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MARCH 20, 2020
AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006
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MEDICINE IN THE FIRST PERSON
The stick
Being a cancer patient isn’t so bad in a number of ways. As many will tell you, there can be surprising beauty in the experience. Having cancer is a prescription for self-examination and personal growth. I have not met anyone who didn’t say they were better, somehow, for having gone through cancer. Then there are the multiple expressions of love from friends and family, the surprising level of support from people you didn’t realize knew or cared about you - and the knowledge that you’re not alone - and the awareness that many are much worse off than you. Having cancer — as with any serious illness really — puts life in perspective. Of course, this is not to minimize the difficulties that come while experiencing cancer symptoms and navigating cancer treatment. I have stage IV ovarian cancer, which has now metastasized and is at this point, incurable. In the twenty months since being diagnosed I have been hospitalized three
times. For a while I needed 24-hour oxygen. I have had fluid drained from my belly and from around the lungs (painful). I currently undergo regular CT scans, and am on a physically difficult chemotherapy regimen which leaves me fatigued and ill much of the time. Two weeks out of every three my husband and I drive a bit over an hour from our home in McCormick, SC, to Augusta Oncology. Carrying my bag with a nice warm blanket, snacks, and a book, I check in with the competent and friendly staff, receive my patient wristband, and mentally prepare for five hours in the chair, receiving my anti-nausea meds, infusion of fluids, steroids, and life-extending chemotherapy drugs. But first, I must endure a brief but anxious visit to the lab where I receive – the stick. I want you to know I am getting much better at having blood drawn. But I am still fighting my needle fear, and I know I’m not the only one. God bless the phlebotomist who makes the stick. They are kind, professional, and usually very expert. And I am blessed with good veins. I have nothing to complain about. But somePlease see THE STICK page 15
Let’s spend a few calm, quiet and rational minutes talking about everyone’s favorite subject, the coronavirus. (This might be a recurring feature for a few issues.)
Do you think coverage of the coronavirus is a media circus? Have the various news organizations blown it all way out of proportion? Is there some kind of conspiracy afoot here? On the other hand, do you think it’s actually far worse than officials are letting on? When the truth comes out, will it be discovered that the government or the media was part of the cover-up? Let’s spend the promised few calm and rational minutes looking at the facts. Right off the bat, there is no denying that news coverage of this outbreak has exceeded any other disease-related anything in the history of news. The organization Information is Beautiful (informationisbeautiful.net) specializes in creative data visualization. When they make a pie chart, it’s a pie chart that looks good enough to eat. They’re all about presentation, but data is always their key ingredient. They have been tracking a lot of WHO and CDC COVID-19 data worldwide, including the number of cases, the fatality rate, average deaths per day globally, and how much news coverage this virus is getting, then comparing all of this information against other leading causes of death, both chronic diseases and past seasonal outbreaks. Seasonal flu, for example, currently kills an average of more than 1,000 people per day around the world. Information is Beautiful reports 202,000 total news mentions of seasonal flu, or 197 news mentions for each death. For the more than 3,000 people who die every day from tuberculosis, the 2.9 million news mentions average out to 986 news mentions per TB death. But the more than 1.1 billion news mentions about coronavirus average out to nearly 18 million news mentions per death. Given those facts, it would be challenging to mount a successful argument that news coverage of COVID-19 hasn’t been way over the top. The numbers certainly make a powerful argument against any cover-up. But since the level of publicity given to this virus is unprecedented, could a reasonable argument be made that it’s all part of a conspiracy of some kind? If it isn’t, why Please see REALITY CHECK page 3
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AUGUSTAMEDICALEXAMiNER
THE FIRST 40 YEARS ARE ALWAYS THE HARDEST
PART 9 OF A 10-PART SERIES BY JONATHAN MURDICK Editor’s note: Our correctional nurse isn’t quite as fetching as the nurse on the cover of the pulp novel shown. Ours isn’t even a female. But our nurse has at least one exceptional advantage over the nurse in the picture: he’s real.
LOCKDOWN
PARENTHOOD by David W. Proefrock, PhD
You have just discovered that your 7 year-old son can’t read. He passed first grade, but is having trouble in second. You have noticed that he is having trouble understanding what he is asked to read. You have given him books below his age- and grade-level to read and he is unable pronounce words or comprehend what he is supposed to be reading. What should you do? 1. Work with him on his reading. Have him read very easy books and talk with him about what he has read. 2. There’s really nothing you can do at home. Let the school take care of his education. 3. Talk with his teacher about what you have noticed and ask that his reading be monitored evaluated. 4. Talk to the principal at his school and arrange for him to repeat first grade.
If you answered: 1. Reading at home is always a good idea. However, in this case it is not enough. Work with the school to address his reading deficits. 2. This is not only a bad idea, it is just not true. Your child’s education is a partnership between you and the school. This should be addressed. 3. This is the best response. The teacher can observe his reading in class and refer for evaluation if necessary. This allows you and the teacher to work together to make sure his reading deficits are addressed. 4. This skips the most important step. The teacher is in a much better position than the principal to assess his reading. Going back to first grade is not the solution. His reading should be observed, assessed, and monitored. That starts with the teacher. Kindergarten and first grade are taught in multiple modes: reading, listening, touching, etc. Specific reading problems may not show up until a little later. This is especially true in bright children who are able to compensate for deficits in one area by using the others. However, this problem will only get worse and should be addressed in partnership between parents and teachers. +
Dr. Proefrock is a retired clinical and forensic child psychologist.
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MARCH 20, 2020
Several months of routine in the pill room had passed and I was becoming quite comfortable in the little pharmaceutical bunker. Inmates no longer protested when I passed medicines; they now actually joked and we had positive interactions. Although I was feeling comfortable in my position as a nurse, several things were bothering me. Security in a prison is expected to be strict and tight. The reality is that we all become complacent in our everyday lives, and it happens in prisons too. I watched as protocol was sometimes relaxed here or there, and officers randomly chose which minor infractions to enforce and which ones to look the other way on. While those issues were worrisome, I became more concerned after watching the inmates when the officers were occupied with other things. Inmates would often begin whispering or passing items between themselves. Some would even get up and pace or try to wander the medical
I Was a
SHOCKING TRUE TALES!
50¢ unit. One of the nurses would yell at them and they would usually go back to their place on a bench. It became a game for the inmates as they tried to see what they could get away with. I brought the issue up with security several times and I was always told they followed their protocols and they would look into the matter. Not really feeling any better, I tried to make my co-workers aware of the tension I was feeling and of my concerns. Some listened, some agreed, but little
Floyd & Leopard
F &L
Prison Nurse !
LLP
changed. One evening I was completing inventory in the back of the medical unit when I heard the front door slam shut. I finished up what I was doing and when I passed the treatment room I saw two nurses treating an inmate with a bloody nose. What I didn’t see was an officer, and with an inmate in the unit an officer should have been there too. That was protocol. A chaplain had dropped the inmate off and left us with him after he had been in a fight at the chapel. I quietly picked up the phone to call for an officer when I heard one of the nurses yelling, “Get off of me.” I ran in and grabbed the inmate, throwing him to the ground. I held him down as one of the nurses ran outside to get an officer. Several minutes later one of the supervisors rushed in and took the inmate away. Fortunately that evening I happened to be there, but staff in other prisons where such lapses occurred weren’t as fortunate. While this day ended without injury I had a terrible feeling it was only the beginning. +
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MARCH 20, 2020
REALITY CHECK… from page 1
has this never happened before with any other outbreak? One of the keys to answering that question lies in the scope of what’s happening. Unlike this virus, some past disease outbreaks have been largely limited to one part of the world, like Asia or Africa. They haven’t spread as widely or as rapidly as coronavirus-19. In addition, while cornonaviruses are nothing new — they were discovered in the 1960s, and were responsible for previous flu outbreaks like SARS and MERS — this year’s model is a new strain. As we all know, there is no vaccine for this virus, and no one has any degree of adaptive immunity provided by previous exposure. Many of the comments on social media make mention of the fact that a disaster or crisis of some kind has happened during every election year in recent memory. The implication seems to be that somehow the government or a political party and its candidates are capitalizing on panic and fear to get more votes or drive some legislative agenda. Depending on your political persuasion, these commenters - and there seem to be a lot of them - believe this is a hoax perpetrated by either Democrats or by Republicans. Whether the every-election-year-crisis can be fact checked or not depends in part on the definition of crisis. But sticking with this year’s crisis alone, the question remains whether the news media is part of a conspiracy of some kind, whether they’re inflating the numbers for ratings purposes or covering up a much larger tragedy. We must say, people who endorse the conspiracy angle restore our faith in humanity. At a time when people are more polarized than ever before, when disagreements about even simple things can and do explode into violence and
hate, it’s refreshing to know there are people out there who believe in their heart of hearts that the World Health Organization, CNN, Harvard and Yale Universities, NPR, Disneyland, the CDC, Jeopardy! and Wheel of Fortune producers, Major League Baseball, the NBA and the NCAA, the Augusta National Golf Club, South by Southwest organizers in Texas, as well as the governments of Italy, France, China, the U.S., and dozens of others are all cooperating in this conspiracy. If true, it would in one sense be truly encouraging and heart-warming. Realistically, however, the “Election Year Crisis” theory takes a very narrow view of the overall situation: It’s all about us. But consider: if this theory is true, it means that in order to disrupt or sway the U.S. political process in some way, a new virus was hatched and released on the other side of the planet in a city — Wuhan, China — very few of us had ever even heard of (despite its 11 million residents) before this all started. As someone recently commented in a social media post about all of this, “not everything is about Trump.” In case some haven’t noticed, the coronavirus outbreak is a global story, not a U.S. domestic issue. That lends further credence to the this-is-not-about-our-elections faction. It’s a safe bet that public health officials around the world know what they’re doing when they make the preventive recommendations they do. Some people think COVID-19 itself proves these people don’t deserve our trust. That implies that the medical community should be able to prevent or cure all diseases. That’s not real-world logic. COVID-19 may be over-reported. Cancellations may reflect caution more than direct, provable reasons. But against a new (novel) and unknown enemy, the overall effort seems reasonable. +
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IS HONEY BAD FOR BABIES? Yes it is, at least for babies less than a year old. No doubt many a mother of years past employed the old trick of dipping a pacifier in honey. If a pacifier wasn’t good enough to quiet a fussy baby, a pacifier dipped in honey just might. If it was so common then, why is it a problem now? It has always been a risk, but it was not discovered until the late 1970s. In addition, not every baby experiences a problem with honey. At issue in this case are two things on a possible collision course. First, spores of Clostridium botulinum (commonly seen as C. botulinum) are often found in honey. Then there’s the fact that the still-developing digestive systems of newborns are more or less defenseless against the spores, which germinate into bacteria and colonize the infant’s bowel. The result is infant botulism, a serious condition that requires immediate treatment, but which is often initially misdiagnosed. Symptoms are constipation, dehydration, poor appetite, weak muscle tone, and listlessness or lethargy. It can lead to respiratory failure; one case described in the literature that occurred in Denmark involved a 5-week-old infant who was brought to the hospital in full respiratory arrest. Although the baby survived, it spent more than 7 months on a ventilator. On a related note, the American Academy of Pediatrics recommends that parents consider offering pacifiers (without honey) to infants one month and older at bedtime to reduce the risk of sudden infant death syndrome. Potential complications of long-term pacifier use include a negative effect on breastfeeding, dental malocclusions (that is, improper positioning of teeth) after two years of age, and ear infections. The American Academy of Pediatrics and the American Academy of Family Physicians say pacifiers can be beneficial for a baby’s first six months, but they recommend weaning children from pacifiers by age one to prevent ear infections (otitis media). Honey has been clinically studied as a cough syrup for children older than 1 with upper respiratory infections and nighttime cough. At best, honey comes out on top in studies comparing it to various cough medications (like dextromethorphan) or placebo. At worst, honey is about as good as commercial cough suppressants. As one study succinctly concluded, “There is no strong evidence for or against the use of honey.” +
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AUGUSTAMEDICALEXAMiNER
MARCH 20, 2020
#111 IN A SERIES
Who is this? ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE
O
ne of the secrets to success discovered by many noted achievers in a variety of fields is to surround themselves with greatness. They build a team of eminently qualified players, knowing that each person’s contributions can build upon and enhance the group’s collective efforts. There may have never been a better team builder in the history of medical research than Robert Koch (1843-1910), who discovered the anthrax disease cycle and the bacteria responsible for tuberculosis and cholera. He was awarded the Nobel Prize in 1905 for his tuberculosis research. But Koch didn’t accomplish his ground-breaking research as a lone wolf. One member of his team was Walther Hesse, who was studying bacterial contamination in Koch’s lab. At the time (1881-1882), gelatin was the standard medium for culturing bacteria in laboratories, but it came with a host of problems. At the optimal temperature for bacterial growth, gelatin liquefies, limiting its use to cooler weather and only with certain microorganisms. Like men sometimes do, Hesse brought his work problems home, literally and verbally. He had a home lab, and he mentioned the limitations of gelatin as a culture medium to his wife, Angelina. She had known since childhood about agar from a neighbor who had once lived in Java. Angelina Hesse Agar is a gelatinous substance made from a tropical seaweed extract. She used it often as a jelling agent when making puddings and jellies, even in warm weather. Angelina told her husband about it, and he in turn told Koch. It turned out to be a perfect medium for cultivating microbes: it was stable at a wide range of temperatures, offered a fertile medium to nourish bacterial growth, and was translucent, a huge advantage in studying bacteria. It is still widely used in labs to this day. Not long afterward, the physician pictured above (top) was added to the Koch team. He worked with Koch and both Walther and Angelina Hesse studying bacteria. Their typical method was using gelatin and later agar spread on a flat piece of glass. That was useful for study under a microscope, but it had serious limitations. The solution was agar plates. Their benefit was in offering a larger medium, but open plates were often subject to cross-contamination from other plates and from airborne bacteria. Enter the gentleman above. You’ve heard his name a thousand times: it’s Julius Petri. He invented the famous dish that bears his name, and it was a massive improvment to have a standardized shallow dish with a snugly fitting cover. It was skinny enough to permit easy viewing and sealable to prevent spills and accidental cross-contamination. As an added bonus, his invention has all kinds of uses in pop culture, as in, “Yuck! This nasty place is a regular Petri dish.” +
Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com by Marcia Ribble The topic on everyone’s minds right now is coronavirus. Today I am thinking about it from two perspectives. The first is about a group of people who may not even conceive that they are among those especially vulnerable to coronavirus. In the US we have millions of individuals who smoke, vape, or both. I am reminding them and their friends and relatives that both smoking and vaping result in decreased or compromised lung function. This virus is infamous for attacking the lungs of those who get it. In cases of infection, these younger folks can be as severely at risk as the elderly or those with underlying illnesses, even though they may feel just fine and don’t exhibit shortness of breath, wheezing, or coughing. They may want to strongly consider quitting any use of cigarettes or vaping even though it may not help them in the short term. These viruses, once in the world, tend to then recur in cycles just like the flu reappears every winter. So be forewarned and get prepared to get your lungs healthier. In a very short time after people quit smoking or vaping their lungs get significantly healthier and while their cancer risks diminish, they will also be less likely to be victimized by coronavirus. Issue two is what are called disease vectors, in this case I am talking about those people who become infected and then pass the disease to numerous others, kind of like typhoid Mary. When I was a patient at Amara Healthcare, one of the things I noticed was the CNAs talking about their work schedules. In many cases Amara was not the only place where they worked, since they were not full time Amara employees. Those contract workers often followed up a shift at Amara
with one at University Hospital or another nursing home or even direct patient care through a home health agency. Sometimes they had three or four such gigs. If we have learned nothing else from the state of Washington, it should be that those old folks in the ground zero nursing home had not traveled outside the home; they had not gone to visit other nursing homes in the area, which also became virus-intensive sites. It is equally unlikely that their visiting relatives had traveled between multiple nursing homes to spread the virus. Therefore, the most likely disease vectors were the personnel at the nursing homes. In Augusta we have not had cases of coronavirus—yet! Unless we are unusually lucky we can only count on that to last for just so long before we too are fighting to not transmit the virus, to protect the most vulnerable, our seniors, and especially our seniors in crowded places like nursing homes. I am not an epidemiologist, but it would make sense to me that we devise a plan ASAP to address and minimize the possibility of nursing home employees of all kinds, including CNAs, becoming virus vectors carrying the disease between health facilities. I don’t know the answer to that problem, but I do know that experts like Dr. Fauci warn that the number of actual cases is far more than the current count because people who have it may not have developed symptoms yet, let alone been tested for it. We don’t know how much preparation time we have, so it is essential that we get on top of this and innovate some type of methodology to prevent disease spread between nursing homes through our usually life-saving nurses and CNAs. Wishing all readers good health and safety wherever you may be! +
The Medical Examiner is what is known as a
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MARCH 20, 2020
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AUGUSTAMEDICALEXAMiNER
ADVENTURES IN
Middle Age BY J.B. COLLUM
Welcome to the club, Mr. Collum! Here is only Jell-O we had was lime and I think it your AARP card and complimentary colonostasted more like a household cleanser. And all copy appointment. By the way, let’s go ahead because doctors don’t want anything sticking and get your type 2 diabetes diagnosis out of to their expensive camera when they put it the way too! where the sun don’t shine. I’ve certainly gotten better perks for join Like all other medical appointments, ing a club. What am I talking about? Joining they have you show up super early so you the middle age club, of course. True, AARP can wait around a long time. I think we got is nice. We get discounts at some restaurants there at 5:30 a.m. I can’t help it; it is just and some good deals on lodging and rental my upbringing. I know I’ll be waiting, but I cars, but the colonoscopy that have to be there on time. So, I was stripped of all you are supposed to get when my son and I sit there and wait. you turn fifty? Not much of an my human dignity Of course, that day they had incentive in my book. I rememcomplimentary donuts and cof— and clothing. ber mine well. Except for the fee and my son, wanting to be actual procedure that is, but that is probably supportive, didn’t even move toward them. all for the best. I’ll explain. He did look at them though, like Dudley The day before my appointment, I called Moore looked at Bo Derek in 10, so I finally the gastroenterologist’s office because they convinced him to go ahead and have some. hadn’t called me about prepping for it and I After some more prompting, he did. had read all of the horror stories. That’s when Eventually, I was stripped of all of my I found out that this appointment was just the clothing and any remaining human dignity consultation. Translation: it’s the appointment in exchange for a backless gown and was where they tell you what they could have wheeled into a clean room where the protold you on the phone or in an email to get cedure would be done. I looked at the clock you ready for the colonoscopy, but this way and then the anesthesiologist told me she was they get to charge you $70 for it. That’s kind about to put me to sleep. What seemed like of aggravating when the actual colonoscopy a few seconds later, I saw that the clock had procedure is a zero co-pay, zero deductible, jumped ahead about thirty minutes and they zero out-of-pocket proposition for me, but said they were done. I didn’t feel anything exthen I have to pay $70 for a worthless visit. cept some gas pain from where they inflated How does that make any sense? my guts. Anyway, I get through that visit, but then After a little while of just lying in the bed they schedule another appointment to have and passing gas, they took me to the car in blood tests. Can it get any better? I think not. a wheelchair and sent me home to rest and What people say about colonoscopies is recuperate for the rest of the day. true though. They are easy. The hard part So my suggestion is to go ahead and get is the prep. Maybe the word “hard” is a that colonoscopy over with as soon as you hit bad choice, because let me tell you, the day 50. And when you prepare for the day before, before the procedure, nothing hard will go get a flavor of Jell-O you like. But be sure in you or come out of you. The few days you’ve already got your AARP card so you can leading up to that are no picnic either, as go out to a nice restaurant afterward and get a in, you can’t go on a picnic because a lot of discount on a big meal to make up for all you things that would be on the menu are strictly missed out on while you were fasting. + verboten. I couldn’t even have vegetables, for example. J.B. Collum is a local novelist, The day immediately before really takes humorist and columnist who wants the cake though, along with every other food to be Mark Twain when he grows except non-red Jell-O, clear broth and other up. He may be reached at johnbcolclear liquids with no nutritional value. The lum@gmail.com
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MARCH 20, 2020
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MARCH 20, 2020
AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006
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MARCH 20, 2020
The
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Will he ever get one right? Probably not.
Never reads the Examiner
Reads the Examiner occasionally
Always reads the Examiner
ON PAPER. ONLINE.
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Questions. And answers. On page 13.
IT’SYOURTURN! Your turn for what? To tell the tale of your medical experiences for Medicine in the First Person. 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. See our “No Rules Rules” below. Thanks!
“My leg was broken in three places.”
“This was on my third day in Afghanistan.” “I lost 23 pounds.” “We had triplets.” “He was just two when he died.” “The smoke detector woke me up.” “It took “She saved 48 stitches.” my life.” “I sure learned my lesson.” “The cause was a mystery for a long time.” “The nearest hospital “They took me to the hospital by helicopter.” “I retired from medicine was 30 miles away.” “I thought, ‘Well, this is it’.” seven years ago.”
“Now THAT hurt!” “OUCH!”
“Turned out it was only indigestion.”
“He doesn’t remember a thing.” “I’m not supposed to be alive.” “It was a terrible tragedy.” “And that’s when I fell.” NOTHING SEEMED “The ambulance crashed.” “It was my first year “At first I thought it was something I ate.” TO HELP, UNTIL... “It seemed like a miracle.” of medical school.”
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 20, 2020
AUGUSTAMEDICALEXAMiNER
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GARDENVARIETY
I am a big hummus fan, and I’m always on the lookout for recipes to kick my hummus up a notch in flavor and nutrition. I tried a new recipe that I think you are really going to like. Lima bean hummus is a smooth buttery dip that is perfect with crackers, vegetables and bread or as a condiment on sandwiches. According to whfoods.org, lima beans are an excellent source of cholesterol-lowering fiber. They provide a virtually fat-free high quality protein. They also offer a notable contribution to heart health, which lies not just in their fiber but in the significant amounts of folate and magnesium these beans supply. Folate helps lower levels of homocysteine, an amino acid that is an intermediate product in a necessary metabolic process called the methylation cycle. Also, the amount of magnesium limas supply puts yet another plus in the column of its beneficial cardiovascular effects. Magnesium is nature’s own calcium channel blocker. When enough magnesium is around, veins and arteries relax, which lessens resistance and improves the flow of blood, oxygen, and nutrients throughout the body. In addition to lima’s beneficial effects on the digestive system and the heart, their soluble fiber helps stabilize blood sugar levels. If you have insulin resistance, hypoglycemia or diabetes, lima beans can really help you balance blood sugar levels while providing steady, slowburning energy. Lima Bean Hummus Ingredients • One 16-ounce bag of lima
Women’s Health
LISA JACKSON, MD & EVAN BAHR, MD
(706) 737-3948 • 2300 Wrightsboro Road • Augusta, GA
Lima Bean Hummus beans, thawed • 1/4 cup tahini • 1/4 cup olive oil • 1 tablespoon white vinegar • 1 minced clove of garlic • 1 tablespoon chopped fresh parsley • 1/2 teaspoon cumin • 1/2 teaspoon chopped fresh thyme • 1/2 teaspoon cayenne • 1/2 teaspoon cracked fresh pepper • 1 teaspoon pink Himalayan salt Instructions Place lima beans in boiling water and allow to boil 15 minutes. Drain and allow to cool. In a blender add lima beans and all the other ingredients, slowly blend
until smooth. The hummus will be thick, so it is good to turn off the blender and scrape sides a few times in the blending process. If need be, add a tablespoon of olive oil each time until hummus is smooth. Serve with pita bread, crackers or vegetables. Toppings could include olive oil, chopped parsley, or whole lima beans. + by Gina Dickson, an Augusta mom to six and Gigi to ten. Her website, intentionalhospitality. com, celebrates gathering with friends, cooking great healthy meals and sharing life around the table. Also on Instagram @ intentionalhospitality
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MARCH 20, 2020
TEN COMMANDMENTS OR TEN MYTHS? by Ken Wilson Steppingstones to Recovery Then comes #7 (See Commandments 1 thru 6 in the previous installment of “This Is Your Brain” in the Feb. 21 issue, viewable at https:// issuu.com/medicalexaminer/docs/02.21.20): “I don’t want to push him over the edge, so I won’t intervene and require him to be clean and sober. And if I do push him and he dies it’ll be my fault.” Really? He’s for sure going over the edge if you don’t do something. Better to try and have it maybe happen than not try and have it certainly happen, earlier rather than later. Tell you what…remember that all addictions are: 1. Progressive, and 2. Fatal unless treated. Would you soft-pedal his disease if it were diabetes and just let him keep eating sugar? Or cancer and let him stay away from the doctor and treatment? Not! Bookoos (that’s the right spelling if I say it is) of addicts and alcoholics are slowly going to the grave because somebody they love doesn’t love them back enough to address their disease in a positive manner. There are plenty of books out about how to do this…it’s called an intervention…(by the way, ignore the media shows with this title…they’re drama…not at all the way to do it!) and there are articles and help at your fingertips on how to do it well. After all, we have internet search engines to do the research for us nowadays. We don’t have to go to the library and search through a card catalog! (If you don’t know what one is, you’re a Millennial! Or younger!) In actuality, what will certainly happen if you don’t intervene…if you let your fear keep you from doing what is best? See #2 above. Will you feel guilty at the funeral? That might be justified. Next up, #8: “It’s just a phase he’s going through.” Well, maybe so. Maybe not. Who knows the complexities of the human brain, combined with all the equations that make a person a unique individual with all their life experiences and genetic pre-dispositions. Who can predict the future of experimental chemical use? No one who sits in my group chairs ever thought they’d be there. It started out so small. If you could sit in my chair for awhile I know you would understand that the issue is not using versus not using but is instead choosing to live or choosing to die. I mean, everyone I know who overdosed and didn’t live to tell the story never knew they overdosed. They just went to sleep, never to wake up. Who would’ve thought! Social drinking is so accepted in the world and millions do it with no negative consequences. I like the easy definition of an addict that I use daily: “you’ve crossed over from social drink-
THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional ing to abusive drinking, or having an Alcohol Related Disorder to use clinical terms, when alcohol (or drugs) start causing problems in your life.” And that’s not a phase someone goes through; it’s a diagnosis. Hopefully if you know someone with a problem the words “it’s just a phase” won’t cross your lips. You’ll intervene instead. Myth/Commandment #9: “It’s his problem, not mine.” I hear this often when I invite family members to attend our Family Workshop. Oh, that this were true! But guess what? If it’s a problem with one family member, it affects ALL family members. This illness is no different than cancer or diabetes in the number of people it affects. When one family member gets sick, all end up adjusting themselves to some extent to provide for the disruption in family function. For a visual, it’s like a mobile hanging from the ceiling – when you barely touch one part of one it affects the balance of the whole mobile. And families do have it worse than the user. They’re the ones who lose sleep, worry, pick up the pieces, and suffer, much more than the addict/alcoholic in most cases I must say. Lastly, #10: “He’s only drinking now – and just beer at that!” Consult past columns in this paper for info on this…it’s called “switching chemicals.” In most cases, in a short time he will be back to his drug of choice. Once the inhibitions are lowered with beer, a No becomes a Yes. All the time. It’s guaranteed. And you know what? Next year I can write another column by this same title and have 10 completely different myths! Maybe I’ll do just that. Until then, do not drink the myth Kool-Aid. +
MEDICALEXAMINER READ THE
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MARCH 20, 2020
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AUGUSTAMEDICALEXAMiNER
DON’T LICK THE BEATERS Useful food facts from dietetic interns with the Augusta University MS-Dietetic Internship Program
Celery Juice: The Magic Potion? by Sydney Engberg, Dietetic Intern
In the past year, celery has
HERE’S WHAT DRINKING CELERY JUICE CAN AND CANNOT DO FOR YOUR HEALTH AND WELLBEING.
CELERY JUICE CAN
• Increase your total water consumption • Introduce phytochemicals, vitamins, and minerals that you wouldn’t be getting if you don’t otherwise eat celery • Contribute antioxidants to your diet • Look great in a photo
CELERY JUICE CANNOT
• Cure or treat any given disease • Provide your body with fibers necessary to feed your gut microbiome • Detox your body • Replace a balanced diet rich in a variety of plant based foods
Additional information on the benefits of vegetables and a healthy diet can be found at www.eatright.com. Information on the website is provided by trained and credentialed healthcare professionals – Registered Dietitian Nutritionist (RDN). +
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celery juice daily on an empty stomach.” Though there was no scientific evidence to support his claims, the practice grew. Additional claims found on the web state that the elixir can reverse inflammation that causes diabetes, psoriasis, eczema, celiac disease, and IBS, as well as treat depression and Alzheimer’s. Celery juice drinkers have reported improvements in energy levels, weight loss, and less bloating. Let’s talk about the nutritional value of celery. Celery, scientifically known as Apium graveolens, is a vegetable that has been grown since ancient times and has been eaten plain and raw or added to cooked dishes for flavor. This vegetable is low in calories, high in water content and has a stringy texture due to its high fiber content. According to the USDA, one medium
U RG
become a superstar among health and wellness influencers everywhere. Juicing and drinking plain celery juice is one of the latest wellness trends. Is it really all it’s cracked up to be? This wellness trend was started by Anthony Williams, an LA based medium known as the Medical Medium. Williams claims that he can “read people’s conditions and tell them how to recover their health.” In 2019, his beliefs about celery juice began to trend on social media and were heavily promoted by health gurus and others. Williams explains why he started the celery juice movement: “Celery is truly the savior when it comes to chronic illness. I’ve seen thousands of people who suffer from chronic and mystery illness restore their health by drinking 16 ounces of
stalk of celery contains roughly 6 calories and can provide the body with Vitamin C, potassium, and phosphorous. Celery has also been used in traditional plant-based medicine across the world because it contains phytochemicals such as flavonoids and phenolic acids that act as antioxidants within the body. Recently, researchers have begun investigating the phenolic and antioxidant compounds found in celery to determine how these effect the human body. In general, most of these studies found that the compounds in celery may have protective benefits against free radicals, due to the presence of glutathione, an antioxidant. All plant-based foods, including celery, provide a variety of vitamins, mineral, and other bioactive compounds essential for normal body function. It is highly likely that the health benefits reported by celery juice drinkers are due to increasing their daily intake of vegetables and water. +
Lance Melcher Owner
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CRASH
COURSE
More Americans have died on US roads since 2000 than in World Wars I & II combined
You see a sign like this and you get over to the left as soon as you can. And what is the reward for your obedience and good manners? Watching driver after driver speed by in the lane that’s ending, zipping up to the head of the line and cutting over ahead of everyone else. But guess what? Those jerks are doing it right! If everyone did what they do, traffic would flow a lot more smoothly. Smooth traffic flow means fewer accidents, fewer injuries and fewer deaths. And a lot less stress and aggravation. Oddly enough, though, whenever we see this happen, we have more stress and aggravation. We don’t like the way these selfish, entitled jerks act like they’re more important than everyone else, as though their time is more important than ours. But again, they are doing it right. Traffic engineers have noticed the same thing we all have, that most people get over right away and a few don’t merge until the last 100 feet. When this happens on an interstate highway, for example, it leaves one lane backed up for a mile and the other lane, the ending lane and all of its car-carrying capacity, sitting there mostly empty, tempting all the “jerks” to zip ahead and cut in. Naturally, far ahead at the actual point of merger, there are people who tailgate the car ahead to prevent cut-ins. They are this guy (left). Still other drivers are highly annoyed by anyone ahead of them who lets the so-called jerks in. “Don’t reward their rude and selfish driving!” The problem with all of this is not the jerks who zip ahead and cut everyone else off. The problem is that we need more jerks. The ideal ratio of jerks to “mannerly” drivers should be 50/50. At least, that’s what traffic engineers who have carefully studied the best ways to keep things flowing at their best when a lane is closed tell us. In fact, an increasing number of states are actively promoting this traffic pattern, known as “zipper merging.” Done correctly, both lanes, the ending lane and the continuing lane, have an equal number of cars. At the point of where the one lane ends, cars alternate, left, right, left, right. It is efficient and smooth and keeps delays to the absolute minimum. Whether or not zipper merging makes its official debut on Augusta area roads in the near future or not, it’s a great idea for Examiner readers to start using. We’re going to be dealing with Savannah River construction delays on I-20 for some time to come, a great place to employ zipper merging. Drivers who exit I-20 at Wheeler Road routinely see traffic from Flowing Wells Road construction backed up all the way to the exit, preventing vehicles from accessing the westbound Wheeler Road left turn lane. Meanwhile the right lane that ends in front of Farmhaus and Frog and The Hen sits empty — except for the jerks who use it to bypass everyone else. Another excellent place to make zipper merging the norm for everyone, not the exclusive domain of jerks. In places where zipper merging is not clearly marked and encouraged by signage (as above), the biggest obstacle to implementation will no doubt be the fear of being a nice person who is perceived as one of those rude jerks. There are right ways and wrong ways to zipper merge. The jerk method is to floor it until the last minute, then muscle your way into the other lane. The better way is to proceed toward the merge point at a moderate speed, turn signal activated the entire way. Don’t force the merge. Ease in when someone lets you. A friendly wave in thanks will solidify the perception that you’re definitely no jerk. The more people who do it, the more it will catch on. +
BE THAT JERK!
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MARCH 20, 2020
HUMAN BEHAVIOR AM I TOO WORRIED ABOUT CORONAVIRUS?
Perception...it’s why when we walk into a room and everyone stops talking, we worry they were talking about us. Why we get upset when our partner once again doesn’t put the new toilet or The Science of Perception paper roll on the right way (“It should be over, not under!”) And especially, by Jeremy Hertza, Psy.D. why some of us are buying out bleach wipes and hand sanitizer from Costco because we’re terrified of coronavirus. Our brains can magnify certain circumstances and minimize others—not always to our benefit. In the case of coronavirus, or COVID-19, it is very easy to get caught up in the frenzy of media coverage—the daily upticks in numbers infected, the constant interviews with experts, and the announcements that someone was infected a couple hundred miles away. If you start to feel your palms sweat, stop and take a moment. What’s happening right now in our brains is that our amygdala is starting to overload. The amygdala is only about the size of an almond, but it’s powerful. It’s where all of our negative emotions like fear and anger are born, and once it gets going, it can be hard for our brains to shut it off. It kicks in our fight or flight response, which pushes blood and oxygen to our muscles and away from our brains—which can make it even harder to think clearly. But once you realize what’s going on with your body, that’s a start. What can you do next? There’s actually a lot you can do to decrease your reactivity to something that could be a misperception:
• Self-talk: Start by asking yourself questions. Gauge yourself: Am I having a reasonable response? If the answer is no, then consider what you can do to regain control. Most people’s fears are tied to what they have no control over. The fears and anxieties then build into useless energy that doesn’t solve anything, so rechannel all that. If you’re worried people are talking about you, perhaps you could turn to the person you know best in the room and ask what everyone was talking about. If you’re upset by something your partner does differently than you, consider this: Maybe they think they’re doing it the right way, so it’s worth talking it out to figure out a way that works for you both. Or, instead of buying up hand sanitizer, realize that the CDC is advising everyone to take regular and rather ordinary precautions like washing your hands and staying away from people who are sick. • Reorient: Life can be chaotic and messy. So if we focus on just one thing that we can control, it can help calm everything down and make us feel in control again. It doesn’t have to be related to your fear; in fact, it can be something as simple as reading a book or folding laundry. The purpose of that is to reframe and deactivate your sympathetic nervous system. • Here’s what you don’t want to do. Don’t obsess on googling “What to do if everyone stops talking when I walk into a room”— or maybe just do it once (you’ll be pleasantly surprised to see that everyone worries about the same thing). Don’t pick a fight and make the toilet paper roll the defining characteristic of your relationship. And don’t veg out in front of the news channel all day, every day. That doesn’t help anybody. What does help is figuring out what’s real and focusing on what you can control—which could include carrying around just one very small bottle of Purell. + Jeremy Hertza, Psy.D., is a neuropsychologist and the executive director of NeuroBehavioral Associates, LLC, in Augusta. Contact him at 706-823-5250 or info@ nbageorgia.com.
MARCH 20, 2020
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AUGUSTAMEDICALEXAMiNER
The blog spot From the Bookshelf — posted by Coby on the patient comment website The Mighty
THE LAND WHERE POOP IS KING As toddlers, our bowel movements are often received with large and public enthusiasm, especially when deposited correctly. Fast forward several years, and you’re living as an adult in a home stocked with products designed to trick others into believing you do not poop, and if you do it smells like lavender sage. Then one day you’re diagnosed with a rare colorectal cancer and “boom,” you’re right back in the land where poop is king. Doctors barely introduce themselves before quizzing you about the texture, frequency, odor (lavender sage, of course), and buoyancy of your bowel movements. You present samples of it to strangers, who actually accept them. You spend a night in hell expelling it all to have a colonoscopy camera inserted somewhere you didn’t know a camera could even fit. After surgery, one of the most anticipated signs of recovery is passing gas. Farting is your ticket home. Once again, you receive encouragement and applause for an act you usually look for a nearby dog to blame. By now, I am immune to poop shaming. I think little of emerging from a bathroom while fanning a magazine and announcing to others, “Don’t go in there, until you’re older…” If annoyed, I may “cup” you (collect a fart in a cupped hand and apply it to the face of the offender). Never pull my finger. A parting report from Poopville: While talking to you on the phone, it’s quite likely I’m on the toilet. Eventually, I may eschew all modern decorum and invite guests in to visit while I attend to matters, like a Roman emperor. Rather liberating. Though I have been accused of potentially adding more than my fair share of methane to the global environment. For that, I will apologize. Don’t forget... Everybody poops (and farts).
Never pull my finger.
Stay Mighty, Coby +
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Lots of people love spicy food, but that doesn’t mean a full cup of black pepper or garlic on their favorite food would make their dining experience better. Just the opposite would be true. In a similar vein, lots of doctors (and their patients) love antibiotics. Their emergence was a game changer in world health: 100 years ago the average life expectancy in the U.S. was 52 years. Today it’s that plus another 30. So the war on germs is a good thing. Or is it? As the authors of this book point out, it’s a war we will never win, nor would we want to. Bacteria outnumber us by astronomical proportions. There are far more bacteria on planet Earth than there are stars in the universe. For each and every one of the trillions of cells in the human body there are about ten bacterial cells sharing the same space in our bodies. We’re more bacterial microbes than we are human beings. In other words, avoiding bacteria is literally and physically impossible. But the
common wisdom is that the only good bacteria is dead bacteria. Germ-free is good. Sterile wipes keep our kitchen surfaces clean, and more significantly, antibiotics enter our bodies in ever-increasing amounts at younger and younger ages. As the authors state, antibiotics may be the greatest medical advancement of all time, but they kill bacterial microbes indiscriminately, good and bad alike. The overall effect of our collective prevention efforts, ironically enough, is an increase in some allergies and diseases. Dubbed the “hygiene
hypothesis,” the general idea is that exposure to various germs, microbes and antigens results in a stronger immune systems, especially in children; conversely, trying to live in as sterile a world as possible results in an immune system that is ill-prepared for battle, doesn’t know or recognize the enemy, and is anything but combat-ready. The hypothesis, which gains more research support all the time, explains why autoimmune diseases are on the rise in developed countries where antibiotics and strong emphasis on sterile conditions are common. For the record, this book is not suggesting that readers (parents especially) take its title literally. But it might make each of us stop and think each time a label shouts out the word “antimicrobial” as a good thing. Maybe it is sometimes. But sometimes it might not be at all. + Let Them Eat Dirt; Saving Our Children From an Oversanitized World by B. Brett Finlay, Ph.D., and Marie Claire Arrieta, Ph.D.; 448 pages, published by Penguin Press in 2015
Research News Universal flu vaccine news What some medical experts call the holy grail of public health has passed two major hurdles with flying colors. Researcher have been attempting for more than a decade to create a socalled universal flu vaccine. What makes the flu such a challenging public health enemy is the ability of flu viruses to change. Researchers actually call them “shapeshifters,” and the name fits. Each flu season, researchers must predict upcoming strains and develop vaccines, but these are no good if the virus mutates mid-season or an unexpected strain suddenly shows up. (Not that that would ever happen.) Researchers have discovered that some parts of shapeshifters never change, and those elements are the focus of new flu vaccine research. Aiming at the viral elements that
are stable and unchanging means that season-to-season changes which made previous vaccines ineffective don’t matter anymore. The universal vaccine has progressed through Phase I and Phase II clinical trials, which establish the safety of the vaccine itself. Next up are more extensive clinical trials among larger groups of patients. According to one researcher, the joke about a universal vaccine has been that it’s always five years away. Now, he said, it might finally be true. Rx extraction needed? University of Michigan researchers tracked more than 325 patients who had a tooth pulled. About half the patients who had a surgical extraction, and 39 percent who had a routine extraction were prescribed opioids for pain. The rest took over the counter pain relievers like Tylenol, aspirin, and
ibuprofen. The UM study followed up with the patients to evaluate their satisfaction with pain management following their tooth extraction. Their expectation was that pain relief would be better among the users of prescription-strength opioid pain meds. To their surprise, patients in the opioid group reported worse pain than those in the non-opioid group whether they had a routine or surgical extraction. Another finding of the study was that about half of all the opioids prescribed were unused by both surgical and routine patients, leading to the possibility of opioid abuse by others if leftover pills are not disposed of properly. With ordinary OTC analgesics proving more effective than opioids, researchers suggest that dental prescribing practices need a complete overhaul. +
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AUGUSTAMEDICALEXAMiNER
The Examiners
MARCH 20, 2020
+
by Dan Pearson
I refuse to let this I agree 100%. In fact, virus confine me to lately I’ve been eating a life of isolation! out more than ever.
I agree! Doesn’t food It does! You think it’s just seem to taste because people are finally washing their hands? better lately?
And enjoying it more than ever!
Me too!
The Mystery Word for this issue: GUTREN
© 2020 Daniel Pearson All rights reserved.
EXAMINER CROSSWORD
PUZZLE ACROSS 1. Prince of India 5. Breath crackles 10. Villain Sweeney 14. Responsibility; burden 15. Take in as one’s own 16. Brainchild 17. Type of grass 18. Move rhythmically 19. 1st or 2nd, as examples 20. Deviate suddenly 22. Dem.’s opp. 23. Sea eagle 24. Pen sound 26. Norse god of thunder 28. Jaw muscle 32. Letting (up) 36. Word of contentment 37. Sequoia starter 39. Hamm the soccer star 40. Med. image 41. ________ massage 43. Farm denizen? 44. Electrically charged atom 45. Greased 46. Command to a horse 47. Endow with a soul 49. Smooth; continuous 53. Auto line from 1897-2004 55. A Hemingway 56. Type of instrument 59. Cam prefix 61. Hotel _____ (2004 film) 65. Jewish calendar month 66. Absurd 68. Way of applying paint 69. Trigonometric function 70. Lymph structures 71. Fencing sword 72. Soviet news service 73. Do a certain Walmart job 74. Computer brand
ME
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Simply unscramble the letters, then begin exploring our ads. When you find the correctly spelled word hidden in one of our ads — enter at AugustaRx.com
Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, MAR. 30, 2020
We’ll announce the winner in our next issue!
E X A M I N E R
8 3 5 7 8 6
3 9 6 4
4
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1 1 5 9 7
by Daniel R. Pearson © 2020 All rights reserved.
S 4 U D 2 7 O 9 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.
by Daniel R. Pearson © 2020 All rights reserved.
DOWN 1. Deprives 2. Once more; again 3. Famous Allyson 4. Baseball team embroiled in scandal 5. Med. district Blvd. 6. Dentist’s org. 7. New York island 8. Disney World neighbor 9. GA county named for Jefferson Davis’ VP 10. Ty Cobb’s team 11. River in central Europe 12. Dizzy baseball player 13. Challenge 21. Contend 25. Pelvic exercise 27. ____ of office 28. Ike’s better half 29. 25-time baseball All-Star 30. Front of lower legs 31. Fair attractions 33. Public perception
34. A person can be dressed to these 35. Microsoft co-founder 38. Helped 41. Bar in downtown Augusta 42. Washington Road and Grovetown Cafe 48. Large quantity, informally 50. Respiratory _______ 51. Kitten’s cry 52. Gas in the old days 54. Mister in Tijuana 56. Point intro? 57. Hip bones 58. Sisters 60. Past tense of bid 62. Neck back 63. Event causing Alexander Hamilton’s death 64. Adam and Eve’s #2 son 67. Originally called; literally: “born”
Solution p. 14
QUOTATIONPUZZLE H O H A S A S N A T T U W R T U T C T O T G R T R I C T A I E U I C N T O B T H I N Y N O E Y Y by Daniel R. Pearson © 2020 All rights reserved
4 9 2 7 5 1 7O2 8 5 G 3 6 6G3 9H4 1 8
— Eliezer Yudkowsky
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.
1. 26843-19 _ _ _ _ _-_ _
6. 24336 _____
2. 24462 _____
7. 7263377 _______
3. 84787 _____
8. 98426 _____
4. 6278377 _______
9. 8378464 _______
5. 87867 _____
10. 2567464 _______
EVERY SOLUTION IN THIS PUZZLE IS A NAME OR WORD CURRENTLY IN THE NEWS. Use keypad letters to convert numbers into the words suggested by the definitions provided. There may be a theme linking all answers. Sample: 742 (body part) = RIB. Answers on page 14.
by Daniel R. Pearson © 2020 All rights reserved
TEXT
1
THE MYSTERY WORD
8 6 3 9 4 1 2 7 5
3 5 9 1 7 2 8 6 4
6 1 8 5 9 4 7 2 3
7 4 2 6 3 8 1 5 9
MARCH 20, 2020
13 +
AUGUSTAMEDICALEXAMiNER
THEBESTMEDICINE ha... ha...
A
utumn was approaching, and the Indians on a remote reservation asked their new Chief if the winter was going to be cold or mild. Since he was an Indian Chief in a modern society, he had never been taught the old secrets. For example, when he looked at the sky he couldn’t tell what the weather was going to be. Just to be on the safe side, though, he told his tribe that the winter was indeed going to be cold and that everyone in the village should collect firewood to be prepared. Being a modern Indian and a practical man, several days later he got an idea. He secretly called the local office of the National Weather Service and asked for their long-range winter forecast. “It looks like this winter is going to be quite cold indeed,” the weather service chief meteorologist at the responded. So the Great Chief went back to his people and told them to collect even more wood in order to be prepared. A week later, he called the National Weather Service again. “Is it still going to be a really cold winter?”
The
Advice Doctor
“Yes,” the National Weather Service man repeated,”Definitely. A very cold winter.” The Chief again went back to his people and ordered them to collect every scrap of wood they could find. Two weeks later, he called the National Weather Service again. “Are you absolutely sure this winter is going to be very cold?” “Yes, all the latest data says it’s going to be one of the coldest winters ever.” “How can you be so sure?” the Chief asked, amazed at the white man’s technology. The weatherman replied, “Because the Indians are collecting wood like crazy.” Moe: So basically you’re single and unemployed. Joe: That’s not how I would describe it. Moe: What would you say? Joe: I’m currently self-quarantined until further notice. Moe: I can’t find hand sanitizer anywhere. Joe: Yeah, every store I’ve checked is sold out too. But you know how to make it yourself, don’t you? Moe: No, tell me. Joe: Find a recipe for hand sanitizer online. Make it, and mix in some Tabasco. Moe: What will that do? Joe: Two things: kill germs and teach you not to touch your face and eyes. Moe: I’m glad my parents were honest and open enough to tell me I’m adopted. Joe: That was very good of them. Moe: But why every day? +
Why subscribe to theMEDICALEXAMINER? What do you mean? Staring at my phone all day has had no Effect on ME!
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Dear Advice Doctor, I was recently involved in an investigation at work that resulted in my immediate supervisor being fired. It remains to be seen whether or not he will be arrested. I was promoted to fill his position. His life is in a tailspin, and he blames me. Recently I came around a corner at the grocery store and came face to face with him. The look he gave me made my blood run cold. I’m concerned for my safety. Any advice would be appreciated. — Moving Up the Ladder - And It’s Dangerous Up Here Dear Moving Up, Something like this always comes up at the worst possible time, doesn’t it? You’re already concerned enough about surgery, and then you get some of the details about how they’re going to do it and things get even worse. It’s clear from your question that you’ve got some kind of complex major surgery coming up. Whenever someone talks about their blood running cold, 9 times out of 10 it’s surgery involving the heart or brain. Medically induced hypothermia dates back to ancient times. Hippocrates advocated using snow and ice to reduce bleeding. Centuries later the therapeutic use of cold got a lot more complex. Research on animals in the 1940s and 1950s established that the brain was not harmed or damaged even if circulation to it was stopped for an hour or longer if the body was cooled significantly beforehand, like down to 50 or 60 degrees (or even lower). In humans, permanent damage to the brain from interrupted circulation occurs within minutes at normal temperatures, but if the blood in circulation is cooled down into the 50s prior to surgery (or connection to a heart-lung machine), the heart can be stopped for surgical repair for 30 or 40 minutes without damage to the heart or brain, or the body as a whole. In basic terms it’s not terribly different from animals hibernating in cold weather, slowing their metabolisms dramatically. As with most medical procedures from taking aspirin to having brain surgery, there are potential side effects. One, ironically enough, is excessive or poorly controlled rewarming. I hope this answers your question. Thanks for writing! + Do you have a question for The Advice Doctor about health, life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.
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THE MYSTERY SOLVED The Mystery Word in our last issue was: INFECTION ...cleverly hidden on a tasty wing in the p. 7 ad for WILD WING CAFE
THE WINNER: TOM CLARKE! Want to find your name here next time? If it is, we’ll send you some cool swag from our goodie bag. The new Mystery Word is on page 12. Start looking!
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...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. Limited sizes are available for shirt prize. 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. 8. Deadline to enter is shown on page 12.
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THE STICK… from page 1 times, with everything we endure as cancer patients, everything we must “buck up” for, or cry over in the dark, or just grit our teeth and take and thank God when it’s over- sometimes, it’s the little thing, the thing that really isn’t that big a deal, the thing that just unnerves us a little bit- that triggers an emotional meltdown. That happened to me about five months into my journey. A great gal, an excellent professional, just had a bad day with my arm. There was some extra poking around; things were taking a bit long, and I was becoming increasingly agitated. We tried some more. I was staring straight ahead, breathing hard. Then I heard her say, “Oh, that’s too bad, the vein rolled.” And it hurt.
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And inexplicably, a grown woman, an educated professional with patients of her own, reverted into a wide-eyed, hurt, teary, vulnerable little five-year-old girl. The tech looked up at my face and observed my state. “Do you want me to try the other arm?” she attempted after a beat. In a trembling five-year-old voice, I said “No!” She then patiently explained that in order for me to receive treatment, they would have to draw some blood and get the labs. “I DON’T WANT TO” I blubbered, and just covered my eyes, wanting it all to go away. For several minutes I shut her out, I shut the lab out, I shut cancer out, I shut the world out, and cried. Very quickly, the tech
realized she needed to call in some cavalry. The head nurse, someone I knew, was soon at my side with a calming voice and a steady hand. She coaxed my other arm out, and while talking me through it, quickly and painlessly, using a “baby” needle, had a good sample, and I was done. I recall she smiled at me and said, “Ms. Jane, I wish we could lend you our arms to draw blood from for you, but it just doesn’t work that way.” Another comforting nurse angel then escorted me, arm in arm, down to the infusion lab. These days I am much better at receiving “the stick.” At my most recent CT, a nurse who would have much preferred to access my port than insert an IV in my arm, but did the IV anyway, jabbed
the needle in half way up my arm, and had to try to suppress a fountain of squirting blood with cotton balls before she finally got things under control. I just turned my head. I never forget to thank the nurses, the phlebotomists, and every lab tech who do what they do for each of us to the best of their ability each day. My oncology nurses at Augusta Oncology - who do their jobs so well, and take a few precious moments to smile, encourage you, ask if you’re doing anything fun that weekend - these are my hero-angels. This is my new normal. This is cancer. And I’m grateful. + Submitted by Jane Coolidge, M.A., CCC-SLP McCormick, SC
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