June 6 14 by Daniel Pearson

AUGUSTA

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recipe feature PAGE 7

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AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

JUNE 6, 2014

A TALE OF TWO FRIDAYS

oday marks the anniversary of a pivotal date in world history. D-Day, the assault on the beaches of France which ultimately spelled the defeat of Nazi Germany and the end of World War II, was seventy years ago today. D-Day was the beginning of the end for a terrible battle that had raged across the entire planet for parts of six years (1939 - 1945). Entire cities with millions of inhabitants were blown to smithereens, along with tiny, seemingly insignificant specks of land in the Pacific that were fought over at tremendous cost. Historians still don’t know the true death toll of World War II, but estimates range from more than 60 million killed up to nearly 85 million. Those numbers include all deaths directly or indirectly caused by World War II, military and civilian. They include those who died as the direct result of combat, as well as other war-induced causes like famine and disease epidemics. Those 60 million or more must be added to as many as 40 million who died during World War I, which ended barely 20 years before the outbreak of the second world war. World Wars I & II rank as the first- and sixth-most deadly wars in human history. The World War II death

How many of these men were still alive five minutes after this picture was taken?

toll for Americans alone was 405,399, while 116,516 are said to have died during World War I. Both of those combined, however, don’t reach the death toll of America’s deadliest war. That dubious honor goes to the Civil War, during which an estimated 625,000 Americans were killed. Another anniversary There was another observance, however, that marked even more tragic and untimely deaths than any of these wars. Did you miss it? Last Friday, May 31, was designated by the World Health Organization as World

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No Tobacco Day. It’s observed annually on May 31. Why? According to WHO, “the tobacco epidemic is one of the biggest public health threats the world has ever faced.” How big? Worldwide, tobacco kills nearly 6 million people per year — worldwide, approximately one person every six seconds — including 600,000 non-smokers who die as the result of exposure to second-hand smoke. The non-smoker body count alone is greater than all US fatalities in World Wars I & II combined, but this death toll

occurs every single year. And it’s not getting any better: WHO says that if current rates continue, the annual global death toll could reach 8 million by 2030. As it is right now, tobacco eventually kills up to half its users. WHO statistics show that tobacco caused approximately 100 million deaths in the 20th century. Sound like a lot of deaths? Tobacco hasn’t even gotten started: at current rates, WHO estimates tobacco-related deaths in this century could reach 1 billion. And you thought World War II’s 60 million deaths was a lot.

Why do people smoke? Good question. In the face of all the evidence against smoking, one would expect smokers would be a rarity. There are many reasons why they aren’t. One of the most insidious is addiction. Nicotine is one of the most addictive drugs known, holding users in its powerful grip more tightly than most illegal drugs. Most smokers want to quit, even those who truly enjoy their habit, but they often wage the battle against their addiction without outside assistance. Failures and relapses are common. Many smokers thought it might be a cool temporary habit during high school or a means to achieve calm nerves in college. They never dreamed that decades later they would still be smoking. Denial is another major factor. Tobacco is a gradual killer, so there is a lag of several years between the onset of smoking and the appearance of symptoms, if they appear at all. If a smoker knows one heavy lifetime smoker who’s as strong and healthy as an ox, that’s all the proof he needs to keep on puffing.

Can the battle be won? If Hitler could be defeated, nicotine addiction can be too. How? Please see FRIDAYS page 6

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JUNE 6, 2014

AUGUSTA MEDiCAL EXAMINER

HEALTHCARE REFORM & YOU by Russell T. Head, CBC, CSA

CONSEQUENCES OF REIMBURSING EMPLOYEES’ INSURANCE PREMIUMS

ffordable Care Act (ACA) reforms that took effect this year may make purchasing health insurance in the individual market more accessible. Due to these reforms and the rising costs of health coverage, some employers have considered helping employees pay for individual health insurance policies instead of offering an employersponsored plan. On May 13, 2014, the Internal Revenue Service (IRS) issued FAQs addressing the consequences for employers that do not establish a health insurance plan for their employees, but instead reimburse employees for premiums they pay for individual health insurance (either inside or outside of an Exchange). These arrangements are known as employer payment plans. Before reviewing the May 13 rulings, a brief overview of some of the IRS opinions leading up to last month’s clarification. Background on Employer Payment Plans In Revenue Ruling 61-146, the IRS provided that if an employer reimburses an employee’s substantiated premiums for nonemployer sponsored hospital and medical insurance, the payments are excluded from the employee’s gross income under Internal Revenue Code (Code) section 106. This guidance allowed an employer to pay an employee’s premiums for individual health insurance coverage without the employee paying tax on the amount. IRS Notice 2013-54, issued on Sept. 13, 2013, referred to these types of arrangements as “employer payment plans.” These employer payment plans are considered to be group health plans subject to the ACA’s market reforms, including the annual limit prohibition and the preventive

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care coverage requirement. The Notice clarifies that these arrangements provided to employees cannot be integrated with individual policies, and thus fails to satisfy the ACA’s market reforms. As a result, effective for 2014 plan years, these plans are essentially prohibited. Consequences for Employers Because employer payment plans do not comply with the ACA’s market reforms, the IRS indicated in the FAQs that these arrangements may be subject to an excise tax of $100 per day for each applicable employee ($36,500 per year per employee) under Code Section 4980D. However, an employer payment plan generally does not include an arrangement under which an employee may have an after-tax amount applied toward health coverage, or may take that amount in cash compensation. Thus, premium reimbursement arrangements made on an after-tax basis will still be permitted. + For further explanation of the ACA/ PPACA provisions outlined in this article, please refer to the following resources: www.hhs.gov www.irs.gov www.healthcare.gov www.cms.gov Russell T. Head is a Partner and Chief Visionary Architect with Group & Benefits Consultants, Inc., Augusta’s largest, privately held, locally owned employee benefits Russell Head consulting firm. He can be reached at 706-733-3459 or rthead@gandbc.com. Visit Group & Benefits Consultants at www. groupandbenefits.com.

JUNE 6, 2014

AUGUSTA MEDiCAL EXAMINER

University leads the way in patient care quality in the CSRA.

Why work anywhere else?

What’s your story?

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

Healthgrades.com Five-Star Ratings University Hospital

The most Five-Star Ratings earned by any other area hospital.

NOW HIRING. Visit www.UniversityHealth.org/jobs to apply.

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.)

AUGUSTA

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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.

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JUNE 6, 2014

AUGUSTA MEDiCAL EXAMINER

Hope IS Possible

My public train wreck Helen Blocker-Adams

’ve never been physically beaten up, but on Monday, May 12th I felt like I had been punched in the stomach. And in a matter of 72 hours, I felt like the whole world was watching my life unravel right before their very eyes. It was the most humiliating and hurtful experience I have ever had in my life. I wouldn’t wish my worst enemy to experience what I did seven days before Election Day. You may have seen my interview on News 12 or WAGT Channel 26 over the past few weeks. If you haven’t, I would recommend so you can get a glimpse of what has been going on in my world over the past 20 years and why my exposed personal financial situation collapsed as abruptly as it did. Hurting my family, executive and core campaign

team, supporters and friends devastates me the most. I am deeply sorry and ask for their forgiveness. I was more or less out of touch for seven days. Not because I was embarrassed and didn’t want to face anyone. But because I needed to get away from the “noise,” both positive and negative, of Facebook, social media, television, radio and newspaper news, and people. Those days in silence, so to speak, were the best thing that could have happened to me. On Thursday, May 15th when I suspended my campaign, I thought I was going to die. It was the worst day of my life. But on the day before Election, May 19th, when I completely exited the race, I was a different person. And it was all because of God. God made it clear that I couldn’t and didn’t have to endure months of personal attacks, which were not only affecting me, but my family and team as well. We knew, and we were warned, that they wouldn’t stop. Some people have said I should have stayed in the race. My respectful response to them is, “I know you mean well, but you are not in my shoes.” When you’re faced with devastation as I was, your only source of renewal, hope, trust, wisdom, faith and guidance, is from God. Period. I found solace in

reading scriptures and studying His word. The silence allowed me to hear Him. Jesus slipped away as often as he could to get away from the crowds. It helped me too. My life over the past 20 years has been so busy taking care of others, wanting to make a difference, but not taking care of myself. But God also revealed something else. I had too much pride, was too independent and in denial regarding the magnitude of my financial situation. As a small business owner for 22 years, it’s easy to get consumed by trying to get the next contract or business deal so you can stay afloat. But when they don’t pay you, or are slow to pay, or cancel, suddenly it puts business owners in a bind, especially when there are no reserves. And I failed to let family or friends know I needed help over the years until it was

too late and the situation grew out of control. More importantly, I failed to allow God to help me with my burdens. There’s so much more, but it’s a story I could fill a book with — and I just might do that. I had to face some harsh realities that were hurtful to me because everyone else saw the mess I’ve made. But even more so because I realized I wasn’t focused on God. I wasn’t making Him first. I believe God allowed this public train wreck to happen so He could get my attention. I had to listen. And it has given me peace. The weight I’ve been carrying for many, many years is gone. I didn’t sleep or eat well for five days in a row. But the peace came, and rest came, and I got back on my feet. There is another chapter in my life beginning now, but this time God is in charge. It’s Kingdom building time. I

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know the best is yet to come. But it will NOT be politics. Oh, trust me it still hurts. A lot. But I am at peace. I’m going to take care of myself, resolve my obligations and mend relationships that have been scarred. God has some exciting plans for me so that I can impact people and the world in a way I have never dreamed of. He’s also taking me out of my comfort zone. The world will witness the greatness and power of God – He will receive all the Glory. I’m very excited about that. I am so thankful Dan Pearson has given me the opportunity to write for this publication for the past five years. My focus has been mental health and mental well-being. Now it is time to focus on my own personal and professional mental health and well-being. With that said, I am going to take a sabbatical from writing my columns in The Augusta Medical Examiner so that I can spend time trying to repair the damage caused by my public train wreck and get back on track. I am so blessed to have friends and supporters like you. Thank you so much for being there for me. Thank you for reading my columns. I am sharing my story with you because I pray that my painful experience will be a blessing to you in some way. + Helen Blocker-Adams is Executive Director of the Southeast Enterprise Institute; mental health advocate; and youth advocate. You can email her at hba@hbagroup-intl. com or visit her website at www. helenblockeradams.com, www. hbagroup-intl.com or www. authorhouse.com

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JUNE 6, 2014

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW ABOUT DOCTORS AND HOUSE CALLS

AUGUSTA

y first practice was in a small town without a hospital. I was the third (and by far the youngest) doctor in town. We had a budding nursing home that had grown to 100+ beds and was a showplace of efficiency and quality healthcare. Funeral homes provided the rarely needed ambulance service at no charge. Regular office hours were 5 days a week, plus walkins on Saturday from 9:00 to noon and Sunday morning from 9:00 to 10:00. We saw everyone who could find the front door, no appointment required. Payment was never mentioned prior to service. We made house calls in the evening for those too sick to come to the office, but not sick enough to go 27 miles to the nearest hospital and emergency room. About 90% of my patients were treated in the office, about 5% in the patient’s home, and about 5% in an examining room at my home at night and during weekends. Less than 1% went

to the hospital or an ER. Back then almost every car had a gun in it, and consequently drive-by shootings, carjackings, road rage, and parking lot fights were unheard of. We did not have a shooting in the 3 years I was there. (There may be a connection there, I don’t know, but those are the facts.) My, my. How our world and medicine have changed. These days you may wait weeks or months to see a doctor. The ER has more cars around it than a Holiness revival tent. The ER is full of garden variety colds, flu, tension headaches, and chronic disorders because patients couldn’t get into a doctor’s office during the day. Sometimes they wait hours, even though advertisements tout “15 minute ER waiting time.” A friend of mine took his wife with a migraine and hyperemesis to the ER. She vomited three more times in a trashcan in the waiting room while waiting four hours to see a doctor. A shot of Phenergan stopped the FREE T AKE-H OME C OPY!

AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

FEBRUARY 21, 2014

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Best vomiting in 15 minutes. Cost: $600.00. If you can find your doctor’s home at midnight and beat on his door announcing your wife is vomiting in your car, the doctor’s wife might have you arrested for disturbing the peace. Or worse still, shoot you through the door for attempted home invasion. It is scenarios like these that are heralding a new form of medical practice: Concierge medicine. You and your doctor have a special arrangement that bypasses the standard HospitalER-Insurance-MedicareObamacare maze. You have a one-on-one relationship with your doctor. You pay him directly, without third part intervention. His overhead is lower because he does not need paper pushers, high dollar computers with super expensive programs, and billing specialists. He spends

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THE AUGUSTA MEDICAL EXAMINER AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

e n i c i d ME

more time with you. You get personalized medical care. You are a patient with a disease, not a disease with a patient. All that is good. But there is an even newer endeavor: house call physicians. They make come right to your home, or to hotels for travelers and vacationers. They are available in Jacksonville, Atlanta, and now Augusta. Let’s say you come home exhausted from a hard day of work. About midnight, your child or spouse develops chills, a worsening cough, and a fever 102.5°. It may be flu and will subside in about five days. Or it may be bacterial bronchitis and prompt intervention with antibiotics is necessary. You must chose. Option 1: Spend a few hours and several hundred dollars in the ER to see a doctor? You will be up all night and miss work the next day.

•

Option 2: Administer aspirin, cuddle the feverish loved one all night long, hoping for the best until morning when you desperately seek a doctor with an afternoon appointment available? You will be up all night and miss work the next day. Option 3: call a house call physician who will promptly make a house call for less than half of what the ER costs? House call physicians are faster and more economical. It is less tiring on you, and your loved one gets immediate care. And you won’t miss work the next day. This is what good medical care used to be: you and your doctor, with no one in between. My, my. How we have advanced. The newest thing in medicine is how I practiced 40 years ago. + Bad Billy Laveau is a retired MD with a pointed sense of humor. Bad Billy speaks and entertains at public and private events for audiences not subject to cardiac seizure secondary to overwhelming laughter and glee BadBilly@knology. net or 706-306-9397

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JUNE 6, 2014

AUGUSTA MEDiCAL EXAMINER

FRIDAYS… from page 1 Not without a full-scale assault. If Hitler or Patton or Eisenhower or Ulysses Grant or Robert E. Lee quit after their first or second or third defeat, wars would be very short. They never are. Be prepared to do battle and wage war until you have won. If you can imagine a heroine junkie trying to go cold turkey, you can imagine what some smokers experience trying to quit. Don’t go there. Talk to your doctor about assistance available to you. Call any major hospital in the Augusta area and inquire about their smoking cessation programs. Speaking of which, any hospital that has designated smoking areas has a truly curious policy, indeed. Not in 1954 maybe, but definitely in 2014. That should be rectified at once, and our local hospitals and healthcare providers who do have

no-smoking policies should continually review and refine their enforcement policies and efforts. For its part, WHO uses its annual World No Tobacco Day to advocate higher taxes as one of the ways to discourage tobacco use, especially among youth and poor people, two of the favorite targets of tobacco marketing efforts worldwide. Every 10% increase in taxinduced tobacco prices causes about a 5% drop in tobacco use, according to WHO figures. If you’re interested, contact your elected representatives, strongly urging them to wield their legislative pens to help quash “one of the biggest public health threats the world has ever faced.” Do it today as your way of remembering those who died for a very different cause in a deadly battle in France seventy years ago today. +

The Medical Examiner says...

A hospital with a designated smoking area

IS LIKE A BETTY FORD CLINIC with a designated drinking area.

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.

“

Don’t go on discussing what a good person should be. Just be one. — Marcus Aurelius

“

JUNE 6, 2014

AUGUSTA MEDiCAL EXAMINER

Southern Girl Eats Clean

Cannellini Bean and Avocado Hummus

This recipe is a great alternative to plain hummus or guacamole. It’s a lovely appetizer that combines white beans and avocado, but instead of chickpeas it has Cannellini beans. This traditional Italian bean gives the dip a completely different taste. I also love that you are getting a double dose of nutrition with the avocado and beans. Avocado has over 20 vitamins and minerals and it’s mono and polyunsaturated fat content make it a great substitute for foods high in saturated fat. The beans in the recipe have twice as much iron as beef and they are a low fat, high fiber food. I actually saw Giada De Laurentiis make a very similar recipe on her cooking show about six months ago. I would watch The Food Network from sun up until sun down. Kind of like how my husband watches college football from 10:00am until Midnight every Saturday during the football season. I love to watch all the different cooking shows and I get tons of recipe ideas from them. Now that we eat a clean diet I try to clean those recipes up and make them more healthy and nutritional. Make this recipe to share with your friends or family this blending by pouring it through • 2 Tbsp. extra virgin olive oil weekend by the pool. Enjoy! the opening on the lid. (Do not • 2-3 Tbsp. of water • 1 Tsp. of Mrs. Dash Southwest remove lid) Once olive oil is incorporated, Chipotle Seasoning Blend slowly add the water a little at a • 1 Tsp. of salt (more or less as time until desired consistency you prefer) is reached. • A pinch of cracked black Chill and serve with organic pepper What you’ll need: gluten free blue corn tortilla • 2 avocados, peeled, seed + chips. Directions: removed and coarsely chopped Place avocado, arugula, • 1/2 Cup of organic arugula cannellini beans, parsley, garlic, Alisa Rhinehart writes the blog • 1 can of Cannellini Beans, www.southerngirleatsclean.com lemon juice, salt and pepper rinsed and drained (I use Eden She is a working wife along with chipotle seasoning Organic brand) and mother living in into a high speed blender. • 2 Tbsp. of flat leaf Italian Evans, Georgia. Visit Blend for 1 minute, then add parsley her blog for more the olive oil a little at a time • 3 cloves of garlic, chopped recipes and information while the mixture is still • Juice of 1/2 lemon on clean eating.

Cannellini Bean and Avocado Hummus

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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

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JUNE 6, 2014

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.

HOW DO I LOSE THIS EXTRA WEIGHT?

lmost everyone has a little or a lot of extra weight that they want to lose. There are many options on the market to help with this cause. Just remember that your old lifestyle put you into this predicament, and only a lifestyle change will permanently cure the problem. That being said a combination approach tends to work the best. This is true in so Sorry, this many parts of the medical field. won’t be Weight, or to be more precise, happening. extra weight, is such a problem that the American Medical Association just classified obesity as a disease. That is a big step in addressing the American tendency to overeat and gain unnecessary weight. So let’s look at the options in getting your weight under control. This is a pharmacy column so I will talk about the drugs that suppress your appetite and generally cause some weight loss. This is a very small part of the total equation in a truly successful plan. “Diet pills,” as they are called, should only be a jumpstart to get you started. Pills should not be used as your sole method of controlling your weight. All diet pills have side effects that can be just as problematic as the obesity itself. The older and more affordable medicines tend to cause nervousness, jitteriness, and in some cases rapid heart rate and increased blood pressure. Let’s not trade a few pounds for a lifetime of stress on your heart. It’s the only one you have, after all. There is a newer medicine that suppresses the appetite without cardiac excitement, but it costs two to three hundred dollars a month and may have other side effects, like depression or lethargy. Also some popular antidepressants may have serious interactions with this new medication. So I support a short term course of diet pills only if you need that extra boost to get started. But let’s

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talk maintenance therapy. Weight loss occurs when the numbers of calories burned each day is higher than the number of calories consumed. It sounds simple but the basics of nutrition and proper ways to eat could fill this whole edition of the Medical Examiner. I will attempt to give a few basic tips and hopefully get you off to that elusive good start. A pound is the equivalent of 3,500 calories, so if you want to lose a pound a week you must burn five hundred more calories per day than you eat (500 calories x 7 days = 3,500). Let’s start with ways to manipulate that weight loss equation. There are two main elements: intake and output. Let’s start by lowering the input, which means eating less while still taking in adequate nutrition. Eat more fruits and vegetables and less fats, and you will decrease the calories in your diet. Another good trick is to decrease the portion size of your meals. Use a salad plate instead of a dinner plate for instance, or impose a ban on second helpings. Either way can lower your caloric intake. Another part of the equation is increasing the calories burned per day. This is where we all have to work for it. You can start an exercise program with little to no out of pocket cost. Push-ups, sit-ups and other exercises done in your home are free, as is walking in your neighborhood, at a park or at the mall. You don’t have to spend big bucks on a gym membership to exercise. It can be as simple as using stairs instead of an elevator and parking across the parking lot instead of waiting for a close space to come open. Any combination of more calories burned and less calories eaten can result in a trimmer waistline and a healthier outlook on life. We all want to spend a few extra years with our loved ones, so let’s get busy and lose that extra weight. We have started a diet and exercise program at our home and the results so far have been noticeable to our friends and family. If we can do it, so can YOU! End this year healthier than you started it. You have this paper and its nutrition column to help you. + Questions about this article or suggestions for future columns can be sent to us at cjdlpdrph@bellsouth.net Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson (cjdlpdrph@bellsouth.net )

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usually see clients in my office because they have exhausted all efforts. Typically it begins with someone seeking to lose weight by working out six or seven days a week. Diets are strict, following exactly what a trainer told them or what they read in a magazine or an online forum. They are precisely counting everything right down to the gram. But then something unexpected happens: they do not lose weight; some gain body fat. What in the world is happening? The initial automatic reaction is to increase the intensity and duration of work outs. Calories are further restricted. Yet as counterintuitive as it may seem, sometimes eating more and working out less is the only solution to this scenario. While this advice may be difficult for hard-core fitness enthusiasts and chronic dieters to swallow, it is necessary to recover the body and reset metabolism. Overtraining is defined by the National Academy of Science and Medicine as an accumulation of training and/or non-training stress resulting in long-term decrease in performance capacity. When it comes to achieving your fitness and body goals, there is a point where you no longer see benefits. The best approach is to overtraining is preventing it from occurring in the first place. Since overtraining is a condition that gradually grows worse, it makes sense to be mindful of its warning signs, a host of physiological and psychological signals: mood changes such as irritability and depression, and the inability to concentrate are among the easiest to detect. Physical changes can include an altered heart rate and blood pressure, especially an elevated resting heart rate early in the morning. And overtraining causes injuries like abnormal aches and pains, muscle atrophy, or easily putting on fat despite low calorie dieting is also seen. Interestingly, overtraining is almost always accompanied by appetite suppression despite increasing energy expenditure.

AUGUSTA MEDiCAL EXAMINER

In order to understand this phenomenon we have to look at the relationship between under-eating and training. Eating enough calories to meet the energy and recovery requirements of your body is good insurance against overtraining. The minimum number of calories your body needs to function at rest is your resting metabolic rate (RMR). RMR plus daily activity and additional exercise expenditures determines total energy needs. You can find online calculators for your RMR, or contact a local dietitian. Depriving your body of the calories it needs, not just to survive, but also to sustain effective exercise is self-defeating. Metabolism is a natural process; your body generally balances it to meet your individual needs. During times of diet restriction, the body automatically compensates by slowing down these bodily processes and conserving calories. If you don’t supply the fuel, you can’t avoid side effects. One of the most noticeable will be loss of strength, because you will not have energy to perform. Body fat may actually increase as the body conserves fat while utilizing other sources for energy. Muscles are not built during work, but rather during subsequent rest and rebuilding. Without adequate nourishment and rest, muscle tone will weaken rather than grow. Weight loss can actually be muscle loss, since muscle weighs more than fat and the body is actually gaining fat. The body is like a car. If you don’t fill the tank it will not travel far. A full tank makes the full trip. In order to achieve goals with weight, training, or general health, the tank needs the appropriate nutrients. What is appropriate for your tank? You can use an online calculator such as www. myfitnesspal.com or www. fitday.com. Once you have determined your maintenance needs you can adjust your intake based on your personal goal. Do not subtract more than your RMR as this will put you back in the adaptive

phase. If your goal is weight loss, subtract 300 calories from your daily maintenance needs. This number may be more depending on how you accounted for exercise in your calculations. If your goal is to build muscle, add calories. So what should you eat? Begin the day with breakfast to start filling your tank. Include carbohydrates and protein in each meal/snack. Eat three meals with two or three snacks.

CARBOHYDRATE PROTEIN DAIRY FRUIT FAT

This keeps glycogen levels stable and muscles nourished. This also decreases the chance of overeating. All food groups should be incorporated into your day. The chart below includes examples from each food group. Clients often say they cannot eat before exercising, but it’s better to have something small that contains carbohydrates thirty minutes to one hour before exercising. Exercising in a fasting or glycogen-depleted state leads to fatigue and decreased performance. For optimal recovery after exercise, have a snack or meal containing a combination of carbohydrate and protein, such as chocolate milk, yogurt and granola, or fruit and peanut butter. When you have been exercising and under-eating for a long time, it may be difficult to make these changes. It takes

a leap of faith to eat more and workout less when the opposite is highly ingrained. Truthfully, you may feel worse before you feel better because you miss the release exercise provided. You may gain a few pounds of water weight as your body readjusts to the changes you are making. This is temporary and usually resolves within a few weeks. I encourage my clients to simply trust the process. It is the only way to break the cycle. + by Amy Culberson, MS, RD, LD www.amyculbersonmsrd.com amyculbersonmsrdld@gmail.com Amy has a private practice in Evans, Georgia. She specializes in weight management, sports nutrition, eating disorders, allergies and digestive disorders. She also performs metabolic testing to determine individual caloric needs.

Toast, cereal, granola, pasta, rice, potato, starchy vegetables Eggs, nut butters (for protein and fat), meat, soy Milk, cheese, yogurt Whole fruit, 1 cup frozen, 1/2-cup canned 1 tsp. oils, butter, 1 tbsp. salad dressing, 2 tbsp. hummus

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JUNE 6, 2014

AUGUSTA MEDiCAL EXAMINER

The Short White Coat “I will love the light for it shows me the way, yet I will endure the darkness for it shows me the stars.” — Og Mandino

“When it rains it pours. Maybe the art of life is to convert tough times to great experiences: we can choose to hate the rain or dance in it.” — Joan Marques

am a little over halfway finished with my rotation in surgery, and spent the first 4 weeks of it with the Surgical Oncology service. So that means I spent a lot of times in the Cancer Center and working with patients receiving cancer treatment. I also have spent a couple of nights working in the Emergency Dept for Trauma Call. Altogether, my experiences have been enriching yet humbling. It is terrifying to think about how randomly misfortunes or illness can strike a person. What could they have possibly done to deserve it? Or avoid it? Or recover from it? I would desperately analyze the situations I saw patients

confront. What if they had gotten a colonoscopy 10 years earlier like their doctor recommended? What if they had worn seat belts or not driven under the influence of alcohol? What if they had done breast self-exams more regularly instead of just waiting for mammograms? What if they had not smoked 2 packs of cigarettes daily for the past 20 years? I would obsess and analyze it all. What can I learn from this? What can I tell other people to do to minimize their own risk of developing illnesses or getting into accidents? Car accidents alone are terrifying to worry about: in a split second everything in your life

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can change and possibly be irreversibly damaged. Victims can have everything from a wrecked car to permanent spinal cord damage to the guilt of a death on their conscience. It is heavy. Extremely heavy to think about. I sometimes wondered if I could handle it on a daily basis working in medicine. I being reminded far too often how fragile our lives are and how haphazard good health or fortune seems to be. The truth is yes, you can get colonoscopies, mammograms, or designated drivers to try to keep you safe. You probably could decrease your risk of lung cancer vastly by quitting the smoking habit. And we all should be vigilant and proactive in such manners. But there are a hell of a lot of people who do live their lives by the book, doing everything correctly, and planning ahead for future and disaster. And yet disaster still strikes. It is mindnumbing and nauseating. Is life just a roulette wheel, and we are all just waiting for our number to be randomly selected? But then I met a patient at the VA hospital one afternoon during one of my general surgery clinic days. He had colon cancer, and as a result almost his entire colon had been removed. He was given a colostomy bag and 6 months to live … 3 years ago. That is correct. It is a true fact that most of the time, when a doctor gives you an approximation of how much time you have left,

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they really don’t know any more than you do. They can go with the facts they are given, the literature they read, expert opinions they hear, and the experience they have had. But honestly, let’s be serious for a minute - and I am not trying to make a religious statement or argument – but I do believe that how much time each person is allotted on this Earth is both within and without their

Because really, we are all dying of something. All of our days are limited. Someday we will all leave this Earth. Every day is a gift and can be taken away quicker than we can sneeze. But as long as we draw breath into our bodies, we are living too. It is strange to reconcile… but everyday we are both living and dying at the same time. Some people are living with cancer. Some are living with

control. Yes we can be proactive about health-saving practices and screen or protect ourselves from the malignant and be the poster child for proactive health get hit by a drunk driver tomorrow while driving to the gym. We can give up on ourselves when we hear a bad diagnosis, or we can fight. Or we can choose to just accept the truth and the facts, and live out our final days in peace – which is entirely our own prerogative in itself. The choice to undergo chemotherapy for cancer or just choose palliative care for pain and symptom management is an individual decision-making process. But at the end of the day, we are all dying. And at the same time we are all still living. Do any of us really know how much time we actually have left? As a doctor phrased it to the patient who came in for his check-up - years after being diagnosed with, treated for, and ultimately beating colon cancer against expected odds: “You can either be someone who is dying of cancer, or be someone living with cancer.”

Alzheimer’s disease. Some are living with alcoholism and cirrhosis of the liver. And some are living healthily and entirely disease-free but have completely different struggles that they face. It really is a bit of a roulette wheel, this life we have. But isn’t it all about perspective? How are we going to approach each day? Bitter and resentful about the poor hand we have been dealt? Or grateful that, for better or worse, we have been dealt another day? Everyone has their burdens, and everyone has their illnesses. It is just a matter of whether we are going to live with these burdens and illnesses, or just merely be dying from them. Will we love the light? Or will we love the darkness? Or will we love them both for what they show us and what they are? The truth is that we cannot have light without a darkness to be illuminated, and there cannot be anything dark without a light to shroud. Such is life, so it seems, and so it will be. + by Caroline Colden 3rd-year medical student at MCG

JUNE 6, 2014

11 +

AUGUSTA MEDiCAL EXAMINER

From the Bookshelf The blog spot – Posted on July 23, 2008 at acountrydoctorwrites.wordpress.com

LOSING A PATIENT TWICE I had some down time in New York this past weekend and spent some of it looking at what Swedish physicians are writing in their blogs. (I am a Swedish physician, too, but I have lived most of my professional life in the U.S.) I came across a brief little piece by a 25-year-old Swedish resident. She connected with a patient on her ward in his fifties (her father’s age), who seemed to be doing OK, but died overnight while she was off duty. I tried to remember the first patient I lost, but I couldn’t. There have been so many in my 29 years as a doctor, some lost prematurely, but most in their old age and after a long illness. A few months ago, a former patient who no longer lived in our town died. He was only a few years older than my own children and the news of his death affected me deeply, even though I hadn’t seen him for years. Bobby Smith was a normal, rambunctious, ten year-old until one day, my second winter in town, when we got a radio call from the ambulance. In those days we had all-volunteer EMTs, and none had any advanced training, so the doctors at our clinic would get called to go on ambulance runs. It had snowed heavily that morning and school was cancelled. By noon the snowfall had stopped, and the sun came out. Bobby went sledding right in front of his house. At first, the new powder slowed him down, but every time Bobby followed the same path down the hill he went faster and farther. The last time, he ended up in the middle of the road. Samuel Trumbull, the town selectman, didn’t have a chance to avoid hitting Bobby as he lay on his sled in the middle of the road. The ambulance had twenty miles to go on the winding, slippery road to the hospital. Bobby was unconscious, not breathing, but with a good pulse and blood pressure. I maintained his airway and bagged him the whole way. He pulled through, but with severe brain damage. He never spoke again. He would make grimaces and smile or poke at you. He was bed bound and incontinent. I did house calls there for a few years. Eventually they wheeled him into his old classroom, mainstreaming him, as they called it. His parents split up, and Bobby ended up moving away from town. I would still often think of Bobby, and poor selectman Trumbull. His life was never the same after that day either. Suddenly, one day this spring, a patient whose maiden name was Smith – something I never reflected on – cancelled an appointment because her brother had died. When I saw her a week later, she mentioned who her brother was. All of a sudden I was back in that ambulance, bagging this little boy, who could have been my son. I lost Bobby all over again, but this time I lost him forever. +

“His life was never the same after that day.”

Speaking of blogs, the Medical Examiner blog is found at www. AugustaRx.com/news. Visit daily!

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Many of us have our chosen heroes within the medical profession: perhaps we admire nurses the most for their vital but often thankless and unheralded work in the trenches of medical care; maybe we’ve had cancer, so an oncologist is our personal hero; or our child’s life was saved by a doctor, so pediatrics is on our personal pedestal. For me, the pinnacle of medicine is the ER trauma surgeon. These men and women don’t have the luxury of many things other doctors take for granted and, in fact, insist upon. You can’t ask your podiatrist to check your sore shoulder, for instance, and even if you could, you would have to make an appointment weeks ahead of time. An ER physician, on the other hand, might treat a sore foot and an injured shoulder in back-to-back patients. The word predictability isn’t even in the trauma surgeon’s dictionary. Check if you don’t believe me. While you and I might be stressed beyond the breaking point by a steady stream of unannounced arrivals in full

cardiac arrest, perforated by bullets and knives, victims of beatings and blunt force trauma, and the entire rest of the trauma rainbow, there are people who enjoy the challenge and actually thrive on the daily adrenaline rush. One of those people is Dr. James Cole, our author du jour. What’s cool about this book is that it seems he has never heard of HIPAA. If you haven’t either, HIPAA (the Health Insurance Portability and Accountability Act) protects patient privacy, often to ridiculous extremes. But Dr. Cole, spins tale after tale in chapter after chapter, and he does so in extreme detail.

Each chapter is essentially a thorough study of a particular patient, or sometimes two, who was wheeled into Cole’s emergency department. The names have certainly been changed, but the tales of trauma treatment are so detailed they are practically suture-by-suture. If you like reading well-written accounts of heroic medical interventions, this is certainly the book for you. Although each chapter is extremely detailed medically (including photographs), Cole sometimes writes with the flair of a novelist. An added plus for Augusta readers, with our huge military medicine community, are the chapters recounting Cole’s stints in Afghanistan (although he did not extensively practice trauma medicine there). Although I wouldn’t have thought it possible, this book has increased my already boundless respect for practitioners of emergency medicine. + Trauma, My Life As an Emergency Surgeon, by James Cole, M.D., 336 pages, published in 2011 by St. Martin’s.

Research News Diet? Or exercise? Which is the better option to pursue if you’re trying to lose weight? A couple of recently published studies (2013, actually) shed light on this common question. In one, researchers compared the daily energy expenditures of average Westerners with members of a hunter-gatherer tribe in northern Tanzania. Although men in this tribe typically walk about seven miles a day, researchers were surprised to discover their daily calories burned was about the same as their sedentary Western counterparts. The second study found that when people begin exercising their resting metabolic rate (Sound familiar? See more info about this on page 9) went down. So if their diet did not change, they would actually gain weight by beginning to exercise. Although the two studies were unrelated, they make a valid point that exercise alone is

not the key factor. Another crucial behavior noted in many studies: when people begin to exercise they tend to give themselves a free pass at meal time. “I can eat more now because I’ll burn it off later.” That may merely be a subconscious thought, but conscious or not, it’s common. The bottom line is that weight loss rarely works without a change in diet. However, even if exercise is not the key to weight loss, it offers other benefits: reducing the risk of cardiovascular disease, diabetes and some cancers; reducing stress and anxiety; and improving mood, among others. Aspirin news Bayer, the company whose namesake gave us aspirin, recently asked the FDA for permission to change its product labeling to reflect aspirin’s role in heart attack and stroke prevention. Not only did the FDA say no, they also said the evidence

does not support the general use of aspirin in stroke and heart attack prevention. The report cited “serious risks” associated with the use of aspirin, mainly from bleeding in the stomach and brain. However, among patients who already have clear coronary risk factors (such as a history of heart attack or stroke), the FDA says for those patients the benefits of aspirin outweigh the risks. Although not every physician or organization agrees with the FDA, what really matters is what your physician says. Make it a point to ask during your next appointment. On the horizon This sounds like science fiction, but Kentucky’s Cardiovascular Innovation Institute is predicting a human heart created by a 3D printer could be a reality within ten years. They have already printed individual heart parts by laying down living cells layer by layer with a 3D printer. +

+ 12

JUNE 6, 2014

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS +

by Dan Pearson

I’d like to switch tablets. Any suggestions? Wow, there are so many options.

There’s Dell, Apple iPads, Samsung Nexus, Samsung Galaxy, big and small screens.. . What are you using now?

I know.

Aleve.

The Mystery Word for this issue: ORHUDSEL

EXAMINER CROSSWORD

PUZZLE

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 Click on “READER CONTESTS”

QUOTATION PUZZLE E R M F M S W A A S H U

A E R H N D F S A A T W E O G F E F F L R I E Y E U N A H A

F R R R

O F S S

— Michel de Montaigne

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.

9 7 5 8

X A M I N E R

6 4

4 5 3

7 9 1

1 2

1 8 7

6 2 3

9 5 8 7

U D O K U

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

Use the letters provided at bottom to create words to solve the puzzle. All the listed letters following 1 are the 1st letters of each word; the letters following 2 are 2nd 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.

L 1 2 3 4 5 6 P 1 2 3 1 2

1 2 3

1 2 3 4 5 6 7

8 9 10 11

— James Reston

1 . B W I C H P 2 . O O U S I E 3 . D V TA N 4 . S L E E 5 . P R S T 6 . T H I 7 . Y C 8 . U 9 . O 1 0 . U 1 1 . S

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

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

20 21 22 23 ACROSS 1. Cold prefix 24 25 5. Prefix for power or 26 27 28 29 30 31 32 carbon 10. Endanger 33 34 35 36 37 38 39 14. Poetic grayish white 40 41 42 43 44 15. President of the 755 Club 16. Cleveland’s lake 45 46 47 48 49 17. Type of jaguarundi 50 51 52 18. Chambers 19. Tune 53 54 55 56 57 58 59 60 20. Freshwater catfish 61 62 63 22. Working in a flower bed 24. Mary-Kate, for one 64 65 66 67 25. Well-known 68 69 70 26. Ding 71 72 73 29. Fire beginning? 33. Toward the stern by Daniel R. Pearson © 2014 All rights reserved. Built in part with software from www.crauswords.com 36. Warning alarm 39. Flair difficulty DOWN 40. Threaten 33. Fantastic Four actress 1. -therapy 42. City in NW Germany 34. Fairway follower 2. Port in downtown Augusta 44. Lead-in to north or love 35. Three-_____ sloth at one time 45. ____-winner 37. Self-esteem 3. Falcons’ measurement 47. Start of a cycle? 38. Earns after expenses 4. Gave a speech 49. Ambulance svc. 41. Seasickness 5. Do no... 50. Confuse 43. -Invasive 6. Ming of the NBA 51. Type of flake 46. University department 7. Go to a watery grave 53. Meat stew braised in red head 8. Ladies’ man wine 48. Italian capital 9. Beginning 57. Grinding tooth 52. Burrowing Australian 10. Recent medical school 61. Tool for kitchen use marsupial graduate 63. Inhabitant of Yemen 54. Consumers 11. Anemia preventer 64. Dejected 55. Bathroom fixture 12. Perform a 19-A 65. Swelling 56. Mournful poem 13. Small cask 67. Belfry denizens 58. Percolate 21. Singles 68. Poker stake 59. Cavern 23. Parking ______ 69. _______Cinemas 60. He is ________ 27. Bethesda inst. 70. Land measure 61. Forearm bone 28. Cable car or trolley 71. Large wild ox of India 62. Skirt worn in Black Swan 30. Swiss river 72. Manner 63. University in Connecticut 31. Worthless person (often 73. At that time 64. _____ reflex used with bag) 66. Grand ___ 32. Makes a living with Solution p. 14

WORDS NUMBER

THE MYSTERY WORD

JUNE 6, 2014

13 +

AUGUSTA MEDiCAL EXAMINER

THE BEST MEDICINE

The Patient’s Perspective by Marcia Ribble

ha... ha...

man and his wife were having an argument about who should make coffee every morning. The wife said, “You should do it, because you get up first, and then we don’t have to wait as long to get our coffee.” The husband said, “But you are in charge of cooking around here, so you should do it because that is your job, and I can just wait for my coffee.” Unconvinced, the wife replied, “No, you should do it. Besides, it‘s in the Bible: the man should make the coffee.” “I can’t believe that,” the husband replied. “You’re going to have to show me.” So she got their family Bible, opened to the New Testament, and showed him the top of several pages. “See? ‘He brews.’” Psychiatrist: What’s your problem? Patient: I think I’m a chicken, doc. Psychiatrist: How long has this been going on? Patient: Since I was an egg. Doctor: What seems to be the problem, sir? Patient: A book fell on my head. Doctor: You have only your shelf to blame.

Doctor: What brings you to my office today? Patient: I hurt myself doing an impression of a tea bag. Doctor: A tea bag? Patient: Yeah, I strained myself. Three wealthy men and a beautiful young lady are traveling in the same private compartment on a train. The men begin flirting with the girl, so she proposes, “If each of you will give me $10, I’ll show you my legs.” The men, charmed by her good looks, all pull tens out of their wallets and give them to her, so she pulled up the hem of her dress just a bit to show her legs above her ankles. “I realize that’s very modest,” she said, “but if each of you gentlemen will give me $100, I’ll pull it up even higher.” Men being what they are, each one gladly gave her a hundred dollar bill, so she demurely pulled the hem of her dress just above her knees. At that moment the train began to slow as its final destination neared. “There’s not much time left,” said one of the men. “Show us more.” After pondering the proposal for a moment she said, “For a thousand dollars apiece, I will show you where I was operated on for appendicitis.” All three quickly and eagerly fork over the additional cash. She stood by the door of the compartment, then pointed out the window to a nearby building the train was passing. “See that hospital? That’s where I had it done.” +

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.

y legs healed, briefly, and then they became infected again with cellulitis. Gross! And to top that off, my three grandchildren are leaving town to move elsewhere. Two of them are moving up to Michigan and one is moving to North Carolina. Of the two events, the one which is affecting me the most is having my grandchildren move away. Since coming down to Georgia, they have been my best buddies and they have provided a lot of joy in my life. I like people my own age, but it is good for us elders to be around young people, too. Mine are all teenagers, ranging in age from 14 to 18, and it has been so much fun to be involved again in prom preparations, award ceremonies, movies, and meals out together with the kids. Church on Easter was more magnificent with the kids there to notice all the details I might not have seen. Not only have the kids been a source of joy and fun in my life, I have been there for them at times when they needed an extra grown-up in their lives, too. As a grandma I can listen at times when parents are overwhelmed with work and family obligations, and children who are good kids can find themselves ignored or brushed aside. Because I am not responsible for them I can encourage (or merely allow) brief excursions into behaviors not accepted by their parents. Not the bad things that might hurt them, just the occasional ability to ignore the rules and allow our wild sides expression. Parents will rarely condone such behavior, but a

Talk is cheap. Not talking can be deadly.

grandparent can encourage kids to run through puddles in bare feet and get their clothes wet or even dirty. Grandmas can put on silly hats. We can deliberately lose card games. We can act like six year-olds and tell really dumb knockknock jokes. With our grandchildren we can revert to child-like dreaming and magic beliefs again. We can free our imaginations to believe that strange things are possible. We can have picnics in the snow, shoot off fireworks, or dance in grassy meadows. While parents are asking teenagers to think in terms of practical jobs, grandparents can encourage children to believe they can become anything, no matter how impractical it might be. We can tell stories about their parents and connect the generations together with links which remind children that their parents were once children too, and they still managed to grow up and become good people, just like our grandchildren will. + Marcia Ribble received her PhD in English at Michigan State and retired from the University of Cincinnati. She taught writing at the college level and loves giving voice to people who have been silenced. She is now teaching again at Virginia College in Augusta. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.

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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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JUNE 6, 2014

AUGUSTA MEDiCAL EXAMINER

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

EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC. WEST AUGUSTA Luxury 3 bdrm, 2 bath townhouse. Garage, quiet neighborhood off Pleasant Home Road. $795/mo. Call 706228-4655.

6.7.8

...cleverly hidden (by the door) in the p. 7 ad for MIDLANDS PROSTHETICS & ORTHOTICS Congratulations to CORA BURKE, 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 be the first to find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries you’ll score our goodie package! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher.

The new scrambled Mystery Word is found on page 12

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

FOR RENT 2 bdrm 1 bath unfurn upstairs condo. Carport, pool, outside laundry. Country Club Hills condos, Milledge Road near GRU/ASU. $700/mo + $500 dep. We furn water, you pay electric. 706-736-7167 Email: ronst79@gmail. com 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. 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. Augustagahomesearch.com Foreclosures • Rentals • MLS Roman Realty 706-564-5885

SERVICES VIDEOS-FOR-THE-WEB SERVICE Documentary style interview or demonstration shot HD with pro audio and basic edits, 3-min. finished video uploaded to your account. Complete package $250. Please call David: 803-645-8370. Documentary Video Productions, LLC – Aiken, SC. BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673) FULL-SERVICE MOVER Anthony’s Professional Moving, 28 years serving the CSRA moving hospital equipment, offices, homes, apartments, etc. Estimates are FREE. Call 706.860.3726 or 706.814.8141

THE PUZZLE SOLVED

WHAT’S YOUR DRUG OF CHOICE?

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

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Send this form with payment to: Total ad cost by number of words as shown above: $

Y A R D S

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

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QUOTATION The Sudoku Solution

COFFEE IS GOOD MEDICINE

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

AUGUSTA MEDICAL EXAMINER, PO BOX 397, AUGUSTA, GA 30903-0397

R O Y A L

QUOTATION PUZZLE SOLUTION: Page 12: “A man who fears suffering suffers already from what he fears.” — Michel de Montaigne

AD COPY (one word per line; phone numbers MUST include the area code): .50

C H E M O

SEE PAGE 12

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

.25

BUSINESS ASSISTANCE Ridiculously affordable and highly visible advertising available through the pages of Augusta’s Most Salubrious Newspaper, aka the Augusta Medical Examiner. Have you heard of it or seen a copy? Rates can be reviewed at AugustaRx.com. Questions? Send an e from the site, or call the publisher directly: Dan Pearson at 706.860.5455. E: Dan@AugustaRx.com

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NOTICE! ATTENTION! If any current or past employer has failed to pay you min. wage or time and a half overtime pay, you may be entitled to an order from US Federal Court awarding you twice the amount of your unpaid wages plus atty. fees. For info, call Arthur H. Shealy, Attorney at Law, 803-278-5149, 1010 Plantation Rd, North Augusta SC 29841. You may be entitled to a similar award for unpaid wages if your employer required you to perform duties during your lunch hour, before clocking in, or after clocking out.

VISIT DRUGOFCHOICECOFFEE.COM

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Thanks for reading!

www.AugustaRx.com

JUNE 6, 2014

AUGUSTA MEDiCAL EXAMINER

15 +

APPS, SCHMAPPS.

YOU DON’T NEED NO STINKIN’ APP TO READ THE MEDICAL EXAMINER ONLINE.

JUST VISIT AUGUSTARX.COM/NEWS ON ISSUE DATES OR ISSUU.COM/MEDICALEXAMINER +

PROFESSIONAL DIRECTORY DEVELOPMENTAL PEDIATRICS

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

DRUG REHAB

CHIROPRACTIC Poppell Chiropractic Clinic 1106-A Furys Lane Martinez 30907 706-210-2875 Most insurance plans accepted

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

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

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

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

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

MEDICAL MASSAGE

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 Floss ‘em or lose ‘em! www.groupandbenefits.com

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

LASER SERVICES

FAMILY MEDICINE Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Thomson: 706-595-7825 Primary Care Rates

HOSPICE Alliance Hospice 3685 Old Petersburg Rd. Suite 145 Augusta 30907 706-447-2461 Hospice Care of America 4314 Belair Frontage Rd. Suite E Augusta 30909 706-447-2626

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

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

OPTICIAN

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

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

VEIN CARE

Murphy & Robinson Phil Harris 1571 Walton Way Augusta 30904 706-737-2020

...PHARMACY

O P T I C I A N S

PHARMACY Medical Center West Pharmacy 465 North Belair Road Evans 30809 706-854-2424 www.medicalcenterwestpharmacy.com

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 PHC Weight Loss & Wellness Centers 246B Bobby Jones Expwy Martinez: 706-868-5332 Thomson: 706-597-8667 www.phcweightloss.com

If you’d like your medical practice listed in the Professional Directory, call the Medical Examiner at 706.860.5455

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AUGUSTA MEDiCAL EXAMINER

JUNE 6, 2014

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