well before I could catch up, since I had to herd my father and uncle along the way. This wasn’t a “Tortoise and the Hare” kind of race in the parking lot. More like a tortoise and a snail. I got back to dad and Uncle Larry with enough time to spare to watch some paint dry thoroughly on a sidewalk bench. When we finally got inside, I was puzzled because I noticed that Mary was wearing a jacket several sizes too big for her that had not been in her possession previously. I ignored that for the moment and asked dad and Uncle Larry what they wanted for lunch as we stood at the counter. Dad didn’t care and told me to choose, and Uncle Larry wanted something that wasn’t available because although this was a Greek restaurant, it wasn’t the one he thought it was. He was ready to argue with the man at the counter about the name of the restau-

{

“If I could have crawled under the table I would have.”

then she turned and went to the table, leaving me to get the check. I should explain; this was the kind of place where you order and pay at the counter first and then wait at the table for your food to arrive. I had planned to buy lunch for my Dad and Uncle Larry, but I guess it wasn’t a big deal to pay for Mary too, even though she probably had enough money to buy the whole place. When I got to the table I asked Mary about her new jacket and she said that she had lost a jacket at one of these restaurants a few months before and so she asked them about it and they pulled this one out and asked if it was hers. It was far too big to logically be hers, but she insisted it was and seemed tickled that she now had it, so I just let it go. Our food was brought out by a young woman with bright blue hair that was cut close on the sides like a crew cut, and her rainbowadorned T-shirt spelled out that she was a member of the LGBTQ+ community. The server dropped off our food and as she walked away, Mary, perhaps thinking she couldn’t be heard past our table, said in a voice that the server and no doubt everyone in the restaurant could surely hear, “Isn’t it nice that this place lets that poor little re-

J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. He may be reached at johnbcollum@gmail.com

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Vegan Black Bean Burgers Ingredients • 1 cup old-fashioned rolled oats • 1/2 cup walnut pieces • 1/4 teaspoon ground turmeric • 1/2 cup chopped onion • 1/3 cup chopped

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Summer is burger season so I whipped up these thick and delicious vegan black bean burgers which are crispy on the outside and juicy inside. Everything in them creates a healthy burger your friends will rave about. You might wonder why use black beans for a burger. According to Medical News Today, there are many benefits. * Maintaining healthy bones: The iron, phosphorus, calcium, magnesium, manganese, copper, and zinc in black beans all contribute to building and maintaining bone structure and strength. * Lowering blood pressure: Black beans contain potassium, calcium, and magnesium, all of which have been found to decrease blood pressure. * Managing diabetes: Studies have shown that individuals with type 1 diabetes who consume highfiber diets have lower blood glucose levels * Preventing cancer: Selenium, found in black beans, plays a role in liver enzyme function and helps detoxify some cancercausing compounds in the body. * Weight loss: Dietary fiber is commonly recognized as an essential factor in weight management by functioning as a “bulking agent” in the digestive system. High fiber foods increase the sense of fullness. So give them a try! Making vegan burgers is quick and easy. All ingredients can be tossed in a food processor, pureed into a smooth mixture, shaped into patties and baked.

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AUGUSTAMEDICALEXAMiNER

JULY 17, 2020

THE NEW SCARLET LETTER ISN’T AN A by Ken Wilson Steppingstones to Recovery

Maybe we haven’t all read the epic novel The Scarlet Letter by Nathaniel Hawthorne, but most of us old timers know the story. The central character is a woman who was convicted of adultery in another day and age and who had to wear a large red letter “A” for adultery on her clothing for all to see for the rest of her life as punishment. Well, few people seem to get riled up over adultery these days, but a new stigma has come along that is every bit as painful and shameful for those guilty of it. It has three letters, not one: DUI! If you’re convicted, everybody seems to find out about it. The local tabloids are on many office desks in town and feature the mugshot from the jail booking to expose the secret lives of otherwise law-abiding citizens from all walks of life, even

far up on the socio-economic scale. Shame, shame, shame! Worse, it seems, than wearing the scarlet A! As a certified DUI Clinical Evaluator for the GA Department of Community Health (#1260!) for the past 23 years, I have enough stories by past clients to drive me to drink! And to write a book about it while doing so! Had I only kept notes! Most notable are the ones who had “only one beer” yet miraculously blew a .09 or higher on the roadside breath alcohol test! Some steadfastly stick to their story even after my chairside education session on the metabolic rates of various beverages with alcohol content. Denial is a cruel bedfellow. Sorry, Shakespeare. I am often amazed and amused at the cavalier attitudes and naiveté of the general public as regards the amount of alcohol one needs to consume in order to earn a DUI, which is a .08 reading

or above. I have suggested to a large number of drivers to obtain an inexpensive breath alcohol tester from online sources or a local drugstore so they can use it to determine their risk to drive after drinking. $50-60 is far cheaper than the $10,000 that an average DUI costs over the long run, with loss of income, loss of license, attorney costs, court fines, required counseling or DUI school, probation costs, increased insurance rates, not to mention general aggravation. As if that isn’t bad enough, the cost goes up still higher if there is a second or third DUI. The accompanying charts were developed by the National Highway Traffic Safety

Administration which is a general guide to the amount of drinks to equal a blood alcohol concentration in the human body for men and women at different weights. Using it alone could make your life much happier if you drink when going out to a restaurant if you are driving. To compute risk, utilize this measurement: 1 beer = 1 ounce or 1 drink 1 shot = 1 ounce or 1 drink Each of these ounces or drinks takes about one hour for the body to metabolize (digest). So guzzling one drink at 8 p.m. would net the ability to drive with .00 alcohol in the body by 9 p.m. Drive smart. Scarlet letters

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AUGUSTAMEDICALEXAMiNER

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

HYPERTENSION AND THE DASH DIET by Isabelle Foster, MS-Dietetic Intern

Hypertension, also known as high blood pressure, is defined as having a blood pressure reading of 140/90 or higher. This condition affects over 100 million adults of all races, ages, and genders in the United States. High blood pressure can be caused by a number of factors, but is greatly influenced by the diet, lifestyle and genetics. Lack of exercise, overconsumption of foods high in sodium, sugar, trans- and saturated fats, excess intake of alcohol, and smoking cigarettes are all contributors to hypertension and its associated health conditions. Hypertension greatly increases the risk of heart failure, heart attacks, stroke, and kidney disease. Recommendations for

those with hypertension include regularly exercising, losing weight if necessary, abstaining from smoking, limiting alcohol use, and following a healthy diet. The DASH (Dietary Approach to Stop Hypertension) diet has been proven to significantly lower blood pressure and improve health status when followed correctly. The focus of the DASH diet is on consuming a diet rich in natural, high fiber, high nutrient-content foods such as vegetables, fruits, nuts, nonfat dairy, and lean meats while avoiding saturated and trans fats and excess sodium. Saturated fats are often referred to as the bad or unhealthy fats. They can be easily identified as the fats that are solid at room

temperature such as lard, coconut oil, and meat fats. These should be avoided, or consumed in very small amounts. Sodium is an essential nutrient that is needed for several important functions. However, excessive intake is negatively associated with several health conditions, including hypertension. The daily recommendation for sodium consumption is less than 2,300 mg per day, but data shows the average American consumes 3,400 mg per day. Many foods that don’t taste salty — like processed foods, frozen meals, and soy sauce — can be very high in sodium. Sugars in the

diet should be limited and preferably should come from natural sources like fruits. It is essential that individuals make a habit of paying close attention to nutrition labels in order to avoid consuming foods with excess fats, sugars, and sodium. For example, a cup of soup with a turkey sandwich may have as much as 2,200 mg of sodium. Limit your intake of foods with 240 mg of sodium or higher per serving. A teaspoon of sugar is 5 grams, so a can of lemonade may contain as much as 7 teaspoons of sugar. In addition, limit eating out at restaurants, or choose places that provide nutrition information. Often the cooking process at dining establishments greatly increases

the content of sugar, sodium and fat in foods due to the use of syrups, sugars, butter, oils, salt, and seasonings used to add flavor and color. Even seemingly healthy menu items may be poor choices due to high saturated fat, sugar and salt content. As one example, okra is a nutrient rich, low calorie vegetable. But when fried in batter, the fat and sodium increases: a cup of fried okra is approximately 250 calories with 80 mg of sodium. However, a healthier cooking method such as steaming will have less than 40 calories and 7 mg of sodium. Sauces and condiments are other sneaky high sugar, sodium, high-fat additions that may seem to be small quantities but can quickly add up and may impact blood pressure. +

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CRASH

COURSE

More Americans have died on US roads since 2000 than in World Wars I & II combined In the past 24 hours, how many people do you think have died nationwide in crashes involving alcohol? Think about that for a moment. The answer is coming up. Impaired driving is a serious issue of public health that can potentially affect anyone, including people who have never had a drop of alcohol in their entire life. That includes hundreds of children who are killed each year by impaired drivers (214 during 2016). The magnitude of the issue is underscored by federal statistics which show more than 1 million drivers were arrested in 2016 for driving under the influence of alcohol and/or narcotics. Estimates of actual instances of impaired driving exceed 110 million per year. In other words, fewer than 1 percent of drunk drivers are stopped and arrested. What if you become a member of the 1 percent? What can you expect? In brief, a massive drain on your finances that will last for years. Let’s break down some of the expense (there won’t be room for all of it).

The first expense will be getting out of jail. Arrest is automatic for driving impaired. Bail for DUI will be at least $1,000. Unless you’re arrested at a roadblock, there will usually be additional charges for things like failure to maintain lane, speeding, running a stop sign, causing an accident, etc. Each additional infraction will increase the amount needed for bail. The money you post will be refunded when your case is resolved, but that could easily be a year or longer. Your case may involve some thorny issues, like major injuries caused to other motorists or pedestrians. You will need an attorney, and as they say, good lawyers aren’t cheap; cheap lawyers aren’t good. Your car, if you didn’t total it, will be towed away. The cost of the tow will be your responsibility. So will getting your car out of impound. Expect to pay $50 for every day your car is in storage somewhere. If it takes you more than 30 days to show up, the towing company is free to sell your car and keep the money. When your court date rolls around, expect to pay fines

and court costs that can easily exceed $1,000. If you manage to avoid jail time and are put on probation, you’ll pay hundreds of dollars over the course of the coming year in probation fees. DUI School is part of many sentences. There goes several hundred more dollars. You will lose your driver’s license if convicted. Conditional driving permits for traveling to work and license reinstatement: hundreds more dollars. Company car? Gone. The big whammy is often insurance rates. Whatever you were paying for car insurance, expect: 1. to be dropped by your carrier, and 2. for your new insurer to charge you up to 4 times what you had been paying for the next three years. It’s a lot to pay compared to one Uber ride. + What is the daily death toll from alcohol-impaired driving? According to the National Highway Traffic Safety Administration, the numbers average out to 29 people killed each day, which is more than one death per hour all day every day year-round.

E M I T S U O I R B U L A FOR A S 5 5 4 5 0 6 8 6 0 7 CALL

JULY 17, 2020

HUMAN BEHAVIOR PAIN IS SUCH A PAIN

My pain often makes it difficult to concentrate — sometimes I stare at my email for hours trying to make sense of by Jeremy Hertza, Psy.D. the words. My pain makes it difficult to do little things, or to enjoy anything. I cannot tell you how many days I’ve spent lying down, or nights I’ve spent wide awake, unable to sleep. When the pain is bad enough, I cannot cook. I cannot eat. I cannot clean, and I cannot bear to sit or stand. And that pain? The pain of knowing I am living half a life? Of knowing I am missing out? That pain is far greater than what I feel in my back. That is the toughest pill to swallow. –Ashley Jane, excerpted from the Scary Mommy blog, www.scarymommy.com Thirty years ago, pharmaceutical companies promised relief to the nearly 25% of Americans who live with chronic pain: opioids. While these same companies were riding high on a golden balloon, families were destroyed. Pills clearly aren’t always the answer. Doctors still prescribe opioids, and patients in pain still benefit from them. But these medications were originally designed to treat the worst pain, 10 out of 10. They’re designed to give immediate relief. They were never meant to be used on a daily basis. So with the medical profession now much more cautious, what can patients and families do to help manage pain that’s 5 out of 10? Or higher? More Pain We’re living longer today. But our bodies aren’t necessarily staying in peak condition. Our backs weaken, our knees are creaking, and arthritis curls our fingers and hands. With chronic pain, experts in physical therapy and rehabilitation often say, “Motion is lotion.” The more you move and stretch, the less pain you tend to have. We say, move and stretch as you are able. That could mean walking, exercise in a pool, gentle yoga or stretches—whatever you are comfortable with. I can’t repeat this enough: Physical activity is important. This is different from acute pain, like from a sprained ankle or broken arm, which needs to stay immobile. While people may be a little skeptical about alternative therapies—they are called “alternative,” after all—studies have shown that acupuncture, biofeedback, chiropractic services, even massage can help knock pain down by about 20%. Stress and anxiety can make pain symptoms worse, so stress reduction is pain reduction. The important thing is to have several tools you can use to help manage your pain before you reach for a prescription pain pill. What About CBD? Derived from the marijuana plant, CBD oil, whether or not it contains THC, is everywhere these days. There is no current research that has found CBD has any harmful effects. As for THC, most studies show no longer-term effects, although that varies depending on how you use it. People using THC through a vape pen have experienced lung problems, even death. Smoking anything can be harmful to your lungs. There’s also very little evidence that it’s chemically addicting, although it could be emotionally addicting. Like anything, use moderation if you choose to explore CBD oil. The Final Word My personal approach is to advise patients to consider a variety of techniques before taking an opioid. By design, opioids are not a first-line treatment; they should be a last-line treatment. Whether that’s exercise and CBD oil or nerve blocks and antiinflammatories, all of those are going to be safer at managing pain. Jeremy Hertza, Psy.D., is a neuropsychologist and the executive director of NeuroBehavioral Associates, LLC, in Augusta. Contact him at 706-823-5250 or info@nbageorgia.com. +

JULY 17, 2020

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AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf — posted by Rabia Jalal, MD, on July 12, 2020

HEALTHCARE SHOULD BE APOLITICAL BUT IT ISN’T Diseases do not have political or religious beliefs. They are equal opportunity haters. Yes, some diseases will have an affinity for a particular gender, race, age group, but never will they affect your body based on your political ideologies. However, the way our health care systems deal with diseases will intersect with our political leaders, their beliefs, political views, and ideologies. Let’s take female reproductive health care as an example. If you need access to birth control, counseling for such services, or abortion services, you are likely to get access or be denied access where you live based on the politicians who are currently making legislative decisions on whether women should be allowed to have such services available, which has nothing to do with [medicine] and everything to do with a politician’s religious beliefs. The 20th century has seen several deadly pandemics, including the Spanish flu, influenza, SARS, and the one we are currently dealing with, the coronavirus and COVID-19 pandemic. These pandemics have caused thousands and thousands of deaths, and while they had no political affiliation, the way they were handled by every country affected was very much dependent on the political will or lack thereof. Politicians either stepped up to the plate and worked with health care workers to curb them, or downplayed them because it made them look bad. The end results of government actions speak for themselves. In the United States, we are currently at over 2 million cases of COVID-19 and over 130,000 deaths* from this disease. This is a tragedy that could have easily been prevented if our leaders cared more about the well-being of their citizens instead of economies, stock markets, and their political campaigns. To all those arguing about how the economy is more important, I ask, how will sick and dead people contribute to an economy? How will sick and dead health care workers contribute to our already broken health care system, which is a critical part of any economy? Before we decide to sacrifice our loved ones for the economy, we must remember that a nation cannot flourish if its citizens are not healthy. +

How will sick and dead people support the economy?

Rabia Jalal is a physician. * Since Dr. Jalal wrote this article, the U.S. figures have increased to 3,694,948 million cases and 141,117 deaths (as of July 17).

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If you noticed the subtitle of this book (“A Funny Book About Horrible Things”) you already understand the contrasts painted by this author. Jenny Lawson, you see, is writing about depression and mental illness. If you would like to read a depressing book about depression, this is not the book for you. In fact, if you’d like to read a G-rated book about depression, keep moving right along. Jenny has what some people might call a potty mouth. She has words, and she’s not afraid to use them. But no one can accuse her of not getting her point across. And it’s a rather important point, since millions of Americans have to deal with chronic depression, severe anxiety, and various mental disorders that range from merely annoying to crippling and life-altering. It probably tells you all you need to know about Jenny Lawson and this book that her readings are a lot like stand-up comedy. But that doesn’t mean she

trivializes this important subject; it just means she isn’t wallowing in despair or living her life curled up in the fetal position in her closet. Depression is giving her a battle, and she’s fighting right back. And making a lot of fair points for all of us, even people who aren’t battling depression. Example: have you ever told someone in the throes of depression to “just cheer up” (or words to that effect)? As defined by this book, you have said the equivalent of telling someone who just had their legs amputated to “just walk it off.”

Have you ever told someone who is depressed that they just have “a case of the Mondays”? If so, you’ll get a reminder that mental illnesses are borne of issues a lot more complex than what day of the week it is. Even so, no one should expect to read this book for scientifically-based clinical insights. It might even be slightly comparable to this newspaper: hopefully informative and insightful, but perhaps leaning more in the direction of general knowledge than doctorate level data. And in the case of this book, throw in an almost prescriptionlevel dose of humor and entertainment. Add it all up, and without discounting the importance of therapy and medication, it offers a light-hearted cheering section for anyone determined to be, despite their depression, furiously happy. + Furiously Happy: A Funny Book About Horrible Things by Jenny Lawson; 352 pages, published by Flatiron Books in 2017

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The Examiners

JULY 17, 2020

THE MYSTERY WORD O

by Dan Pearson

The label on my new box The company’s legal of masks says they don’t They definitely offer Then why would the department probably label say that? protect against COVID-19. some protection. insisted on it

Just a CYA kind of thing?

No, they’re just for facial use.

The Mystery Word for this issue: ELLBIRA

N ACAthen begin exploring Simply unscramble theVletters, TIONspelled word our ads. When you find the correctly hidden in one of our ads — enter at AugustaRx.com

EXAMINER CROSSWORD

PUZZLE ACROSS 1. Easy stride 5. Short note 9. Breath sounds 14. Part of the eye 15. Parched 16. Late film critic 17. Almost tailless rodent 18. Home of a noted medical school 19. Robust (Scottish) 20. 1969 bestseller (ending with “-Five”) 23. Natal start 24. Bottom-row key 25. His donkey spoke 29. A woman, in old movies 31. A little taste of a drink 34. Unwraps 35. Alpha follower 36. Main ingredient in some salads and casseroles 37. Eye specialist 40. Swing around 41. Threaten, as a crisis 42. Locations 43. Lead-in for 56-D 44. Macon county 45. 2-point football play 46. Tavern 47. There’s a big one in Columbia County 48. Mathematical operation 56. Augusta ________ 57. A month of the Jewish calendar 58. Sports award 59. Bladder liquid 60. Sea eagle 61. On the sheltered side 62. Noted apostle 63. No longer living 64. Monthly expense

E X A M I N E R

46 48

We’ll announce the winner in our next issue!

5 9 4 6

2 5

6 3

3 9

9 2

S U D O 1 K 9 3 U

1 5

7 6

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

DOWN 1. They can be cyanotic 2. Spoken; verbal 3. Size of type 4. Jacob’s twin 5. Chaos 6. Muse of lyric poetry 7. 1,760 yards 8. River in central Europe 9. A job for a cobbler 10. Approximately 11. Optical device 12. Scottish Gaelic 13. Pigpen 21. Grind teeth together 22. Brightest star in the Aries constellation 25. Uplift 26. Singer Fiona 27. Tiny island west of Kauai 28. Poker stake 29. Send troops home at war’s end (in brief) 30. It comes from a Greek word meaning indivisible

4 9 7 6 3

QUOTATIONPUZZLE

31. Connected series of rooms 32. A small map within a map 33. Nashville’s Cline 35. Glob or spot 36. Week-ending abbreviation 38. Person used as one’s excuse 39. He founded al-Qaeda 44. Local high school 45. _______ Heart 46. Flying vehicle 47. Princess of Wales, 1981-1996 48. Female horse 49. Single entity 50. Piper adjective 51. Small harplike stringed instrument 52. It can precede gas 53. Small piece of land surrounded by water 54. Nasty type of fracture 55. No to Boris 56. It often follows 43-A

4 7 3 S V R9 N T C1 A A E6 8 Y5 2 — Antisthenes

9 6 8 3 5 2 7 4 1

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

Solution p. 14

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.

C 1

1 2

S 1 2

U 1 2 3 4 5 6

F 1 2 3 4

I 5

— George S. Patton

1 2 3 4 5 6

1.C H O A F L I M 2.SOOONIE 3.LANUN 4.RRUDG 5.EATI 6.NERG 7.GE

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

WORDS NUMBER

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, June 1, 2020

2 1 5 7 4 8 6 3 9

5 9 7 1 6 3 4 2 8

3 2 1 4 8 5 9 6 7

8 4 6 2 9 7 3 1 5

JULY 17, 2020

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AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

man is on his way to his regular Friday night outing with his buddies when he gets a flat tire, so he calls his wife. “Babe, I need you to come get me and take me to the bowling alley. I got a flat tire.” “Have you got a spare?” she asked. “Honey,” the man said. “You’re not listening to me. I haven’t even made it to the bowling alley yet.” Moe: Why do Chinese people love IPhones and Apple products? Joe: Tell me. Moe: Because the greatest gifts are always the ones your children make. Moe: Why does China have the best baseball team? Joe: I give. Why? Moe: Because they took out the whole world with a single bat. Moe: Ok, here’s a better one. What starts with “O” and ends with “nions” and makes people cry? Joe: That’s easy. Onions. Moe: No, opinions.

The

Advice Doctor

Moe: How do you get water into a watermelon? Joe: This has to be the last one. How? Moe: You plant it in the spring. Employee: Excuse me sir, do you have a moment? Boss: Sure, come in. What’s on your mind? Employee: Well sir, as you know, I have been an employee of this prestigious firm for more than ten years. Boss: Yes, I know. Employee: I won’t beat around the bush. Sir, I would like a raise. I currently have four companies after me and so I decided to talk to you first. Boss: A raise? I would love to give you a raise, but this is just not the right time. Employee: I understand your position, and I know the current economic downturn has had a negative impact on sales, but you must also take into consideration my hard work, pro-activeness and loyalty to this company for more than a decade. Boss: Taking into account these factors, and considering I don’t want to start a brain drain, I’m willing to offer you a ten percent raise and an extra five days of vacation time. How does that sound? Employee: I accept! Thank you, sir! Boss: Before you go, just out of curiosity, what companies were after you? Employee: Let’s see... the gas company, electric company, water company and the mortgage company. +

Why subscribe to theMEDICALEXAMINER? What do you mean?

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

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

Dear Advice Doctor, I hate to air dirty laundry in public, so the anonymous format you’ve provided here is perfect. My question is about my husband. He’s a quiet man, which I don’t mind at all. But when I want him to talk, it’s like pulling teeth. The man is the poster child for poor communication. How can I get him to open up? — Sounds like the sounds of silence Dear Sounds, You used an apt analogy: it’s not easy to pull teeth. It can be when teeth, gums or bones are abnormal in some way. But pulling a healthy tooth, such as an orthodontist does to make way for realigning teeth, is a bit of a job. Fortunately, anesthesia makes it easy for the patient. In fact, if you do feel pain during a dental procedure like an extraction, don’t be afraid to speak up (if your mouth isn’t full of gauze and cotton balls, that is). There’s no need to try to be a hero. In various medical settings patients are sometimes told, “You’re going to feel a little pressure.” In many cases they should probably just go ahead and say pain instead of pressure. But in a dental setting pressure is the perfect word. As we have established, the goal is for dental patients to feel little to no pain. But removing a tooth is a rather physical act. The phrase often used, pulling a tooth, as though pulling a knife from its sheath, paints a very inaccurate picture. After all, teeth are solidly embedded in bone, held in place by ligaments. That’s how we can bite into apples and steak and corn on the cob without our teeth coming out. They are very firmly entrenched. Extracting a tooth requires a little wiggle room, and a dentist or oral surgeon will try to provide that as step two (step one being anesthesia). The composition of bone in the jaws is spongy, comparatively speaking, so wiggling a tooth around with special dental tools enlarges the space around the tooth and makes extraction easier. It might be compared to trying to pull a deeply driven tent stake straight out of the ground versus trying to wiggle it around sideways in all directions to loosen the ground’s grip on the stake before pulling it out. That is basically what a dentist is doing prior to extracting a tooth: moving the tent stake — I mean tooth — around to make it easier to remove. It’s pretty physical. It’s the perfect time to say, “You’re going to feel some pressure.” Best wishes! + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will only be provided in the Examiner.

SUBSCRIBE TO THE MEDICALEXAMINER +

Why read the Medical Examiner: Reason #170

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 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

BEFORE READING

AFTER READING

5 + 14

1 5

7 9 6 3

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

N O I T in the p. 16 ad for ...cleverly hidden on a windowframe A C A CLEANING CO. AUGUSTA WEST V ON

THE WINNER: WE STUMPED THE PANEL! NO WINNER! 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!

JULY 17, 2020

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED L I P S

O R A L

P I C A

B O O S T

A P P L E

L E H U A

M U C A N U R I P E T

E S A U G N A A N S T H E B P U L T A L N E E R

M A Y H E M A L I B I

E R A T O

M I L E

B L O B

D E M O B

P I E D

L Y R E

O D E R H A A M T A O L M S D A I C A R N E A D

R E S O L E O S A M A

A B O U T

L E N S

E S R T S Y E

T G I F

S U I T E

I N S E T

P A T S Y

T E A R

I S L E

O P E N

N Y E T

SEE PAGE 12

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

...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. 8. Deadline to enter is shown on page 12.

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JULY 17, 2020

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PEDIATRICS101 TIPS, TRICKS & TALKS TO KEEP TOTS TO TEENS HAPPY AND HEALTHY

ECZEMA

Got a kid with itchy or dry skin ? They may have underlying eczema (also known as atopic or allergic dermatitis). Eczema is known as the “itch that rashes” - in other words, the itchy dry feeling and constant scratching may come before any obvious rash shows up. Once rashes do start popping up, parents can get very frustrated by how difficult it is to get the rashes to go away. Eczema rashes very commonly affect the areas in between arms at the elbows, behind and in front of the knees, hands, ankles, and feet. In babies, the cheeks are a very common place for eczema to pop up and will leave a baby with constantly dry, rough, irritated, often times red cheeks. Older kids and toddlers will often scratch constantly at the irritated patches, and many parents worry their child doesn’t sleep well at night because of the

constant itching and clawing even during sleep. Eczema tends to flare seasonally - some kids especially struggle in the winter when skin gets drier, and other may struggle when pollen and allergy season peaks (especially in the spring and fall). This is because pollen and other allergens can make the skin even more irritated and itchy - worsening the itch-scratchrash cycle. So what can we do to relieve the itch and rash of eczema ? Daily, thorough moisturizing is a great place to start. There are tons and tons of products that are available these days that claim to help eczema. When trying out different brands, look for ones that have little (ideally no) perfumes, fragrances, or irritating ingredients. Same with any laundry detergents or soaps that come in contact with a child’s skin. Heavily

AUGUSTAMEDICALEXAMiNER scented lotions/creams and heavy duty detergents can irritate and dry the skin out more, exacerbating eczema. Parents will want to stick with everything gentle and bland. Good old basic products like Vaseline or Aquaphor (petroleum) are also good starting points. Moisturizing the skin helps prevent the dryness which in turn can help with itching. It is believed that eczema at its root is related to deficiencies in proteins that comprise the skin layer as a barrier against the environment so the patient with eczema will be more sensitive to irritation and also be less able to retain natural moisture and hydration. Supplementing the skin with topical emollients and barriers to lock in moisture and also protect against irritation will vastly improve eczema symptoms. The next big key to managing itchy dry skin is gentle cleansing daily, especially evening baths or showers so that the pollens, dust, and other allergens accumulating on the body are removed before bedtime to help reduce nighttime irritation and itching. It is

JULY 17, 2020 important to note that bathing with very hot water (which children really shouldn’t be doing anyways) can definitely dry skin out more, and that lukewarm water is better for skin hydration and health. Avoiding excessively rough wiping with towels (it is better to gently “pat” skin dry after bathing) is a good tactic as well. Some children may have worsening dryness with daily bathing due to soaps, so at times just plain water is preferable for bathing if only to remove dirt, dust, and pollen without the irritating soap products. It may take families a few trial and errors until they determine the best routine for their child’s skin care management. It might also be worthwhile to discuss with your child’s pediatrician about possible seasonal allergies, as allergies and eczema frequently go hand in hand (and can make each other worse). Signs of allergies of course can include sneezing, runny nose, congestion, nasally voice, and watering eyes - but worsening of skin itching and rashes can also hint at uncontrolled sensitivity to allergies.

For significant or recurrent flares of eczema, it is important to meet with a child’s pediatrician for further management. At times, for severe flares and rashes, topical steroids may be indicated (but should be prescribed by the child’s doctor) and should not be used for more than a few days as frequent topical steroid use can cause other complications including thinning of the skin and pigment changes. For maintenance and management of eczema beyond bathing, cleansing, and moisturizing routines, talk to the pediatrician about other ways a child’s itchy dry skin and frequent rashes can be resolved. But sometimes, a solid skin care routine goes a long way! + by Dr. Caroline, an MCGtrained, board-certified pediatrician. This article is not intended to substitute medical advice and is merely to be used as a tool of education. If questions arise or you have concerns about your child, please consult a medical care provider accordingly and avoid any delay in treatment, as all children deserve treatment on an individual basis.

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