June22 18

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JUNE 22, 2018

AIKEN-AUGUSTAʼS MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

Here’s the 411 on

not to waste time talking on the phone.

“Just get here and you’ll find out for yourself!” seems to be the message of many callers, says Dunlap.

The problem is, where exactly is here?

He offers another example.

“Let’s say a 911 caller says some guy just shot this lady and then he ran over to 3rd and Broad. He’s still there.”

At fi rst glance that sounds like pretty good information: police know exactly where their suspect is located. But when they roll up, there are four corners at that intersection, and with Broad Street’s wide Olde Town median, the corners are not close to each other. With all the commotion, there are a number of people standing at each of the four corners.

Suddenly the information provided by the caller seems to be of very limited value.

No wonder 911 operators ask for as much information as possible.

But that doesn’t mean sending help is delayed.

The mechanics of an incoming 911 call work something like this: the person who answers the call begins assembling the information needed by first responders, whether that means police, fi re, paramedics or all three. Using CAD (computer aided dispatch), the operator begins building a

911 Daniel Dunlap, Augusta’s 911 Director, hopes people understand what a complex job it is to field calls from people reporting emergencies.

“You never know what the next call will be,” is a mantra repeated over and over by people in his field.

The call might be reporting a minor fender-bender or a double murder, a robbery in progress, a house fi re with occupants trapped inside, or someone with a migraine headache.

You never know what the next call will be.

But no matter its subject, one thing never changes: information is gold.

“A caller might say ‘There’s a bad wreck in front of Walmart’ and then hang up,” says Dunlap. Ok, but which Walmart?

“One of the most common concerns we hear is that we ask too many questions,” Dunlap reports. People want the quickest possible response,

Please see THE 911 411 page 2

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ou hear the faint strains of a siren over the sounds of the music you’re listening to as you drive down Washington Road.

Looking in your rearview mirror you see the image above. Or perhaps it’s a police car or an ambulance. What should you do?

A. Slow down but maintain your lane B. Come to a complete stop as quickly as possible C. Turn up the volume and continue as before Actually, the correct answer is displayed across the right side of the photo: “Move to the right for sirens and lights.” It’s not complicated, but it is very important.

In fact, we asked an EMS (Emergency Medical Services) professional, Major John Smith, Director of Operations for Gold Cross EMS in Columbia, McDuffie and Richmond Counties, to give us a behind-the-wheel peek into the trials and tribulations of his ambulance personnel, both up front and in the back with patients. Brace yourself for a wild ride.

AUGUSTARX.COM

MOVE TO THE RIGHT FOR SIRENS AND LIGHTS Let’s go for a ride

by Major John T. Y. Smith Gold Cross EMS A common theme is distracted drivers.

They could be texting, talking on the phone, using ear buds or driving with a pet in their lap. We have very loud sirens, loud air horns and lots of flashing lights to try and get everyone’s attention, but it doesn’t always work. One time on Peach Orchard Road going towards town just past Bobby Jones, a beverage delivery truck pulled out of a restaurant right in front of us and I had to slam on the brakes. My partner was working with our patient and wound up in the floor in the back of the ambulance. She wasn’t hurt but could have been.

Another common theme is drivers who appear to not care. We will have the lights and sirens on trying to get through an Please see MOVE TO THE RIGHT page 6

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AUGUSTAMEDICALEXAMiNER

JUNE 22, 2018

ADDICTION IS AN ILLNESS

WE CAN HELP! 2467 Golden Camp Road • Augusta, Georgia 30906 Augusta’s 911 Center is staffed by 10 to 15 people around the clock, every day of the year, with staffing peaks during certain events and holidays and at times of expected severe weather.

THE 911 411… from page 1

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digital package describing the situation. They can immediately ship it to 911 dispatchers in the same room to get responders rolling while continuing to gather information from the caller and forward it to people on the scene.

For example, police can immediately be dispatched to our earlier shooting location example (3rd and Broad) and while they’re on their way, additional details can be sent: the suspect is wearing a white baseball cap, a red shirt and blue jean shorts.

In short, 911 response is a 2-step process: when we call we speak to trained 911 Why do 911 operators ask for my address? Isn’t that shown on their screen already?

911 personnel to call back as soon as possible.

Not always, says Dunlap. If someone’s home phone land line uses a VOIP service such as Ooma, set-up usually has the customer entering their home address for 911 compatibility. When people move, they often forget to update that information.

An ambulance could respond to their old residence 5 miles away. And in a military community with frequent moves like Augusta, a phone with an Augusta address setting can route a 911 call to Augusta even if the call is made from San Diego.

Does my cell phone work for 911 calls?

I called 911 and no one answered.

TELL A FRIEND ABOUT THE EXAMINER!

operators; they, in turn, communicate to dispatchers who actually send out the troops.

So the operator who tells us help is on the way and continues to ask questions for additional details is neither wasting time nor delaying response; they’re doing exactly the opposite.

Once emergency responders are on the way, let’s all do what the other page 1 article (and the law) says we must do: move to the right and get out of the way. They might — heaven forbid — be on the way to help someone you know and love. +

That rare event can happen during disasters and other times of prolonged high call volume.

It happened in Texas during and after Hurricane Harvey. All missed calls are listed in a queue for

Yes. Augusta 911 is text-compatible, and next generation 911 will enable callers to send pictures and video in the not-too-distant future, which could be of great value to emergency responders.

Current 911 calls may not always show a physical address, but will normally show at least the location of the nearest cell tower.

What calls are not appropriate for 911?

Do not call for traffic updates. (“I’ve been stopped on XYZ Highway for 20 minutes. What happened?

Any idea how much longer before traffic clears?)

Do not call for legal advice. (The officer who arrested my child said/did _______. Is that true?

Can they really do that?”) +

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AUGUSTAMEDICALEXAMiNER

JUNE 22, 2018

PROFILES IN MEDICINE presented by Queensborough National Bank & Trust Co.

THE BOY WHO LAUNCHED A REVOLUTION Since its inception this series has profiled exceptional people who made a lasting impact in Augusta’s medical history.

This installment will be no different, except that the exceptional story this time begins with a pre-schooler whose contribution effected global change.

That’s him, Tariq Fischer, in the photograph with his dad, Paul Fischer, MD. The revolution began innocently enough one day in a restaurant when Tariq used a straw to imitate cigarette smoking and then announced to his dad that when he grew up he wanted to smoke cigarettes and drive fast cars.

At the time he had yet to reach his third birthday.

When the dust finally settled, the issues exposed by those simple comments were the subject of congressional hearings, were featured in The New York Times, the Wall Street Journal, the Journal of the American Medical Association (JAMA) and a thousand other news outlets from here to Tokyo, and fundamentally changed major aspects of American life and public health.

Let’s back up a few years and set the stage. Dr. Fischer describes himself as the

original Navy brat in a family that moved often from one coast to another with his father’s frequent postings.

The family eventually settled in Connecticut, where Paul attended UConn School of Medicine, followed by residency in Chapel Hill. As a newly minted primary care physician, Dr. Fischer took advantage of the National Health Service Corps’ program of college loan repayments for doctors who agree to practice for a time in communities that are medically underserved.

For him, that meant three years in Weeping Water, Nebraska, population 1,050 (at least that’s what it had grown to by the 2010 census). He was the only doctor in the entire county.

When his service to the NHS was completed, Dr. Fischer and his wife, Asma, also a physician, accepted positions at the Medical College of Georgia, she as a pediatric neurology faculty member and he as director of the Department of Family Medicine.

His position, which played out as about one-third clinical, one-third teaching, and Please see PROFILES page 16

Editor’s note: this is a monthly series presented by Queensborough National Bank & Trust and the Medical Examiner profiling exceptional physicians and others of note in Augusta’s long and rich medical history.

W E A LT H M A N A G E M E N T Our experienced, financial team focuses on you, our client, to ensure that all aspects of your financial affairs are being monitored and managed appropriately in accordance with your life goals. We welcome the opportunity to serve. Call today for an appointment.

How does sunscreen work?

If your first thought was, “what a timely question as summer begins,” strike that thought: there is no time of year when protection from excessive exposure to the sun is a bad idea. In fact, a person can get a serious sunburn on a cold, cloudy day.

They might even be more likely to get one precisely because of the mistaken idea that clouds offer protection.

Sunscreens shield the skin from the sun’s damaging ultraviolet (UV) radiation, which comes in two types: UVA and UVB. Neither one is friendly. UVA rays penetrate the skin more deeply and are implicated in premature wrinkles and saggy, leathery skin. UVB rays are the main culprit in skin cancers (memory aid: B is for burning), but UVA rays are thought to amplify the carcinogenic effects of UVB rays.

Sunscreens work in two main ways. Some of the ingredients in sunscreens, like zinc oxide, are physical barriers to the sun’s rays.

You might see someone at the beach with what looks like white paint on their nose. Those are often zinc or other physical barriers.

Other ingredients harmlessly absorb or dissipate UV radiation so it does not damage skin.

The SPF (Sun Protection Factor) ratings on sunscreens reflect greater protection with higher numbers, less protection with lower numbers.

Even so, SPF ratings are actually individualized for each user.

It works like this: according to the Skin Cancer Foundation, SPF ratings refer to about how long it will take for a person’s unprotected skin to start turning red. For someone who begins to show signs of sunburn within 10 minutes, a sunscreen with an SPF 15 rating offers 15 times longer “safe” exposure to the sun, or 150 minutes.

For someone who begins to burn after 20 minutes, SPF 15 would theoretically offer 300 minutes (5 hours) of protection. In reality, however, sunscreen should be applied at least every two hours, more often if swimming or sweat causes it to be lost (or toweled off).

One ironic but persistent myth about sunscreen is that it causes cancer. It does not. The “logic” behind the belief is that rising rates of skin cancer in recent decades perfectly mirror the accompanying rise in sunscreen use. In truth, many factors are behind the rise in skin cancers, among them better and earlier detection, skimpier fashions with more exposure to the sun, the popularity of tanning salons, and even ozone layer depletion. +

MEDICALEXAMINER

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AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

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The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of salubrious news within every part of the Augusta medical community.

Direct editorial and advertising inquiries to: 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. © 2018 PEARSON GRAPHIC 365 INC.

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JUNE 22, 2018

AUGUSTAMEDICALEXAMiNER

#69 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

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f it had not been for this man and a few of his colleagues, the Medical Examiner might have a completely different symbol or icon than this: + The life of Louis Appia (above) — and the fi rst steps to our symbol — began 200 years ago in Germany’s Frankfurt-amMain in 1818 after his parents moved there as part of his father’s vocation as an evangelical preacher.

At age 20, Louis began the study of medicine at the University of Heidelberg. After graduating in 1843 he returned to Frankfurt to begin the practice of medicine. Within five years, however, a series of revolutions erupted in country after country across Europe with such regular timing that their names sounded like a calendar, beginning with the February Revolution in France and the March Revolution in German states. Eventually they were to make 1848 a year of upheaval in Italy, Denmark, Hungary, Sweden, Switzerland. Poland, Ireland, Belgium, and as far away as Brazil and Chile.

It was clear to any observer, especially Apia, who treated wounded in France and Germany during the February and March revolutions, that war was a widespread scourge.

Relocating to Geneva, Switzerland, after the death of his father in 1849, Appia put some of his experience in battlefield medicine to use in the invention of a new type of splint to immobilize broken arms and legs during transport. He also published a paper on improvements in the surgical treatment of wounded soldiers. His expertise may have been the reason why his brother George, carrying on the family tradition as a preacher in northwestern Italy, wrote Louis in 1859 to describe the desperate condition of soldiers wounded in the AustroSardinian War. In response, Louis traveled to Italy and spent the summer working in field hospitals in Milan, Turin and other cities, all the while sending letters back to Geneva to friends and colleagues requesting donations to help the wounded.

Returning to Geneva with his experiences fresh in mind, Appia wrote and published a book entitled The Ambulance Surgeon, or Practical Observations on Gunshot Wounds.

Appia’s reputation as an experienced battlefield medic led to him becoming in 1863 one of five people who called themselves the International Committee for Relief to Wounded Soldiers. Appia suggested that all committee volunteers wear a white armband on the battlefield to identify them as medical non-combatants. In 1876 the committee renamed itself the International Committee of the Red Cross (ICRC) and adopted a symbol that displayed a red cross on a white background, the reverse colors of the Swiss flag. Another noted member of the Committee of Five, General Henri Dufour, later suggested the addition of the red cross on the armbands, and the red/white cross was established from that point on as a medical symbol.

The establishment of the Red Cross globally came about as part of the Geneva Conventions, a series of treaties adopted between 1864 and 1949 which established laws for humanitarian treatment during war (and which the United States initially refused to sign). When Appia met Clara Barton in Switzerland in 1869, their dialogue was instrumental in the U.S. adoption of the Geneva Convention and the founding of the American Red Cross upon her return to the U.S. Appia remained an active member of the ICRC until his death in 1898. +

by Marcia Ribble With chronic medical issues like I have, there’s a growth of understanding that slowly accrues over time. That means that gradually, better control and better health should be an achievable goal as my doctors and I negotiate things like medications, treatments, and attitudes. Neither they nor I can do it alone.

They have information I don’t have, but I also have information they don’t have.

When my legs are swollen and oozing, using standard gauze doesn’t work. It just increases the irritation and makes healing take longer. The gauze used most often by doctors and hospitals is loosely knit together and has a tendency to bunch up, loosen, slide down, and fall off.

It further irritates already irritated skin. I found a different kind of gauze that is tightly knit, slightly stretchy, and forms a tight, smooth leg support that helps my wounds heal faster. It doesn’t roll, bunch up, slide down, or fall off. That makes it far more comfortable for long term or short term treatment, and it feels so nice on healing skin, causing far less itching, and thus reducing the temptation to scratch at skin that is already fragile.

I learned about the smooth gauze from my sister, who has suffered for many more years than I have with delicate skin that breaks down easily. I can’t say when or from whom she learned about it, but in my estimation it’s

a godsend. Using the usual gauze, my legs, when unwrapped, looked like seersucker cloth and often their condition had worsened due to restricted blood flow. When this smooth but stretchy gauze is taken off, the skin underneath is smooth, so its effects are measurable, visible, and easily compared to skin after the other gauze is used. I’m pretty sure that if the differences between them was studied the smooth gauze would be found to promote faster healing.

Because I’m a diabetic, this is the kind of thing that can make a difference between saving my legs and losing them. The Joseph M. Still Burn and Wound Clinic at Doctor’s Hospital, the burn floor, and the great folks who work there have done a great job of keeping my legs healthy and bringing them back to health when they get into trouble.

My next big project is to work with my doctors to get my fluid levels to behave, since retaining fluid is what causes my skin to break down. We know that my kidneys are working, so the doctors are suggesting a consult with a nephrologist to see if we can get better control of that issue and prevent skin breakdown instead of just reacting afterward when it does break down again.

I feel empowered when I am a member of the team of doctors who work with me to improve my health. I am not helpless. I can proactively work on my own behalf to achieve better health. +

Are raw vegetables healthier?

WHICH WILL IT BE? Not necessarily.

Common wisdom these days seems to believe that the closer anything is to its completely natural state, the healthier it is.

Obviously that doesn’t apply to everything — unless you like raw okra and potatoes, to take a couple of examples.

On the other hand, some raw vegetables are more appealing when raw because they are

crisp and crunchy, and when cooked they’re mushy and limp, and who wants that?

But the subject under discussion in this space is not about munchy versus mushy; it’s about which version is healthier.

Many nutrients are “trapped” in plant’s cells, and heat or cooking releases them.

For example, a 2008 study published in the Journal of Agricultural Food Chemistry found that boiling carrots until tender boosted their available carotenoids by 14 percent.

Similarly, a study in the International Journal of Food Science & Technology found that cooking asparagus (not a

popular raw vegetable anyway) boosted levels of six nutrients.

Another study of cooked versus raw found in cooked asparagus double the amount of two types of phenolic acid, which some studies have linked to lower cancer risks.

Another nutrient linked to reduced rates of cancer and heart disease is lycopene, the element which gives tomatoes their red color. A 2002 study discovered that heating tomatoes to about the temperature of simmering soup (190°F) for 30 minutes raised the level of available lycopene by 35 percent.

Sometimes raw is healthier.

But not always. +

JUNE 22, 2018

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Musings of a Distractible Mind

by Augusta physician Rob Lamberts, MD, recovering physician, internet blogger extraordinaire, and TEDx Augusta 2018 speaker.

Reach him via Twitter: @doc_rob or via his website: moredistractible.org

MEDICAL

INER

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JUNE 22, 2018

AIKEN-AUGUSTAʼS MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

AUGUSTARX.COM

This newspaper is delivered to more than

924 private practice doctors offices and to 14 area hospitals.

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AUGUSTAMEDICALEXAMiNER

We are Aiken-Augusta’s Most Salubrious Newspaper

hen you approach a doctor - especially one you’ve never met before - you come with a knowledge of your disease that they don’t have, and a knowledge of the doctor’s limitations that few other patients have.

You know more about your disease than most of us do. Your MS, rheumatoid arthritis, end-stage kidney disease, Cushing’s disease, bipolar disorder, chronic pain disorder, brittle diabetes, or disabling psychiatric disorder can be something most of us don’t regularly encounter. Even doctors who specialize in your disorder don’t share the kind of knowledge you can only get through living with a disease. It’s like a parent’s knowledge of their child versus their pediatrician’s.

You see why you scare doctors? It’s not your fault, but ignoring this fact will limit the help you can only get from them. I know this because, just like you know your disease better than any doctor, I know what being a doctor feels like more than any patient ever will. You encounter doctors intermittently (more than you wish, perhaps); I live as a doctor continuously.

Even so, you have depth of knowledge that no doctor can possess.

So let me be so bold as to give you advice on dealing with doctors: 1. Don’t come on too strong. Yes, you have to advocate for yourself, but remember that doctors are used to being in control.

All of the other patients come into the room with immediate respect, but your understanding has torn down the doctor-asgod illusion. That’s a good thing in the long run, but few doctors want to be

greeted with that reality from the start. Your goal with any doctor is to build a partnership of trust that goes both ways, and coming on too strong at the start can hurt your chances of ever having that.

2. Show respect. I say this one cautiously because there are certainly some doctors who don’t treat patients with respect - especially ones like you with chronic disease.

These doctors should be avoided. But most of us are not like that; we really want to help people and try to treat them well. But we have worked very hard to earn our position. Just as you want to be listened to, so do we.

3. Keep your eggs in only a few baskets. Find a good primary care doctor and a couple of specialists you trust. Don’t expect a new doctor to figure things out quickly. It can take me years of repeated visits to really understand some of my chronic disease patients.

The best care happens when a doctor understands the patient and the patient understands the doctor.

This can only happen over time, but there is something very powerful in that.

4. Use the ER only when absolutely needed.

Don’t expect emergency room physicians to really understand you. That’s not their job. They went into their specialty to fi x problems quickly and move on, not to manage chronic disease. The same goes for any doctor you see for a short time: they will try to get done with you as quickly as possible.

5. Don’t avoid doctors.

One of the most frustrating things for me is when a complicated patient comes in after a long absence with a huge list of problems they

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want me to address. I can’t work that way, and I don’t think many doctors can.

Each visit should address only a few problems at a time, otherwise things get confused and more mistakes are made. It’s OK to keep a list of your own problems so things don’t get left out - I actually like getting those lists, as long as people don’t expect me to handle all of the problems. It helps me to prioritize with them.

6. Don’t put up with the jerks - unless you have no choice (in the ER, for example), you should keep looking until you find the right doctor(s) for you. Some docs are just not cut out for chronic disease, while some of us like the longterm relationship. Don’t feel you have to put up with doctors who don’t listen or minimize your problems. At the minimum, you should be able to find a doctor who doesn’t totally suck.

7. Forgive us. Sometimes I forget about important things in my patients’ lives.

Sometimes I don’t know you’ve had surgery or that your sister comes to see me as well. Sometimes I avoid people because I don’t want to admit my limitations. Be patient with me - I usually know when I’ve messed up, and if you know me well I don’t mind being reminded.

Well, maybe I mind it a little.

As a patient with a chronic condition you know better than anyone that we docs are just people - with all the stupidity, inconsistency, and fallibility that goes with that - who happen to doctor for a living. I hope this helps, and I really hope you get the help you need. It does suck that you have your problem; I just hope this might decrease the suckishness a little bit. +

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DRIVE RIGHT even without sirens and lights

As discussed in our previous issue, traffic laws on both sides of the river mandate driving in the right lane unless preparing to turn left, or when passing another vehicle. By law, if a motorist drives the length of Riverwatch Parkway in the left lane, he could get be cited for a traffic violation even if there isn’t another car within half a mile.

Why are such laws on the books? According to the National Motorists Association, there are 4 key benefits: • fewer accidents resulting from smoother traffic flow • better gas mileage, another benefit of efficient traffic flow • faster travel, since using roads as designed (slower traffic keeping to the right) reduces congestion • less stress, conflict, tailgating and road rage from “left lane hogs,” a common source of driver irritation +

AUGUSTAMEDICALEXAMiNER

JUNE 22, 2018

MOVE TO THE RIGHT… from page 1 intersection or turn, and drivers will look right at us and keep going. One night we were on I-20 east bound and a car moved from its lane right in front of the ambulance and slowed down. I had to hit the brakes which threw my partner around in the back. She wound up with a concussion.

I don’t remember what road we were on but a car pulled in front of us from a side road. The car didn’t pull over or speed up enough to get away from us.

Instead, they stayed 10 or 12 car lengths in front of the ambulance.

Coming down Washington Road with the lights and sirens on heading toward Riverwood, three cars pulled over to the right, just as the ambulance was coming up on the cars, the car in the middle decided to pull out into the road. We slammed on the brakes, swerved to the left and barely avoided hitting the car. Thankfully, no one was coming in the opposite lane and the ambulance didn’t turn over.

We were behind a car on a four lane road in moderate traffic. We were in the far left lane driving right at the speed limit, maybe a little above and the car in front of us stayed right were it was and kept moving at the same speed. They didn’t try to move to the right or anything. I started looking to see if I could get around them when the brakes light lit up on the car in front of us. The car swerved over the right and as we passed, I noticed the driver was wearing ear phones and I guess never heard us behind him.

On Peach Orchard Road going towards town just past Bobby Jones, a beverage delivery truck pulled out of a restaurant right in front of us and I had to slam on brakes. My partner was working with our patient and wound up in the floor in the back of the ambulance. She wasn’t hurt but could have been.

People also tend to panic and just stop right where they

are. That creates a traffic hazard because we have to slow down and/or stop to get around them. The cars behind us don’t know what’s going on and don’t know what we need to do. We had a really sick patient and were heading to AUMC. We were on Washington Road between Bobby Jones and West Town. The traffic wasn’t terrible but there were cars in each lane. We were in the left lane, right were we are supposed to be when the driver in front of us just slammed on their brakes and didn’t move over even though the lane was clear.

We were turning left onto Washington Road from North Belair Road. When we got to the intersection, the traffic light was red so we stopped, changed the tone of the siren and blew the horn. I moved out one lane at a time as traffic stopped. When I got out a little bit in the intersection, I looked to the left in the second lane. The first car coming was slowing down as well as the second car but I could see the third car wasn’t slowing down at all. Everyone else on all sides of the intersection was stopping but this one car. All we could do was watch as the third car hit the car in front of it and knocked that car into the first car. We made eye contact with all the drivers involved in the wreck to make sure they were OK and continued on to our patient.

Any delay in getting to a patient can be detrimental. If someone is in cardiac arrest, having a stroke, choking, having an allergic reaction or any other life threatening event, time is of the essence and minutes can make the difference between a full recovery or life-long disability, even between life and death.

Move out of the way of an emergency vehicle as if its destination is your house and the people they’re on the way to help are your loved ones.

DRIVE SAFE

WE’RE BEGGING YOU We’re never too proud to beg. What we’re begging for is Medicine in the First Person stories. With your help, we’d like to make this a feature in every issue of the Medical Examiner. After all, everybody has a story of something health- or medicine-related, and lots of people have many stories. Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx.com. Thanks!

“The cause was a mystery for a long time.”

“And that’s when I fell.” nearest hospital “He doesn’t remember a thing.” “The was 30 miles away.”

“I was a battlefield medic.” “He was just two when he died.”

“OUCH!”

“It was a terrible tragedy.” “She saved “I sure learned my lesson.”

“I retired from medicine my life.” “It seemed like a miracle.” seven years ago.” “We had triplets.”

“It was my first year “I thought, ‘Well, this is it’.” NOTHING SEEMED of medical school.”

“They took me to the hospital by helicopter.” TO HELP, UNTIL. . “It took 48 stitches.”

ambulance crashed.”

“Now THAT hurt!” “The “My leg was broken “I’m not supposed to be alive.”

“This was on my third day in Afghanistan.” in three places.”

“I lost 23 pounds.” “Turned out it was just indigestion.”

“At first I thought it was something I ate.” “The smoke detector woke me up.”

Everybody has a story. Tell us yours.

Here’s our “No Rules Rules.” We’ll publish your name and city, or keep you anonymous. Your choice. Length? Up to you. Subject? It can be a monumental medical event or just a stubbed toe. It can make us laugh or make us cry. One thing we’re not interested in, however: please, no tirades against a certain doctor or hospital. Ain’t nobody got time for that.

JUNE 22, 2018

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AUGUSTAMEDICALEXAMiNER

Southern Girls Eat Clean Zucchini and Yellow Squash Icebox Pickles For me, summertime always brings to mind fresh vegetables and homemade pickles. I remember my grandmother canning bread & butter pickles almost every summer. The pickles in this recipe are a variation of the typical bread & butter ones that she use to make, but to me, they are way better because even though they do have a small amount of sugar, they are not overly sweet. You truly taste the vegetables, which I think makes them the best pickles ever.

That, and the little “kick” of spice that comes at the end.

Another huge plus to these pickles is that you do not have to go to all the trouble of boiling the jars and the whole canning process. They are called icebox pickles for that reason. They can last about two to three weeks in the refrigerator, but at our house they never last that long. I could seriously eat a half a jar in one sitting. They are perfect with a light meal in the summer or as a condiment for a grass-fed burger.

This recipe was inspired by a recipe that I found in one of my favorite cookbooks, Southern My Way by Gena Knox.

Gena has some amazing southern dishes in her cookbook. She has already lightened up many of them, but with a little imagination sugar sugar, garlic, mustard seed, it’s not that hard to make • 3 cloves fresh garlic, dill and crushed red pepper. some of them completely crushed Stir well and bring to a boil. clean. Check out her website • 1 tsp. of mustard seed Reduce heat and simmer, http://genaknox.com and • 1 tsp. of dill weed stirring occasionally for order one of her books.

• 1 tsp. of crushed red pepper approximately 8-10 minutes Have a great summer, my until slightly thickened. friends, and as always, enjoy!

Instructions: Pour vinegar mixture over Slice the vegetables and vegetables in the jars, seal jar Ingredients: place in a large mixing bowl and let cool.

• 2 large zucchini, thinly and toss to coat with salt.

Store in the refrigerator up sliced Place vegetables in a to 2-3 weeks. + • 2 or 3 yellow crookcolander and place colander neck squash, thinly sliced Alisa Rhinehart writes the blog over a mixing bowl. (depending on the size of the www.southerngirlseatclean.

Cover and refrigerate over squash) com She is a working wife and night or at least 8 hours.

• 1 Vidalia onion, thinly mother living in Rinse and drain the sliced Evans. Visit her vegetables well and place into • 1-2 Tbsp. of Real Salt blog for more recipes 3-4, 16 oz. mason jars.

• 3/4 cup apple cider vinegar and information on In a saucepan over medium • 3/4 cup white wine vinegar clean eating. to high heat, add vinegars, • 1/4 cup organic pure cane

Icebox Pickles

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JUNE 22, 2018

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THE MONEY DOCTOR FINANCIAL PLANNING METRICS

A

situation to others.

fter gaining an understanding of a client’s values, goals, priorities, and current commitments, we get a high level snapshot of where a client is at by looking at several metrics. These metrics are not to compare you with others, but to help track progress toward goals. It is important to note that each metric will mean very different things depending on your personal situation, so you must be careful when using rules of thumb or general guidance.

Here are a few metrics that we help clients understand and track.

Net Worth – Understanding and calculating your net worth can be one of the best things you do each year. Net worth is the sum of all your assets minus the sum of all your liabilities. Your assets generally include bank accounts, investment accounts, home, auto, and personal property. Your liabilities normally include debt such as mortgages, auto loans, student loans, and any credit card debt. Updating these balances once a year will help track your overall financial progress.

The ultimate goal for most people is financial independence. The number you need to be financially independent will be much different than other people, so using your net worth as a measuring stick when assessing your progress toward financial goals can be much more powerful than comparing your

Savings Rate – It is important to note that your savings rate is a much larger predictor of success than your investment returns. Your savings rate is the amount of money saved annually divided by gross income. Your gross income is the amount of money you earn before taxes. You should include saving for all long-term goals which normally includes retirement, education, or large one-time future expenses. You can consider including any principal debt payoff as well. In general we like to see a 15% to 20% savings rate toward retirement. Your overall savings rate may be more than 20% when you include all other goals and debt payoff.

Make sure you do not “rob Peter to pay Paul” as the saying goes. This means be careful with your accounting. If you put $5,000 in your retirement account, but then use $5,000 from an emergency savings fund to cover your expenses during the year your net savings amount is zero. If your net worth is decreasing you may have a negative savings rate even if you are contributing to retirement account during the year.

Withdrawal Rate – For those in retirement, your withdrawal rate is the percentage of money withdrawn annually from your portfolio divided by the total portfolio value.

Please see MONEY DOCTOR page 10

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LIFELONG LEARNING

by Ken Wilson Executive Director, Steppingstones to Recovery

THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional

N

cured by vaccines, cannot be healed by medication, won’t just disappear, might be fatal – but is treatable” Back in the mid-1950s alcoholism and addiction finally were accepted by the medical community when doctors realized that this condition met EVERY requirement of the standard definition of a disease!

We now see the futility of a six-week program or the proverbial “28-Day Program.”

Though sobriety is important, the main point of recovery is a lifelong Recovery To Sanity – to add a chapter to your knowledge of addictive diseases. Nobody wants to be around a nonpracticing addict or alcoholic, the same mindset as before minus the alcohol or drugs; but we all want to be around a loved one in recovery who is experiencing and practicing lifelong learning in thinking, acting, and being. And we never get to the point of Arrival.

Every sane person we meet is our teacher, because “when the student is ready, the teacher arrives.”

Until I find that just-right smart-phone class, my teacher is anybody with such a phone under the age of 20! Whoever would’ve thought it: an old man learning from a teenager.

Talk about lifelong learning! +

KE

cancer, back pain, diabetes, ad infinitum, life as we once knew it changes. It will never be the same again. Diet changes.

Exercise changes. Perhaps a change in friends is necessary.

For sure, we do find out who our true friends are after such tribulations. We often make new ones, ones who have “been there, done that” who serve as our accountability and support system.

When we sign up for recovery, we’re signing up for lifelong learning. It’s kind of like, the more you learn, the more you realize you don’t know. We are fortunate to live in this age and not 50 or 100 years ago as far as resources and knowledge about recovery is concerned.

Books and self-help groups abound. Nowadays there are even a number of recovery apps to interact with on smartphones: questions/answers, recording your recovery journal, relapse prevention help, blogs, and online recovery meetings available 24/7.

You see, a lay person’s definition of a disease might include things like this: “A condition that might have genetic influences, that has clearly identifiable stages, is prone to recur, is chronic, lasts 3 months or more, cannot be

AI

As I near retirement (7 more years, maybe) I have been amused when looking for classes to take to keep my mind sharp that aren’t college classes (at my age who needs another degree?) but which are nevertheless professional, credible, and informative. I also need to learn how to use my smart phone (which is smarter than me) better, and I need to learn more about my computer’s capabilities; not a lot more, just a little more. Teachers for some of these classes aren’t much older than my grand-children.

And they’re college teachers!

I’m learning that the best search engine phrase to use is “lifelong learning,” and some programs are called just that.

And that very phrase is the story of recovery from addiction: lifelong learning.

There is rarely a point beyond which one does not need the two vital element necessary for continuing success: Accountability and Support.

Many lone-rangers out there trying to get well by themselves struggle unnecessarily because they don’t want to put forth the level of effort which for most people most of the time (but not all people all of the time) is required for long term sobriety.

Far be it from me to discount your sainted grandfather who realized one day he was drinking too much and just up and quit, “cold turkey.” It does happen, but it is the exception and not the rule.

This column piggy-backs on one a few months ago, the one about the illusion of the quickcure, short-term alcohol or drug treatment and then going back home to live a normal life. Why should addiction be any different than other diseases? After treatment for heart problems,

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H H H H H 6/11/2018 I always get confused. Is it comb your hair and brush your teeth, or comb your teeth and brush your hair? + H H H H H 6/11/2018 Teeth are okay I guess, but they sure take a lot of work. Brushing, flossing, white stripping... +

Bob J. North Augusta, SC

Myra K. Augusta, GA

JUNE 22, 2018

MONEY DOCTOR… from page 8 There is a lot of academic research surrounding this number.

Often times you will hear people say that a 4% withdrawal rate is the rule of thumb. Like most rules of thumb it is best to take them with a grain of salt. This number is different for everyone depending on their personal situation. Items like long-term care policies, fi xed income streams such as pensions or social security, rental property income, mortgages, and living expenses should be taken into account. It is important to keep in mind that when your portfolio value drops your withdrawal rate will increase, so understanding when you need to make adjustments is key.

Tax Rates – There are two tax rates that are important to understand and track. Your marginal tax rate and your effective tax rate. As a best practice you can have your CPA provide those rates during tax planning in the fall or when filing your return in the spring. The effective tax rate is calculated by adding up all the taxes you pay annually and dividing by your annual gross income. The marginal tax rate is the amount of tax you paid on your final dollar of earnings.

Your effective tax rate will be lower than your marginal tax rate because the United States has a progressive tax system with rising rates for higher income earners. Understanding these numbers helps when making decisions such as Roth vs. traditional contributions, tax-free vs. taxable bonds, dependent care accounts vs. dependent care tax credit along with many others.

There are many other metrics we use when planning for clients such as investment returns, inflation rates, liquidity needs, debt to income ratio, expense ratio, and more. Having a financial planner help you understand the importance of tracking different metrics along the way can help provide a peace of mind that you are on track to meet your financial goals. +

by Clayton Quamme, a Certified Financial Planner (CFP®) with Calvary Wealth, LLC (HYPERLINK “http://www.calvarywealth. com” www.calvarywealth.com). Calvary Wealth is a fee-only financial planning and investment advisory firm with offices in Augusta, GA and Columbia, SC.

H H H H H 6/12/2018 I think it’s cool how when you’re little you have little teeth and then all by themselves they just fall out and replace themselves with big ones. Little mouth, little teeth. Big mouth, big teeth. +

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H H H H H 6/15/2018 Hardest working body part - go teeth! + H H H H H 6/18/2018 I had my wisdom teeth pulled out and now I feel really stupid.

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H H H H H 6/18/2018 My husband pays me no respect whatsoever, but my dentist gave me a crown. Thank you, doctor. +

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H H H H H 6/19/2018 My wife got a crown and now she thinks she’s the queen. I can’t even get her to do the dishes. +

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

JUNE 22, 2018

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Our new word puzzle on page 12!

JUNE 22, 2018

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AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf A MEDICAL STUDENT’S PSYCHIATRIC HOSPITALIZATION “You work here?!”

I nodded, a hint of a smile revealing my bemusement at his incredulity. “Well ... probably not after this.”

The other patients in the psych waiting area of the ER nodded in agreement. In my newly issued brown scrubs, stripped of my belongings, I was no longer a research coordinator at a top hospital, but instead one of them. And sadly, they believed being one of them meant you couldn’t be much else. I didn’t add that I was going to be a doctor, but in hindsight I wish I had.

I wish I had because it’s wrong that they’d been conditioned to feel the way they did.

I wish I had because, well, it probably would’ve been funny to see their reactions.

And I wish I had because I hate with every fiber of my being that I’m afraid to submit this under my actual name.

The ER doctor who examined me when I arrived told me, “You know, some people come in because they have a heart attack. This is just like that, except in your brain.” It was so simple, yet so unbelievably comforting. I’d faced stigma from past doctors who, reading my medication list, would reach the psych meds and immediately change demeanor, growing increasingly skeptical at my every word. The ER doctor’s statement made it clear from the start that I would be treated like any other patient, that my opinions would matter, and that I would receive optimal care.

A few hours after getting a bed, my roommate arrived — she had been dozing off and on in the waiting area, but by this point she was alert enough to continuously unwrap sugary snacks to combat her dope sickness. At first, it irritated me to no end, but by our second day she was hoarding two of everything in case I wanted one. She made my first hospitalization far less frightening and lonely than it could have been by constantly cracking jokes, collecting as much “contraband” as she could for our room, and vehemently complaining that the floor was worse than jail. I sort of doubted that since we had a piano, therapy dogs, and pretty decent food, but she was quick to point out that she’d been to jail and I hadn’t. Fair enough. I gave her my number when I was discharged but never heard from her. I often wonder if she’s okay.

The lead doctor on my care team asked me if there was anything in particular stressing me out recently. The impending start of medical school was certainly a factor, and I talked about how I had thought I’d get “this” under control before starting. His reaction startled me — he just started laughing. “No, no, no,” he said. “You’ll never get this under control. It’s not going away. But you’ll deal with it.”

He proceeded to tell me how he knew doctors with serious depression, bipolar disorder, and even psychosis. Oddly, hearing that there would be no neat end to my suffering was a relief. His words marked one of the first major steps toward acceptance of my diagnosis.

I could write far more than a blog post about the other details of my stay, but in the end what matters is that I now know a psych hospitalization isn’t some scary, mysterious thing. It’s just an intervention that’s sometimes needed, and one I won’t hesitate to use again if necessary.

I still keep my bracelet from that stay hanging in my room.

In some ways, it serves as a warning of what could happen if I don’t stay committed to my care. But it also serves as a reminder of my own perseverance, a reminder that no one is infallible, and that we all need help at times. Most importantly, it is a reminder to never underestimate myself or anyone else on the basis of a diagnosis. +

It was unbelievably comforting

The author is an anonymous medical student.

From Booklist: Expect to be moved by this anthology of tales from the front line, written by veteran nurses and nurses-in-training. One contributor describes his experiences as a nursing student at the beginning of the AIDS epidemic, when the disease was called gayrelated immune-deficiency syndrome, particularly his nurse’s intuition of knowing when a patient is going to die. There was a stigma to the work I was doing, he writes.

But I eventually got to a point where I wasn’t afraid to say, when someone asked what I did, ‘I work with persons who are dying of AIDS.’ Several of the essayists lace their emotional tales with humor. A University of Pennsylvania nursing student records her friends’ reaction to her job: So you actually cleaned up poop?

A woman who survived Hodgkin’s lymphoma as a teen becomes an oncology nurse. And a nurse recounts watching a person die for the first time. Essayists note

worked along side nurses and already appreciate their risking their own health and wellness while caring for others, usually in an over-worked, under-paid environments. In addition, I suggest this book as a must-read, for patients, family members, and other caregivers so we can all improve in our care and comfort of others.

that they’re not supposed to get too close to patients, but they do it anyway. It’s easy to love these empathetic people, and their beautifully written stories.

Amazon reader reviews: • This is an amazing selection of essays written by nurses, ranging from fears of newly-trained nurses, to the reflections of those with decades of experiences. I will never look at a nurse the same again. That said by a physical therapist who has

• I would highly recommend this book to anyone in the medical field, as well as to people who either know a nurse or want to be one. As a student nurse, I am finding that I relate to a lot of the stories, and it is comforting to know that someone went through much of what I am going through now. Sometimes it feels like a struggle, and reading about other people’s experiences help. + I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse, edited by Lee Gutkind, 320 pages, published in April 2013 by In Fact Books

Research News Staggering statistics Everyone has to die of something, right? So in the most strictly cold and clinical sense, death rates from various causes merely measure the inevitable.

Public health officials have therefore devised ways to measure and express premature deaths using a yardstick often abbreviated as YLL or PYLL. The letters stand for Years of Life Lost, or Potential Years of Life Lost. To illustrate, if a certain disease strikes down someone at age 25 whose statistical life expectancy was 75, the disease robbed that person of 50 years of life.

Such statistics help measure the societal impact of certain diseases.

Something that often affects people in their 70s and 80s deserves as much attention as any other illness, but it is not stealing away breadwinners or children with many productive decades of life still

ahead; it may be stealing less than 5 potential years from the average victim With that as a preamble, a county-by-county study in Ohio has revealed a staggering numbers of years of life lost in a very short period of time (2010-2016) from a single cause: opioid overdoses. The average overdose victim in Ohio lost more than 40 years of life compared to their expected lifespan (based on Social Security Administration lifespan data).

The tally exceeded half a million years of potential life lost. 519,471 years, to be exact. Many individual counties lost tens of thousands of potential years of life among their residents, including more than 35,000 years lost in Montgomery County, about 50,000 years lost in both Franklin and Hamilton Counties, and a whopping 61,939 years lost in Cuyahoga County.

Deaths from one opioid alone, fentanyl, rose during the study period from 77 deaths in 2010 to 2,357 deaths in 2016. Fentanyl was responsible for 67 percent of the overdose deaths in Ohio during 2016.

The death toll from opioids was enough to reduce the state’s overall average life expectancy by more than a full year.

Silence is golden Research by an MCG neuroscientist at Augusta University published in the journal Cerebral Cortex on June 18 may have cracked the decades-old mystery called the neural code.

Findings by Dr. Joe Tsien show that the comparative “silences” between fi rings of neurons in the brain are the key to what the brain is actually doing, whether it’s storing memories, managing a sleep cycle, or enabling speech. +

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AUGUSTAMEDICALEXAMiNER

THE EXAMiNERS

JUNE 22, 2018

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I think my fitness program just got a major upgrade. What happened?

by Dan Pearson

I wasn’t making any progress and struggled to stay motivated.

That’s wonderful.

I hired a personal So many trainers are so impersonal. trainer.

So what did you do?

The Mystery Word for this issue: NIKEA

© 2018 Daniel Pearson All rights reserved.

EXAMINER CROSSWORD

PUZZLE

ACROSS 1. Ordinary Joe’s last name 6. Nasty fracture type 10. Male swan 13. Fox show (2003-2007) set in Southern California 14. Liver fluid 15. Dark Angel star 16. Word in North Korea’s official name 18. _____-biter 19. Park name 20. Capital of Peru 21. Washed lightly 23. Insect stage 24. A single or initial dose of medicine 25. Temple of the Far East 28. Starting point used for later comparisons 31. White poplar tree 32. A varicose vein 33. Fish appendage 34. Small recess 35. Trees on Georgia library card 36. Victories 37. Wrigley product 38. The pancreas is one 39. One is next to your nose 40. GA county named for Jefferson Davis’ VP 42. Suggestive of the forest 43. Mill prefix 44. Tailless South American rodent 45. Tooth decay 47. Size of type 48. Objective 51. Of the ear 52. Loyalty 55. Nap 56. Close

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VISIT WWW.AUGUSTARX.COM

QUOTATIONPUZZLE

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All Mystery Word finders will be eligible to win by random drawing.

We’ll announce the winner in our next issue!

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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

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by Daniel R. Pearson © 2018 All rights reserved

by Daniel R. Pearson © 2018 All rights reserved. Built in part with software from www.crauswords.com

57. Saltpeter 58. Go ___; get crazy 59. Converts hide to leather 60. Ignore a sound or syllable (in speech) DOWN 1. Herpes, et al 2. Actor who played Rusty Dennis in Mask 3. Rope fiber 4. Sound from a pasture 5. Close off, as a vein 6. US President #44 7. Middle Eastern bread 8. Inventor Whitney 9. Localized death of cells 10. Confidential; secret 11. Off-Broadway theater award 12. “Chrome-dome” 15. Invalidate 17. Former All My Children star 22. Genus of holly plants 23. Cedartown’s (GA) county

24. Uncovered 25. Feelings of hunger 26. Concerning 27. Put into geometric form 28. Notice of intended marriage (Old England) 29. Rule of _____ (in burns) 30. Elevate aloft 32. Article of food 35. __________ Home Road 36. Command to a horse 38. Clarified butter 39. Drug with a soft drink nickname 41. Cost 42. Augusta NPR call letters 44. Wharves 45. Conclusion, esp. in music 46. On the top of 47. A synonym of 48-A 48. Social intro 49. How tea can be started 50. No more than; only 53. Actress Michele 54. Be ill Solution p. 14

— Hippocrates

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.

E X A M I N E R

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S U 1 D 3 O K 4 U 6

by Daniel R. Pearson © 2018 All rights reserved. Built with software from www.crauswords.com

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

Use keypad letters to convert numbers into words suggested by the definitions provided. Sample: 742 (body part) = RIB. Solution on page 14.

1. 393 (body part) ___

6. 84787 (illness cause) _____

2. 7455 (drug dosage) ____

7. 763393 (symptom) ______

3. 9729 (procedure) ____

8. 26844 (symptom) _____

4. 24378 (body part) _____

9. 2547837 (symptom) _______

5. 25663 (body part) _____

10. 278474847 (diagnosis) _________

by Daniel R. Pearson © 2018 All rights reserved

TEXT

1

THE MYSTERY WORD

JUNE 22, 2018

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AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE

The

Advice Doctor

watching worthless TV shows and playing video games.

“You know,” he said to his son, “when Abraham Lincoln was your age, he was reading law books by candlelight.”

“Well,” replied the son after a moment of thought, “when Abraham Lincoln was your age, he was president of the United States.”

ha... ha...

©

Moe: I just realized that one time I was sober for 21 straight years.

Joe: Then what?

Moe: Then I turned 21.

A

school teacher asked her class one day if anyone knew what the opposite of right is.

One boy raised his hand and said, “Left.”

“Wrong,” she said.

Moe: What happened when the semicolon broke the rules of grammar?

Joe: I give. What?

Moe: He was given two consecutive sentences.

Moe: Are your eyes doing better?

Joe: Yes. Thanks for asking. I got some really good treatment tips at a website I found.

Moe: What website was it?

Joe: It’s called conjunctivitis.com Moe: That’s sure a site for sore eyes.

Moe: Did you hear about the blacksmith who was sent to prison?

Joe: No. What did he do?

Moe: He forged a check.

Moe: Why are cats afraid of trees?

Joe: Probably because of their bark.

Trivial but true: If you rearrange the letters of “mailmen,” they get really annoyed

Moe: What do you call a crab that plays baseball?

Joe: A pinch hitter.

Doctor: This is highly unusual unprecedented, in fact - but from the tests it appears that your DNA is backwards.

Blonde: And?

Moe: Believe it or not, I used to have a goldfish that could break dance on carpeting.

Joe: Wow. I would love to have seen that.

Moe: Well he could only do it once.

Moe: How do you keep someone frustrated and annoyed for a full 24 hours?

Joe: No clue. How? Moe: I’ll tell you tomorrow. +

One perfect summer evening a father decided he was fed up with his son staying indoors doing nothing with his summer vacation except

Why subscribe to the MEDICAL EXAMINER? What do you mean?

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

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

Dear Advice Doctor, June is the month of brides - and I want to be one! I have been dating the greatest guy for more than two years. We are perfect together and I know he wants to get married, but he hasn’t popped the question. I also know if I ask him he’ll say yes in a split-second. The thing is, I keep losing my nerve at the last second. I’ve come this close about five times now. What should I do to make this happen?

— I Keep Losing It Dear Loser, I know you must feel helpless, but if you were to ask your friends and co-workers I think you would discover you have lots of company in this situation. By one estimate, more than 3 million people in the United States alone are in the same boat as you.

The medical term for losing your nerve is neuropathy.

Sometimes it’s what you’ve experienced, a complete loss of nerve sensation, but for other people neuropathy causes tingling in the hands and feet, itching, skin crawling, “pins and needles,” or sharp stabbing pains. But whether the symptom is complete numbness, tingling or pain, neuropathy is definitely something for your doctor to evaluate. That is my advice for the first step you should take.

Medical examination is vital because loss of nerve sensation isn’t something that just happens out of the blue. If the cause can be identified, effective treatment can begin that can minimize the effects of neuropathy. Sometimes the cause is immediately obvious. Chemotherapy is one of the common triggers for peripheral neuropathy. Diabetes is another top cause. Peripheral identifies the location, often the most distal (or distant from the torso) body parts like fingers and toes.

Beyond numbness and tingling, sometimes neuropathy can cause systemic issues like excessive sweating, constipation or diarrhea, blood pressure changes or sexual dysfunction.

Obviously then, neuropathy is clearly an issue that demands medical attention.

There are a number of treatment options ranging from addressing dietary deficiencies to applying topical creams, or taking prescription medications. Self care options to minimize or possible end neuropathy include regular exersize, quitting smoking, and maintaining a healthy diet.

Hopefully your boyfriend will soon say, “You’ve got some nerve!” + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will only be provided in the Examiner.

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6. VIRUS 7. SNEEZE 8. COUGH 9. BLISTER 10. ARTHRITIS

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QUOTATION QUOTATION PUZZLE SOLUTION “Natural forces within us are the true healers of disease.”

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JUNE 22, 2018

PROFILES… from page 3 one-third research, was the perfect environment (or so it seemed at the time) for exploring why a 2-year-old would be so enamored of smoking.

Beyond the amusing family story was the larger issue of the millions who have died from the effects of tobacco: smoking was and is the #1 cause of preventable death worldwide. It deserves all the attention and exposure that can be given to it.

Previous studies into tobacco use among youth had focused exclusively on teenagers, but Tariq had opened the door to an entirely new avenue of research. Were children being deliberately targeted by tobacco advertising? And if they were, were the attempts meeting with any success?

With grants and funding support, along with help from professional research organizations, Dr. Fischer was able to launch the largest study of its kind ever undertaken to that point. Children aged 3 to 6 years were

shown corporate logos and asked to match them to the products they represent. More than 90 percent of 6-year-olds correctly matched pictures of Joe Camel, a cartoon character used in marketing by R. J. Reynolds (RJR) tobacco company, with pictures of cigarettes. Among 3-year-olds, the recognition rate was about 30 percent.

Of a dozen logos shown to children, the highest recognition rates were for Joe Camel and cigarettes, and Mickey Mouse and The Disney Channel.

Further studies measured sophisticated markers like tracking eye movement as people viewed tobacco advertising, revealing that warning labels are routinely ignored.

After publication in JAMA late in 1991, Dr. Fischer says the impact was immense and immediate.

Media attention was tremendous.

Congressional investigations were launched. Additional facts came to light from independent sources that

supported Fischer’s research. For example, it was revealed that almost a third of all cigarettes sold illegally to underage buyers after the Joe Camel campaign began were Camels, up from less than 1 percent previously.

Another lawsuit brought against RJR alleged that Camel sales to teenagers approached half a billion dollars in 1992 versus only $6 million in 1988 when the Joe Camel ad campaign started.

Clearly, Joe Camel was on the ropes, but so was Paul Fischer. He spent three years in court battling powerful attorneys from the tobacco industry.

As an employee of a state institution (MCG), a lawsuit against Fischer was viewed under the golden dome in Atlanta in the same light as litigation against Georgia itself. The job of the state attorney general, simply put, was to defend the state, not Paul Fischer, so it was up to him to provide his own legal support.

Thankfully, Bo Hunter represented

Dr. Fischer pro bono, and right, not might, eventually prevailed.

Even so, the environment at MCG no longer felt as welcoming, understandably enough. Dr. Fischer was at a career crossroads, but the decision really was not a difficult one to make: primary care had been his first love as a physician, dating back to his early days in Weeping Water.

Fischer left MCG to found Center for Primary Care, a practice that has grown over the past 25 years into 8 locations from Thomson to Aiken served by 40 physicians, including Paul and Asma Fischer’s daughter, Shireen.

As for Tariq, he was the victim of a tragic car accident in July 2005.

Although his life was cut short, his innocent remarks as a child sparked a huge and ultimately successful battle in the ongoing war against the leading cause of preventable death in the U.S. and the world. +

PROFESSIONAL DIRECTORY +

ALLERGY

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

AMBULANCE SERVICE

AMBULANCE • STRETCHER • WHEELCHAIR

706-863-9800

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

DENTISTRY

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

PHARMACY

Medical Center West Pharmacy 465 North Belair Road Evans 30809 Floss ‘em 706-854-2424 or lose ‘em! www.medicalcenterwestpharmacy.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

DERMATOLOGY

Parks Pharmacy 437 Georgia Ave. N. Augusta 29841 803-279-7450 www.parkspharmacy.com

PSYCHIATRY Psych Consultants 2820 Hillcreek Dr Augusta 30909 (706) 410-1202 www.psych-consultants.com

Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Augusta 30904 Augusta Gardens Senior Living Community 706-733-3373 3725 Wheeler Road SKIN CANCER CENTER www.GaDerm.com Augusta 30909 SENIOR LIVING COMMUNITY Resolution Counseling Professionals 706-868-6500 3633 Wheeler Rd, Suite 365 www.augustagardenscommunity.com Augusta 30909 706-432-6866 Karen L. Carter, MD www.visitrcp.com 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com Your Practice And up to four additional lines of your choosing and, if desired, your logo.

Keep your contact information in Steppingstones to Recovery this convenient place seen by tens of 2610 Commons Blvd. thousands of patients every month. Augusta 30909 Literally! Call (706) 860-5455 for all 706-733-1935 the details

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

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