Mar17 17 by Daniel Pearson

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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

AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

MARCH 17, 2017

How shift work affects health — and how to survive ’til morning

The Walking Dead Memo to all expectant women, aggressive motorists, bar patrons and substance abusers: kindly arrange your affairs so as to have your next medical emergency during normal business hours. Thank you.

ouldn’t that be nice? In the real world, however, there is always going to be the need for around-the-clock staffing. Babies come into the world whenever they feel like showing up, whether it’s 3 pm or 3 am; drunks behind the wheel do some of their best work after midnight; many factories run 3 shifts, meaning someone is always working midnights; police and security guards know mayhem and hijinks tend to break out more often under cover of darkness. So while sleep is always at a premium for some people, March 2017 has been a bad month for the roughly 100% of human beings who need sleep. Item #1: On March 10, the group that establishes work standards

for U.S. medical school graduates (that is, for residents and interns) scrapped the old 16-hour shift limit for fi rst-year residents and replaced it with a new rule approving shifts of 24 hours straight effective July 1. Item #2: This past Sunday morning, Americans lost nearly 325 million hours of sleep in a single second, the time it took for the official time to go from 2:00 am Standard Time to 3:00 am Daylight Saving Time. Millions of people experience sleep disruptions every time we spring forward and fall back. This week especially, sleep is front and center for us all. Let’s talk about outside challenges to a good night’s sleep and what we can do about it. Please see SLEEP page 2

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

THE REHAB QUAGMIRE by Ken Wilson Executive Director, Steppingstones to Recovery Before doing an intervention, make sure you understand the many faces of “rehab.” “He’s gone to rehab” could mean many things to John Q. Public. All that glitters is not gold! First, there’s “detox,” meaning medically supervised oversight to insure that an addict/alcoholic safely withdraws from chemicals. This could be done on an inpatient hospital basis, or as an outpatient doing “ambulatory” detox. In an ideal world, careful evaluation should be done by a medical professional specializing in chemical dependence before such programs are begun. For acute alcohol and benzodiazepine withdrawals, for instance, an inpatient stay is usually recommended because if not medically monitored properly, a patient is at risk of a seizure and possible death as a result of physical withdrawals. For a less risky patient coming off alcohol or benzos it may be possible for a medical doctor to prescribe an ambulatory detox routine for “detox” at home. In such a case, the medication must be in the hands of a responsible individual other than the patient. An addict might take the whole bottle of pills in a single day with disastrous results. These days I do not know of an insurance company that will authorize an inpatient admission for opiates alone with no other diagnosis. A qualified doctor knows the safe medications to Please see REHAB page 6

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MARCH 17, 2017

AUGUSTA MEDiCAL EXAMINER

SLEEP… from page 1

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A hard day’s night Sometimes the factors that interfere with our sleep are beyond our control. Shift work, an absolute in the medical field, is a prime example. Studies show that while people become more accustomed to working nights over time, the body never fully adjusts, even after years. That is because the rest of the world never changes, and night shift workers have no choice but to revert to daytime activities on their days off. They can’t pick up the dry cleaning at 2 am or get the car repaired in the middle of the night. Such errands and necessary items have to take place during the day, and family obligations and socializing also generally happen while they would normally be asleep. The choice: keep the work-week sleep schedule and miss out, or do stuff and miss sleep. Neither option is optimal. What can shift workers do to protect their precious sleep? • Getting to sleep as soon as possible after working a night shift is best when possible. By necessity, some people can’t sleep all day even after working all night. They have to split up their sleep between just after their shift and again just before. Use the schedule that’s best for you in your individual circumstances. To the extent possible it’s best to stick to the same schedule once you have found your optimal schedule. • As a general rule, naps work best when they are extra sleep time, not an attempt to make up for lost sleep. Most of us at one time or another have awakened from a nap feeling worse than if we hadn’t slept at all. That’s a function of sleeping too long or not long enough. Again, we know our own bodies and what works and what doesn’t. Set alarms to help manage naps. • When switching from nights back to days, what’s the best sleep strategy? Let’s say a worker finishes a week of night shift and goes on days Monday. The CDC suggests getting a couple hours of sleep immediately after your night shift. After being up the remainder of the day, go to bed that night at your usual bedtime. • Day sleepers should turn off their phones, silence or disconnect the doorbell and perhaps post a note at their front door to keep visitors from knocking. The bedroom should be dark, quiet and comfortable and as isolated from daytime family activities as possble. Family members can cooperate by listening to TV or music on headphones, avoiding noisy activities like vacuuming or loud playing. +

WHAT EMPLOYERS CAN DO Employers who spread the shift work around using “swing” shifts — the practice of rotating the workforce so that over time every group works every shift — can actually help minimize sleep disruption and in the process, improve the health and quality of life (and work) for their employees. The key is to rotate shifts forward, not backward. In other words, day shift workers rotate forward to evening shift, not backwards to night shift. Midnight shift rotates forward to days, not evenings, and so on. Work schedule design is important. Schedules should be regular and predictable. Communicate with staff so that people have time to plan for and adjust to any upcoming changes. Quick changes should be avoided; for example, switching people from days to nights on the same day of the week (getting off work at 4 pm and being due back at 11 or 12 pm the same day) is not unheard of, unfortunately, even though it’s practically inhumane. Avoid combining long shifts and overtime. Examine shift start and end times: a 5 or 6 am start time interferes with night sleep. Over time, taking worker health into account improves morale, productivity and profit. +

WHY SLEEP MATTERS Shift work is a fact of life for nearly 10 million Americans. The number of family members affected is far more. Research shows that shift workers have higher rates of obesity and Type 2 diabetes. They’re more prone to depression and have a higher risk for heart disease and hypertension. They tend to eat poorly because of missing family meals. They have a higher risk of stroke. On-the-job accidents can be more likely when workers are sleepdeprived and operating at less than full capacity. They experience anxiety more than their dayshift colleagues, and have a greater risk of breast cancer. All of these factors strongly suggest that shift workers should take their sleep, diet, exercise, on the job safety and overall health very seriously. +

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MARCH 17, 2017

AUGUSTA MEDiCAL EXAMINER

The

PROFILES IN MEDICINE

Advice Doctor

presented by Queensborough National Bank & Trust Co.

HE SAW PATIENTS FOR 48 YEARS

ell, not literally. Dr. William H. McNorrill was a successful physician in Waynesboro from 1875 until his death in 1923. He was part of the 18741875 graduating class of the Medical College of Georgia, a class that included a grand total of 14 students. His professors were keynote names in Augusta’s medical history, names like Henry F. Campbell (see this space in the Jan. 20, 2017 Medical Examiner); Louis A. Dugas; Joseph Eve, the fi rst cousin of Paul Fitzsimmons Eve, founding faculty member of MCG, as well as Robert C. Eve; Lewis D. Ford and DeSaussure Ford. At 12 doctors, the faculty was almost as large as the student body. McNorrill and his 13 fellow students probably did not incur a lot of student debt. There was a $5 matriculation or enrollment fee; tuition for the “full course” was $50, with an additional one-time $10 fee for the

William Howell McNorrill, M.D. Practical Anatomy course; and at the end of it all, a diploma cost a whopping $30 — but 89-year-old Dino Loren of Hephzibah, McNorrill’s granddaughter, has been told the beautiful and ornate diplomas of the day were hand-lettered on sheepskins. She would love to know what became of her grandfather’s 1875 diploma. The freshly minted Dr. McNorrill set up practice in Burke County, but soon there was trouble. One day in 1877, it felt like he had a piece of sand or

grit in his eye. The eye was red and itchy, and pretty soon the other eye felt the same way. The doctor had conjunctivitis, commonly known as pink eye. “And there were no medicines for it back then,” says Loren. Less than two years after graduating from the Medical College of Georgia and still in his early twenties, Dr. William McNorrill was blind, his medical career over almost before it began. Or was it? Thanks to family support, McNorrill was able to attend a school for the blind in Macon. House calls were standard operating procedure for nearly all doctors those days, so whenever any student at the school for the blind was sick, a doctor would be summoned. McNorrill was allowed to accompany the doctor on his rounds, says Loren, and the doctor would allow McNorrill to take the lead, diagnosing the patient’s Please see PROFILES page 15

Editor’s note: this is the tenth installment in 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

+ Dear Advice Doctor, My elderly neighbor is the sweetest old guy. He’s retired and has all the time in the world, but he thinks everyone else does too. Every encounter with him means a half-hour trip down memory lane, so most of the time I try to avoid him, or I pretend I don’t hear his greetings. I feel like a bad neighbor, but maybe he is. Any suggestions? — Who’s the bad neighbor? Dear Who, I do have some suggestions that I think will help you, but hopefully will help your neighbor even more. You didn’t mention his age, just that he’s “elderly.” Among older adults falls are a serious issue, so when you said every encounter with him involves a trip, I was immediately concerned. There are many simple ways to help him avoid these trips and reduce his risk of falling, and these apply to all older adults. A survey of the home is the first step. Are there area rugs that might present slipping or tripping hazards? Removing everything that makes for uneven floors is a good idea. Check to make sure that porch or star railings are solid and secure and that the steps are in good repair. If a ramp would be safer than porch stairs, check into building one (zoning or neighborhood covenant restrictions, cost, etc.). If grab bars are not present in the bathroom, install them and make sure they’re solidly anchored, and that the shower or tub has a non-slip floor. Health and medical considerations provide another avenue of assistance. Are there balance issues? A doctor can often pinpoint and treat the cause. Sometimes prescription (or to a lesser degree, over-the-counter) medications can have side effects that can affect balance, agility or alertness. Ask the pharmacist or doctor if any such medications can be replaced. With a little effort, many risk factors for trips and calls can be easily eliminated. + 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 be provided only in Examiner issues.

AUGUSTA

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MEDICAL EXAMINER

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

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#40 IN A SERIES

Who is this?

MARCH 17, 2017

AUGUSTA MEDiCAL EXAMINER

OLD NEWS +

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

s this long-running Medical Examiner series amply demonstrates, medicine is a fascinating field in that its ground-breaking pioneers are sprinkled across many centuries. This medical pioneer may have lived and worked in the 12th Century; that one may be making discoveries as we speak; no doubt a future article in this series will celebrate the researcher who makes yet another breakthrough advancement. As you can tell from the photo above, this installment will note one of the more recent additions to medicine’s Hall of Fame. The man pictured, Thomas Starzl, has been called the “Father of Transplantation.” Born in Iowa in 1926, Starzl knew how he wanted to spend his life: in the priesthood. But his plans changed at age 21 when his mother died from breast cancer, and Starzl decided to try to save and improve lives in a different manner. That fall he entered Northwestern University Medical School, supporting himself by proofing and editing medical stories for the Chicago Tribune. While at Northwestern he began a long friendship with a mentor, professor and neurosurgeon Loyal Davis, M.D. (whose daughter, Nancy Davis, married a guy named Ronald Reagan). Starzl spent an extra year at Northwestern completing his doctorate in neurophysiology. After Northwestern, Starzl studied surgery at Johns Hopkins and Jackson Memorial Hospital in Miami, where he began to develop an interest in liver biology. In a makeshift lab in a Miami garage, Starzl figured out how to keep a patient alive without a liver, which, after all, is the first half of a liver transplant operation. By 1958, Starzl was back at Northwestern, conducting liver transplant experiments that always ended the same way: within about a week the body would reject the foreign tissue. Starzl and other physicians grappled with this problem. Meanwhile, he joined the faculty of the University of Colorado in 1962, and three months later attempted the world’s fi rst human liver transplant. The patient would not survive the operation, nor did the next four. Starzl’s legendary tenacity gradually led to solutions, but it didn’t happen overnight. It wasn’t until 1967 that the first successful liver transplant was performed — by Starzl, of course, but in concert with various physicians and researchers around the globe who helped solve the problem of tissue rejection. Today, organ transplants are routine (although still major surgery), so much so that Starzl’s 2003 autobiography, The Puzzle People (ranked in 2010 as the 3rd-best book about doctor’s lives by the Wall Street Journal), takes its name from his prediction that someday people would have numerous replacement parts, inserted like puzzle pieces. Ironically, Starzl confessed in the book that he was not “emotionally equipped” to be a surgeon and was sick with fear before every operation. Despite that, he is a true pioneer in the annals of surgery, as well as a leading researcher: the Institute for Scientific Information says Starzl’s thousands of published papers are cited more than any other researcher in the world - 26,456 times between 1981 and 1998 alone. Starzl finished his career at the University of Pittsburgh School of Medicine, where he died earlier this month at age 90. +

A LITTLE BACKUP DOESN’T HURT

hen choosing a prescription drug plan the best we can do is do our homework and due diligence and make the best choice available at the time of enrollment. We don’t have a crystal ball to tell us what drugs we may need in the coming year, so it’s just our best guess. When it came time for me to figure this out like everyone else, I asked myself what if something unforeseen comes up and a drug is not covered by my plan? Prescription costs are high and getting higher at each and every opportunity the drug companies can invent for themselves. I know what antibiotic I respond to best, what I am allergic to, and what I use on a regular basis. But how can I protect myself so I don’t go broke if I need something unexpected? Let’s say you come down with the flu. Let’s also say you develop a terrible cough that traditional remedies are not helping. Your physician prescribes a very expensive medication and it is not covered under your plan. You can certainly appeal it and

have your doctor let them know all else has been tried and you need this medication, perhaps generating a Letter of Medical Necessity. But that takes time and you need it now. You are ill and in no shape to be on the phone pleading your case. Chances are you’ll go ahead and pay for the prescription and deal with it later and hope for the best outcome. But there’s another option. There are discount prescription drug cards available. They don’t expire and are offered to anyone who wants one of any age, regardless of your type of insurance, or even if you have no insurance. Those who have bought into the Affordable Care Act may want to get one because it is my guess these people can make the best use of these cards. The deductable associated with ACA plans are

outrageously high, and those who are not being subsidized benefit from very little coverage, if any at all. The way this works, you give the card to your pharmacist and he/she enters the information into your account in their computer. When you have a prescription filled, if it is not covered under your regular insurance plan, they check to see if there is any savings in using your discount card. I have never had an instance where it did not benefit me to use mine. You can’t apply the savings for the same medication from both your insurance plan and the discount card; you must use one or the other. The idea is to have the discount card as a backup if your drug plan does not cover the medication you need. It’s a wonderful option to have in place. To get a discount drug card simply call either the United Way 211 hot line and ask for one, or call the Area Agency on Aging and get one from them. They can be reached at 706-2102019. +

MYTH OF THE MONTH “Left brain” and “right brain” people are different As often as the two sides of the brain are referred to as a means to explain people’s differences, you would expect this to be an established scientific fact. As the story goes, the left brain is logical, analytical and fact-driven, while the right brain is the control center for all things artistic and intuitive. Calling the whole thing a fable, Scientific American says this: “The left brain/right brain notion originated from the realization that many (though not all) people process language more in the left hemisphere and spatial abilities and emotional expression more

in the right. Psychologists have used the idea to explain distinctions between different personality types. In education, programs emerged that advocated less reliance on rational “left brain” activities. [However] brain-imaging studies show no evidence of the right hemisphere as a locus of creativity. And the brain recruits both left and right sides for both reading and math. + — by F. E. Gilliard, MD, Family Medicine 4244 Washington Road, Evans, GA 30809 706-760-7607

MARCH 17, 2017

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW res? ABOUT UNFUNNY THOUGHTS OF THE BRILLIANT

k good eno r skin can ugh cer? son.”

o k

am frequently humbled by the wisdom of those far more brilliant than I. With vivid understanding they reduce a complex problem to a few profound words. I’ll share a few from my collection with you.

• Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life thinking it is stupid. ~ Albert Einstein • This is the most extraordinary collection of talent, of human wisdom, that has ever been gathered together at the White House, with the possible exception of when Thomas Jefferson dined alone. ~ John F. Kennedy • When we get piled upon one another in large cities, as in Europe, we shall become as corrupt as Europe. ~ Thomas Jefferson

• To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves and abhors is sinful and

tyrannical. ~ Thomas Jefferson

• The democracy will cease to exist when you take away from those who are willing to work and give to those who would not. ~ ascribed to Thomas Jefferson • I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them. ~ Thomas Jefferson • My reading of history convinces me that most bad government results from too much government. ~ John Sharp Williams in a speech about Thomas Jefferson • The strongest reason for the people to retain the right to keep and bear arms is, as a last resort, to protect themselves against tyranny in government. ~ ascribed to Thomas Jefferson • It is incumbent on every

t s e B generation to pay its own debts as it goes. A principle which if acted on would save one-half the wars of the world. ~ Thomas Jefferson

• The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants. ~ Thomas Jefferson • No free man shall ever be debarred the use of arms. ~ Thomas Jefferson

• I believe that banking institutions are more dangerous to our liberties than standing armies. ~ Thomas Jefferson • If the American people ever allow private banks

e n i c i d ME

to control the issue of their currency, fi rst by inflation, then by deflation, the banks and corporations that will grow up around the banks will deprive the people of all property until their children wake-up homeless on the continent their fathers conquered. ~ Author unknown When I read these profound thoughts and realize that they are not part of a satirical comedy act on Saturday Night Live, I have to fight the urge to crawl into my closet and lock the door. The quotes I gave you are profoundly brilliant and accurate. While I remain The Funny Doctor, I struggle to find humor here. Unless of course, I revert to sarcastic

humor and find some perverse glee in the way our elected officials and judges can fail to follow the brilliance of our Founding Fathers. I can almost see Thomas Jefferson going through Congress and the Supreme Court with the mind-set Jesus had when he cast the money changers from the temple. If we cast that scene in modern times, John Belushi could have been Jesus with his whip. Maybe for a brief moment, Belushi could have made our governmental mess seem funny. + Bad Billy Laveau is a formerlyretired MD who wields a pointed sense of humor - and now, tongue depressors too. He speaks and entertains at events for audiences not subject to cardiac arrest secondary to overwhelming laughter and glee. BadBilly@knology.net or 706-306-9397.

F REE T AKE-HO ME CO PY!

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MEDICAL EXAMINER

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MARCH 17, 2017

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MARCH 17, 2017

AUGUSTA MEDiCAL EXAMINER

The Short White Coat

THE BALANCING ACT OF THE TRAVELING MEDICAL STUDENT I visited my grandparents last weekend. Growing up I would visit them often, however, medical school changed that. When I told them I would be A med student’s notebook traveling to the West Indies to pursue my dream of becoming a physician, they were excited. Nevertheless, the excitement was accompanied by worry. Understandably, they worried that I would be living alone in a foreign country. My family is close knit and this would be a big change for all of us. When I landed on the island of Saint Kitts, I was overjoyed, and yet overwhelmed. I had never felt so grateful, however, everything about my present reality was new. Saint Kitts is a beautiful land, surrounded by the calming Caribbean Sea on one coast and the rocky waves of the Atlantic Ocean on the other; each are mesmerizing in their own way. Sure, everything inside me wanted to explore and make the most of this adventure. Nevertheless, my horse blinders were on and my goal was clear: Please see SHORT WHITE page 14

REHAB… from page 1 prescribe to minimize withdrawals over a period of a few weeks on an ambulatory level. To emphasize: the above is NOT rehab! It’s detox only. What is rehab? Rehabilitation is a long-term treatment process that is more intense in the beginning, maybe the fi rst 4 to 6 weeks, when the addict attends daily group therapy hopefully led by a qualified individual. I must stress “qualified” – and that doesn’t mean one who just “wants to help others” or is only in recovery themselves. Qualified means someone who has passed the test of licensure, credentials, and whose work history shows evidence of competent work. This process is long-term (often 2-5 years) and does not come easily. Often, people in recovery themselves do well in this process, although a recovering individual working in the rehab process brings both an upside and a downside to the equation. So, secondly there’s “rehab” which could mean many things. Here is a list of popular options, several of which are often misunderstood as “treatment.”

• True “treatment” is done only in licensed/accredited facilities, directed by licensed/credentialed professionals utilizing a written list of Problems/Goals/Expected Time Frames called a “Treatment Plan,” often with a cross mix of professionals: doctor, counselor, recreation therapist, dietician, etc. This option is usually more costly – perhaps $3,000 per month for Intensive Outpatient groups and up to $30,000 to 40,000 monthly for inpatient treatment. • “Recovery” or “Rehab” programs are not required to have accountability to any agency other than its own leader or board. These programs may or may not have daily educational counseling sessions. They may be work programs during the day and 12-step meetings in the evenings — or not. They are relatively inexpensive – maybe $700-1500 per month and up. • Religious programs often do not utilize the 12-step model but usually have their own curriculum. Though not all are free, they are about the only ones left out there that may have no charge.

• Halfway Houses are not rehab but are invaluable for housing a recovering addict for 6-12 months while their brain heals and new habits are formed, and the client usually has a full time job and returns at night for meetings. Cost for these can range from $600 to1500 per month. • Attendance at AA/NA or other established step programs or nationally known group meetings are not treatment, but supportive in nature such as Celebrate Recovery, Al Anon, Nar Anon, Cocaine Anonymous, etc. These are totally free, but they do accept donations from attendees in recovery. So there you have it. An entire book could be written about each of these levels of care, but this is a simple introduction to some of the possibilities out there for help in recovery. If you need help choosing what to do for your loved one in need, pick up the phone and call a local rehab center – they’ll be glad to help steer you in the right direction and save you days of calling around. +

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.

MARCH 17, 2017

AUGUSTA MEDiCAL EXAMINER

Southern Girls Eat Clean Fresh Pineapple Salsa Spring has sprung in Augusta, Georgia. Well, I suppose we didn’t really have a winter here but, who’s complaining? When warmer weather arrives, I start to think of ways to incorporate fresh fruit into our meals. After a season of warm, comforting and savory dishes, I love to lighten things up a bit by adding fruit such as strawberries, blueberries, melons and pineapple to my recipes. Fresh tomato salsa is a staple at our home and I almost always have all the ingredients on hand to whip up a batch. However, this flavorful pineapple salsa is a new favorite. I used to occasionally pick up a container of Whole Foods house made pineapple salsa. Then I realized that it would be super easy to make it at home myself, and a lot less expensive too. This salsa is so versatile and you can use it • As a topping for grilled salmon. • As another nutritional Fresh Pineapple Salsa ingredient to your dark salad greens. seeds removed and finely Place the jalapeno into the • As a condiment for any Tex chopped (Less if you prefer) bowl also. Mex inspired dish such as • 1/3 cup of fresh cilantro, In a small bowl, whisk fajitas, tostados, or a healthy chopped together the lime juice, olive burrito bowl. • 2-3 Tbsp. of fresh lime juice oil and honey or agave. Pour • Or it is just perfect all by • 1 Tbsp. of extra virgin olive into the mixing bowl and toss itself with blue corn chips. oil with the other ingredients to Spring is the perfect time to • 1 Tbsp. of honey or agave coat well. try this beautiful and colorful • A pinch of kosher salt Add a pinch of salt to taste salsa. Make a batch to have and stir again. If you prefer, on hand for your Masters Instructions: add a bit more lime juice or party or to share with guest Peel a fresh pineapple using honey as they drop by on the way a large knife discarding the Allow to set aside for to the course. It’s healthy prickly outside and core, at least an hour, stirring and delicious with the bright or purchase a pre-cut fresh occasionally, before serving. yellow pineapple, green pineapple. Will keep in the refrigerator jalapeno and cilantro. Chop the pineapple and for 2-3 days in a sealed glass Green and yellow? place into a medium mixing container. + This salsa even looks like bowl. springtime in Augusta. Finely chop the red onion Alisa Rhinehart is half of the Enjoy! and place into the bowl with blog southerngirlseatclean. Ingredients: • 3 cups of fresh pineapple, chopped • 1/3 cup of red onion, finely chopped • 1 fresh jalapeno pepper,

the pineapple. Slice the fresh jalapeno vertically and using a small paring knife, remove seeds and stem. Finely chop, being careful to wash hands afterward or wear gloves.

com. She is a working wife and mother living in Evans, Georgia. Visit her blog for more recipes and information on clean eating.

We’ll see you in mid-April. Details on page 10. In the meantime, TTFN!

Pharma cy 4 11

OUR NEWSSTANDS Medical locations: • Children’s Hospital of Georgia, Harper Street, Main Lobby • Department of Veterans Affairs Medical Ctr, 15th St., Main Entrance • Dept. of Veterans Affairs Med. 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) • Georgia War Veterans Nursing Home, main lobby, 15th Street • Augusta U. Hospital, 1120 15th Street, South & West Entrances • Augusta U. Medical Office Building, Harper Street, Main Entrance • Augusta U. Medical Office Building, Harper Street, Parking Deck entrance • Augusta U. Hospital, Emergency Room, Harper Street, Main Entrance • 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. • Family Y (Old Health Central), Broad Street, downtown Augusta • Hartley’s Uniforms, 1010 Druid Park Ave, Augusta • International Uniforms, 1216 Broad Street, Augusta • Marshall Family Y, Belair Rd, Evans • Parks Pharmacy, Georgia Avenue, North Augusta • Southside Family Y, Tobacco Road, Augusta • Surrey Center, Surrey Center Pharmacy, Highland Avenue, Augusta • Top-Notch Car Wash, 512 N. Belair Road, Evans • Wild Wing Cafe, 3035 Washington Road, Augusta

Plus more than 875 doctors offices throughout the area for staff and waiting rooms, as well as many nurses stations and waiting rooms of area hospitals.

MARCH 17, 2017

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.

I HAVE HIGH BLOOD PRESSURE. WHAT DOES THAT MEAN I CAN’T HAVE?

large percentage of our population has high blood pressure, also known as hypertension, and many more have congestive heart failure. Congestive heart failure is a common later stage occurrence after years of hypertension. So it stands to reason if you have even the beginnings of hypertension, to try and limit anything that could make it worse, or lead to congestive heart failure. What does that mean you need to limit? The first part of this article is going to be about sodium. Sodium causes fluid retention throughout the body and can be seen most commonly as swelling in the ankles. The increased fluid load to pump will not only raise your blood pressure but can also hasten along the problem of congestive heart failure. The American diet is full of salt despite the recommended daily intake for a healthy person being one teaspoonful. This is the grand total of salt used in cooking, added to food at the table, and what is already contained in the prepared foods that we eat. And if you are already a hypertensive patient, that amount is cut to just half a teaspoonful. The #1 source of sodium isn’t the salt shaker on your table: it’s the sodium already in foods when we buy them. We all need to learn to read the nutrition facts label. All foods have a nutrition label that lists amount of numerous components per serving. Notice I highlighted the serving size, because that can be the most important number on the label. It tells you how much of the food is considered a serving. If your serving size is double the stated value, then all other numbers on the label must also be multiplied by two. This is where a lot of sodium enters the American diet. A better (although sometimes difficult) alternative is to cook all your food at home, where you control how much salt goes in. At the very least, work to reduce restaurant eating, or choose low-sodium menu options when you do eat out. Other products to avoid if you have hypertension are over-the-counter nasal decongestants. Pseudoephedrine and phenylephrine are two common examples, and both can raise the blood pressure. In a cruel twist, they have the worst effect on blood pressure in patients whose high blood pressure is

Some drug stores are owned by huge corporations.

already high. They make a bad situation worse. These decongestants should only used with your doctor’s approval. For nasal congestion relief, an antihistamine may be tried instead. If the congestion is in your chest use an expectorant such as guaifenesin. There is a line of cough and cold products developed for hypertensive patients by Coricidin. These are known as the Coricidin HBP line (for High Blood Pressure). They combine antihistamines, cough suppressants and acetaminophen to treat symptoms of a cold without using a decongestant. As with all medicines and medical problems, consult your physician if you have any problems that do not respond to over-the-counter remedies, or if you feel your problem is above the level of these remedies and a prescription medication is required. + 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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MARCH 17, 2017

AUGUSTA MEDiCAL EXAMINER

Kid’s Stuff NOTES FROM A PEDIATRIC RESIDENT by Caroline Colden, M.D., Children’s Hospital of Georgia

HEMOGLOBIN 101

How many parents out there wonder why hemoglobin and lead levels are checked when their babies go for their 1st and 2nd year check ups? The lead level is simple enough: pediatricians want to make sure there is no potential lead poisoning that could cause brain damage, especially at the ages when exploring children are putting everything they can find into their mouths. But what is a hemoglobin level and why is it important? Hemoglobin is the substance that transports oxygen throughout the body and it is carried by the red blood cells. There are different cut-off points at various ages below which a certain hemoglobin level is considered low. A low hemoglobin level is associated with decreased oxygen-carrying capacity for red blood cells, which can be harmful to a child’s growing brain and body which depends on oxygen to function. Low hemoglobin in a patient is called “anemia.” Hemoglobin is made from iron, which is why iron deficiency is a major cause of

anemia. In an otherwise healthy child, i.e. in whom no other reasons for anemia can be identified (such as sickle cell disease or major blood loss), iron deficiency is assumed to be the cause of a child’s anemia and iron supplementation in the form of ferrous sulfate is prescribed to fi x it. Anemic children may display odd food cravings, eating things like dirt, clay, or cornstarch, likely in a subconscious effort to increase their mineral intake. Anemic children often will tire out easily, appear paler than normal, and have a rapid heart beat. If a child remains anemic after a period of time even with iron supplementation, other causes of anemia are investigated. Children coming to check ups at 12 months and 2 years are checked for anemia because failing to recognize it and employing a simple fi x like iron supplements can be a big deal for the child’s brain function for life. This is also why it’s advised to not start feeding cows milk to a child until at least 12 months of age, and limiting milk intake to only about 2 cups per day once it is introduced. While milk is full of calcium and nutrients, it is not a great source of iron. And excess intake of cows milk can fi ll a child up and discourage them from eating other foods, slowly developing iron deficiency. Milk also makes it more difficult for the gut to absorb dietary iron. Good sources of iron include foods like leafy green veggies, red meat, nuts, raisins, beans, and bran. Like anything else in life, consumption in moderation and with balance is the best approach. And the best medicine is proactive medicine, and (most of the time) childhood anemia is a problem that we can fi x pretty simply. +

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MARCH 17, 2017

AUGUSTA MEDiCAL EXAMINER Part M of a 26-part series

The kissing disease The bane of teenagers everywhere, mononucleosis (mono for short) is sometimes called the kissing disease. The name fits: it is readily spread via saliva. POP QUIZ: Have you ever had the Epstein-Barr virus? If you answered no, you’re misinformed. EBV is found all over the world, and is so common that nearly everyone has had the virus whether they know it or not. Its symptoms are usually so mild they aren’t even noticed, or they are chalked up to something else, like a simple cold. And once a person is infected with EBV, it’s basically permanent, although the virus is usually latent or inactive.

your

www.facebook.com/ AugustaRx

THANKS!

IS FOR MONO So why isn’t this installment of our alphabetical series entitled “E is for Epstein-Barr”? First, we’ve already done E (it was emphysema); and secondly, mononucleosis, our topic du jour, is caused by the Epstein-Barr virus. EBV symptoms are a lot

like mono symptoms: fatigue, fever, sore throat, swollen lymph nodes in the neck, and a couple more that aren’t as readily noted by patients: enlarged spleen and swollen liver. Mono (and EBV) is highly contagious, and as an added bonus, most people don’t experience symptoms for the fi rst 4-6 weeks after they’re infected. So kissers go right on kissing, not realizing they are spreading mono to their latest crush — and maybe others too. Mono can also be spread by sharing eating or drinking utensils with an infected person, but that goes right back to its main route of transmission: saliva.

Although EBV lives and grows in the nose and throat and is thus associated with saliva (plus tears and mucus), it can also be spread by blood transfusions, so a person with mono should not donate blood. There is no effective medical treatment for mono. It just has to run its course. Patients won’t have to be told to rest; they have no energy anyway. Because of the involvement of the liver and spleen, contact sports or doing anything strenuous is not recommended for about a month. Aspirin is not recommended for anyone under age 20, but other pain relievers may help with sore throats and headaches. Drink plenty of fluids to prevent dehydration. Oh, and lay off the kissing for awhile too. +

SILENCE

DIAGNOSIS… from page 6

How How will will you you handle handle the the coming coming

EXAMAGEDDON? The Medical Examiner publication schedule twice a month, normally every 1st and 3rd Friday. Every now and then (like this month) there is an extra Friday. Whenever there are five Fridays that means three weeks between issues instead of two. This time, the Friday after that falls during Masters Week, and that’s not a week when many doctors offices are open. So the next Medical Examiner after this one will be

dated April 14, not April 7. Yikes! Almost a month! So how will you handle the coming Examapocalypse? Here’s a suggestion: prevent Examiner withdrawal symptoms by visiting issuu.com/medicalexaminer and feast your eyes on more than 125 previous issues of the Examiner. Years worth of salubrious reading! There should be enough to tide you over until April 14.

MARCH 17, 2017

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AUGUSTA MEDiCAL EXAMINER

The blog spot From the Bookshelf — posted by Richard Loomis, MD, on November 21, 2014

AVOID THESE 4 MISTAKES WHEN USING A COMPUTER IN AN EXAM ROOM With the growing usage of EHRs, more and more doctors are bringing their computers and tablets with them into the exam room. But just because you’re using a computer in the exam room doesn’t mean that you’re using it properly. Computers can be one of the most beneficial tools you use in an exam room, or they can lead to deteriorating patient engagement. Make sure you don’t make any of these four common mistakes when you use your computer in the exam room. • Focusing solely on the screen. Making eye contact with your patients is essential. It conveys that you’re interested in the conversation and are paying attention, building trust. It can be easy to focus on what you’re entering into your EHR and you may not realize that you’re avoiding eye contact with your patient. Be cognizant about when you choose to type and when you are actively engaging with your patient. Here’s a quick look at the psychology of eye contact: “When a person looks directly into your eyes when having a conversation, it indicates that they are interested and paying attention. On the other hand, breaking eye contact and frequently looking away may indicate that the person is distracted, uncomfortable, or trying to conceal his or her real feelings.” • Assuming you heard the patient correctly. When people are excited or anxious, they can have a tendency to accelerate their rate of speech. It can be difficult to capture everything in these situations. Repeat back to the patient what you entered. This does two things: It lets the patient know that you are actively listening and it also verifies that the information entered is correct. • Ignoring your body language. Good body language sends a signal that you are actively listening to your patient. If you are facing your computer and not your patient, it can convey that you are paying more attention to it than you are to them. Consider angling your body towards your patient as you take notes on your computer. • Blocking your line of sight. If you’re using a large desktop computer in the exam room, it can actually act as a barrier between you and your patient. Additionally, a computer that it stationary in the corner of the exam room can make creating eye contact with your patient difficult. Consider using both a small laptop or tablet as well as a mobile working station. This prevents your computer from blocking your field of vision and allows you to move to face your patient no matter where they are sitting.

There is a right way and a wrong way.

Your computer is a tool just like any other tool in your exam room: There is both a right and a wrong way to use it. However, since many of us have been using computers for so long, we have an established way in which we hold them, view them and use them. That’s why self-awareness is so important when you’re introducing a computer to the exam room to make sure that you aren’t accidentally making one of the four above mistakes. When using your computer properly, it can not only make your practice more efficient, but it can increase the amount of engagement you have with with patient during an exam. + Richard Loomis is senior medical director of Practice Fusion.

Longtime Examiner readers may remember the two-part article/interview a few years ago featuring Columbia County coroner Vernon Collins. Since then, I’ve asked one or two funeral directors to allow me to do a respectful, in-depth piece on what they do - everything they do. I would envision shadowing them through a typical day or two, but maybe I wouldn’t make it through a full day or two. It’s certainly not a business for everyone, although everyone is heading for that business, whether sooner or later. Quite a few years ago I visited a funeral home regularly as a vendor/supplier. One day when I was running late and had many more appointments to go, I was invited by the funeral director to observe an embalming they were about to begin. I didn’t have the time, but I thought it would be an interesting experience. Most of us, I’m quite sure, are at least a little curious about what happens between the moment of death and the moment of burial. I still would like to do an Examiner article on the subject. In the meantime we have this

book, one of a number available that discuss the business people are dying to get into. Author Robert Webster is not really author Robert Webster; he’s mortician Robert Webster, so he knows whereof he speaks. He has 30 years’ experience in the funeral business, and even throws in an interesting look at the history of funerals. The funeral business is like a lot of professions where we may think, “Oh, I could do that,” but if we were actually in a position to try we would discover how very much we do not know. Over the course of time, many difficult situations

arise: the deaths of children, suicide, accident, and murder victims, to name a few. It’s no surprise that being a funeral director requires a tremendous amount of tact, courtesy, professionalism and finesse. It must be a dignified business, but that doesn’t mean that funny things don’t happen. They do all the time, and Webster recounts them, always in good taste. Some unusual events he relates are incredibly touching. He writes of an elderly man whose wife of many years died. After the service, the room empty of mourners and the casket about to be closed, the man handed Webster a $50 bill and asked him to slip it into his wife’s bra. Apparently it was a longstanding tradition of theirs that whenever she went anywhere without him, he would playfully slip $50 into her bra so she would always have spending money. This time would be no exception. + Does This Mean You’ll See Me Naked? by Robert Webster, 256 pages, published May 2011 by Sourcebooks.

Editor’s note: since the above review first appeared in March of 2014, we have indeed profiled a mortician, at Kinsey & Walton Funeral Home. Read all about in our Oct. 17, 2014 issue at issuu.com/medicalexaminer

Research News This is your brain on blueberries. Any questions? The health properties of blueberries are legendary. Clinical research has proven their role in improving vision and memory, reducing heart disease and cancer risk, fighting Alzheimer’s disease, and reversing or slowing aging. Someone should start a newspaper called the Blueberry Examiner. The latest entry in blueberry’s impressive resumé comes from the University of Exeter, which conducted a test using subjects aged 65 to 77 who drank concentrated blueberry juice every morning. Compared to blueberryfree control group, the blueberry drinkers showed improvements in blood flow to the brain, cognitive function and memory compared to baseline tests done at the outset of the

study. Researchers give the credit to flavonoids in blueberries, rich in antioxidant and antiinflammatory properties. “Social” media news This may fall under the “you needed a study to establish that?” category, but University of Pittsburgh Schools of Health Sciences researchers have found that the more young adults use social media, the more socially isolated they feel. Both frequency of use and time spent online contributed to the perceptions of social isolation. As is often the case, further study is needed, but the working theories on why more socializing digitally is counterproductive include the following: • Social media use displaces authentic, realworld personal interactions

• Certain aspects of social media promote a sense of exclusion, such as seeing photos of friends at a party or event to which they were not invited • Exposure to selected events in others’ lives presents an idealized picture that promotes envy and the mistaken belief that others lead happier and more successful lives Researchers caution that their results are broad generalizations. Some individuals may handle social media quite well even in quantity, while others are affected more negatively than shown in the study results. “The results of this study simple reminds us,” said one of the study authors, “that on the whole, use of social media tends to be associated with increased social isolation and not decreased social isolation.” +

+ 12

THE EXAMiNERS +

Well, well, well! Congratulations!

MARCH 17, 2017

AUGUSTA MEDiCAL EXAMINER

Oh, you heard about my new job?

by Dan Pearson

You’re the new ombudsman, right?

Apparently I was misinformed. What is your new job?

Wrong.

I’m the new ombudsperson.

The Mystery Word for this issue: CLEENIS

EXAMINER CROSSWORD

PUZZLE ACROSS 1. Nuisance 5. Common fire adjective 10. CMC these days 14. Legal group 15. Major vessel 16. Stevenson title character of 1886 17. Norse god of thunder 18. Cinemas brand name 19. On sheltered side 20. Schmooze 22. Building wing 23. Riverwalk, for example 24. One entry on a list 26. Type of bird? 28. Nonsensical talk 32. Washington follower 36. Be sick 37. Three-masted ship of the Mediterranean 39. Choose 40. Squealer 41. Installment 43. Obamacare, in brief 44. Two’s half 45. Abnormal mass 46. Empty ____ 47. Start for 10-D 49. Keep apart 53. Unit of length 55. Challenge 56. Every country has one 59. Coal scuttle 61. Renter 65. Bath follower, often 66. Belch 68. Hood worn by monks 69. Above 70. Sesame Street star 71. Applications 72. Obtains

24 28

Click on “READER CONTESTS”

QUOTATION PUZZLE 33

46 49 54

VISIT WWW.AUGUSTARX.COM

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

53 56

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

L T V O O H W H C

55 60

61 67

DOWN 1. Garden walkway 2. Type of chamber 3. Messy person 4. Root vegetable 5. Shop variety 6. Fish eggs 7. Exhort 8. Stable compartment 9. Venerated 10. 47-A follower 11. Bright green tree frog 12. River in central Europe 13. Squad noted on some VWs 21. Baseball’s Mel 25. Men’s magazine 27. Cigar smoking might be one 28. Chocolate substitute 29. Woody vines 30. Change 31. Mexican money

E Y I I O D Y E E N D T L N N C E E V A L

73. Destitute 74. Relaxation

I E E T E D N D E R E L S S P E R H

33. Australian marsupial 34. Disney destination 35. Georgia, for example 38. Made a hole 41. English public school 42. Large cask or barrel 48. Ty Cobb’s team 50. Meager; insignificant 51. “____ you serious?” 52. Save 54. ____ shoe 56. Hollow beginning? 57. Zero to Serena 58. Drive a getaway car 60. Italian dictator’s nickname 62. Slammin’ Sammy 63. Female sheep 64. Ultimatum word 67. Drafting program

— Harold Hulbert

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.

X A M I N E R

6 7

4 1 5 3 7 5 2 1 7

7 8 8 3 1 9

3 6 5 4

7 6

Solution p. 14

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

’ 1 2

1 2 3 4

P 1 2 3 4

E 1 2 3 4 5 6 7 8

1 2 3

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

M 1 2 3 4 5 6 7

— Ronald Reagan

1.HHBCCSWEE 2.EEEVVOUAA 3.MTLLNEEN 4.RRETPP 5.OYY 6.ONO 7.ENN 8.EE

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

WORDS NUMBER

THE MYSTERY WORD

MARCH 17, 2017

13 +

AUGUSTA MEDiCAL EXAMINER

THE BEST MEDICINE

couple of days after going for a hike in the woods, a lemon found a tick on his side. It was embedded pretty well, but even though the lemon was able to remove the tick, he was concerned enough to go to the doctor. After a brief examination, the doctor said to the lemon, “Well, at least we know it isn’t Lyme disease.” Moe: I used to have a job selling security alarms door to door. I was pretty good at it too. Joe: Oh yeah? Moe: If no one was home I would just leave a brochure on their kitchen table. Moe: Last night I dreamed I was weightless. Joe: Really? Moe: Yeah. I was like 0mg! Moe: The other day my wife asked me to pass her lipstick to her, but I accidentally gave her a glue stick. Joe: And? Moe: She still isn’t speaking to me. Moe: I used to be against brain transplants.

Moe: I’m wondering if this joke I know is too old. Joe: I’m not sure what you mean, but tell me the joke and I’ll decide. Moe: Ok. Here goes. What’s the difference between a dollar bill and the Atlanta Falcons? Joe: Too old. Moe: Wait! A dollar bill is good for 4 quarters! Joe: I said too old! Moe: You know what? I think making fun of fat people is really cruel. Joe: Totally. Like they don’t have enough on their plates already. A drunk staggers into a Catholic church and stumbles into a confessional booth, sits down, but says nothing. The priest coughs a few times to get his attention, but the drunk continues to sit there in silence. Finally, the priest knocks three times on the wall. The drunk mumbles, “Ain’t no use knockin,’ there’s no paper on this side either.” +

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

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A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble wrote a long-time column in this paper entitled The Patient’s Perspective reincarnated in this new format. Feel free to contact her at marciaribble@hotmail.com Today I am faced with a periodic tweet coming from one of three monitors supposed to protect my life. They are all in the same room, so I’m not sure which of them is beeping at me, only that the sound was annoying yesterday, while today it is close to being maddening. My dog, KC, has bailed on me and has taken refuge in the back yard. Like many dogs, loud sounds hurt her ears. Help is on the way, but not for a couple of hours, so we both deal with what is. One of the things I like least about aging is losing the ability I once had to just fi x things like this without needing help. I am still strong, but have had serious issues with falling for the last ten years because diabetes has robbed me of balance. So climbing up on furniture to reach something on the ceiling is like asking for a broken hip. I like my hips unbroken, so that’s a risk I am not willing to take! While the Area Agency on Aging and other similarly helpful programs are allowing many of us seniors to age in place, a big gap in that process lies in keeping a home functioning mechanically. Some seniors can care for their homes without help, but many of us do need help with minor plumbing issues, lawn mowing, changing the batteries in our fi re alarms, small repairs, and all the daily inconveniences that can plague us, but not major enough to require calling in a major company to fi x the issue. I am lucky because I do have family members nearby who can and do help me, like my granddaughter Yvette who arrived a little while ago to take on the dreadful and obnoxious tweeting machine. She climbed up on a chair to take off the cover and replace the battery. The cover would not budge, even after much prying. Eventually the entire smoke detector fell off the wall in one piece. We learned it was attached to an old, mostly non-functioning alarm system from long before I moved in. Just across from it, in a more accessible space, is a newer, better fi re alarm, hard-wired into the house wiring with a battery back-up. Do I need two fi re alarms in one room? Especially when one of them is dysfunctional? No, I do not need that malfunctioning piece of junk, I decided, whereupon Yvette gave it an unceremonious toss into my outside trash container. My world is once again tranquil. KC can come and go as she pleases without her ears hurting. But I am still concerned about the elders who live alone and don’t have family to help them when small issues become unsolvable without additional help. A community of this size has more than adequate resources to address a problem like this. All it needs is a centralized organization to take on the task of helping seniors to stay at home and get the help they may need to do so successfully. +

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

a million people can’t be wron n a h t g. Less +

STATE

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MARCH 17, 2017

AUGUSTA MEDiCAL EXAMINER

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

...very cleverly hidden (on the brick wall) in the p. 8 ad for MAKERSON DENTAL THE WINNER: DIANA WILSON Want to find your name here next issue? If it is, we’ll send you some cool swag from our goodie bag. The new Mystery Word is on page 12. Start looking!

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

The new scrambled Mystery Word is found on page 12

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The Augusta Medical Examiner publishes on the 1st and 3rd Friday of every month. Your ad should reach us no later than 7 days prior to our publication date.

SHORT WHITE… from page 6 learn medicine and get back home. There are many aspects of my experience in Saint Kitts that I will forever hold dear to my heart and use as tools to keep me grounded and focused. I always knew the importance of embracing cultures outside of one’s own and my time on the rock provided the opportunity for this on a daily basis, whether it was getting to know the grocers and taxi drivers by name and learning about their history, or realizing that goats on the main road and monkeys hanging out by the beach was the norm. My school of medicine also provided the opportunity to learn about other people right on campus. Our student body, faculty and staff represent a multitude of races, ethnicities and religions. Yet, despite our differences there is one main unifying factor – our desire to learn about health and medicine. It seems to have been a wonderful experience, however, it is all about perspective. Do I hold any regrets about my experience? Sure! A balanced approach to life is key. Life appears to continue to present me with that lesson time and time again. We can strive to be the best in the field and bring our all to the table but if we don’t take care of our own wellbeing, sooner or

later we won’t be able to help anyone. Preparing healthy meals, exercising and seeking avenues for personal growth are all essential to achieving peak performance. Reading books, exchanging ideas with family, friends and colleagues, and/or meditating are a few ways of achieving personal growth. The horse blinders I held so tightly during my time on the island might have helped me attain my goal, but they also kept me from being able to disconnect and make time for my own wellbeing. I believe that priorities are essential to success, but balance is key. I am not sure if I will ever be able to “live the lesson”, but I can say that I will try. As my grandparents always say, “Ser feliz no es tener una vida perfecta. Ser feliz es reconocer que la vida vale la pena vivirla, a pesar de todas las dificultades.” Which translates to, “Being happy is not having a perfect life. Being happy is realizing that life is worth living, despite all of its difficulties.” + by Jasmine Rivas, a fourth year medical student at University of Medicine and Health Sciences. Feel free to contact her with questions or feedback: jrivas@umhs-sk.net

NEVER MISS AN ISSUU!

Visit us at issuu.com/medicalexaminer EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC. FOR RENT 2000+ sqft warehouse space w/ loading dock, Walton Way Medical District. Available immed. $850.00/mo. incl. utilities. 706-564-1644 ROOM FOR RENT with private bathroom and full house privileges. Martinez $600/mo (706) 840-6860 FOR SALE 3 bedroom/2 bath, single garage Townhouse in Martinez. Master/ bath down, 2 upstairs bedrooms share bath, large loft for office, playroom, den; wood-burning fireplace, covered back porch. Freshly painted with new flooring, lighting and ceiling fans. Easy access to Riverwatch Parkway, Washington Rd, I-20, Augusta. 1987 sq.ft. $147,900. 706-836-7001. ROOM FOR RENT 1 room, private bathroom, 2bdrm MH on private lot. Clean quiet neighborhood. Non-smoker. $600 monthly. Must be stable, verifiable references and income. Cable and Internet included. Warrenville, 5 min from Aiken, 20 min to Augusta. (803) 270-2658 POND VIEW! Evans all-brick 2-story with solar panels. Avg. electric bill $170 in Northwood, 3,400 sqft. Call 1-800401-0257, ext. 0043 24/7 for price and details.

SERVICES PETS Dogs walked, cats sat, in the comfort of your home by retired pharmacist. No kennel noise, fleas, disease, transport cost/time. Avail 7 days/wk in Martinez/ Evans. $15 per visit. References. Call for free interview at your home. Call Buddy for your buddy: (706) 829-1729

HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706-877-0421 F. E. GILLIARD, MD FAMILY MEDICINE Acute & Chronic Illnesses Occupational Medicine PROMPT APPOINTMENTS (706) 760-7607

MISCELLANEOUS QUEEN SIZED Black wrought iron bed frame and 2 night stands. Excellent condition! $800. Call 706-306-4666 SUNSET MEMORIAL GARDENS Opening and closing at Sunset Mem. Gardens in Graniteville. Sale: $760 (Value: $1520+) Call 706-736-0596 ANTIQUE maple dinette set with buffet corner cabinet table with pull-out leaves. Four chairs with two captain’s chairs. Excellent condition. $300. Double bed early 1930s with mattress spring coverlet shams $150. Call (706) 860-2170 CEMETERY SPACES (2) Sunset Memorial Gardens, Graniteville SC adjacent to lighted military flagstaff, includes granite bench with urn space, installation and inscription. All $4700 ($8600 value). Spaces only: $2700. Call (803) 2953033 FISHING CLUB wants more grey-haired members. Meet 2nd Thurs of month at Harbor Inn Restaurant, 12 noon. “Adventure Before Dementia” Info: (706) 736-8753

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THE PUZZLE SOLVED P A T H

E C H O

C A R O B

L I A N A

F R O G

L O V E

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T B R U A O R R E N O B I T E M A P T R A L X T E P I E T U M R T O N I N C H A G H O B E E R E R O S T S N E

U R G E

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H A L L O P W E B E S O D O R S E P D A D L U C T C A R E D Y

C H A P V E I L C E

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K O A L A R A R E E S S C O U S E A

E P C O T

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SEE PAGE 12

QUOTATION QUOTATION PUZZLE SOLUTION: Page 12: “Children need love, especially when they do not deserve it.” — Harold Hulbert

The Sudoku Solution 6 7 2 9 3 8 1 4 5

1 8 3 4 7 5 9 6 2

9 5 4 1 6 2 7 3 8

7 3 1 6 5 9 8 2 4

8 6 5 2 4 1 3 9 7

2 4 9 7 8 3 6 5 1

4 9 7 8 2 6 5 1 3

5 2 6 3 1 7 4 8 9

3 1 8 5 9 4 2 7 6

WORDS BY NUMBER “We can’t help everyone but everyone can help someone.” — Ronald Reagan

MARCH 17, 2017

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AUGUSTA MEDiCAL EXAMINER

PROFILES… from page 3 problem and prescribing what he thought would be the best treatment. The physician would then confi rm whether or not his blind protégé’s assessment was correct. McNorrill also learned Braille while in Macon, as well as how to navigate the world without sight. Even so, the future could not have looked too bright for William McNorrill when he returned to Burke County. He kept up to date with the latest news of the profession, however, since his subscriptions to medical journals continued and his aunt took the time to read the articles to him. Still, the obstacles to resuming his practice seemed insurmountable Then one day a unique set of circumstances let the

Janie B. McNorrill, the wife Dr. McNorrill never saw.

figurative scales fall from his eyes and the path back into medicine was clearly seen. “It seems there was a baby in the community that was sick, and Dr. McNorrill was the only doctor the parents could find,” says Dino Loren. “He sent them away to another doctor, but he was

on a house call.” After they returned to McNorrill more than once he finally relented, agreeing to see if he could do anything to help the baby until another doctor arrived. Two things happened: no other doctor ever arrived, and the sick baby got well under McNorrill’s care. Then one other thing happened. He came to the realization that if he could effectively treat an infant who could not communicate its symptoms, surely he could treat adults who could. The rest, as they say, is history. Loren says her grandfather delivered threequarters of the babies in Burke County while he was in practice, employing a driver to take his horse and buggy up and down country roads to the homes of patients.

And that, as Paul Harvey used to say, is really the rest of the story. It was quite unusual in the late 1800s for physicians to attend births. Medicine was an almost exclusively male profession, and many people considered it improper, indecent and embarrassing for a male to be present during childbirth. That delicate situation was solved through the use of midwives. But Loren says no one had a problem with a man being present during labor and delivery — if he was blind. The liability had become an asset. McNorrill died on March 16, 1923, days shy of his 70th birthday, of “bilateral bronchial pneumonia.” His obituary the following day in Waynesboro’s True Citizen

newspaper noted, “McNorrill had been blind for a number of years, but continued his practice of medicine and had quite a lucrative practice.” He is buried in Botsford Cemetery. + Editor’s note: According to family history, William McNorrill clearly remembers seeing his future wife, Janie Boyd Tomlin, who was 19 years his junior, when she was a young girl. He would tell people he had the prettiest wife there is because he remembered her childhood beauty. Later in life when a physician offered to try to reverse his blindness, Dr. McNorrill refused the offer, saying he wanted to keep intact the memory of his wife’s face from the days of her youth. Janie McNorrill died October 20, 1932.

PROFESSIONAL DIRECTORY ALLERGY

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

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

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

DENTISTRY

DERMATOLOGY

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

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

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

FAMILY MEDICINE

F. E. Gilliard MD, Family Medicine 4244 Washington Road Evans, GA 30809 706-760-7607 Industrial Medicine • Prompt appts. Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Thomson: 706-595-7825 Primary Care Rates

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

PHARMACY

YOUR LISTING HERE

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

TRANSPORTATION Caring Man in a Van Wheelchair-Stretcher Transports • Serving Augusta Metro 855-342-1566 www.CaringManinaVan.com

VEIN CARE

Medical Center West Pharmacy 465 North Belair Road Evans 30809 Vein Specialists of Augusta Dr. Judson S. Hickey Your Practice 706-854-2424 Periodontist And up to four additional lines of your www.medicalcenterwestpharmacy.com G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 501 Blackburn Dr, Martinez 30907 2315-B Central Ave choosing and, if desired, your logo. Floss ‘em 706-854-8340 Augusta 30904 or lose ‘em! Keep your contact information in Parks Pharmacy www.VeinsAugusta.com 706-739-0071 this convenient place seen by tens of 437 Georgia Ave. thousands of patients every month. N. Augusta 29841 Jason H. Lee, DMD Literally! Call (706) 860-5455 for all 803-279-7450 116 Davis Road the details www.parkspharmacy.com Augusta 30907 Medical Weight & Wellness 706-860-4048 Specialists of Augusta THE AUGUSTA Maycie Elchoufi, MD MEDICAL EXAMINER Steven L. Wilson, DMD 108 SRP Drive, Suite B Psych Consultants Family Dentistry Evans 30809 • 706-829-9906 AUGUSTA’S 2820 Hillcreek Dr 4059 Columbia Road MOST SALUBRIOUS YourWeightLossDoctor.com Augusta 30909 Martinez 30907 NEWSPAPER (706) 410-1202 706-863-9445 www.psych-consultants.com

WEIGHT LOSS

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M.E.

PSYCHIATRY

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AUGUSTA MEDiCAL EXAMINER

MARCH 17, 2017