Medical Examiner 7.3.20 by Daniel Pearson

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JULY 3, 2020

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THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

JULY 3, 2020

The path I have chosen by Kimberly Savage

PARENTHOOD by David W. Proefrock, PhD

Dr. Proefrock is a retired clinical and forensic child psychologist.

“The practice of medicine is just that: practice.”

apist is to manage the ventilator. It’s what I specialize in. I will also be the one held accountable should something happen to the patient because of inappropriate ventilator settings such as pneumothorax, barotrauma or volutrauma. If you need something ventilator-related, find me! I am assigned to the unit and I will adjust the ventilator or explain why I do not think it’s a good idea, and hopefully you will understand or maybe you can help me understand why something needs to change. Regardless, come find me!

— Kimberly Savage is a respiratory therapist who works at two Augusta-area hospitals

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this article is a few words of friendly advice from an area respiratory therapist for those new residents just getting started… Rule number 1: Do not touch the ventilator! One of my jobs as a respiratory ther-

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If you answered: A. If you keep him away from social situations, he will never learn to handle them and may spend the rest of his life being isolated and afraid. B. They are right, but this is not the best way to socialize him. Take him out in as non-threatening situations as possible and do more as he becomes better able to handle them. C. Grandparents can be interfering at times, but they are a good source of help and support to new parents. Don’t ignore what they say. In this case, they are right. D. This is the best response. Children do need to learn to deal with people. A child who is fearful, as yours seems to be, should be taken along slowly and deliberately, but taken along nonetheless. Teaching socialization is one of your primary jobs as a parent. It is important for children to learn to interact with others and it is your responsibility to ensure that they do. +

July 1st means different things to different people. Obviously, it is the beginning of a new month, marking the halfway point through the year. Some people associate July with vacation since many people plan vacations around the July 4th holiday. Some seek shelter (aka air conditioning) as the dog days of summer settle in. This year, many families with school aged children are making decisions about the upcoming school year. In hospitals across the United States, July 1 marks the day residents fresh out of medical school begin their residency. For them, it is a day filled with expectation, anxiety, joy, and fear, a day they have worked incredibly hard for, the starting day for putting all the knowledge they have acquired into practice. For many hospital personnel, mainly nurses and respiratory therapists (to my knowledge) it is a day many of us dread because all the book knowledge, while necessary, cannot prepare you for the rules and customs of each individual hospital. So

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Before the pandemic, your parents and your in-laws were both telling you that you’re being overprotective of your 2-year-old son. They think you should take him out more to be around other people and other children. He seems to have a difficult time dealing with crowds, though, and you hate for him to be frightened and upset. What should you do? A. There’s no reason to upset him needlessly. Keep him at home and away from crowds until he starts to handle them better. B. They are right. Take him out with you to stores, parks, and restaurants. Just let him cry until he calms down and starts to get used to being around others. C. Grandparents don’t know your child as well as you do. Start him with new things when you think he’s ready to handle them. D. Take their advice. Begin with slow, but purposeful efforts to take him out among other people. Start with a little at a time and add more as he gets used to being around others.

Rule number 2: Contrary to popular belief, albuterol does not fix everything. There are conditions such as asthma or COPD that benefit from the use of bronchodilators. That said, it will not fix crackles in a patient with chronic kidney disease who missed dialysis last week and is now fluid overloaded, or a patient who is experiencing shortness of breath due to congestive heart failure exacerbation and has gained 12 pounds in 2 days and needs some form of diuresis. It is important to look at the patient as a whole, not just the symptoms. Rule number 3: Treat other colleagues, patients, and family members with the same level of respect, courtesy, and humility you would want to be treated and/or the way you would want your family treated. This rule can be applied to all areas of your life and is the most important in my opinion. The practice of medicine is just that…practice. Medicine evolves and changes (COVID-19 is the perfect example) and you must evolve with it. There is no place for large egos when caring for a human life. Finally, CONGRATULATIONS! You have worked very hard to get to this point. Remain teachable and you will go far! Allow others to help you, and if you do not know, ask. There are no stupid questions. Again, this is just a respiratory therapist perspective. You have nothing to lose by applying these rules, and what you could gain may be as valuable as the knowledge you gained in medical school. Good luck! +

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Let’s spend a few calm, quiet and rational minutes talking about everyone’s favorite subject, the coronavirus. (Part 7 of a feature of unknown duration.)

Sometimes it seems like this pandemic and all its many inconveniences will never end. Nearly the entire world is asking the same question: how much longer? The phenomenon has resulted in yet another side effect of this virus: “quarantine fatigue” is one of its names. Others call it “pandemic exhaustion.” These and other similar labels describe being sick and tired of the assorted restrictions associated with the efforts to contain this thing. One of its major symptoms is one we have all seen: largescale impatience to get things moving again: to restart the economy: in short, to get back to “normal.” One commentary we heard at Medical Examiner world headquarters offered a sobering reminder. In so many words the person said, “You do realize the world you want to go back to, the so-called ‘normal’ world of six or eight months ago, is one that at the

time you thought was seriously messed up, right?” Ok, so maybe that was a world of random school and workplace shootings, Greta Thunberg and climate worries, wealthy parents paying bribes to get their underachieving kids into prestigious schools, and Boeing 737 Max jet crashes. But most of us would take that world over dealing with this pandemic. Duly noted. Agreed. Unfortunately, however, no one is offering that choice. We have to deal with the present situation whether we like it or not. Maybe it will disappear “like magic” as the president hopes, but nothing so far indicates that’s about to happen. Instead, we’re asked to follow the best recommendations of the experts. No one, the experts included, thinks the efforts to contain COVID-19 in this country have been handled as well as they could have been. Without question, mistakes have been made as scientists continue to

learn more about the virus. But as the events of the past two weeks clearly demonstrate, there is no shortcut to a solution. In Georgia and South Carolina and across the country in recent days, new virus cases are at all-time peaks. You and I might be so over this virus, but that doesn’t mean the virus agrees. Impatiently abandoning the best advice we have at the moment has not worked. You can’t pull the cake out of the oven after five minutes and enjoy a delicious dessert. It takes time. Similarly, we can’t get to the destination we all want to reach by impatiently ignoring the carefully considered advice of public health officials. To listen to some folks and their belief that this is all a sinister plot to control the masses, you would think we’re living in a totalitarian state. Ironically enough, these are often flag-waving Make America Great-type patriots, yet they seem to believe the U.S. resembles Nazi Germany or Communist China. “They’re doing this to gradually take away all our freedoms!” In fact, some people say making mask-wearing mandatory is violating their freedom. Well so is wearing a seatbelt when driving, but no one seems to think that’s Big Brother. When all is said and done, we all have to trust someone. Will it be social media posters and their claims? If it is, our long journey back to “normal” might take even longer. +

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Does an apple a day keep the doctor away? It’s possible. Apples are a good source of fiber, are helpful for maintaining good colon health, and can also help in weight control. All of that is good for health, especially if someone is eating an apple a day instead of, say, a bag of potato chips. But will it keep a doctor away? Not if you (assuming you’re the apple eater) care about your health. Regular checkups are a mainstay of a salubrious lifestyle. If you brush and floss as the experts recommend, would you stop going to the dentist? If you answered “no, of course not,” give yourself a gold star. In the same way, those apples we’re eating every day don’t mean that our blood pressure or cholesterol levels are necessarily where they need to be. Even if you own a professional quality stethoscope, would you know if you heard something in your heart or lungs that signalled a possible problem? Do you have a bp cuff so you can correctly and accurately check your blood pressure? So to get back to the original question and our initial answer, yes, it is possible that an apple a day could keep our doctor away. But if it does, it’s by our own choice, and it’s not a very good choice. A better option: keep eating apples, and keep getting checkups on a schedule you and your doctor agree upon. +

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. +

MEDICALEXAMINER

AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

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

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Opinions expressed by the writers herein are their own and/or their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., nor its agents or employees take any responsibility for the accuracy of submitted information, which is presented for general 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. © 2020 PEARSON GRAPHIC 365 INC.

JULY 3, 2020

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#118 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

ho is this? Why it’s none other than Robert Furchgott. Yes, that Robert Furchgott, the guy who won the 1998 Nobel Prize in Medicine, the guy whose discoveries led to untold billions of dollars in pharmaceutical sales, the guy whose work made millions of people happy. No wonder it’s so hard to find anyone who hasn’t heard of Robert Furchgott. It all started in Charleston, South Carolina, in 1916. That’s where Furchgott was born. He graduated with a degree in chemistry from the University of North Carolina at Chapel Hill in 1937 and went on to earn a Ph.D in biochemistry at Northwestern University three years later. Although one of his earliest positions was on the faculty at Cornell University, Furchgott spent the bulk of his career — more than 50 years (1956 to 2009) at the State University of New York Downstate Medical Center as professor of pharmacology. His research focused on drug interactions with receptors in blood vessels. He and others discovered that cells in the endothelium, or inner lining, of blood vessels produce an unknown signaling molecule. This molecule, later identified by Furchgott as nitric oxide (NO), acts to dilate blood vessels. Its discovery helped to identify the long-sought explanation for nitroglycerin’s effectiveness: it induces the production of NO, helping to quickly alleviate angina pectoris, which is chest pain usually caused by insufficient blood flow to the heart muscle. Various drug companies sought to develop ways to capitalize on Furchgott’s discoveries to help treat patients with hypertension and angina. One of those companies was Pfizer, where in 1989 two pharmacologists (Peter Dunn and Albert Wood) working at its Kent, England, laboratories tried to develop a new drug for that express purpose, testing various formulations with no success. Just as the project for that drug-in-development was about to be dropped, someone noticed that male study participants reported an unusual and unexpected side effect: robust erections. Suddenly the possible heart benefits went onto the back burner. Almost a decade later, after more than 20 clinical trials involving thousands of patients (the oldest, 87) the drug Sildenafil, aka Viagra, aka “the little blue pill” was approved by the Food and Drug Administration as the first-ever drug treatment for erectile dysfunction. Good thing someone at Pfizer noticed the unintended side effects for a drug that was supposed to treat heart problems: according to one source, in its first year of production, sales of Viagra topped $1 billion. +

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One of the unexpected outcomes of the virus, because many of us are still homebound, is to discover that our old recipes have become super boring, assuming we can still find the required ingredients. For me this has led to a combination of new dishes and experimentation with old favorites. This week that led to having a Mexican dish delivered that was mostly a baked chicken half with rice, refried beans, and an avocado salad. I ate half of the rice, beans, salad and dark chicken meat. Then the second night I had the rest of the rice, beans, and salad and about half of the white meat. There were three corn tortillas and the rest of the white meat still left that I had cut up in small pieces. Normally I would have added mayo to the chicken and made a chicken sandwich, but I felt that would be cheating somehow. So, instead of falling back on the tried and true, I imagined something new based on what I had on hand. I had the bits of chicken, an avocado, a little wheel of Brie, and the tacos. I laid out the three tacos, cut slices of Brie, and laid them on the tacos, put the chicken on top of the Brie and heated them up in the microwave until the Brie had melted. Then I cut up the avocado and put the chunks on the tacos. It was delicious, much more satisfying than a chicken sandwich would have been! The rice wasn’t Spanish rice, so I mixed it with the beans the first night, and the second night I mixed all three together. I really liked the taco chips included, so I used them to

scoop up the rice, beans, salad mixture like they were an exotic dip. Yummy stuff! I have lots of the chips left, so now I need to figure out what to do with them. I still have some avocado, a small container of grape tomatoes, and a big bag of Mexican blend shredded cheese. I also have a bag of raw shrimp to cook. I haven’t had nachos made with anything but hamburger, but why not try them with shrimp, since that is what I have on hand? I have ordered hamburger five times and not gotten any, so the first rule of self-preservation is to use what is available. Since I’ve had Mexican food three days in a row, I’ll most likely cook the shrimp tonight and have shrimp and sauce that I make with ketchup and horseradish after I cook and peel the shrimp. I’ll have plenty of leftover shrimp for nachos tomorrow. I’ll add a salad and some veggies to go with the shrimp. And I have some frozen yogurt for dessert. I do need to order some groceries, but the longer I can wait between orders, the more I am forced to be creative in using up what I already have in the refrigerator and freezer. I am also put in a position to use up fresh food before it goes bad and has to be thrown out. What is even more important, though, is that I am using more healthy food in creative ways and that makes my tummy and the rest of my body feel better. I see the same thing in meals my friends post online too. One of my friends noted today that the healthier food has resulted in her losing weight instead of gaining it. That’s a win every time. +

Do you struggle with moderate to severe unsalubriousness?

Doctors recommend twice-monthly

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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 3, 2020

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age BY J.B. COLLUM

on the porch and hanging on for dear life, I rang the doorbell and began to learn about patience. Uncle Larry knew we were coming, but not the exact time, so we weren’t shocked to wait a little while at the door. However, after five minutes of waiting and not hearing a peep, we started to worry, so I called Larry’s phone, but there was no answer. Dad was getting tired of standing and said

for them. I thanked him and assured him that I would treat them well. The plan next was to go to lunch together and then go see his wife, Ty, at the nursing home afterwards. Getting Larry and my father in the car took about twenty minutes, half my remaining allotment of patience for the next week, and many muttered curses said under their threshold of hearing, along with silent prayers for forgiveness afterwards. We managed to get about twenty feet down the road from Uncle Larry’s house when a tiny little lady in her eighties in a pink jogging suit waved us down. I was going to keep going because I didn’t know who she was, but Uncle Larry told me her name, (we’ll call her Mary for the purposes of this story) and asked me to stop and roll down the window, which I did. Mary introduced herself and spoke primarily to Larry, who then introduced us. She asked about his wife, and Larry mentioned that we were going to see her. She asked if she could come along, to which my uncle, with panic in his eyes, quickly replied that we weren’t going straight there, but to eat some lunch and then go. That didn’t faze Mary. As she cocked her hips to one side, placed her hand to her waist and flashed a coquettish grin she said, “Hey, a girl has to eat too, you know.” Larry looked more worried now and whispered “no” to me, leaving it to me to save us from this unknown threat. I chickened out and said something noncommittal like, “Well, we don’t know where we are going yet, and we might run some other errands first and maybe afterwards.” Instead of taking the hint, she said that she didn’t mind where we went and had all the time in the world. Without waiting for a response, she said that she’d just go grab her purse. I gave up and offered to drive her to her house, but she said she wanted to walk instead, so I slow-

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This issue’s column might read like a sitcom, but I assure you, this is fact, not fiction. Only some names have been changed to protect the innocent and the guilty. I previously shared the joys and perils of traveling with my aged parents in a column about a trip to the Smoky Mountains. That trip had the advantage of my daughter driving my parents to and from the location in their own car and not riding with me. A little less than two years ago, I had the opportunity to travel alone with my father to see his uncle Larry in Charlotte. This is my father’s sole surviving uncle, and with my father’s Alzheimer’s diagnosis the previous year along with the fact that his uncle is in his late eighties, I figured that I shouldn’t delay in taking him on trips like this. It did not go as expected and in fact, dad’s condition turned out to be the least of my troubles on this frustrating, embarrassing, yet funny and poignant trip. Before it was over, I would meet an octogenarian millionaire with virtually no inhibitions and a kleptomaniacal streak, and for some reason, I would buy her lunch instead of the other way around. My patience (or lack of it) would be tested to the limit and I would hear some priceless stories from my father and uncle. The drive up wasn’t bad because my father is at his sharpest in the mornings after his coffee. We talked mostly about old times as I drove and asked him to tell me about the good old days. His memories of the distant past were and still are his strongest. Short term memory? Not so much. We enjoyed some breakfast on the way and generally had a great time. Upon our arrival at his uncle’s house, we struggled to get my dad from the car and up the steep driveway and steps. His legs aren’t very stable due to another health condition unrelated to his dementia. Once he was leaning up against the railing

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“An 80-year-old lady in a pink jogging suit waved us down.”

that he wanted to wait in the car, but the thought of repeating that long and arduous process made me re-double my efforts. I had rung the doorbell and knocked multiple times already, but I tried both one last time. I was contemplating breaking in since I began to wonder if something bad had happened. But just then, through a window, I saw Uncle Larry creeping into the room about an inch at a time with his walker. He saw me too and said for me to “hold my horses.” Now that I could see him coming, I had stopped worrying, but waiting the additional twenty minutes for him to traverse the last six feet to the door was exhausting for my father. Okay, so it wasn’t twenty minutes. More like one minute. It only felt like twenty. Once we got inside and sat down, we visited for a while before he asked me to do my usual long overdue tech support tasks like helping him remember his passwords, reconnecting devices to Wi-Fi, getting rid of all the viruses and trojans on his computer, installing the Alexa Echo Dot I had bought for him to talk to since he lived alone, fixing TV remotes, etc. Once that was done, he generously gave me some family heirlooms he wanted me to keep, and explained how I should care

ly drove alongside her for a couple of hundred feet as she walked home. Awkward moments were beginning to become normal for me. Cars slowed down, looked at us as we drove alongside this old lady in a pink jogging suit, and I couldn’t help wondering what they might be thinking. Did they think she was training for a marathon and we were her trainers? I had lots of time to think about this. At least she was faster than Larry. While we crept along beside her, Larry took this opportunity to tell me that Mary was the wife of his late friend who had made a fortune in the energy business and had recently died, leaving Mary with millions in the bank. Mary finally climbed into the car after retrieving her purse and we headed to the restaurant. Along the way she commented

about how honored she was to be taken to lunch by such handsome younger men. She said it in such a way that I feared I may be forced to tell her that I was a married man. This was also when I knew she had some serious issues with her vision that would be confirmed further as the day progressed. What happened next? Tune in next issue when the “fun” (in quotes) really began at the restaurant. Until then dear readers, stay safe and healthy, and don’t pick up octogenarian joggers on the side of the road. + 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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GARDENVARIETY

If you are in search of a nutritious yet hearty refreshing summer salad, then you need to try this Summer Farro Salad. It is very easy to make and can be prepared ahead if you need to do so. Some of you may ask, what is farro? It is a nutrient-packed grain in the wheat family that has been traced back to early Mesopotamia. It is a nuttyflavored whole grain that is packed with nutrients and has a chewy texture, which makes it perfect for risottostyle dishes, soups, stews, casseroles, and salads. It looks similar to rice, but farro is a healthier alternative to white rice or products made with white flour such as white bread, regular white pasta, and many cookies, cakes, breakfast cereals, crackers, and snack foods. Quinoa has become known as a superfood, but farro is quickly gaining popularity. A little softer and more tender in texture, it’s similar to rice. Some people don’t like the slightly nutty flavor and poppy texture of quinoa, so they will love eating farro, which has a consistency more like rice. For those who deal with any sort of wheat intolerance, it’s important to note that farro is not a gluten-free grain. The good news is if you are on a lowfat diet, a 1/4 cup quinoa has 2.6 grams of fat, but farro has zero and several more grams of protein. To pin this recipe, read more tips and find information where you can buy farro be sure and visit my blog at, www.intentionalhospitality. com/summer-farro-salad Summer Farro Salad Ingredients • 1 cup farro • 1 teaspoon salt, divided in

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Gina Dickson photo

half • 1/8 cup olive oil • 1 tablespoon freshly squeezed lemon juice • 1 cup fresh or frozen peas • 1 cup zucchini chopped in small cubes • 1/4 cup pesto • 1/4 cup finely chopped sweet onion (optional) • 1 tablespoon finely minced fresh parsley • 1/2 teaspoon fresh ground pepper

tender. Drain any excess water and then fluff with a fork. Place cooked farro in a medium-size mixing bowl, add all other ingredients and toss well. Serve and enjoy! +

Instructions

by Gina Dickson, an Augusta mom to six and Gigi to ten. Her website, intentionalhospitality. com, celebrates gathering with friends, cooking great healthy meals and sharing life around the table. Also on Instagram @ intentionalhospitality

Prepare Farro: Measure 1 cup of farrow and rinse in a colander. Bring to boil two cups of water and a dash of salt in a medium saucepan. Add farro, stir and cover. Reduce heat to a simmer for 20 minutes until soft and

You can find this post at: https:// intentionalhospitality.com/ summer-farro-salad/

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ASK DR. KARP

NO NONSENSE

NUTRITION Chris, from Appling, Georgia, asks: “Is eating a lot of bacon really a health issue? I just read that one fast food place is now offering 8 strips of bacon as a “side” item. I love bacon. Is that a problem?””

As is the case with just about any other food, you are not going to fall over dead if you eat a strip of bacon once in a while. The problem these days is

the obsession with bacon. Today, people are “pigging out” on bacon all day long. Bacon seems to be on everything, from hamburgers to donuts to ice cream. I imagine that some of you are probably salivating right now, simply thinking about bacon. (Editor’s note: if not, please enjoy the photo to the right.) What is bacon? It comes from the belly, side and back cuts of pork. This part of the pig is first soaked in large amounts of salt water (known as curing), then it is dried and, sometimes, smoked. In this country, the USDA defines bacon as “the cured belly of the swine carcass.” There are other types of “bacon” made from different animals, such as cows and lambs, usually eaten by people who do not eat pork products. Bacon is very flavorful and adds a crispy, crunchy texture to food. Remember when you were growing up and bacon was always part of a Sunday morning breakfast? Mama only gave you one or two slices. Mama, as usual, was right. Moderation is the key. The health issues with bacon are that, 1) it is high in fat, 2) it is high in saturated fat, 3) it is high in trans fat,

4) it is high calorie, 5) it is high salt, and 6) it is highly processed and preserved. It is actually very difficult to find another food that is so opposite the nutrition recommendations of just about every health organization on the planet. Centuries ago, smoking bacon was a way of preserving meat over the long winter, but, honestly, get with it. We have refrigerators and freezers today. In addition to all the nutrition issues, eating processed meats such as ham, bacon, salami, sausages, hot dogs, luncheon meats, and pepperoni is related to increased cancer risk. It may be because they contain chemicals like nitrites, nitrates or nitrosamines. Although we are not quite sure what increases cancer risk, we are

JULY 3, 2020

very sure that the consumption of processed meats increases cancer risk. People who eat a lot of processed meats, such as bacon, have an 11% higher risk of death from cancer (and a 72% higher risk of death from heart disease). Wowie! What about turkey bacon? Is it any healthier? Not really. Be aware that not all turkey bacons are created equal, so you need to read the Nutrition Facts Label. Some turkey bacon may contain as much saturated fat, salt, etc. as regular bacon. Read the label. Just because a product is made out of chicken or turkey doesn’t mean it is healthy, or even healthier. For most people, the “emotional” content of bacon apparently outweighs

concerns about the nutrition content. Let me give you an example. I remember when a former neighbor of ours was rushed to the hospital with a heart attack. He survived the heart attack and was discharged home. As his “welcome home” breakfast, his wife made him bacon and eggs. How do we know? We could smell the crispy frying bacon all the way to our house. Even though the family met with a registered dietitian nutritionist (RDN) for a nutrition consultation prior to leaving the hospital, the wife’s idea of a “celebration” breakfast was bacon, eggs, grits and biscuits… heart attack or not! What’s the “No-Nonsense Nutrition” advice for today? Eating some bacon now and then, like any other food, is not a problem. Showing moderation when eating bacon might be described as occasionally having about an ounce of bacon. Moderation is not having a contest with your friend at the buffet to see who can stuff as much bacon as possible into his or her mouth. Although most people would like it to be true, the fact is that bacon is not a food group. +

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

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Ask a Dietitian FROOT LOOP FANTASY

by Kim Beavers, MS, RDN, CDCES Producer and Co-host of University Hospital’s Eating Well with Kim Follow Kim on Facebook @Eatingwellwithkimb or @Timetoeatwellwithkim How do you know if a food is healthy or raisin bran = 45g. raisin bran has 11 more not healthy? The most direct and simple angrams of carbohydrate. This does not mean swer is to consider the source—literally. That it is better or worse, it is simply higher in is usually the Nutrition Facts panel on nearly carbohydrate. Part of this has to do with the all foods. density of the food (refer back to the weight In addition, it is important to keep a few of the food).But let’s look at the source. key facts in mind. To find the source of the carbohydrate we • One food does not make an entire diet must look at the ingredient list - often this is healthy or unhealthy also when you have to put on your reading • Healthy food goals are glasses. Carbohydrate inindividual gredients for Froot Loops • Less processed foods include corn flour blend, are almost always the best sugar, wheat flour, whole choice grain oat flour, cornstarch. Let’s go through an Some of this is whole example using cereal. grain (which is great) A friend called my attenbut the second ingredient tion to a question in the is sugar. Carbohydrate cereal aisle where a friend ingredients for Raisin of his had identified Froot Bran include whole wheat Loops as one of the best meal, raisins, wheat bran, choices based on the Nucane sugar, flaxseeds, oat trition Facts Panel. bran.Raisin Bran has more As a dietitian I’ll always whole grain ingredients tell someone to read the and whole raisins that BLUE BREAKFAST OATMEAL make it a bit less refined, Nutrition Facts Panel No more Blue Mondays! This oatmeal is as a first step in label and sugar is further down packed with nutrients to help you take reading. But numbers the ingredient list indicaton Monday or any day of the week. do not tell all. Just like a ing less sugar is added. headline, there is always Sugar is comparable • ½ cup microwavable steel cut oats more to the story. You with 12g per serving for (such as McCain) must consider the source. Froot Loops and 13g for • ½ banana cut up The labels below are for raisin bran. The next line, • Pinch of salt Kellogg’s® Froot Loops® “added sugar” will help us • 1-½ cup water and Nature’s Path® Raisin determine the source of • 2/3 cup frozen wild blueberries Bran. the sugar in the product. (thawed) Let’s break it down. Added Sugar: 12g in • 2/3 cup Greek yogurt Serving size: Froot Loops, 6g in raisin • 2 tablespoon almonds Froot Loops: 1 1/3 cup bran. Let’s look into that (39g) with 150 calories a bit more. The total sugar Place oats, bananas and water in a Raisin Bran: 1 1/4 cup in Froot Loops is 12g and large bowl (must be a large bowl to (60g) with 210 calories the added sugar is 12g, avoid boil over). Microwave the oatmeal Similar serving size but which means that all of for 90 seconds. Stir, and repeat the prothe weight of the food is the sugar in Froot Loops is cedure two more times. Remove from different. The raisin bran added. In Raisin Bran the the microwave, stir and add blueberis actually more dense, total sugar is 13g and the ries, yogurt, and almonds. so you are getting more added sugar is 6g meaning food by weight with a that 7g of the total sugars Yield: 2 Servings similar serving size. This Nutrient Breakdown: Calories 260, Fat 6g (0.5g are natural (it comes from saturated fat), Cholesterol 0mg, Sodium 30mg, is not something I typithe raisins). Why is this Carbohydrate 44g, Fiber 7g, Protein 15g. cally discuss when label important? For starters we Diabetes Plate Plan: 2 Starches, 1 Fruit, 2 Lean reading but it is worth know that added sugar Meats + noting here since we are contributes to poor health, taking a deeper dive into while natural sugar is not label reading. The raisin bran is more dense considered a health hazard. Natural sugar is and therefore has a few more calories as a packaged in whole foods with fiber, vitamins result, which may actually help increase the and minerals. For reference purposes, the “fullness factor” of the food. American Heart Association recommends that Fat: Both are low in fat which is to be women consume no more than 24g of added expected. We are comparing cereal here, not sugar per day and men consume no more steak. They are naturally low in fat. than 36g of added sugar per day. One serving Sodium is exactly the same at 210mg. of Froot Loops and the ladies are halfway to Total Carbohydrate: Froot Loops = 34g the recommended limit. To clarify further;

the “Total Sugar” line on the label includes all the sugar in the product, added AND natural. The added sugar line has recently been included on labels making it much easier to figure out how much added sugar is in a product. This is important because added sugar is sneaky and adds up during the day. Now there is a simple and reliable way to compare foods and make informed choices. Fiber is a good indication food quality, with higher fiber usually indicating a less processed food. Froot Loops has 2g fiber, while the raisin bran comes in at 9g. There is little fiber in Froot Loops because it is made of mostly processed flours. Raisin Bran (while it is processed) is made from whole wheat flours and contains whole fruit — not “froot” — in this case, raisins. This is what contributes to the fiber content and part of the reason the carbohydrate content is higher in the Raisin Bran. Important Ingredients: as we have done in this label exercise, referring to the ingredient list is how you “consider the source” on a food label. The numbers on the nutrition facts panel are a great way to review and compare products, but keep in mind you can miss a few things unless you go that extra step. For example, when you simply look at numbers you miss the fact that the Froot Loops have multiple food dyes, while the raisin bran does not. Food is meant to nourish and fuel our bodies. It is never all about numbers and it’s always important to consider the source, and of course enjoy the eating experience. +

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CRASH

COURSE

More Americans have died on US roads since 2000 than in World Wars I & II combined

ot car season is back. It comes around every year, even when a pandemic is going on. If you’re unfamiliar with the term “hot car season,” it collectively describes the annual seasonal tragedies that happen when children die inside cars baking in the summer sun. This is not a huge problem numerically — unless it happens to your family or to someone you know and love. But somehow even one or two deaths like this seem especially tragic. What is even sadder is that this problem is getting worse. Here are the recent numbers for hot car deaths in the U.S.: 2015: 25 2016: 39 2017: 43 2018: 54* 2019: 52 *All-time peak According to kidsandcars.org, there have been 6 hot car deaths this year so far, the most recent just a week ago today (June 26), an 11-month-old girl who died in Springfield, Virginia. The age of the average victim is 2 years, 5 months. Unfortunately, the numbers don’t reveal the full toll taken by these tragedies. How many individuals and families are destroyed by each incident? In one recent Florida case, the distraught father who accidentally left his young son in the car took his own life after suffering through months of anguish. In that case, as in many others, the culprit was a deviation from the norm: the man’s wife normally took the child to daycare, but on the fateful day she was unable for whatever reason. The husband was only too happy to help out, but once he got in his car, autopilot took over and he drove to work as he always did, the child asleep in the car seat in back. He parked and went into the office. Someone happened to notice the child around lunchtime.

The keys to preventing these tragic deaths are in the hands of adults. Here are some prevention tips and reminders: • As indicated by the chart about, over half the cases involve forgetting the child is in the car. If you have kids, “Look before you leave” after parking. A quick glance is all it takes. • Always keep your car locked. A number of deaths have been caused by kids playing in their own car, right in the driveway. Sometimes they’re too small or not strong enough to open the door. • Make sure whoever normally keeps your child — daycare, school, grandparents, neighbor, etc — knows to call you immediately if they are not dropped off as usual. • Place the car seat in the middle of the backseat where it’s easier to see when it’s occupied rather than behind the driver seat. • Place something important in the backseat whenever you’re transporting a child, like your purse or even one of your shoes. Place something of the child’s, like a toy, in the front seat with you. • Be extra alert anytime your routine changes. • As the chart shows, 17% of deaths involve a child knowingly left in an unattended vehicle. Never do that, even if the engine is running and the air conditioning is on. +

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HUMAN BEHAVIOR Your once-sweet child has become a rude, moody teenager who is disturbing everyone in the family — including the dog. Do you just have to wait it out until the terrible teen leaves for college or grows out of by Jeremy Hertza, Psy.D. his hormonal rage?

THE MOODY TEEN WHO RUINS IT FOR THE WHOLE FAM

Here’s What’s Happening Your child’s brain is reacting—hard—to hormonal changes during puberty, which can begin as young as 10 years old. What hormones do is take what we normally might feel and amplify it. So if your child typically struggles when handling change or has trouble handling emotion, hormones make it even harder. Kids who have been diagnosed with ADHD, bipolar disorder, oppositional defiant disorder or conduct disorder also have a harder time since a hallmark of these disorders is difficulty regulating attention or controlling behavior.

A New Normal Just because hormonal changes are normal doesn’t mean they don’t come with a lot of emotional challenges. What can help is to start teaching kids—well before puberty— how to recognize when their emotions are heightened and giving them tools to deal with bigger-than-life emotions and to release tension. • Internal methods: Remember time-out for your 2-year-old? It’s the same principle. Teach kids to think through what they’re feeling to help them process and overcome negative emotions. Or, they can write or draw what they’re feeling, or talk it over with someone who will listen. • External methods: These include ways to distract from negative emotions and reduce stress. It could mean exercise, like running or yoga; a game, whether that’s on the computer solo or a board game with a friend; or an activity with a friend, like going to a movie, bike-riding or swimming. Kids may end up doing both methods at the same time or at different times. Parents can do the exact same things to deal with their own stress and frustration. It’s very important that parents monitor their own emotional reactions and not turn a minor problem into a bigger one. Remember, even though a child is always responsible for their own behavior, it’s important to take things in context, too. Try This At Home The situation: My teen is freaking out about having to finish homework. The fix: Acknowledge your child’s frustration, but ask, “What would you like to do to solve this problem?”, making it clear they understand the consequences at school and at home. Maybe your child wants to set a time when they will work on homework, or needs something before they can start. The situation: My teen is really mean to a younger sibling. The fix: One idea is to get them to work together on a project to foster a little teamwork. Or, if that makes things worse, try figuring out what exactly is happening (is the older child wanting to control the younger one? Is the younger one unsure of how to deal with the older child?). Work with each child to provide guidance/tools on how to fix the situation. The situation: My teen is pushing back against all authority figures. The fix: Get your teen to stop and think about what they want out of the situation and how they plan on getting it. Say they want parents/teachers to stay out of their business; are they achieving that by starting fights and causing trouble? It can really help when you put it into perspective and work on setting goals. The Small Details Pay attention to small details and trust your intuition. If something seems off with your child, don’t brush it off. In this day and age, also make sure that any weapons are locked up. Please see HUMAN BEHAVIOR page 13

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The blog spot From the Bookshelf — posted by Suneel Dhand, MD, on June 30, 2020

NOTHING SHOULD STOP COMMUNICATION One aspect of medicine that anyone who reads my work knows I’m passionate about is keeping excellent communication at the core of healthcare. It’s a vastly under-taught skill, and although medical schools are certainly getting a lot better at teaching the fundamentals than they were a few years ago, there’s still nowhere near enough reinforcement throughout one’s medical career. It’s therefore easy for all of us to slip into bad habits. Don’t get me wrong, physicians have a difficult job, and it’s probably only a tiny minority who are really bad communicators. However, everyone can do better. I’m going to relate one story in particular that happened to me not long ago. I was back in England, and my mom had been scheduled for elective surgery. I made sure that I would be home for it (thankfully it wasn’t anything major), and the whole family went to the hospital in the morning. We spoke to the surgeon, and he went through the procedure and took consent. He told us the surgery would be later in the day. So we waited. And then the afternoon came, and we continued to wait -- 2 o’clock, 3 o’clock, 4 o’clock. No word, and my mom was not eating (NPO). We asked a couple of times if there was any news about the timing, and the nurses just apologized and said they would let us know as soon as they heard something from the OR (in England we call it an “operating theatre”). Finally, close to 5 o’clock, the surgeon came through the waiting room and went to speak with the charge nurse. He then strolled straight past us, all of 10 feet away, gave us a glance as we stared at him, and just carried on. The charge nurse came out and said that unfortunately, due to some staffing issues, the OR was closing, and they couldn’t do the surgery on that day. She expressed a genuine apology, but we were, of course, very disappointed. The surgery ended up being delayed for over a month). What disappointed us the most was the behavior of the surgeon. My mom’s life would be in his hands, and we had placed our trust in him. Yet he walked past us several times during the day, and finally at the end, he traversed right past us without even acknowledging us, despite knowing full well we had been waiting the whole day. I wasn’t really as upset as my mom; I know slights like this happen every day in medicine. How much effort would it have taken for that surgeon to stop, say sorry (for factors that were probably beyond his control) and at least respectfully acknowledge my mom? Probably all of 20 seconds. Even at the National Health Service, with much less of a customer service mentality than the U.S., it’s still the respectful thing to do. Whether healthcare professionals like it or not, we are held to a higher standard of courtesy by the general public than a plumber or grocery cashier is. “The patient [or their family] has some questions.” Every physician should see these requests as a natural part of the job, one that is truly remembered and leaves a lasting mark. All doctors should see themselves as the “Communicator-in-Chief” and the face of medical care, not just the physician-scientist. Nothing should come before communicating with our patients. If you’re a doctor, do not underestimate the power of having just a minute of extra conversation with a patient and family member. Stick your head in a room as you walk past, stand there for 20 seconds and ask if everything’s OK. When you see a family all sitting in a room, go in, say hello, and introduce yourself as the doctor in charge. These little sincere things can blow the minds of your patients and their family, because it’s still so rare, and it will instantly put you ahead of 95% of other doctors in their minds. +

2 o’clock came and went, then 3, then 4...

Suneel Dhand, MD, is an internal medicine physician

I heard this book being discussed on a radio program a few weeks ago and I was instantly intrigued and knew I wanted to read it. The subject of PTSD (posttraumatic stress disorder) has been on the short list of topics for Medical Examiner cover stories for quite awhile. It’s a fascinating topic on its own merits, but we in Augusta live in what is, by some measures, a military town. Statistically, we have the likelihood of facing PTSD issues much more than people in many other cities. However, as this book reminds its readers, psychological trauma is not exclusive to the military. It is experienced by crime victims, members of families splintered by domestic violence, and victims of rape, molestation and abuse, to mention just a few. PTSD is a curious affliction: why does a person continue to relive a terrifying event years, even decades, after it happens? Why, long after the danger has passed and the person is safe and sound and has been for hours, days, weeks or years, do they continue in the grasp of the original terror? In short, how can distant memories — even some we thought were

forgotten long ago — become more important than the reality of today? One of the keys to unlocking that secret, van der Kolk says — and which is alluded to in his book’s title — is that the machinery of the entire body is involved. Experiences that cause emotional trauma are not just emotional or mental, even if there are no physical scars. In other words, “post-traumatic stress isn’t ‘all in one’s head,’ as some people suppose.” The entire body’s response to the original trauma comes into play, not just the mind’s. Having said that, the book’s glimpses into the power of the mind to create alternate realities, even from something as generic as an inkblot, are dramatic, illustrating the

mind’s ability to superimpose one scene on top of another. That can just as easily happen at the dinner table as in a psychiatrist’s office. This is an extremely important topic in today’s world, and for us, living in a center of both medicine and the military, one that many more of us should become conversant in. As van der Kolk says, for every soldier who serves in a war zone abroad there are ten children right here at home who are living through their own war of neglect or abuse. They could be our relatives or neighbors. van der Kolk does his part for us: he seems to take pains to avoid the complex medical terminology of his profession, and when he does use a word or phrase not familiar to mere mortals he explains it clearly and simply. This case-history-filled book knows the score in a game that affects countless lives. + The Body Keeps the Score: Mind and Body in the Healing of Trauma, by Bessel van der Kolk, MD, 464 pages, published in Sept. 2014 by Viking. NOTE: This review appeared in a previous issue of the Medical Examiner.

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The Examiners +

Whew. I’m exhausted.

by Dan Pearson

Well, you know what they say.

A woman’s work is never done.

What’s that?

That is definitely true. Well no wonder women are paid less.

JULY 3, 2020

THE MYSTERY WORD O 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. Type of pitch 5. Peak 9. Synagogue scholar 14. Code start 15. IV 16. Hammerin’ Hank 17. In Cairo, for instance 19. Laminated rock 20. Where you’ll find Mumbai 21. Market on Washington Road 23. Tea serving 24. Thrill; delight 26. Consume 28. Shakespearean prince 31. Anne of Green Gables setting (abbrev.) 32. Bush Field abbrev. 33. Type of doc 37. _____ in (or _______ on it) 41. Nearby SC town, pop. 218 (2010 census) 44. It can be kept in a safe 45. _______ driver 46. Musical drama 47. Apple product 49. Tractor-trailer 50. Certain keyboard key 52. Abilities 55. Defer 58. More recent 60. Abbrev. for inflammation of the female genital tract 61. Support for art 63. Pertaining to a node 67. Newborn score 69. _________ artery 71. Kind of wheat 72. Solo during 46-A 73. Colored portion of the eye 74. He was once an Egyptian prince 75. Prying 76. Yield

33 42

61 68

49 53

62 69

47 50

19 21

E 8 X 1 A M7 I N E R 5

5 7

S U D 3 O 5 K 8 U 9

1 4

6 3 9

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. Dry watercourse 2. Anemia preventer 3. Obscene 4. Village namesake 5. Letters in many a front yard 6. Vine intro? 7. Bishop’s headdress 8. Fencing sword 9. Haste; recklessness 10. Massage comment? 11. Support 12. Large single dose 13. Maladroit; clumsy 18. Discount event 22. Little drink 25. Consumed 27. Bass organ 28. Blood prefix 29. Upon 30. Built 34. Pen prefix? 35. Pinch 36. Type of towel

We’ll announce the winner in our next issue!

38. British nobleman 39. Wicked 40. Tent holders 42. Standard thermometer 43. Surrey Center restaurant 48. Washington Road shoe store 51. It’s often iced 53. Lottery game 54. The opposite of what was expected (adj.) 55. Involuntary muscle contraction 56. “River horse,” in brief 57. Borders 58. Nervous prefix? 59. Downtown Augusta street 62. Extent of time or space 64. Virginia _____ 65. Parched 66. Undergo lysis 68. Beer variety 70. Might

Solution p. 14

4 6 8 3 1 5 6 2 W C V L 7 L O K T 1 3 9 N I L E 9 8 A D 2 7 5 4 — Arthur Rubenstein

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

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

C R 1 2 3 4 5 6 7 1 2 3

L 1 2 3 4

1 1 2 D 1 2 3 4 5 6 7 1 2

O 1 2

O 1 2 3 4 5

H 1 2 3 4

1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8

1.A A AT T T T F L I W O 2.VAAAAMSHOOF 3.SUNAXXEO 4.DINAART 5.DDITT 6.ICIE 7.DOAO 8.NN

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

7 2 9 8 5 4 3 6 1

3 5 2 1 8 7 4 9 6

1 7 4 5 9 6 2 3 8

8 9 6 3 4 2 1 5 7

JULY 3, 2020

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AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

m I mentioned in the will?” the nephew impatiently asked. “You certainly are, Paul!” replied the lawyer. “It says right here, ‘To my niece Susan I bequeath five hundred thousand dollars. To my cousin Alice I leave two hundred fifty thousand dollars, and to my nephew Paul, who was always asking if he was going to be mentioned in my will, Hi Paul!’” Moe: I have a hard time falling asleep. Joe: I’m the same way. It’s so much easier to fall when I’m awake. ATTORNEY AD: Has COVID-19 caused you to wear a mask and glasses at the same time? You may be entitled to condensation. A politician visited a small rural county seat and asked what their needs were. ”We have two basic needs sir,” replied the tiny town’s mayor. “First, we have a small hospital, but no doctor. The only one we have comes up from the big city for half a day twice a month.” On hearing this, politician took out his cell-

phone, punched in a number and after speaking for several minutes he reassured the town leader that a doctor would be there the next day. He then asked about the second problem. “Second sir, there is no cellphone coverage anywhere in town.”

The

A minister started his sermon to a children’s Bible study class with a question: “Who knows what the resurrection is?” One young boy raised his hand and said, “I don’t know what it is, but I know if you have one lasting more than 4 hours call your doctor.” Two drunk friends were talking in a bar. “My wife ran away with my best friend yesterday,” said the first guy. “I thought I was your best friend,” said the second guy. “Who did she run away with?” “Charlie,” said the first guy. “Charlie?” said the second guy. “Since when is Charlie your best friend?” “Since yesterday,” said the first guy. Moe: Think we’ll still be dealing with the coronavirus by Halloween? Joe: I don’t know, but if we are you know what would be the scariest costume? Moe: What? Joe: One without a mask. Moe: What did the Tibetan monk say when he saw the face of Jesus in a tub of margarine? Joe: I give. What? Moe: I can’t believe it’s not Buddha. +

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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, The store where I work has plenty of staff, and even during this pandemic with all of its restrictions we have had a steady stream of customers. Business is good. Sometimes too good. The problem is that some of my coworkers seem to go deaf when the phone rings, or blind when customers walk in. Or they suddenly get real busy on some imaginary project that cannot be interrupted. I often have to work through lunch and I get so hungry I could eat a horse. Then I overeat. I’m gaining weight. What’s your suggestion? — At a loss Dear At a loss, I’m so glad you took the time to write in about this. This all adds up to a very curious situation in this country. I specifically say “this country” because if you were so hungry you could eat a horse in, say, Canada, Belgium, or Italy, you could. Literally. You could eat a horse. Horse meat is a common part of the diet in those and a number oc countries, including our next door neighbor, Mexico. By contrast, the history of horse meat in the U.S. is long on negativity and short on actual eating. Eating horse meat has gone back and forth over the years between illegal and illegal, but even when it’s legal, in this country it carries the stigma (probably undeservedly so) of poverty. That is because periods when eating horse was more common here were sometimes sparked by things like economic disasters and wartime food shortages. It has also used against politicians. President Truman was nicknamed “Horse meat Harry” by Republicans during food shortages in the run-up to the 1948 “Beefsteak Election.” Historically, horses all over the world have long been associated with royalty, loyalty, companionship, and national pride, since they were often the engines of war in the days before tanks and planes. In some parts of the world those factors made eating horse meat distasteful, while elsewhere those same factors for some reason didn’t enter into the discussion. Similarly, eating dog meat is not common in many places, yet it’s quite ordinary in other parts of the world. It often boils down to personal taste and societal customs. I hope this answers your question. Thanks for writing! + Do you have a question for The Advice Doctor about health, life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.

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Stay in control as the parent, and don’t allow your hormonal child to be in control. Finally, remember that it’s OK for your child to talk to a counselor (sometimes your child might be more willing to talk to a counselor). And your pediatrician is a great resource for therapies to help regulate hormones if things are really out of control. +

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IT’S A QUESTION OF CARE How do we get loved ones to eat when they are in a nursing home? by Amy Hane, a licensed Master Social Worker in South Carolina and Georgia, an Advanced Professional Aging Life Care Manager and a Certified Advanced Social Work Case Manager.

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AUGUSTAMEDICALEXAMiNER Last month, we addressed how to encourage your loved one who lives at home one to eat more food. This month, we will address how to encourage your loved one, who lives in a nursing home, to take in more nutrition. • One idea is to visit during mealtimes and actually eat with your loved one. Many residents in nursing homes eat in congregate dining halls, and you can join them. The socialization piece of this is very important and will hopefully persuade him or her to eat more of what is offered. You can eat the same food, comment about it, and encourage them to try certain things they might not normally try. If they eat alone in their room, particularly joining them during mealtime gives them some company. • Another way to tempt the taste buds is that you can always bring in foods from the outside. These could be prepared foods from restaurants or they could be some of their favorite snack foods or drinks. (Be sure to not start a tradition that you cannot uphold. They very well might get used to expecting this extra food, and you may not be able to always show up at the same time or with the same items.) It’s always nice to get a treat, and bringing treats periodically can encourage them to eat more, and in turn, increase their metabolism so they eat better at regular meals as well. • Lastly, if someone is drinking a Boost or Ensure as a meal supplement or replacement, ice cream and/or peanut butter can often be mixed with the drink. The ice cream provides extra calories and often a better taste, while the peanut butter provides calories, protein and some extra fat. This can be helpful, in particular, if someone wants something that tastes more like a treat or if you’re working hard to keep weight on your loved one if they have a tendency to lose weight. +

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