June19 15 by Daniel Pearson

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#3 IN A SERIES IMPORTANT PEOPLE YOU’VE NEVER HEARD OF

Who is this man?

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

Anti-Aging Exercises for the Brain by Kathy Crist Medical researchers are finding that a fitness program just for your brain is loaded with healthful benefits. A regular cognitive workout can improve your Kathy Crist

concentration, comprehension and recall in everyday life from remembering people’s names to driving across town. Memory, reasoning and speed of thought processing are known to slow with age, yet expanding cognitive neuroscience research shows great promise in stretching routine “muscle memory” with new challenges that stimulate

brain chemistry and activate fresh cerebral circuits. The more you challenge your brain, the more cells and nerve connection pathways you form across your cerebral cortex. Cognitive stimulation builds helpful proteins, which support nerve cell growth and enhance communication between neurons. Instead of gray matter Please see BRAIN page 4

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Kid’s Stuff

NOTES FROM A PEDIATRIC INTERN by Caroline Colden, M.D.

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I don’t know about you, but I sweat like it’s my superpower. I can completely drench myself even if I am not working out really hard. Just sitting in my hot car is enough to force those salty beads of sweat to surface on my upper lip and forehead. With all my sweating, I am very conscientious about hydrating myself. Very few things feel as bad as a dehydration headache. Fortunately, I am what some people would call a “fish” when it comes to drinking water. I have a pretty good thirst mechanism and sometimes even drink water just because I’m bored. But I am finding that many people are not like me. They are what I call “camels” who can somehow go for hours, even an entire day, without the urge to drink anything. Usually they will feel fine if they are not overexerting themselves or exposed to a lot of heat, so they will be relatively asymptomatic despite physically being dehydrated. Over time they have acclimated themselves to this state. This can be dangerous because if someone who is already dehydrated loses more water, severe dehydration can occur and hit hard. Symptoms can include headache, nausea, drowsiness, dry mouth, increased heart rate, “seeing spots,” generalized weakness, and dizziness with standing. Some people report feeling like their heart is pounding. If dehydration is severe, alterations in mental status or fainting can occur, and if not corrected quickly, can result in hospitalization. Water comprises a greater percent of a person’s body weight than anything else. So when a person has not taken in enough fluids, the entire body suffers. Tissues become dry, normal metabolic functions are impaired, and the blood becomes thicker and more difficult to circulate throughout the body. As a result, the heart will pump harder and faster in order to compensate, and this can be perceived by the dehydrated individual as a pounding or racing heart. To make things more complicated, the dehydrated state can decrease the amount of blood returning to the brain to help it do its daily work. As a result, dizziness, “fogginess,” and mental impairment can result. If a dehydrated person stands up too quickly, fainting can occur. The symptoms and severity of dehydration can be especially dangerous in children. Children cannot recognize signs and symptoms of something such as dehydration the same way

• ACNE • SKIN CANCER SURGERY

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an adult can, and can be confused about why they are feeling bad. They can also have trouble articulating their need for fluids to a caretaker. Furthermore, children manifest signs and symptoms of fluid depletion and volume loss a little differently than adults, so it can be more difficult to recognize dehydration in a child. But because of their smaller size and overall smaller everything, dehydration can affect them more profoundly than it would adults. For this reason, it is especially important to monitor fluid intake and loss in children. Fluid losses don’t necessarily need to occur in the form of sweating or from exposure to heat; increased urination, illness, fever, diarrhea or vomiting can all lead to substantial losses that will need vigorous rehydration. Regular water is never ever a bad option, but if a child is particularly at risk for dehydration, special drinks like Gatorade, Powerade, Pedialyte, or any drink that contains water as well as electrolytes will be helpful. Soda and juice are less desirable, since soda has almost no nutrient content and juice is packed with sugar. At the end of the day, however, any fluid is better than no fluid, especially with the heat that characterizes Augusta during the summer. So I urge everyone who reads this article today to be mindful of staying hydrated and to be especially mindful of keeping the little ones around us hydrated as well. Summer is one of the best times of year, and even more so if you are not in the Emergency Room. Stay cool, Augusta! + Caroline Colden, M.D., is a pediatric resident at the Georgia Regents University Hospital. As a medical student she formerly wrote the Short White Coat.

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JUNE 19, 2015

AUGUSTA MEDiCAL EXAMINER

This Month in

MEN’S HEALTH What’s Guys, let’s face it. We can sometimes be a little stubborn about going to the doctor. Or maybe “cautiously and judiciously reluctant.” Better? The solution — well, a partial solution — will be found right here in every 3rd Friday issue of the Medical Examiner. A real live doctor with real live answers. Right here. Tune in!

UNDER PRESSURE

Nearly all of us — even doctors and nurses — are sometimes patients. Perhaps you were recently injured playing your favorite sport, or years ago you somehow got hurt without even leaving your favorite recliner. Maybe you were diagnosed with a dreaded disease, mugged in a dark and lonely parking lot, or you stubbed your toe in the safety of your own bedroom. On the other hand, perhaps you needed medical attention 5,000 miles from home. Whatever your medical experience, we’d like to hear your story for our Medicine in the First Person feature. It can be frightening or funny, ordinary or extraordinary, just a few paragraphs long or quite a lengthy tale, bylined or anonymous. We’ll publish your encounters with the medical profession as often as we receive them. + Send your submissions for Medicine in the First Person to the Augusta Medical Examiner via e-mail: info@AugustaRx.com or to PO Box 397, Augusta, GA 30903-0397. (The Medical Examiner reserves the right to accept, reject, or edit any submission at its sole discretion.)

to experience changes in blood pressure and heart rate. The physiologic response to stress tends to be tied heavily to a lack of control, and habits, both good and bad, are simply a means of taking that control back. The challenge as a healthcare provider frequently lies in my inability to prescribe vacations, new parents (or children), a new job, or a new partner for my patients. Psychogenic ED and low testosterone result as a direct consequence of a stressful lifestyle, and can be very daunting to treat. Ultimately I have to recommend to many of my patients suffering from these conditions that they don’t have to turn their entire life around in a month, they just have to get a small part of it back. That is sometimes all it takes to set the wheels in motion on a path away from anxiety and bad habits in the direction of a longer, healthier, less stressful lifestyle. + Dr. Darren Mack is a graduate of the Medical College of Georgia at Georgia Regents University and is a urologist at Augusta Urology Associates. He is accepting new patients at the Augusta and Evans offices and can be reached at (706) 722-0705.

AUGUSTA

We’ve all heard that stress is a killer, but when it comes to men’s health, the farreaching effects of life stressors mean more than just that old sinking feeling in our chest, sweaty palms and a racing pulse. With zero stress there would not be a natural fight or flight response that drives a great deal of our productivity. So stress is actually, at its root, vital for our survival. The Canadian endocrinologist Hans Selye famously divided biologic stress into two categories based on either a positive or negative response. Beneficial “eustress” forges productivity and interest, while “distress” causes disorganization of thought and actions. Granted, some individuals are better equipped with the emotional tools to turn broader types of stress into positive responses and actions. Thus, one man’s eustress is another’s distress, because situations are processed very differently from individual to individual. Some people manage stress with exercise, religious activities, or time off, while others turn to pharmacologic help. A 2013 study showed that up to 13% of the US adult population is on some form of an antidepressant. These startling numbers mean that if only 13% are treating stress and or depression with medications, then how are the other millions of adult Americans coping? If anyone reading this plays golf, you know that bad shots often lead to a difficult set up for the next shot, which in turn leads to another bad shot. Recent research has shown that these vicious cycles more negatively affect men when it comes to their habits. For instance, men are more likely to miss work because of life stressors as well as manifest a host of other problems. In particular, stress leads to more cigarette use and alcohol abuse in men. In men and women with heart disease, men are more likely than women

your story?

MEDICAL EXAMINER

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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 news within every part of the Augusta medical community. Submit editorial content to graphicadv@knology.net Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com Augusta Medical Examiner photography: H + D Photography www.handdphoto.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397

(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net Opinions expressed by the writers herein are their own and their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., or its agents or employees take any responsibility for the accuracy of submitted information, which is presented for informational purposes only. For specific medical advice, diagnosis and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2015 PEARSON GRAPHIC 365 INC.

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BRAIN… from page 1 simply dying as you age, new cells can be activated to grow at any age. Protecting brain health is essential, especially for older adults who want to remain independent at home. In providing in-home care and assistance for seniors, we often find that those who work at keeping an active mind experience fewer difficulties in negotiating daily activities. Being lax with mental agility can lead to foggy thinking, impaired judgment, mood swings, anxiety and depression. A number of brain workout routines are recommended to reduce mental slowing: • Learn a new skill. Your brain kicks into action when you take up a new hobby or activity such as learning to cook different foods, speak a foreign language, or play an instrument or sport. • Read and explore books, newspapers, magazine articles and other forms of written communication. • Write as often as you can. Whether you keep a journal, write emails, jot down family history and memories, or create fictional stories – keep at it. • Complete crossword and Sudoku puzzles. These brain builders are especially beneficial if you set a time limit and work quickly. Merriam-Webster online is a great resource for puzzles and word games. • Play bridge, chess, or board and computer games. Expose yourself to the paces of mental strategy and focus. • Sharpen your vocabulary through a daily words calendar or more challenging reading topics. • Continue to socialize and verbalize. Talk with others about world events and issues important to you and your community. You don’t have to be a know-it-all – just stay open to interesting conversations without a need to argue. In addition to proactively engaging the mind, a holistic approach to better brain health by lowering stress, eating nutritiously, maintaining regular physical exercise, getting adequate sleep and staying socially engaged is best. + Right at Home is dedicated to helping caregivers and those needing care by providing private-duty care giving services. Right at Home has served the CSRA since 2005. For more information, please call 803-278-0250 or visit us on the web at www.rightathome.net/csra.

I’m glad you folks haven’t subscribed to the digital version of the Medical Examiner. We need the business!

OLD NEWS +

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

DEBT COLLECTION SCAMS

hony debt collectors have been around for a long time but there is always new twist in the game. The latest: they search internet databases for personal and financial information in order to sound legitimate when they call to collect on a debt that you may actually owe. They can sound very convincing. The way it works is, the scammer will call and say they are collecting on a debt you owe on, let’s say, your VISA card. You actually do have a VISA card with a balance, so you believe this is a legitimate collection call. Of course, the money you pay this collector will not go toward your debt balance, but into the pocket of the caller along with any other funds they can access through the financial information you provide. Never under any circumstances give your bank account, credit card, or Social Security number to anyone over the phone. If you get a call from a collection agency there are

three questions you should ask: 1. What is your professional license number, the name, address and phone number you are calling from? Many states require collection agencies to be licensed. If the caller can’t or won’t give you their

number, hang up. Even if they give you a phone number and you call back to verify, know that legitimate collection agencies have a complex phone system. If a collector answers directly, it’s likely a cell phone and a sure sign of a scam. 2. Will you send me a validation notice? If you are convinced you are speaking to a representative of your credit card company, it’s a good idea to still request a validation notice. This notice must be sent within 5 days of the initial contact and must include the amount of

the debt owed, name of the creditor, and a description of your rights under the federal Fair Debt Collection Practices. Refuse to discuss any debt you may owe until you receive this notice. (The Consumer Financial Protection Bureau has sample request letters. Visit www.consumerfinance.gov) 3. What are the last four digits of the debtor’s (that is, your) Social Security number? True debt collectors will never answer this question because doing so violates the Fair Debt Collection Practices Act (FDCPA). If the caller cites correct numbers for your bank account, Social Security card or credit card, don’t confirm them over the phone. A scammer can use the information to commit identity theft by charging your existing credit cards, opening new ones or a checking account, writing fraudulent checks and taking out loans in your name. Remember, even if the debt they are trying to collect is one you legitimately owe, it doesn’t mean the person on the other end of the phone is entitled to collect it. The best thing to do is to request a validation notice and hang up. Any time you suspect you have received a phony call requesting any personal information or offering a “good deal,” it is best to report the call to the Federal Trade Commission. +

MYTH OF THE MONTH Wait 30 minutes after eating before swimming

But if you prefer digital, simply visit

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This could actually be a non-mythical statement if you’re planning to swim the English Channel. In the same way that it would not be wise to eat a heavy meal right before running a 26-mile marathon, an athlete-swimmer would not want to jump in the water right after a few trips though the buffet line and expect to perform at his or her competitive best. But for the casual swimmer, the backyard pool swimmer, even the just-ate-barbecue-at-the-lake swimmer, there is no medical reason to wait an hour, a half hour, or even five minutes after eating before going for a swim. There have been studies attempting to find any documented cases where a drowning was attributed to eating shortly beforehand. The studies came up empty.

For the non-Olympic swimmers among us, the 30-minute wait rule is just an old wives tale. + — by F. E. Gilliard, MD, Family Medicine 639 13th St Augusta, GA 30901 706-823-5250

JUNE 19, 2015

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW res? k good eno r skin can ugh cer? son.”

ip replacement surgery causes an average loss of one to two units of blood and frequently requires blood transfusions. A decade back, contracting HIV/AIDS through blood transfusions was a concern. A new drug promised to induce human red blood cell production, thereby reducing the number of blood transfusions. To get FDA approval to market Procrit, a clinical trial at 20 sites nationwide was necessary. Dr. Bob Brand and I recruited 20 patients at Doctors Hospital for our portion of the study. The clinical trial was successful. With FDA approval for use in hip surgery, the indication list soon expanded to renal cancer, radiation therapy, and other anemias. The medical field was happy. The drug company was profitable. Then came off-label usage. That is, uses not approved by the FDA. k

ABOUT CLINICAL TRIALS AND WONDER DRUGS Top athletes sought a competitive edge. Endurance sports are predicated upon oxygen transport during competition. Procrit increased the number of circulating red blood cells and improved oxygen transport. Soon the International Olympic Committee outlawed Procrit in their athletes. To market a drug in the US, you must obtain FDA approval. The intent is to keep unsafe and unproven drugs off the market, thereby protecting US citizens from danger and scams. From start to finish the approval process usually takes a minimum of $200 million and five years or more. That explains why new drugs cost so much when they first come on the market, and later the generic equivalent costs less but does the same thing. The FDA is not perfect Take, for example, the common aspirin, acetylsalicylic acid. It is over-the-counter and FREE T AKE-H OME C OPY!

MEDICAL EXAMINER

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t s e B treats headaches, hangovers, arthritis, heart attacks, strokes, blood clots, fevers and more. However, it can cause bleeding ulcers, hemorrhage, dangerous accentuation the effect of Coumadin in treatment of blood clots, and Reye’s syndrome in children with viral infections. If aspirin was a brand new discovery today, would the FDA approve it? Ethyl alcohol poisons mental function, decreases coordination, hampers good judgment, creates dependencies and addiction, leads to gastric ulcers, causes hallucinations, and precipitates antisocial behavior. On the other hand, alcohol has stood the test of time as a major “panty dropper.” Just check out frat parties, night clubs, beer joints, honky tonks, and even teen clubs. Or remember your younger years back before you had the benefit of clergy.

e n i c i d ME

Alcohol removes two layers of civilization. The problem is, many of us only have three layers of civilization to begin with. Alcohol’s good points are that it is a minor tranquilizer, kills germs when topically applied, and dilates blood vessels. Or take tobacco. I grew up on a tobacco farm. We grew 28,000 pounds of tobacco each year. It had a bright golden hue with a slight tinge of red. Its aroma pleased the nose. But those noxious fumes that emanate from that blackened, smoldering mess rolled in white paper called cigarettes are nothing like the tobacco we grew. Tobacco leads to cancer, emphysema, house fires, and addiction. Black lung is found only in coal miners who smoke cigarettes. Tobacco has few if any known good points. Today, would the FDA approve tobacco? Or alcohol?

Or even aspirin? Heavens, no! So why do we tolerate such destructive chemicals to be freely available to the public? They are grandfathered into our daily lives. But there is another compelling reason: they generate huge tax dollars for our government to spend or give away. What do we need to know about all this? The FDA does a fairly good job overseeing the best medical system in the world. Clinical trials are necessary, although they are too expensive and take too long, making the cost of medicine artificially high. We need thoroughly tested drugs on the market for health reasons. Don’t take away my aspirin. I might have a highball tonight and a headache tomorrow. + Bad Billy Laveau is a formerlyretired MD who wields a pointed sense of humor - and now, tongue depressors too. He speaks and entertains at events for audiences not subject to cardiac arrest secondary to overwhelming laughter and glee. BadBilly@knology. net or 706-306-9397.

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JUNE 19, 2015

AUGUSTA MEDiCAL EXAMINER

The Money Doctor

purchase as much disability coverage as the insurance company will offer you. You will need to meet certain standards or disclose certain information about your health, hobbies, occupation, income, and age. This policy will follow you no matter where you work or what associations you belong to, giving it more flexibility than group insurance.

Disability Insurance — What are your options?

Disability coverage is one of the most ignored insurance coverages. Many people spend a significant amount of time trying to find the right medical, life, home, auto, or umbrella policy, but they overlook one of the greatest assets they have – their human capital, or ability to earn a living. Research from The Life and Health Insurance Foundation for Education shows that one in three women and one in four men will have a disability that keeps them out of work for 90 days or more. If you are a working mom and you are planning to have a child in the future, planning for short-term disability coverage can make maternity leave much more enjoyable. Taking the time to understand your options for coverage is well worth the time. Employer group coverage Many employers offer

coverage and may pay for all or part of the coverage, but do not simply assume your employer covers you or that you are automatically enrolled in the plan. You will often need to enroll in the plan when you start your job or during a benefits enrollment period. If you do not opt for coverage during one of those periods you may have to wait 12 months for the next enrollment period. Keep in mind that you cannot take the policy with you and normally cannot convert it, so it is important to compare it to an individual policy. Organization group coverage If you are self – employed or your employer does not offer group coverage, you may want to ask the professional organizations you are a member of if group coverage

is available. Group coverage is generally less expensive than individual coverage, but such policies offer less flexibility and may not fit your specific needs. If the organization drops the group contract or if you leave the organization you may be without coverage. Individual coverage It is a good idea to compare your group coverage to an individual policy. You will generally pay more for an individual policy, but in return you will typically get more for your money. You can include or drop features to customize the policy to your situation. For doctors this is highly advantageous. Generally it is recommended that you

“For doctors this is highly advantageous.” Government sponsored coverage If you are military, civil service, or a government employee there are many disability programs set up for you, but normally they will not follow you if you leave the service. For non-government employees, Social Security and workers compensation are two well-known government disability programs. These programs will provide basic protection against a severe

long-term disability, but they are designed with restrictive terms that make it hard to qualify for benefits. You should not rely on them as your main source of income if you are disabled. Once you have identified your options for disability insurance coverage, compare the different policies including short-term and long-term options. You will also want to review how your premiums are paid. It is advantageous to pay your disability insurance premiums with after-tax funds. If your employer pays your premiums, make sure they include those payments in your gross income if at all possible. That way, any benefits paid to you will not be subject to income taxes, which will boost your buying power. + by Clayton Quamme. Clayton is a financial planner with Preston & Cleveland Wealth Management, LLC (www.preston-cleveland. com). Preston & Cleveland is a fee-only financial planning and investment advisory firm with offices in Atlanta and Augusta, GA and Columbia, SC.

WE’RE BEGGING YOU! Congratulations, graduates!

MEDICINE IN THE FIRST PERSON Everybody has a story. Tell us yours!

Pictured above are the graduates of the 2015 class of the Augusta Area Dietetic Internship Program, the 34th class of dietetic interns in AADI sponsored by University Hospital. These are the people each year behind the Medical Examiner’s long-running series, “Don’t Lick the Beaters.” (See page 9 of this issue for the latest installment) Thanks to each of them, and congratulations from the Medical Examiner! The graduates are: Front row, L to R: Catherine Doran, Rebecca Fox, Meredith Hawk, Katie Ochwat and Emilie Koetter Middle row, L to R – Hannah Wigington, Jennfier Goodman, Allie Sulok, Melanie Wells and Benjamin Sisci Back row, L to R: Hilary Garreau, Kelsi Brock, Elodie Bouchard and Rachel McConnell +

Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx.com. Tell us if you want it “by you” or if it needs to be anonymous. Thanks!

Read the Examiner — and lots more — online at AugustaRx.com/news

JUNE 19, 2015

AUGUSTA MEDiCAL EXAMINER

Southern Girl Eats Clean

Southern Caviar

With all the barbecues, family get-togethers and picnics that will go on this summer, you are sure to need a healthy and delicious dip recipe that everyone can enjoy. Paula Deen has a recipe that is similar to this using black-eyed peas and bottled Italian dressing. She calls her recipe “South Georgia Caviar.” I liked that name so I gave my dip the name “Southern Caviar” because no matter where you live in the South, from Kentucky to Florida or all the way over in Texas, Southerners are not pretentious. Fresh, simple foods like beans and corn are what we prefer over fish eggs. This is super simple to put together. You can have it ready in 15 minutes with items that I’ll bet you already have on hand in your pantry and fridge. This dip is absolutely perfect to add flavor to grilled chicken or fish too. Southern Caviar is such a fabulous dip and a crowd pleaser for sure. Both healthy and clean. I just know your family and friends will love it. Enjoy! (To those who might be admiring my beautiful bowl, it’s handmade by a local pottery artist, Jerry Pruitt, whose work • 1/4 cup of extra virgin olive pinch of salt and pepper. is at Art on Broad in Augusta.) Pour the dressing over the oil • 3 Tbsp. of Red wine vinegar beans and vegetables. Stir Ingredients: well to mix together all • Salt and cracked black • 1 can of organic black ingredients. pepper to taste beans, rinsed and drained Taste and adjust seasoning • 1 can of organic sweet corn, if necessary. Directions: rinsed and drained Allow to sit for at least 30 Rinse and drain the black • 1/2 red bell pepper, finely minutes to 1 hour, stirring a beans and sweet corn and chopped few times in between. + place into a medium sized • 1/2 yellow bell pepper, mixing bowl. Alisa Rhinehart writes the blog finely chopped Finely chop the red and www.southerngirleatsclean.com • 1 Jalapeno pepper, finely yellow bell pepper, jalapeno, She is a working wife and mother chopped red onion and cilantro and living in Evans, • 1/4 red onion, finely place into the bowl with the Georgia. Visit her chopped beans and corn. blog for more recipes • 1/3 cup chopped fresh In a smaller bowl whisk and information on cilantro together the olive oil, red clean eating. • 1 clove of garlic crushed wine vinegar, garlic and a

Southern Caviar

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

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

Plus... 600+ doctors offices throughout the area for staff and waiting rooms, as well as many nurses stations and waiting rooms of area hospitals.

JUNE 19, 2015

AUGUSTA MEDiCAL EXAMINER

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

AH, THE JOYS OF POISON IVY

ummertime brings flowers blooming throughout a large portion of the country. This includes certain plants that we try to avoid, such as the poison ivy family of plants. Poison ivy grows in most parts of the country as a climbing vine, a shrub or a small tree. The plant contains a chemical called urushiol which is the key culprit in causing the hated poison ivy rash. Any contact with urushiol in a person sensitive to this chemical will result in an itchy, blistering rash. All parts of this plant contain this chemical and can therefore cause the allergic reaction. The severity of the rash will depend on the person. So how do we prevent, and if necessary, treat this rash? The answer to preventing this rash is, first and foremost, avoid the plants. No contact means no rash. Let’s identify this plant. Look for a green plant in either vine or shrub form with a pattern of three leaves. Usually this will be what is called a paired leaflet and a third leaf on the end of the pair of leaves. The plant will produce a yellow to white berry and often has black spots on the leaves. These spots are urushiol. The second part of the prevention strategy is to protect your skin. A barefoot walk through the woods wearing shorts and short sleeves? No. Wear long sleeves and pants to keep the oil from getting to the skin. An ivy block barrier applied to the skin can also help. Most local pharmacies carry the ivy block products. Remember to wash all clothing that may have come in contact with the plant. Also clean any yard tools or anything else that may have picked up some of the oil from the plant. Let’s say you failed to prevent and now you are left treating the resultant rash. First, determine if you need to see a doctor. If the rash covers a large percentage of your body, is extremely severe or if you have swelling or other facial symptoms including difficulty swallowing or breathing or swelling around the eyes, mouth or throat, seek medical attention. If you are treating the rash, first take a lukewarm shower with soapy water. This will wash off most of the oil and should be done as soon as possible after exposure. An almost impossible request when it comes to a poison ivy is “Don’t scratch!” Scratching the blister can result in infection as the protective skin is torn away. How you treat the rash will depend on its severity. Severe rashes can be treated by a doctor with steroid tapers and

We’re cool. Even in this heat.

topical corticosteroid creams, such as triamcinolone. Usually an antihistamine such as hydroxyzine will be added to help with itching. For those of you who feel it is not quite so severe your pharmacist will become your best friend. Topical calamine lotion can help cover and protect the rash and prevent spread of the oil from one body part to another. We also have over-the-counter antihistamines such as Benadryl to help with the itch. While Benadryl may work most efficiently, it also causes the most drowsiness and can be substituted with a non-drowsy antihistamine such as Claritin. Hydrocortisone cream is also available as a low-potency steroid but still a good option for self-treatment. Colloidal oatmeal bath packets can help with itching. Other options are adding one cup of baking soda to your bath water, and using cold compresses. Both will help the itch temporarily. Any rash not improving in seven to ten days, or any rash that you feel may be infected should be evaluated by a doctor. + Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson. Questions, comments and article ideas can be sent by email to cjdlpdrph@bellsouth.net

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JUNE 19, 2015

DON’T LICK THE BEATERS Useful food facts from dietetic interns with University Hospital’s Augusta Area Dietetic Internship Program

Cool Off with Whole Grains by Rachel McConnel, Dietetic Intern Augusta Area Dietetic Internship, University Hospital

Summer is the time of the year for fresh local produce, but one item on the food wheel we tend to forget about during this season is whole grains. Just as eating fresh food has its health benefits, eating whole grains has been shown to reduce the risk of stroke by 30 to 36 percent, type 2 diabetes by 21 to 30 percent, heart disease by 25 to 38 percent, help reduce inflammatory disease risk, lower risk of colorectal cancer, promote healthier carotid arteries and blood pressure levels and lessen the chance of gum disease. Few other foods can offer such diverse benefits. However, despite current dietary guidelines recommending that individuals consume at least one-half of all their grains as whole grains, dietary data from the

Continuing Survey of Food Intakes and the National Health and Nutrition Examination Survey (NHANES) indicates 95 percent of Americans are not meeting this daily grain intake. If whole grains are so important, what is the difference between whole grains and white or refined grains? All grains start life as whole grains where the kernel is made up of three key edible parts: the bran, the germ, and the endosperm. To better break down the kernel itself, the outer bran layer is composed of non-digestible insoluble carbohydrates, and the inner germ and the starchy endosperm contain viscous soluble fibers, lignans, vitamins, minerals, polyphenols, proteins and oils.

WHO?… from page 1

Store-bought whole grains are defined by the FDA as consisting of the “intact, ground, cracked or flaked fruit of the grain whose principal components — the starchy endosperm, germ and bran — are present in the same relative proportions as they exist in the intact grain.” When grains are refined into white flour, the outer bran and inner germ layers are removed, leaving the endosperm to be processed into flour. Without the bran and germ, about 25 percent of the grain’s protein is lost, along with at least seventeen key nutrients. Clearly, the fiber and natural nutrient content is inherently richer in whole grain options compared to refined grains. Chilled whole grain salad recipes have become quite popular recently, and for good reason. When it comes to buying whole grains, whole wheat or whole grain items such as bread typically are at the top of the grocery list to be incorporated into someone’s meal. As this is a good example of a whole grain item there are many other forms of whole grains you can add to your food pantry such as: barley, quinoa, brown/wild rice, farro, cornmeal, oats, popcorn, buckwheat, amaranth, millet, and rye. These whole grains all have longer shelf lives,

Le Fort I is a horizontal fracture of the jawbone (maxilla) just above the teeth and palate. Le Fort II

Le Fort I

Le Fort II is a triangular or pyramidal fracture of the jawbone (maxilla) in which the fracture lines meet near the bridge of the nose.

Le Fort III is a facial fracture of the maxilla and one or more facial bones which causes complete separation from the skull bones above. Le Fort III

Summer Farro Salad with Tomato, Cucumber & Basil • Olive oil, for cooking • 2 large shallots (or 1 sweet onion), finely chopped • 2 cups farro (uncooked) • 4 cups reduced sodium chicken or vegetable stock • 1⁄4 cup red wine vinegar • 2 tablespoons olive oil • 1 pint cherry or grape tomatoes, halved or quartered • 1⁄2 large English (hothouse) cucumber, diced • 1⁄4 cup finely chopped basil • Sea salt and freshly ground black pepper Heat a tablespoon of olive oil in a heavy saucepan over medium heat. Add the shallots and saute until translucent, about 5 minutes. Add the farro

and cook for 1 to 2 minutes, stirring to coat each grain. Pour in the stock and bring to a boil. Reduce heat to a simmer, cover, and cook until farro is soft but still chewy in the center, about 12 minutes. Strain out any leftover stock. Cool the farro to room temperature. Add the red wine vinegar and olive oil, and stir to combine (one part vinegar, two parts olive oil). Fold in tomatoes, cucumbers, and basil. Season to taste with salt and pepper, adjust vinegar and oil amounts to taste. Serve chilled or at room temperature. Serves 4 to 6 Source: www.thekitchn.com + website assists you create a whole grain salad recipe helping you prevent food waste by using the ingredients you have on hand or by incorporating ingredients you think will fit best together. However, if whole grains are new to you, try the basic farro salad recipe above for a good start and fill up right while cooling off your taste buds! +

different tastes, textures and cooking times, making them the perfect ingredient to have in your pantry to create a chilled whole grain salad to bring to your next summer event! If you have access to a computer and are feeling creative, check out www. finecooking.com whole grain salad recipe generator! This

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looks so harmless. In case you’re wondering what his ghastly but useful research produced, here are the three categories of Le Fort fractures.

AUGUSTA MEDiCAL EXAMINER

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AUGUSTA MEDiCAL EXAMINER

JUNE 19, 2015

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several times. The tick will let go of your dog. 4. Put the tick in a glass jar, plastic bag, or another sealable container with a teaspoon of rubbing alcohol. The alcohol will kill the tick. Save the container for a few weeks. If your dog seems ill, take the tick to your vet, who can examine it to see what kind it is, which can help determine IT’S TIME: TICK, TICK, TICK if it made your dog ill. 5. Clean the bite and the skin around it with antiseptic, his skin. Look for a black, icks are tiny, but they can brown, or grayish-brown bug. or dab it with antibiotic cause big problems for ointment. Clean the tweezers You might only see the tick’s your dog. or tool with alcohol, and wash body, or you might see its Check your pet for ticks your hands, too. legs, too. every day if he’s been in a 6. Check the bite area often grassy or woody area, no matter where you live. While these pests are more common in certain parts of the country, they can be found in every state in the continental U.S. Ticks feed on blood. While a tick bites your dog, it can pass on illnesses like Lyme disease and Rocky Mountain spotted fever. Both of these can cause stiffness, joint pain, and other health problems. It takes a tick at least 24 hours of feeding to infect an animal. But if you know how to find and remove them early, you can lower the chances of your dog getting sick. You can also prevent him from bringing a tick into your home, where it could attach itself to you and make you ill.

PET VET

How to Check Your Dog for Ticks Yes, this photo is painful to look at, but it graphically illustrates how 1. Check him before you go important it is to check your dog thoroughly (including under the ears), inside, or just inside the door, and the extreme consequences that can come from not doing so. to lower the chance of a tick coming into your home. over the next few weeks. If 2. Comb through his fur How to Remove a Tick it looks irritated or infected, with your fingers. Press gently 1. You’ll need a pair of call your vet. If your dog so you can feel any bumps latex or rubber gloves, seems especially tired, has rubbing/isopropyl alcohol, on the skin. Ticks can be as trouble walking, or doesn’t an antibiotic ointment or small as a pinhead or as big eat or drink like usual, make antiseptic liquid, and a clean as a grape. Be sure to check an appointment with your pair of tweezers or a tickhis feet (including between removing tool, which you can vet (and bring the tick with his toes), inside his ears, and you). buy at pet supply stores. around his face and neck. 2. Wear gloves. Find the tick 3. If you find a bump, part again and part your dog’s fur If You Aren’t Sure You Can your dog’s fur so you can see Remove a Tick so his skin and the tick are Call your vet. She or a vet exposed. tech will remove it for you, 3. If you’re using tweezers, and show you how to do it grab the tick as close to your so you can take the next one dog’s skin as possible and pull off yourself. upward. Try to remove it in one motion. Jerking can cause Prevent Bites part of the body to break off There’s no surefire way to and get stuck in your dog’s keep your dog tick-free, but skin. certain medicines can lower If you have a tick-removal your pal’s odds of getting an tool, put the “forked” part illness spread by the pests. under the tick, close to the If you live in an area with skin. Don’t pull straight out. a lot of ticks, your vet might This, too, can cause a break also suggest you use an and leave part of the tick A tick after it has become insect repellent on your dog behind. Instead, slowly turn engorged with blood. the tool in a clockwise motion when it’s outside. +

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JUNE 19, 2015

11 +

AUGUSTA MEDiCAL EXAMINER

From the Bookshelf The blog spot — Posted by Michael Kirsch, MD at mdwhistleblower.blogspot.com on June 8, 2015 (edited for space and content)

DON’T MAKE WAITING FOR THE DOCTOR A STRESS TEST As I write this, I am seated in the Detroit airport waiting for my connecting flight to take me to Boston. Every aspect of air travel is a stress test; from the moment that I book tickets online to the time that I sink into the plush and spacious seat that can comfortably accommodate a skinny gerbil. I have just discovered that my flight is to be delayed 50 minutes, or so they say. I fear that the dreaded delay creep (DC) might set in here. Here’s how this works: They announce a 50-minute delay. Forty minutes later, the delay is extended by 35 minutes. A half hour later, an announcement advises the smiling passengers that an update will be forthcoming at a time of the airline’s choosing. DC in its purest form ends hours later with the flight’s cancelation. My mom had this exact experience on her way to visit me in Cleveland. Did the $14.00 food voucher make her whole? Long before I earned a medical degree, patients were complaining about unreasonable waits to see their doctor. We do our best to run an on-time shop, but there are times that we miss the mark. Sometimes, it is our fault. We come to the office late. We squeeze patients into the schedule rather than add them on at the end of the day or tomorrow. We don’t build “firebreaks” into the schedule despite knowing that every day brings delays that are not anticipated. For example, if at the conclusion of a patient’s office visit she tells me that her husband has just been diagnosed with cancer, should my response be, “Our time is up today, but please give him my best wishes”? Sometimes patients cause delays. They arrive late or don’t do the paperwork that we request to be done in advance. Additionally, some of our elderly need extra time at home to get ready and need transportation to get to our office. For the most obvious reasons, sometimes they just don’t make it on time despite their intentions to do so. When this happens, which of the following responses would readers advise? “Glad you made it! Take a few deep breaths in the waiting room and we’ll be with you as soon as we can.” Or, “Back of the line, Granny!” Some emergency rooms are using Twitter and other means to update their patients on the wait time. Can physicians improve in their on-time performance? We have seen in recent years that there is a potent force that influences physician behavior: reimbursement. If payment is linked to how long you have to wait for us, then our schedules will run like a Swiss chronometer. Everyone’s time is valuable. The next time you’re in the waiting room, consider any extra waiting time to be a gift. This is your opportunity to collect your thoughts, read another chapter or two of a gripping novel*, write a thank you note to someone in longhand, or ponder buying a gift for a special person for no reason. Just don’t turn it into a stress test. +

We do our best. But delay happens.

AUGUSTA

* Editor’s note: Or the Medical Examiner

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It’s almost swimsuit season!

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Swimsuit season... Is that the annual drive to lose weight and firm up so we can look good enough in swimwear to go bake in the sun on a beach or poolside and thereby raise our risk for skin cancer? Uh, can we rethink that? Here are some much better reasons to celebrate “swimsuit season.” • Live longer We might as well start off on a high note: the same kind of stuff that would offer the trivial benefit of looking better in a bikini or — perish the thought, a Speedo — is the same kind of activity that lengthens life. And the good news is that a mere 15 minutes a day can make a big difference. • Lower your diabetes risk. Not that diabetes rates are skyrocketing or anything, but one study found that people who walk just 3,500 steps a day (there are roughly 2,000 steps in a mile) had a lower risk of developing diabetes than the people who walked the least in the study. • Have fewer migraine headaches. Anyone familiar with migraines knows that relief can be hard to come by. But a small 2011 study found that regular exercise worked just as well as medication or relaxation therapy at stopping debilitating migraine headaches before they start.

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• Strengthen your bones Regular, weight-bearing activity has been shown to build up bone strength, which prevents some of the natural decline in bone health often seen as we age. Weight-bearing activity — like walking — does the trick. • Get sick less Thank your walking shoes next time you’re the only one at the office who hasn’t caught that bug going around. Regular exercise seems to boost the immune system. Translation: fewer colds and bouts of the flu. • Decrease your cancer risk Let’s see... look good in a bathing suit or have a lower cancer risk... That is a certifiable no-brainer. The risk for certain types of cancer — colon cancer for one — seems to be significantly affected by regular physical activity. Other studies suggest that teenage and early adulthood exercise may protect against breast cancer down road. • Reduce your risk of stroke According to the National Stroke Association, up to 80 percent of all strokes are preventable. Lowering blood pressure and losing excess pounds help, but just moving more makes a big difference too. In a 2013 study, inactivity was linked with a 20 percent increase in risk of stroke. Experts say a moderate-intensity workout at least five days a week has the most benefit, but any and all exercise is a step in the right direction. • Sleep better A 2013 poll by the National Sleep Foundation found that people who self-identify as regular, vigorous exercisers got better sleep than their sedentary peers. Of the vigorous exercisers, just 17 percent said they got fairly or very bad sleep, while nearly half of the non+ exercisers reported the same. +

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There is a lot of middleclass suburbia in the Augusta area. But there are also entire neighborhoods in the Garden City where the houses look like sharecropper shacks from some tiny poverty-stricken town in the 1930s. In other words, in some ways we aren’t too far removed from Brick City, the nickname for Newark, New Jersey, a city we might automatically (and perhaps unfairly) associate with rust belt inner city poverty and crime. If you grew up there and care about yourself and your family and your future, you want to better yourself. In short, you want to get out. That’s what’s kind of amazing about the journey of Dr. Sampson Davis, the author of Living and Dying in Brick City. It’s not much of a journey: he was born and raised in Newark, then grew up to live and work there. On the other hand, it’s an incredible journey: he was born and raised in Newark, was arrested for armed robbery as a teenager there; saw his sister become a drug

addict there and subsequently die of AIDS there; saw his alcoholic older brother become paralyzed as the result of injuries in a bar fight there; and then after all that, he grew up to live and work in that very city. And not just at any job, either. As you’ve probably already noted, he’s a physician. This book is his chronicle of working in the ER at Newark’s Beth Israel Medical Center, often treating patients he grew up with. Variously described as “riveting,” “informative,” “heartfelt,” “dramatic,” and

“powerful,” Living and Dying in Brick City looks at medicine through both micro and macro lenses. He tells tales of treating gunshot wounds in patients he has known since childhood, and also takes a big picture approach and makes some pointed observations about the overall state of healthcare delivery in the United States. Along the way, topics like gang and gun violence, drug dependence, domestic abuse, sexually transmitted diseases, mental illness, unwanted pregnancy and obesity inescapably arise. Unfortunately, they are problems to which no city, including Augusta, is immune. As one New Jersey newspaper noted in its review of this important book, it should be required reading “for the kids in suburbia who have no idea what life is like in the inner cities, and for the kids in the inner cities to know that there is a way out.” +

Living and Dying in Brick City, by Sampson Davis, M.D., 256 pages, published in February 2014 by Siegel & Grau

Research News “Let’s just ask the patient” or “1+1+1+1 doesn’t equal 4” In many hospital ERs, medical personnel determine how much pain medication to administer. But in those often crowded and stress-filled surroundings, it can be difficult to accurately assess someone else’s pain. Pain is, after all, highly subjective. In a Bronx, NY, emergency department study, they turned that job over to the patients, asking simply, “Do you want more pain medication?” The protocol was to provide 1 milligram of IV hydromorphone to adult patients reporting severe, acute pain, then repeat that question up to three more times at 30-minute intervals, giving an additional 1 milligram (mg) every time the patient answered “yes.” If you think that’s an open invitation to abuse pain meds in an urban setting, the results may surprise you: of the 207 patients enrolled in the study, 114 received only 1 mg, the initial dose; 78 received 2 mgs,

nine took 3 mgs, and just six received the maximum 4 mgs. Almost all the patients were satisfied with this approach to pain management: 29 percent were “satisfied;” 67 percent were “very satisfied.” Prevention or intervention — which works best? A Swedish study released this past weekend has discovered what is behind a more than 50 percent drop in deaths from coronary artery disease in that country. The decline in deaths among all age groups between 1986 and 2002 has been striking: 53 percent in men; 52 percent among women. Researchers wanted to know whether the drop was the result of healthier living (prevention), or from advances in medical treatment after diagnosis (intervention). Using data which essentially included the entire Swedish population in the results, the verdict was that 75 percent of the decline was related to prevention.

Much of the improvement was identified as related to changes in three risk factors among healthy people: they smoked less, had lower cholesterol levels and lower blood pressure. After a diagnosis of coronary artery disease, the administration of drugs to lower cholesterol and blood pressure was only marginally effective. Smoking cessation was, however, equally effective in both healthy and diagnosed populations. Sleeping pills = traffic trouble A five-year Washington University study of 400,000 drivers enrolled in the state’s health plan compared sleeping pill use with highway safety data. Drivers using any of the three most popular sleeping aids — Restoril (temazepam), Desyrel (trazodone), or Ambien (zolpidem) — had between a 25 percent and three times higher risk of being involved in an accident while driving, all equal to or above risk factors for legally drunk driving. The CDC says 8.6 million Americans take prescription sleep aids. +

+ 12

JUNE 19, 2015

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS

THE MYSTERY WORD

You were a nurse at Buckingham Palace?

Yes, but I only treated staff, not royals.

by Dan Pearson

No, but of all Was he a nobleman? the staff he was Maybe an earl? probably the earliest.

I’m sure even the staff True. There was was quite regal. one gentleman...

The Mystery Word for this issue: LEONNI

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’d find Mumbai 21. ______ Market 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 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

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

VISIT WWW.AUGUSTARX.COM 1

Click on “READER CONTESTS”

QUOTATION PUZZLE

H L O F E V L O O O B W C V L L T H E F Y Y F U U L O K T I I V A E I F E N I L E A I A D U

— 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.

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 vent 22. Little drink 25. Consumed 27. Bass organ 28. Blood prefix 29. Upon 30. Built 34. Pen prefix? 35. Pinch 36. Type of towel

38. British nobleman 39. Wicked 40. Tent holders 42. Standard thermometer 43. Surrey Center restaurant 48. Whole Foods neighbor (abbrev.) 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

X A M I N E R

9 2

6 3 7

9 7 1

S U D O K U

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

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.

1 2 3 4

L 1

M 1 2 3 4 5 6 7

8 9 10

1 2 3 4

U 1

1 2 3

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

I 5

1.CHITTTWWUGLI 2.RHHOOSAIMAE 3.PAVEEETURE 4.THREADO 5.TISN 6.OSEE 7.SIND 8.TB 9.L 10.E

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

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

JUNE 19, 2015

THE BEST MEDICINE ha... ha...

an is the only animal that blushes. Or needs to. — Mark Twain

The scale company was very proud of the super high-tech bathroom scale it was introducing at an industry trade show. “Listen to these features,” the company man recited to a group of gathered sales reps. “It can measure as little as a tenth of an ounce. It can measure your height in feet or meters and calculate your BMI in a split second. It gives all of its readings in a brilliant LED display in your choice of colors. It has an advanced computer-chip brain that stores data indefinitely and offers health tips using a human-voice simulator in your choice of six voices and acccents.” “Pretty impressive,” said a hefty sales rep. “I’ve been on a diet lately, so I’d like to see what it says. Mind if I try it?” “Be my guest,” said the company man. As soon as the man stepped on the scale, a very human-sounding voice from the scale said, “One at a time, please! One at a time!” What do you call a Filipino contortionist? A Manila folder.

What did one lab rat say to another? “I’ve got my scientist so well trained that every time I push the buzzer, he brings me a snack.” The personnel director was interviewing a job applicant. “Since you have no experience whatsoever,” she said, “you’re asking for an awfully high salary.” “True,” replied the applicant, “but think how much harder the work will be for me if I don’t know anything about it.” A big-time celebrity had an evening performance, but his agent always booked some daytime appearances. The free publicity was good for the star’s image. One afternoon the celebrity was doing a benefit at a senior citizens home. He approached one of the elderly ladies, sat down beside her and asked, “Do you know who I am?” “No,” she said, “but if you go to the front desk, they’ll tell you who you are.” “I feel like Mexican for lunch,” said Joe, “but the real thing, not some imitation place.” “I know just the restaurant,” said José. “This place is the real deal.” “Really?” replied Joe. “Oh yeah. It’s so authentic, the last time I went there the waiter poured me a glass of water and warned me not to drink it.” How many men does it take to wallpaper a feminist’s entire house? Only four if you slice them thin enough. +

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

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

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

WORLD OF MEDICINE There are medical students in Augusta from all over the world. They have a unique perspective borne of their observations here and abroad. In this new series they’ll share some of those observations.

by Aaron Vazquez

he student doctor chuckled every time he spoke the word “borborygmus” to his patients. He auscultated their tiny abdomens and then encouraged them to repeat back the same word in the plural form, “borborygmi.” Through the paper-thin walls of the pediatric clinic, everyone outside of the room could hear the chuckles turning into laughter. This light-hearted routine went on daily for six weeks throughout the pediatric rotation. He effectively alleviated any tension he and his patients might have been experiencing at that moment. Everyone has a favorite word to repeat. Some words are just fun to pronounce, while others have personal significance to the speaker. Until recently, the word “catharsis” was neither fun to say nor had any special connotation to me. I had little use for the word throughout my medical training. I naively viewed myself as someone who was immune to the emotional and cognitive effects of pent-up psychosocial stressors. After all, medical school had broadened my shoulders and I had done many hard things in life. In fact, I had helped others to develop coping strategies for significant life events when I worked as a mental health counselor. As a psychology major, I recalled how Greeks viewed the positive change that cathartic events have on the body and mind through a process of emotional cleansing. However, Sigmund Freud was the first to begin using free association with his patients to evoke emotionally-charged memories. He believed that helping them to recall an intense memory in the presence of a supportive friend, would cure their clinical symptoms. In essence, the therapy was the release of negatively repressed emotions linked to a previous traumatic event. Freud theorized that a simple human response, such as crying, was cathartic in and of itself. However, having theoretical knowledge of the therapeutic solution is not enough to prevent the aftermath of a cathartic situation. In essence, one cannot intellectualize their way out of needing an eventual emotional cleansing. I discovered this the hard way when a false sense of security made me truly vulnerable. The sequence of events began when I scheduled an away rotation for the final block of medical school. Although I knew it would be logistically difficult, I wanted to get some hands-on experience at the hospital wheer I would soon be a resident. It was over 2,000 miles away and would require a long road trip. That journey completely disrupted my normal routines of sleep, diet, exercise and communication with friends and family. The anxiety and excitement of working in a large new academic medical center only served to heighten my tensions. I had not previously considered the personal impact that disrupting my daily coping strategies for stress would have on me later. After struggling to fall and stay asleep in different beds night after night, eating unhealthy foods on the go and not exercising for many days, fatigue was beginning to take over. But at least I had a new apartment — sight unseen, admittedly — awaiting me at my final destination. Unfortunately, however, I had booked an apartment above an Italian restaurant which blasted Bocelli’s greatest hits into the streets, hour-after-hour, until closing time. In addition, my new roommate was a musician and he was very faithful in practicing until well after midnight. I continued to sleep poorly in this new environment. Initially, the effects of these life changes were subtle, but by the end of my first day on the wards, I was emotionally, mentally and physically spent. Managing my new responsibilities in the hospital seemed much more taxing than they normally would have been otherwise. Although I was keenly aware of the psychosocial factors contributing to my altered state of being, I realized that having that insight was not enough to overcome it. I needed a viable method to alleviate my psychological and emotional burden. I was irritable, and in need of a conduit to funnel out my tensions. Please see WORLD page 15

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JUNE 19, 2015

AUGUSTA MEDiCAL EXAMINER

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

...cleverly hidden (on the man in the maze) in the p. 16 ad for GROUP BENEFITS & CONSULTANTS Congratulations to AMY PAULL, who scores a coveted Scrubs of Evans gift card, 2 movie passes courtesy of Health Center Credit Union, and a $20 Wild Wing Cafe gift certificate. Want to find your name here next issue? The new Mystery Word is on page 12. Start looking!

The Celebrated MYSTERY WORD CONTEST ...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher.

EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC. ONE BDRM COTTAGE FOR RENT with off-street parking/carport in Hill area 2 blocks from college. Washer/dryer. We furnish water, you pay electric. $675/$500 dep. No pets. (706) 736-7168; email: ronst79@gmail.com Pictures avail. ROOMMATE WANTED! 3 bdrm, 2.5 bath house with pool, 2 minutes from colleges. Perfect for medical or grad students. $425+share utils. 706.993.6082 WEST AUGUSTA House for rent. 3 bdrm, 2 bath, 1500 sqft, 1-car garage, 3024 Sterling Road, located off Stevens Creek at Riverwatch Pkwy. $850/mo. Call 678467-7187. AUGUSTAGAHOMESEARCH.COM Foreclosures • MLS • Rentals • Builders 706-564-5885 FOR SALE: GORGEOUS, immaculate, never occupied townhome located mins from Medical District. 2 bed, 2 bath, master en suite, walk-in closets, office. 1450 sq ft. hardwood floors throughout, fabulous upgrades, custom kitchen and baths. Floor to ceiling windows, fenced yard. Partially furnished! 120k OBO. 803-507-6621.

HELP WANTED

MISCELLANEOUS

PART TIME HELP NEEDED Flexible independent contractor tutoring opportunity with locally owned educational services company. Students served include K-12 and college seeking support in ALL subjects. Immediate openings for Spanish, anatomy, physics and statistics tutors. Contact info@maeseducationcenter.com

CEMETERY SPACES (2) Sunset Memorial Gardens, Graniteville SC adjacent to lighted military flagstaff, includes granite bench with urn space, installation and inscription. All $4700 ($8600 value). Spaces only: $2700. Call (803) 295-3033

SERVICES HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706.267.9947 DOES YOUR HOME NEED CLEANING? A little of that extra? Need organizing assistance or help to make clutter vanish? Seniors will get a discount. 706-7553803

FISHING CLUB wants more grey-haired members. Meet 2nd Thurs of month at Harbor Inn Restaurant, 12 noon. “Adventure Before Dementia” Info: (706) 736-8753 or (706) 829-1729 PET CARE in Martinez-Evans area. Dogs to 40 lbs, $9.00. Cats (1-3), $9.00 For interview/information, phone 706-829-1729 CEMETERY PLOTS Side-by-side cemetery plots for sale located at the Heart Section of Hillcrest Cemetery. $3600 for BOTH. (706) 798-8495

Thanks for reading the Medical Examiner!

BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673) F. E. GILLIARD, MD FAMILY MEDICINE Acute & Chronic Illnesses Occupational Medicine PROMPT APPOINTMENTS 706-823-5250

The new scrambled Mystery Word is found on page 12

SENDING US A CLASSIFIED? WHAT’S YOUR DRUG OF CHOICE? USE THE FORM BELOW AND MAIL IT IN, OR GO TO WWW.AUGUSTARX.COM AND PLACE & PAY CONVENIENTLY AND SAFELY ONLINE. THANKS!

(OURS IS COFFEE)

Augusta Medical Examiner Classifieds

THE PUZZLE SOLVED W

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

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SEE PAGE 12

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QUOTATION PUZZLE SOLUTION: Page 12: “I have found that if you love life life will love you back.”

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

— Arthur Rubenstein .25

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The Sudoku Solution 2

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COFFEE IS GOOD MEDICINE

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JUNE 19, 2015

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AUGUSTA MEDiCAL EXAMINER

WORLD… from page 13

The Medical Examiner is what is known as a

In this moment, I developed a greater understanding of the role I once played as counselor for others who needed a release. I consider myself fortunate to have had someone to call upon for support. I unloaded a week’s worth of built-up frustrations onto my unsuspecting spouse from 2,000 miles away. She gave some practical advice, but mostly she just listened. My tears of irritability turned to tears of laughter when she said, “but I thought you loved Bocelli.” Ah, catharsis at last. +

GOLDILOCKS PUBLICATION. At 16 pages every issue, we’re just right.

Aaron Vazquez, like last issue’s inaugural “World of Medicine” correspondent, is a medical student from the University of Medicine and Health Sciences in St. Kitts pursuing a career in psychiatry. He has done General Surgery and Research rotations in Augusta and is currently doing a psychiatry rotation at University Hospitals Case Medical Center in Cleveland, Ohio.

PROFESSIONAL DIRECTORY DERMATOLOGY

ALLERGY

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

CHIROPRACTIC

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

DEVELOPMENTAL PEDIATRICS

Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A 706-860-4001 www.evanschiro.net Poppell Chiropractic Clinic 1106-A Furys Lane Martinez 30907 706-210-2875 Most insurance plans accepted

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

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

LASER SERVICES

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

Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048 Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

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

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

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

EMPLOYEE BENEFITS Group & Benefits Consultants Inc. 3515 Wheeler Rd, Bldg. C Augusta 30909 706-733-3459 www.groupandbenefits.com

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

M.D.S:

MEDICAL MASSAGE

OPHTHALMOLOGY

DRUG REHAB

FAMILY MEDICINE Floss ‘em or lose ‘em!

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

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

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

...SENIOR LIVING

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

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

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

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

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

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

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AUGUSTA MEDiCAL EXAMINER

JUNE 19, 2015

Lost in the maze? Why enter in the first place?

We know the way. EMPLOYEE BENEFITS • COMPLIANCE • WELLNESS • CONSULTING • EXCHANGES • PARTNERSHIPS • TECHNOLOGY

RUSSELL T. HEAD, CBC, CSA-PARTNER • 706-733-3459 • E: RTHEAD@GANDBC.COM • WWW.GROUPANDBENEFITS.COM