Medical Examiner 5-1-20 by Daniel Pearson

MEDICALEXAMINER

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MAY 1, 2020

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

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THANK YOU! NURSES MAKE A DIFFERENCE

If you were expecting a glowing tribute in this space to the nurses in

the trenches, on the front lines in this war against our invisible enemy, sorry. You will have to go elsewhere. It isn’t that we don’t have immense respect for those nurses. They are literally putting their own lives at risk to save the lives of others. It’s trite and overused to describe them as heroes, but they really are. In the same way that the vast majority of us don’t have coronavirus, however, the vast majority of nurses are not treating coronavirus patients. In fact, thousands of them aren’t doing much of anything: the practices where they work are closed, or are operating at the IV equivalent of KVO: the barest minimum. Nearly all elective procedures have been canceled. There are no cataract procedures happening right now. No hip and knee replacements are taking place. Dental offices are closed. Surgeries, no matter how important they may be to patients and the relief of their pain, are on indefinite hold. Only emergency cases are being seen. Routine doctors appointments have all but disappeared in many practices. As a result, many nurses are facing the same situation everyone else is: out of work, confined to home, grappling with financial issues, cabin fever, boredom, restless kids, and an uncertain future. Let’s give a huge shout out to all nurses all the time. They deserve it. They are the very backbone of medicine. Let’s especially commend those treating coronavirus patients in the middle of this pandemic for their selfless efforts. But let’s also honor the thousands of nurses and other allied health professionals who have been idled by this crisis and cannot practice their craft. They too deserve our deepest respect. Strictly speaking, they aren’t patients, but they are hurting. Don’t forget the ones you know who are in this circumstance. Reach out and do something to help them and let them know how much they are appreciated. +

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PANICNEGLECT AUGUSTAMEDICALEXAMiNER

THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD by David W. Proefrock, PhD

This essay, “I Loved You Enough.” is for Mothers’ Day. It was written years ago by columnist Erma Bombeck. It says pretty much all there is to say about being a parent: Someday, when my children are old enough to understand the logic that motivates a mother, I’ll tell them… I loved you enough to bug you about where you were going, with whom, and what time you would get home. I loved you enough to insist you buy a bike with your own money, which we could afford, and you couldn’t. I loved you enough to be silent and let you discover your handpicked friend was a creep. I loved you enough to stand over you for two hours while you cleaned your bedroom, a job that would have taken me 15 minutes. I loved you enough to say, “Yes, you can go to Disney World on Mother’s Day.” I loved you enough to let you see anger, disappointment, disgust, and tears in my eyes. I loved you enough not to make excuses for your lack of respect or bad manners. I loved you enough to admit that I was wrong and ask your forgiveness. I loved you enough to ignore what “every other mother” did or said. I loved you enough to let you stumble, fall, hurt, and fail. I loved you enough to let you assume responsibility for your own actions at 6, 10, and 16. I loved you enough to figure you would lie about the party being chaperoned, but forgave you for it…after discovering I was right. I loved you enough to shove you off my lap, let go of your hand, be mute to your pleas, and insensitive to your demands… so that you had to stand alone. I loved you enough to accept you for what you are, and not for what I wanted you to be. But most of all, I loved you enough to say no when you hated me for it. That was the hardest part of all. + Dr. Proefrock is a retired clinical and forensic child psychologist.

If you do a web search for the words in our title, you’ll find a number of articles dealing with epidemics and pandemics. Most of them are a few years old and have nothing to do with COVID-19. All of them address an aspect of public health and human nature that goes far beyond our current state of affairs. The panic-neglect cycle is one that has been repeated often on the pages of history. As one public health official put it recently, in the midst of an outbreak everyone is running around with their hair on fire. But once the perception of danger has passed, it’s quickly back to business as usual. Not long ago there was a federal playbook for handling mass disease outbreaks, and people ready to deploy the plan when needed. But then that department and all its readiness plans and experts were dismantled. At the time there didn’t seem to be much of a need. Experts in public health say as often as they can that there is always another disease outbreak on the horizon. It’s never a question of if, but when. But let’s be realistic. What we’re in right now seems like a once-in-a-lifetime event. Pandemics don’t happen every day. A young child in 2020 could see a second pandemic before his 10th birthday, but it’s far more likely he’ll live to a ripe old age and never see anything like this again. Of course, that is exactly the kind of thinking that perpetuates the panic-neglect cycle.

MAY 1, 2020

Let’s spend a few calm, quiet and rational minutes talking about everyone’s favorite subject, the coronavirus. (Part 4 of a feature of unknown duration.)

What this has to do with you and me on a personal level could be one of the unexpected benefits of COVID-19. Lesson #1: individuals do the panic and neglect thing too, not just mighty nations. Let’s say your average Joe has a recurring symptom of some kind. He ignores it for a while, but eventually he gets checked by his doctor, who tells Joe it was foolish to wait so long with persistent evidence that something is wrong. Joe starts to get worried. This sounds serious, and it is. But the doctor writes a prescription and assures Joe he’ll be fine if he takes the medicine. Joe did a common and popular variation of the cycle: neglect, then panic-neglect. Fast forward a few years and this time when Joe has some trouble he goes to his doctor right away. The doctor is gravely concerned about Joe. He tells Joe his only hope (after surgery) is to quit smoking and excessive drinking, lose weight

and change his diet. Joe is scared. He is a model patient; he does everything the doctor tells him to do and more. Some time later, the doctor gives Joe the all-clear. Joe is relieved. The burden of worry and uncertainty is gone. Life seems good again. Joe relaxes a little, confident that he can successfully face the next challenge too - if it comes. Gradually, Joe slows down on exercise. He goes back to his old ways and gains a few pounds, then a few more. One day he has a cigarette. Soon he’s smoking as much as ever, and he’s back to drinking too. Joe has just become poster child #82,742,653 for the panicneglect cycle. We’ve all done it to one degree or another. And we’re all seeing on a global scale what it can lead to. It’s just as devastating on a personal level. Next time, let’s not be Joe. There is no room in a salubrious life for neglect. When neglect is out of the picture, panic tends to disappear too. +

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AUGUSTAMEDICALEXAMiNER

MAY 1, 2020

MEDICINE IN THE FIRST PERSON

I have coronavirus When I first started hearing about the coronavirus, I thought it was mass hysteria. People were stocking up on food, toilet paper and other essentials. At the time I thought, “I will not be a participant in this frenzy.” And then I got it. I work for a contractor. Right now we’re building a medical center in Decatur, Georgia. My roommate is a counselor at a substance abuse treatment center. Several weeks ago he started feeling sick and we joked about it being the coronavirus. That weekend I was at my girlfriend’s house and I mentioned my roommate’s symptoms, including his loss of taste and smell. Her parents, who both work in the medical field, said those are symptoms of coronavirus. Uh oh. Since one of my roommate’s co-workers was the only person he knew who had tested positive, he was pretty sure that’s where he got it. My roommate got tested, and while waiting for his results to came back we got word that his co-worker had died. That news sent him into complete and total panic. His girlfriend, who is 4 or 5 months pregnant and lives in the same apartment with us, also tested positive, although she was having only very mild symptoms. She has since tested negative and went back to work on Monday of this week (April 27), just in time to get furloughed. Meanwhile, I was starting to feel sick. Initially I had this burning sensation in my nose, and I was sneezing constantly. I was hoping it was just allergies, but all the same I kept away from everyone. I never had a fever, but I did have mild headaches and a lot of congestion and phlegm. I coughed a lot. I knew I had to find out what was going on, so I went in on a Friday to get my test. If you haven’t had the experience, the probe goes up your nose so far it feels like they’re touching your brain. Not fun. I notified my employer that I was having symptoms. As it turned out, the next week there were some situations on the jobsite that required me to be there. My employer told me to just wear a mask and everything would be fine. So I was on the jobsite all day Monday and Tuesday.

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Then on Wednesday I found out I was positive for coronavirus. That was scary. Not because I was worried about the outcome or thought I would die (although I knew that was a possibility), but because of the thought that maybe I had unknowingly given it to others. The source of my infection, after all, was dead. I don’t know how I could live with myself if I knew I was the cause of someone else’s death. I had to contact everyone I had been in close proximity to, and I’m sure all of them had to get in touch with everyone they had been around. The irony of the whole job situation was that the company had done a voluntary shut-down just prior to this, encouraging all employees to stay at home, the whole flatten the curve thing. I complied, and got infected anyway — in the safety of my own home. That Monday after my Friday coronavirus test was our first day back. Our crews were immediately pulled off the job as soon as I got my results on Wednesday. The symptoms I described earlier are long gone, but I still haven’t been able to return to work. I’ve been symptom-free for two weeks, but my coronavirus test a week ago (April 24) came back as positive. It was explained to me that I could be “shedding COVID cells,” although they told me that I am not contagious. Even so, I need to have two negative tests back-to-back to be considered safe to return to work. I feel like I’m negative, but there are so many unknowns. What if I really am still positive? My parents live in Augusta. My dad is in his early 70s. I don’t want to take the risk that I could give them this disease. The worst thing I can think of about this whole experience is the thought of infecting someone else. As for the sickness itself, for me it wasn’t that big of a deal. I’ve been a lot sicker than this. But my roommate’s co-worker is always in the back of my mind. For some people it has been a very big deal. + — Submitted by Bill Knick Kennesaw, Georgia

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Are tetanus shots really important? I read that tetanus is extremely rare. True, tetanus is very rare. On average, only about 30 people are diagnosed with tetanus or “lockjaw” each year in the United States. But whether they recover or go to an early grave, those 30 undoubtedly fervently wish they had gotten a tetanus shot. There are not many ways to die that are more horrible than tetanus, and it’s not exactly rare in other parts of the world. The medical journal Lancet reports that some 59,000 people died from it in 2015, which is actually wonderful news: as recently as 1990 the death toll was well over 350,000. Tetanus is often called lockjaw for good reason. One of the earliest signs is contractions and rigidity in the jaw, creating a characteristic grimace, followed by spasms and stiffness that gradually spreads across the face, neck, chest, back and abdomen. A person may have difficulty swallowing and/ or breathing. As the disease rapidly progresses (from onset to death can take as little as four days), spasms can be so violent that they tear muscles and break bones. Fever, excessive perspiration, drooling, uncontrollable urination and defecation and irregular heartbeat are not uncommon symptoms. Death can result from suffocation or heart attack. Fortunately, tetanus is rare in persons who have had a tetanus shot; the disease occurs almost exclusively in those who have not. An unvaccinated person who experiences a puncture wound — the classic stepping on a rusty nail, for instance — a dog bite, or any wound contaminated with dirt, saliva or feces is advised to thoroughly clean and disinfect the wound and get a tetanus shot pronto. Tetanus is more common in hot, damp climates where soil is rich in organic matter, so keep that in mind on your next exotic vacation or mission trip to a third world paradise. No matter where you are in the world, including your own backyard, always practice good wound care, even for little cuts and scrapes. And make sure you are up-to-date on your tetanus shot. Even adults should get a booster every 10 years. +

MEDICALEXAMINER

AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

www.AugustaRx.com The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of salubrious news within every part of the Augusta medical community. Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397

(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net www.Facebook.com/AugustaRX Opinions expressed by the writers herein are their own and/or their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., nor its agents or employees take any responsibility for the accuracy of submitted information, which is presented for general informational purposes only. For specific medical advice, diagnosis, and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2020 PEARSON GRAPHIC 365 INC.

MAY 1, 2020

AUGUSTAMEDICALEXAMiNER

#114 IN A SERIES

Who is this? ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com by Marcia Ribble

here is no mystery as to this woman’s identity. She is quite obviously Edith Cavell. But who is Edith Cavell? If you have glanced down at the illustration below, you know the real question is, who was Edith Cavell? Glad you asked. Born in England in December of 1865, Cavell worked as a governess for a wealthy family, a job which took her to Brussels, Belgium, between 1890 and 1895. She had to return to England to care for her seriously ill father. After his recovery, Cavell’s care-giving experience led her to pursue a career in nursing. She was skilled enough to be recruited by a Belgian doctor in 1907 to be matron of a newly established nursing school near Brussels. Within a year, she was training nurses for three hospitals, two dozen schools and a handful of kindergarten schools, and publishing a nursing journal she launched, L’infirmière. Alas, World War I was soon to erupt across the European continent and beyond, and Cavell’s clinic and nursing school were commandeered by the Red Cross. Germany occupied Belgium by November of 1914, but Cavell and others worked on, treating wounded soldiers without regard to their nationality. The school and clinic, however, as well as Cavell’s house, were being used to secretly help British and French soldiers and civilians escape Belgium for the neutral Netherlands. For this, Cavell was arrested on August 3, 1915, for war treason against Germany. She offered no defense, and in fact, freely admitted at trial to doing exactly what she had been accused of. She was found guilty, and despite a tremendous worldwide outcry for mercy and clemency, was executed by an 8-man firing squad at dawn on October 12, 1915. Visited by a chaplain the night before her execution, she said, “I must have no hatred or bitterness towards anyone.” +

How are y’all doing these days? In true I’m-tough-and-I-can-handle-it fashion, I’m sure many have the instant response, “I’m fine.” For a lot of us that may be true, but for some of us that answer is a bunch of boloney. “Just hanging on by a fingernail” is true for many who don’t know when the next check will arrive. They may be unsure of how they will make next month’s or even last month’s bill for essential needs. Their cupboards are bare. They’ve run out of toilet paper. Their children are on their very last bit of rope. Some are even questioning whether life itself is worth living. I’m really, lucky to be in a space where the Social Security checks keep coming and health care is certain even though its very expensive. But I have been in those other places in the past, and I remember just how scary it was. I remember slapping one of my children who asked for a candy bar at the grocery store because I didn’t have enough money to buy one for her. I was ashamed, frightened, disappointed in myself, angry with the world and feeling hopeless. That was a bad place to be. A really frightening place. But I didn’t stop trying to find a way out of the fears and anxieties. Gradually our situation improved. Life improved one little job after another, one sacrifice for the kids and more stretching of who I am and who I might someday be. So I know what it is to have sleepless nights worrying about the future and even more about making it to the next day, next week, and next month. The reality is that things change. They always do. Life, thank God, is not static. It can be bad or even very bad, but it doesn’t have to remain that way. While we are not

in total control of changing life in more positive ways, we do have some control. We might be unable to make the Covid-19 disappear, but we can do the staying at home that is likely to lessen the length of time it affects our lives. We can use our creative energies to make life better for ourselves and others. Mark Cuban, a multimillionaire sports team owner and one of the Sharks on Shark Tank, said today that this is an extraordinary time for the creation of businesses to answer needs which become obvious in times like these. Just one example of a needs-created business is grocery delivery services. A mere month ago, grocery deliveries were a small niche business. Few other than the homebound had even heard of them. Today many people are able to earn a living delivering groceries to people unable —or unwilling — to get out to buy their own groceries. Ask yourself, what kind of business could I start to help others with tasks that need to be done, that wouldn’t place me or them at greater risk? As a former college professor of English, one service I could provide from home might be to help parents dealing with home schooling. Many of them are overwhelmed with teaching K-12 Language Arts. They may have struggled themselves in their elementary, junior high, and high school English classes. How can I help them? How can I get the word out that I have a service they might need? What should I charge? What skills, talents, and ideas do you have that could help you begin the move toward greater prosperity, better mental and physical health? The world has needs you could meet to help you survive this pandemic. Blessings to all and good wishes for your days and weeks ahead! +

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age

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Ease of Tech Support If your parents are like most people in this age bracket, they will need a lot of help to navigate our modern world. Lately under lockdown it is especially difficult because people who don’t live in the same house with their parents can’t safely go into the home to handle things like resetting the TV input, getting the metric ton of spyware off their computer, setting the stove and microwave clock after the brief power outage, helping them remember their password or find where they wrote it down so they can see if their stimulus check has arrived, or any of the hundreds of other problems they face that are insurmountable to them, and yet seem like child’s play to us. And by child’s play, I mean the most tedious and unfun child’s play you’ve ever experienced. It isn’t so bad when they just want you to fix it. We can usually do that in a flash, but when they want you to teach them what they did wrong and how to do it right is when the real fun begins. This is “double black diamond” difficult, for you snow-skiers out there. I have discovered that my father would make a great QA tester for software and electronics because he can get his iPhone into states that would have Steve Jobs rolling over in his grave. I will have no idea how he did it. The designers didn’t think it was possible, and yet he did. Usually when this happens, they want to write down instructions that you can’t even begin to describe. Teaching them how to do it is harder than teaching someone how to conceptualize the eleven dimensions of string theory. You don’t remember the steps; you just look at it and it seems obvious or you try clicking a few things until it works. Yet, you had better do it patiently. Remember, you no doubt tried their patience many times on even simpler things like learning to tie your shoes or potty training. Now, try to do this type of support over the phone. It would be easier and less time-consuming to just buy them a new device and ship it to them. I suppose you could try it over a Zoom meeting, but that opens up a whole new can of tech support worms. I only shared these two benefits of having your parents live with you, but there are more. Perhaps you could send me an email with some of your observations that I could share in a future column. I look forward to hearing from you. My email address is at the bottom. + J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. He may be reached at johnbcollum@gmail.com

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Improved Communication Why is it that when we finally have the time to sit back and relax, we lose a lot of our senses to the point where we can’t enjoy that relaxation as much as we had planned? Never mind, I know why. It was a rhetorical question. Anyway, one of the difficulties in taking care of aged parents from a distance is the loss of hearing that normally occurs with age. Here’s an example of an actual phone conversation my father and I had about a year ago: Me: Can you hear me, Dad? Dad: What? Me: That answers my question. Ha, ha. Dad: What? Me (louder now): I was asking if you could hear m, but since you said, “what?” I have my answer. Dad: Huh? Me (even louder): I was asking if you could hear me well, but since you said, “what,” that answers my question. Dad: Huh? Me (shouting): I WAS ASKING IF YOU COULD HEAR ME WELL, BUT SINCE YOU SAID, “WHAT” I KNOW THE ANSWER; YOU CAN’T. [long pause] Dad: Uh, okay. Nice talking to you too, son. Me: Okay, Dad. You probably can’t hear me, but I love you. Bye. Dad: What? I saw him in person the next day and told him we needed to take him for a hearing exam. His response? “My hearing is fine.” Before we moved them over here, there were timess I gave up and drove to their house just to communicate a simple but important fact when my mother wasn’t there to answer the phone and relay it to him. The communication improvement isn’t just with my father either. He isn’t much of a talker anyway, especially on the phone. His typical call, even when he could hear well, was usually something like, “Hey, how are you doing? Okay? Good. Just checking on you. I’ll talk to you later.” My mother, on the other hand? Since I didn’t get to see her a lot and I hate talking on the phone, when I did visit it took me about four hours to get away. In that four hours, I spoke no more than a few sentences and my father usually just got to say hello, goodbye and maybe a word or two more (if he raised his hand) because my mother was starved for com-

munication. I understand. She lived alone with my father, and to him, Harpo Marx was Chatty Cathy. Now, since she is around all the time, we get a better chance to communicate and she doesn’t feel like she has to squeeze in a week’s worth of news, thoughts, and expressions of love in one brief visit. I get it.

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It’s been almost a year since we moved my parents into the house with us in order to take better care of them. As soon as we decided it was necessary, we got all kinds of advice from lots of well-meaning friends, family, and co-workers. Most of it was quite horrific, and they were all wrong because it is much worse than they described, but I’m not here today to talk about the negative aspects of moving your aging parents in with you. I’m going to talk about the good points of it. Let’s just talk about two of the best things about having your parents in the house with you.

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MAY 1, 2020

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few years ago I temporarily got into an unfortunate tradition of massive annual sinus infections. Thankfully that phase of my life has come and gone, but while it lasted I was in abject misery for a few weeks every year. The first episode was especially bad because I thought it was just a cold and would eventually go away on its own. Why go to a doctor? I let it go until it was evident that medical intervention was necessary to preserve my sanity, and my skull. That moment occurred during a trip to Nashville. While making the interstate climb over Tennessee’s Monteagle Mountain, I was 100% convinced my head was going to explode. I do not mean metaphorically. I mean literally. My wife had been forced to take the wheel miles back, and I was begging her to find a hospital. Run people off the road if you have to, I groaned. Before we saw a blue H sign, we had descended from the heights and my head no longer felt in imminent danger of detonation. Back home in Augusta, I followed through on the realization that medical intervention was necessary, and thus for the first time learned the difference between a cold and a sinus infection. Treatment became routine. Every year I visited a doctor and got a prescription for some high-powered infection killer. I woke up one day during an especially wretched sinus adventure with a feeling of intense nausea any time I attempted to raise my head more than an inch off the pillow. “Where is that medicine?” I said. It was time for the first pill of the day. I managed to reach over, get a pill and down it, sans water. I then laid back — just for a moment until the nausea went away. Instead, I fell into a sound sleep and woke up more than an hour later. Uh, did I mention that the side of the medicine bottle said, in bold black letters on a fluorescent orange label, “TAKE WITH FOOD OR MILK”? My intention had been to chase the pill with a piece of dry toast, but that ship had sailed. To my raging sinus infection and waves of nausea, I had added an atom-splitting headache, easily a 9.3 on the Richter Scale. It was like Monteagle all over again. If I moved my head off the pillow so much as a half centimeter, ice picks and chainsaws and sledgehammers pummeled what was left of my already tiny brain. At some point, my long-suffering wife responded to my groans and came into the bedroom to, I presumed, witness my death throes. Through my delirium I commanded her to call the doctor’s office. She did so and came back with their instructions, quote: Press 1. Ha ha. Just kidding, she said. Actually, they told her to get my carcass to the office ASAP. Of course, this would require moving my head off the pillow far more than half a centimeter (see above), so I wasn’t optimistic, but I tried. It was not easy. First, I tried a full centimeter. Then two. Eventually, I got all the way off the pillow and into the car in the back seat in the fetal position for the trip to the doctor’s office. They put me in a room right way, thankfully. By this time I was feeling considerably better, although the headache was still about a 7.1 and I was still feeling nauseated. The doctor came in soon enough and got right in my face to look down Please see NURSE STORY page 16

MAY 1, 2020

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GARDENVARIETY

Have you been overindulging on snacks and goodies while sheltering in? Does your scale tip a little too far, and your intestinal tract is not letting you forget it with discomfort and extra pounds? Our body is equipped to detox and cleanse on its own. However, certain health-promoting foods and drinks can assist the body in this process. This Mint Lemonaid Detox drink does just that. As life gets back to normal, try this delicious detox drink each morning instead of coffee to start your day on a healthier note. This drink has three main ingredients, lemon, ginger, and mint. The ginger has anti-inflammatory properties, so it protects cells from damage done by free radicals and other toxins, like those from not-so-great food and drink choices. Lemonaid is the ideal flushing food, packed with potassium and water to restore healthy fluid balance and flush out any bloating salt that may be causing you to store water and puffiness. Mint soothes the stomach and contains potassium to help restore healthy fluid balance and flush out bloat. Mint Lemonaid Detox Ingredients • 1/2 cup fresh mint leaves, plus more for garnish • 1 cup white sugar, or preferably stevia substitute • 1 cup fresh lemon juice and pulp • 1 teaspoon grated ginger • 6 cups room temperature

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Mint Ginger Lemonade filtered water • Ice, as needed • Lemon wheels and mint leaves for garnish Instructions Using a muddler or wooden spoon, gently muddle the mint leaves, being careful not to tear them. In a gallon size pitcher. combine the mint leaves, lemon juice, and pulp, ginger, and sweetener with room temperature filtered water

Stir until sugar or stevia is dissolved Add ice to chill and the lemon wheels, allowing them to float in lemonade. +

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

Fun fact: Gina Dickson does all her own photography for the photos that accompany each of her recipes.

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For external use only. May be habit-forming. Take regularly; do not discontinue reading unless advised by a physician. Product not child resistant. Do not chew or crush. Not to be taken by mouth. May be taken (read) on an empty stomach, or with food. May be taken one hour before or after meals. And at any other time. Product may not be gargled. Do not drive a motor vehicle or operate heavy machinery while reading. Use in conditions of adequate light. Store in a cool dry place. Not to be used as a personal flotation device. Dispose of properly. Overeating, poor diet, cigarette smoking and excessive drinking may alter the effectiveness of this product. Do not use near spark or flame. Not dishwasher safe. If you become too salubrious, please read fewer articles.

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ASK DR. KARP

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NUTRITION

Michelle, a Facebook friend from Atlanta, asks, “What are your thoughts on taking Vitamin D, zinc and other dietary supplements to aid your immune system in fighting off Covid-19? Many of my friends and family have started taking these supplements during this pandemic.” Thanks for the question, Michelle. You can bet that you will be seeing a lot of advertising and social media buzz for using dietary supplements

that help you fight Covid-19. Whenever there is a disease or condition for which there is no known cure, people always start hoping that it can be prevented, ameliorated or cured in some way by what you eat, either with food or supplements. Covid-19 is no exception. History is filled to the brim with this kind of wishful thinking. Dietary and nutritional recommendations are meant for the general population, not specific individuals. Is it reasonable to take a dietary supplement when one has no specific personal data to back up the recommendation? I think not. It is an irrational approach to medical nutrition, which can lead you down the road to making reasonable rather than evidenced-based medical and nutritional decisions. The other problem with this line of thinking is the idea that somehow taking a supplement one minute will improve your immunity the next minute (or the next day). The effect of food and supplements on your immunity and your responses to a disease is a very long-term process. It is not something that happens overnight. I have seen, for example, suggestions to take Vitamin D supplements to boost your immunity during the Covid-19 crisis. The fact is that a recommendation for Vitamin D should be based on an individual’s blood Vitamin D levels

MAY 1, 2020 Televangelist Jim Bakker has recently been in legal hot water for hawking a supplement alleged to prevent or cure the coronavirus.

(easily measured during a routine physical), medical history and clinical findings. Only then, based on a finding of deficiency, does it become reasonable and logical to apply a general recommendation for a Vitamin D supplement to a specific individual. In addition, knowing an individual’s Vitamin D status can help define how much Vitamin D to recommend and for how long. It also gives you a way of monitoring a person and deciding when to decrease the amount of supplement or even discontinue it. Don’t forget that the Vitamin D supplement recommendation for an individual also depends upon the person’s age, gender, condition (such as pregnancy), amount of exposure to sunlight and their dietary intake of Vitamin D, mainly as enriched dairy products, fatty fish, orange juice, cereals and other foods. As for zinc, there is certainly a lot of research and information on this micronutrient. The suggestion that it would be reasonable to take a zinc supplement would hold much more weight if the United States

were a country where zinc deficiency is common. In fact, it is not. Zinc deficiency is rare in the United States. On the other hand, if a general recommendation for zinc supplementation were made for people living in Sub-Saharan Africa, a region in which zinc deficiency is present in 20% or more of the population, that recommendation would be reasonable. The usual comeback to the argument advocating zinc supplements is that zinc deficiency in the US is “sub-clinical.” This is a non-provable argument. The National Academy of Sciences, Food and Nutrition Board, sets the Dietary Reference Intakes for all the macro and micronutrients and has very in-depth information about zinc. They also set tolerable upper intake levels, describe adverse effects (yes there are adverse effects) and document how zinc supplementation can suppress copper absorption in the GI tract. Most importantly, if your friends and family are concerned about the relationship of nutrition to their immunity

and the ability to fight off Covid-19, instead of getting a sense of false security by popping a pill, they need to concentrate on nutrition and diet-related factors that are known to reduce the immune response. These factors include being overweight/obese, having poorly-managed diabetes and high blood pressure, being at increased cardiovascular risk and having a lack of physical activity. Nutritional factors affecting immunity are long term effects. Popping nutrition supplements during a crisis would be expected to have little if any immediate effect on your overall immunity. In fact, permit me to hypothesize a reason Covid-19 is striking a younger population in the U.S. compared to the rest of the world. It may be related to the decreased immunity in this population because of the epidemic of obesity, diabetes, hypertension, cardiovascular risk and the lack of physical activity in the younger population in this country. Future studies will examine this question. What is the “No-Nonsense Nutrition” advice for today? Simply this: your body’s immunity is affected by many factors. If you want to improve your immune status, instead of popping a supplement, pay attention to all those known risk factors for chronic disease. +

Have a question about food, diet or nutrition? Post or private message your question on Facebook (www.Facebook.com/AskDrKarp) or email your question to askdrkarp@gmail.com If your question is chosen for a column, your name will be changed to insure your privacy. Warren B. Karp, Ph.D., D.M.D., is Professor Emeritus at Augusta University. He has served as Director of the Nutrition Consult Service at the Dental College of Georgia and is past Vice Chair of the Columbia County Board of Health. You can find out more about Dr. Karp and the download site for the public domain eBook, Nutrition for Smarties, at www.wbkarp.com Dr. Karp obtains no funding for writing his columns, articles, or books, and has no financial or other interests in any food, book, nutrition product or company. His interest is only in providing freely available, evidenced-based, scientific nutrition knowledge and education. The information is for educational use only; it is not meant to be used to diagnose, manage or treat any patient or client. Although Dr. Karp is a Professor Emeritus at Augusta University, the views and opinions expressed here are his and his alone and do not reflect the views and opinions of Augusta University or anyone else.

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NOTHING THIS NICE IS IN YOUR GARAGE?

A GREAT START TO A HEALTHY HEART

by Lizzie Keen, MS, RD, LD, Doctors Hospital, Augusta Did you know that May is National Stroke Awareness Month? A stroke or CVA (cerebro- vascular accident) occurs when the blood supply to part of the brain is interrupted or reduced. This prevents brain tissue from getting the oxygen and nutrients it needs, causing brain cells to die within minutes. Strokes affect more than 795,000 people per year in the US alone and unfortunately result in around 140,000 deaths per year. This equates to about 1 out of every 20 deaths! Common risk factors for stroke include high blood pressure, unhealthy diet, physical inactivity, obesity, diabetes, heart disease, smoking, and family history, among others. Although there are some risk factors such as genetics that are difficult to avoid, it is estimated that up to 80% of strokes are preventable through lifestyle changes. Consuming a well-balanced diet like the DASH diet (Dietary Approaches to Stop Hypertension), made up of a variety of colorful fruits and vegetables, whole grains, lean protein sources, and healthy fats, is a great way to decrease the risk of having a stroke. Increasing physical activity is another beneficial preventive measure: The American Heart Association recommends at least 150 minutes per week of moderate-intensity aerobic activity. Other preventive measures include maintaining a healthy weight, smoking cessation, and reducing alcohol consumption. It is no coincidence that May is High Blood Pressure Education Month as well, because high blood pressure is the number one cause of stroke. High blood pressure, also known as hypertension, affects nearly 1 in 3 adults in the United States. Although there are multiple keys to maintaining a heart healthy diet, I’d like to narrow our focus to one particular area: sodium. Sodium is often mistakenly referred to as “salt” but they are not quite the same.

LEMON PEPPER ROASTED ASPARAGUS

This is simply delicious and sodium free – and adding a few toasted nuts takes the recipe over the top! 1 pound asparagus (trimmed) 1 tablespoon extra-virgin olive oil 1/8 teaspoon black pepper (or more to taste) 1 teaspoon lemon zest 1 tablespoon lemon juice (divided) 1 teaspoon minced garlic 2 tablespoons toasted almonds Cooking spray Cover a baking sheet with aluminum foil and spray with cooking spray. Lay asparagus on baking sheet in a single layer. In a small bowl combine the oil, pepper, zest, 1 teaspoon juice, and garlic and whisk together. Drizzle mixture over asparagus and toss to coat with your hands. Roast asparagus in a 350 degree oven for 11 minutes turning after about 6 minutes. In the meantime toast the almonds in a dry nonstick skillet over low-medium heat for 3-5 minutes. Watch the almonds carefully they burn quickly. Transfer asparagus to a serving platter, drizzle with remaining lemon juice and sprinkle with toasted nuts. Yield 4 servings Nutrient breakdown: Calories 80; Fat 5g (2.6g mono fat); Cholesterol 0mg; Sodium 0mg; Carbohydrate 6g; Fiber 3g; Protein 3g. Nutrient Breakdown: 20% DV for Vitamin C, 10% DV Vitamin A Diabetes Exchange Values: 1 Vegetable, 1 Fat Citrus Power

Sodium is actually just one of two components of salt; the other is chloride. Sodium is an essential nutrient needed to keep our bodies running smoothly, even though in excess it can be dangerous. In fact, the leading cause of high blood pressure is too much sodium in the diet. Decreasing sodium intake can help decrease blood pressure and promote a healthier heart. Being mindful of sodium intake is increasingly important during this time

of uncertainty, as many of the items commonly being bought in bulk for stocking the pantry (canned foods, processed meats, frozen dinners, shelf-stable foods such as snacks, pasta, and instant noodles to name a few) are chock full of sodium. This is because salt is used as a preservative to extend the shelflife of these items, making them last much longer than fresh, unprocessed foods. Don’t skip a beat this May! Get a head start on maintaining a healthy heart! Here are some tips for decreasing sodium in your diet whilestill consuming well-balanced, nutrient-rich foods that are still delicious. • Fro-zone: Try fresh or frozen fruits and vegetables! Frozen produce often gets a bad rap, but it’s actually frozen at peak nutritional value, making it just as healthy as fresh, and much longer-lasting! If this is not an option, do not fear, for canned fruits and vegetables can be healthy options too- see tip #2. • Rinse, Repeat: Thoroughly rinse canned fruits and vegetables before cooking. This can decrease sodium content up to 41%. • Snack Attack: Opt for fruit, unsalted nuts, yogurt, or fresh veggie sticks instead of salty snacks like potato chips or pretzels. • Don’t get too saucy: Condiments such as ketchup, BBQ sauce, some salad dressings, and soy sauce are loaded with sodium! Use other ways to flavor your dishes such as vinegar, pepper, onion, or sodium free seasoning options. Adding citrus such as lemon or lime juice can also help decrease the need for salt. • Avoid the excess: Add salt to food after cooking rather during. A sprinkle to taste goes a long way! • Powerful Protein: Limit processed meats such as deli meats/cold cuts, bacon, sausage, and fried items, as they tend to be high in sodium. Instead try choosing leaner, Please see MAY HEALTH page 16

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CRASH

COURSE

More Americans have died on US roads since 2000 than in World Wars I & II combined

How do you feel about roundabouts? Or as some people call them, rotaries? People seem to either love them or hate them, with the smallest group, the “I don’t care much either way” group, in the middle. But like them or not, they are here to stay, and traffic engineers say they will be appearing in ever-growing numbers. Some states (New York is one) have mandated that every new intersection, and every intersection up for an overhaul, upgrade, or redesign, should be converted to or originally built as or a roundabout whenever possible. Of course, not every intersection is a candidate for the roundabout treatment. They aren’t well suited for intersections where one road has very heavy traffic and the other road has very light traffic. Sometimes there are geographical limitations; there just isn’t enough room, or there are physical barriers that can’t easily be removed. Why are roundabouts the next big thing in road design? (Believe it or not, the Insurance Institute for Highway Safety says the first modern roundabouts in the United States were constructed in Nevada in 1990.) Two factors come into play that are at first glance opposing objectives. One goal is to keep traffic moving. The smooth and orderly flow of traffic is a key safety consideration on all roads, but increases in importance as the vehicle count on any roadway increases. Anything that isn’t smooth and orderly — sudden lane changes, stop-and-go traffic, driving much slower or much faster than surrounding cars, construction zones — increases the chances of accidents and injuries. Smooth and orderly traffic flow is Safe Roadway Design 101. But the second goal of roundabouts, conversely, is to slow traffic down. The very design of these intersections make it an absolute necessity. But in doing so, roundabouts accomplish a huge boost in safety. Consider typical accident scenarios in traditional intersections: someone runs a red light or a stop sign and T-bones another vehicle. Both are traveling at full speed. The consequences are often devastating. Or maybe a driver starts a left turn and doesn’t see the approaching car behind a large truck. One car is traveling full speed, the other is almost stopped. The resulting crash is almost head-on. Collisions like that are eliminated by roundabout design. All traffic is traveling in the same direction, and at slow speeds, typically only 15-20 mph. At worst, roundabout collisions are minor rear-enders or low speed scrapes. Fatal accidents are no stranger to traditional intersections, but are extremely rare in roundabouts. One study found that drivers viewed new oundabouts unfavorably, but a follow-up study a year later discovered opinions had improved dramatically, illustrating the point that sometimes the problem with roundabouts is nothing more than a lack of familiarity. Once we get the hang of them we’re good to go. One of the keys to their safety, however, is good design. Unlike the illustration above, a flat center circle is inviting accidents. Drivers unfamiliar with the area driving in conditions with poor visibility (at night, in fog or rain) could easily see headlights straight ahead and not even notice that the intersection is a roundabout until it’s too late. Signage, landscaping, and lane markings are all important elements in helping roundabouts live up to their full potential in making travel safer. Then it’s up to drivers to go with the flow. +

CAN YOU SOLVE ThE THIS REBUS?

MAY 1, 2020

HUMAN BEHAVIOR THRIVING TOGETHER

After the COVID-19 pandemic is over, some experts are wondering, “What’s coming next?” But they aren’t talking by Jeremy Hertza, Psy.D. about another virus. As all of us are together at home, many of us are noticing problems we may never have seen before. We’re seeing how our children are struggling with paying attention to schoolwork; how our marriages or relationships aren’t thriving with more time together; how we’re all feeling really isolated, missing school, work, friends and all the normal outlets we normally would have. Frankly, many of us are talking about a second epidemic of reactionary mental health problems because of COVID-19. Social distancing is essentially a situation that is breeding mental health problems, and doing so in a way that’s taking away all of our traditional coping mechanisms. Here’s how it’s playing out: Parents are homeschooling kids and realizing their children have learning problems. On top of that, they’re managing work. Their spouse is home too, and they’re not used to spending so much time with their spouse. Ultimately, it’s a pressure cooker of stress. My patients are telling me now that they are exhausted all the time, even if they’re not doing much. My response is that we all have a bucket, and there’s Free weekly help groups usually room to handle more in that Virtual or audio-only bucket. The problem is that right now, To sign up or get more our buckets are half to three-quarters information: full already with just what’s going on info@nbageorgia.com around us, and there’s no room for any other stress coming our way. So it’s no wonder we feel exhausted, emotionally drained, and stressed. My answer: Community. When we share our problems in a group, that gives us an outlet. It also helps us see that we’re not alone in this when other people share they have the same problem. But sharing also has to be in a space where you don’t feel as though you’ll be judged, and where a facilitator can help everyone focus on how to solve a problem, not just feed off one another’s anxieties. To help, NeuroBehavioral Associates is starting free weekly COVID-19 anxiety groups for children and adults, offered virtually or audio-only, depending on preference. For children, groups will be divided by age group, and adult groups will also be divided by preference; women-only, men-only, marriage and parents are some of the possible options. Groups will have 10 to 12 participants max. To sign up, email info@nbageorgia.com. By talking together, we hope people can feel more connected with each other and not feel so alone; gain skills to manage the current situation; and not just maintain relationships but use this period to further develop relationships. Let’s not just survive this, but let’s end up better off than we were before, with a better support system and new coping skills we never had. +

COVID-19 STRESS? ANXIETY?

Jeremy Hertza, Psy.D., is a neuropsychologist and the executive director of NeuroBehavioral Associates, LLC, in Augusta, on the web at http://nbageorgia. com. Contact him at 706-823-5250 or info@nbageorgia.com.

MAY 1, 2020

The blog spot — posted by Tracey L. Henry, MD on April 29, 2020

REOPENING GEORGIA IS A GAMBLE. HERE’S WHY. When I first heard that my state is planning to reopen soon, I was shocked. I was busily seeing patients that day when I received an alert on my phone. Perplexed and stunned, I couldn’t help but stop what I was doing and reach for some hand sanitizer so that I could actually pick up and use my phone, and then I re-read the message. As a physician, I personally have been risking my life and potential livelihood with other health care workers and support staff every day to take care of patients with COVID-19. I have been wondering and worrying that at any moment I could be infected and could unknowingly spread it to my patients, friends, or family. I could even get sick and become a burden to my own family. For now, I have been risking my safety to offer what support I can to patients who can’t physically see or touch their family members. I lend my personal phone so that patients can FaceTime and at least see the loved ones that they have been separated from during their prolonged hospitalizations. We as health care workers have now become their family and support system. The federal government and leading medical organizations like the American College of Physicians have previously established metrics that recommend when it might be safe to open states like mine during a pandemic like this. They identify core benchmarks like a downward trajectory of documented cases within a 14-day period, a robust testing program in place for at-risk healthcare workers, including emerging antibody testing, enough PPE for all healthcare workers, the ability to trace contacts of COVID-19 positive results and a sufficient healthcare workforce and health system capacity to treat patients with the virus if such a dramatic surge in need occurs. We currently do not meet any of these benchmarks. Georgia is still on an uptick with an increasing number of new cases of COVID-19 announced daily by our health department. Reopening is a gamble. There is a lag time between when people are infected and their subsequent need for hospitalization. We know that one of the main ways to mitigate the spread of this virus is social distancing. So how can our patients social distance in communal spaces like the barbershop, bowling alley, or tattoo parlor? Social distancing, air ventilation, the ability to screen patrons before entering a business are just a few of the many challenges businesses must address before being safely able to reopen. Daily when I leave the hospital, I have to change out of my scrubs before I can enter my vehicle and drive home, and I do not engage with my family until I have fully decontaminated myself. What was the purpose of all of this to simply reopen before any metrics have been safely met? I support a strong economy, but in order to have a strong, healthy economy, we need strong, healthy communities. Reopening makes this harder, if not impossible—by increasing risks to our citizens and health care workers. In fact, reopening now is like not finishing your antibiotics because you are finally starting to feel better. I understand that our leaders have to make a great deal of difficult calls. As physicians, we understand that well, but reopening our state is not one of them. +

We’re not meeting any of the benchmarks.

Tracey L. Henry is an internal medicine physician

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A FEW FACTS ABOUT...

ow much do you know about the woman who is popularly known as the founder of modern nursing? Here are a few facts and figures for you in case you wind up on Jeopardy! someday and one of the categories is “Florence Nightingale.” • She was born almost exactly 200 years ago (May 12, 1820) into a rich, upper-class, wellconnected British family in Florence, Italy, and was named after the city of her birth. Florence’s older sister Frances Parthenope had similarly been named after her place of birth, Parthenopolis, a Greek settlement now part of the city of Naples. The family moved back to England in 1821, with Nightingale being brought up in the family’s homes at Embley Park (below) and Lea Hurst. • Her sister and mother were said to be intensely angry about and opposed to her intention to work in nursing.

• Despite the opposition she experienced from her mother and sister, her father gave her an income equivalent to about $65,000 a year in today’s money, allowing her to pursue her career.

Despite that, she rejected the expected role and the restrictive social code for affluent young English women — basically to become a wife and mother — and entered the nursing field in 1844. • As a young woman Nightingale was attractive, slender and graceful. While her demeanor was often severe, she could be very charming and her smile was radiant. Her most persistent suitor was the politician and poet Richard Monckton Milnes, 1st Baron Houghton, but after a nine-year courtship she rejected him, convinced that marriage would interfere with her ability to follow her calling to nursing. Most Nightingale scholars believe she remained chaste for her entire life.

• Nightingale was one of the first healthcare practitioners to recognize the importance of hygiene in patient aftercare, noting that ten times more Crimean War soldiers died from illnesses like cholera, dysentery, typhus, and typhoid fever than from their battle wounds. • A 1911 book about her work stated that her efforts reduced the death rate from 42% to 2%, although Nightingale herself never made such claims. • She was one of the first persons to ensure that healthcare was not denied to patients due to their morals or financial condition, making care accessible to paupers, and working to repeal prostitution laws that were overly harsh to women • Her travels took her as far as Greece and Egypt. • She died at age 90 on August 13, 1910 + Source: wikipedia.org

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Research News Using light to kill coronavirus It isn’t all a joke. Ultraviolet (UV) light can be effectively used to decontaminate surface, water and air using technology that has been around for some time. The UV light we are regularly exposed to from the sun is of two types, UV-A and UV-B. The UV wavelength that is effective against germs is the much rarer UV-C, which does not occur naturally. Its only sources are man-made devices. A 30-second exposure of LED UV-C light is 99.99% effective in killing bacteria, but is applied in the absence of humans. In fact, the World Health Organization warns

against using ultraviolet disinfection lamps to sanitize hands or other areas of the skin; even brief exposure to UV-C light can cause burns and eye damage. The burnout blues A new study from our neighbors at the Medical University of South Carolina has discovered that burnout among medical students is closely related to depression. The previous school of thought was that burnout was caused primarily by workplace factors, while depression was linked to primarily with personal factors. The MUSC research, undertaken in collaboration

with Harvard’s Brigham and Women’s Hospital, identifies the two issues as much more closely related than previously known, which can help make treatment more effective. Study authors noted at least 142 different definitions of burnout in clinical literature. What would be accepted as burnout here wouldn’t be there, leading to wide variations in correct diagnosis and treatment. By contrast, depression is very clearly defined clinically, leading to a greater likelihood of proper diagnosis and care. The findings suggest that treatment for either condition is likely to be effective for both. +

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AUGUSTAMEDICALEXAMiNER

The Examiners +

This is interesting.

What?

by Dan Pearson

Apparently flat earthers are extremely concerned about this pandemic.

They’re afraid social distancing may push some people over the edge. I’m sorry I asked.

Why?

PUZZLE

26 29

36 39 42 45 47

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, MAY 11, 2020

We’ll announce the winner in our next issue!

E X A M I N E R

22 25

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

55 59

9 7

S U D O K U

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

34. What surrounds a pupil 35. Support 38. Early prefix for plane 39. Intro for mate or block 41. Augusta’s “The _____” 42. Liver fluid 44. Sickness 45. Barbary sheep 47. Raccoonlike carnivore 48. Product recall culprit, sometimes 49. Augusta’s “Blue _____” 50. Gravel ridge 51. Slammin’ Sammy of MLB 52. Talon 53. Forearm bone 54. Blackbird 57. Adjective for lunch or lady 58. Fish eggs 59. Permit

Solution p. 14

QUOTATIONPUZZLE F B I O B

E Y F R

W E C I

T I S H A N W L D T D E A C O

R L W G ’ N N N E H E E I ’ T T I G

4 2 6 3 1 8 9 4 5V 7 2D 1 7 5 8T 6 3 9

— Al Boliska

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.

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.

G G 1 2 3 4 5 6 7

1 2 3 S 1 2 3 4 5 6 7 8 9

U 2 3

— Dalai Lama

1 2 3 4 1 1 2 3 4 1 2 W R T 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6

1.IWWWLOASSGNY 2.UOOOOSHEAFT 3.AUCMTTNNR 4.DETTTOK 5.KITE 6.INER 7.MGF 8.UE

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

K 1 2 3 4 9.SL

L 2

I 3

N 4

D 5

ACROSS 1. Dry adjective 23 24 5. Hollywood jobs 27 28 10. Ali’s last name? 32 33 34 35 14. Ancient Greek coin (onesixth of a drachma) 37 38 15. Show jubilation 40 41 16. Type of severe fracture 17. Young boys 43 44 18. Properly; suitably 46 19. Thin layer of gold leaf 20. Kill Bill star 51 52 53 54 21. Helper 56 57 58 22. Australian marsupial 23. Readily sold 60 61 25. Half a quart 63 64 27. Sick 28. Having droopy ears by Daniel R. Pearson © 2020 All rights reserved. 32. Gradual decline 35. Regulation; ordinance DOWN 36. Where The Wild Things ___ 1. Dose given all at once (med.) 37. Highway sight 2. Biden’s former boss 38. Equipped 3. Pertaining to a node 39. ____-ups 4. Ernie of the PGA 40. Black bird 5. Get more medicine 41. Piles 6. Rust 42. Pulitzer Prize winning 7. Stringed instrument poet with Augusta ties 8. Right angle joint 43. Sully 9. Pigpen 45. To be ill 10. Capital of Colombia 46. Century Plant 11. Capital of Samoa 47. Paine _________ 12. ____ Auditorium 51. A pair of oars 13. Rectangular wall pier 54. Pouting grimace 21. Competent 55. Long-leaved lettuce 22. Was aware 56. Earthen pot 24. Helps 57. The staff of life 25. Natives of Krakow 59. Style; fashion 26. Apple product 60. Type of trap 28. _____ node 61. It comes from the heart 29. Tedesco successor at AU 62. Otherwise 30. 4th-largest Great Lake 63. Apart 31. Road mishap result 64. Extremely cold 32. Crust covering a cut 65. Level 33. Avenue

WORDS NUMBER

THE MYSTERY WORD The Mystery Word for this issue: ELLBIRA

EXAMINER CROSSWORD

MAY 1, 2020

5 9 7 8 6 3 4 1 2

3 7 2 6 9 5 1 4 8

6 4 5 2 1 8 9 3 7

8 1 9 3 4 7 6 2 5

MAY 1, 2020

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The

Advice Doctor

Moe: A poor workman always blames his fools. Joe: You mean tools? Moe: Agh! This stupid keyboard!

Moe: My book on clocks finally came. Joe: It’s about time.

hen I was about 9 years old, my father made me go with him to the funeral of a friend of his, some man I didn’t know. When we arrived I was the only kid there, so I stayed in an inconspicuous spot, waiting for time to pass by. At some point a man approached me and said, “You better enjoy your life, son. You’ll learn that time flies. Seems like just yesterday I was 9 just like you, but look at me now...” He tousled my hair and sadly wandered off. Before we left my father said I needed to pay my respects to the dead person. When I looked in the coffin, I was startled to see that the man in the coffin was the same man who had been talking to me earlier! For years after that day, I was not able to sleep properly. And when I could finally fall asleep, terrible nightmares would wake me up. I was terrified of death and afraid of the dark. I didn’t turn off the light at night — ever. My teen years and early adult life were nothing but fear and misery. And then one day I discovered something incredible that changed my life. The dead guy had a twin brother.

Moe: Sadly, I’ve lost 20% of my sight. Joe: I’m sorry, I didn’t hear you. Your what? Moe: Sigh... Moe: Hey, what’s made of leather and sounds like someone with a cold? Joe: A shoe. At the parole board hearing, the inmate stepped up and the lead officer asked, “Tell us, why do you think you should be released early?” “Well,” began the inmate, “I think...” “Yes?” said the officer. “I just feel like I’ve...well...I don’t know exactly how to say it, but...” “Go on,” said the parole officer. “Since I’ve been here...” “Please go ahead,” interrupted the officer. “Would you just let me finish my sentence?” yelled the inmate. “As you wish,” said the officer. “Parole denied.” Moe: My friends and family all laughed when I told them one day I would discover the secret of invisibility. Joe: If only they could see you now. +

Why subscribe to theMEDICALEXAMINER? What do you mean? Staring at my phone all day has had no Effect on ME!

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

Dear Advice Doctor, My supervisor asked me to do a job that was his responsibility on the basis of an excuse that turned out to be completely bogus. Not to brag, but I nailed it and he got all kinds of praise for the project, yet he never told anyone that I did the work. Not only did he fail to thank me (even privately), he offered a left-handed compliment about the job that was really more insult than commendation. Do you think I should go upstairs and tell his supervisor the whole truth? — Wants to Return the “Compliment” (if you know what I mean) Dear Wants to Return, Once upon a time this would have been a simpler topic to discuss, but as more research is conducted and analyzed, some former “facts” are relegated to myth status by new and unexpected discoveries. Even so, very little about left-handed anything (except compliments) is carved in stone. For instance, in the days of old, wishing left-handedness upon someone was like putting a curse on them: left-handers were believed to be more susceptible to sickness and have shorter life spans. Scientists now generally accept that being a leftie or a rightie has no effect on longevity. There are differences, however. Some studies suggest that being left-handed affects early learning and school performance in areas like vocabulary, reading, writing, social development, plus gross and fine motor skills. Oddly enough, ambidextrous or mixed-handed kids perform at a lower level than southpaws. Some studies also suggest a link between left-handedness and a greater incidence of mental health issues like dyslexia, attention deficit hyperactivity disorder, and some mood disorders. Being left-handed may also be connected to a higher risk of breast cancer, sleep problems and PTSD. On the plus side, being lefthanded can help protect against arthritis and ulcers. But keep in mind that despite the findings of any ten studies, there are millions of left-handers who don’t exhibit learning disabilities, mental health issues, or any other negatives for which lefties are supposedly at higher risk. Ultimately, what researchers don’t know about this topic is far greater than what they do know. 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 WINNER: WE STUMPED THE PANEL! NO WINNER! 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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MAY 1, 2020 First Impressions • How does it “feel” (and smell) when you tour it? • Did you schedule a tour or did you just “show up”?

IT’S A QUESTION OF CARE Questions to ask when selecting a senior residence

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Health & Wellness • If the person lives in a locked unit, are they allowed to leave the unit — with supervision — to interact with the other residents? • How do they ensure that your loved one drinks/eats enough? • Who handles the scheduled activities so that the residents do not go without stimulation and social interaction?

Staffing • What is the staff-to-resident ratio? • How do they calculate the staff-to-resident ratio? • What is their system to ensure that there are always enough caregivers? • How often do they check on each resident? Insurance & Costs • Will the facility help file long-term care insurance if someone wants to use his or her policy? • What are the hidden costs, if any? Examples of hidden costs:

• Requiring use of in-house pharmacy instead of a less expensive alternative • Incontinence supplies which must be purchased by resident • Fee charged if meals are brought to a resident’s room Knowledge is power and if you do your homework, you will make a smart choice. + by Amy Hane, a licensed Master Social Worker in South Carolina and Georgia, an Advanced Professional Aging Life Care Manager and a Certified Advanced Social Work Case Manager.

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ACUPUNCTURE

Dr. Eric Sherrell, DACM, LAC Augusta Acupuncture Clinic 4141 Columbia Road 706-888-0707 www.AcuClinicGA.com

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

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

IN-HOME CARE

Floss ‘em or lose ‘em!

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

DERMATOLOGY

Everyday Elder Care LLC Certified Home Health/Caregiver 706-231-7001 everydayeldercare.com Zena Home Care Personal Care|Skilled Nursing|Companion 706-426-5967 www.zenahomecare.com

LONG TERM CARE

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NURSE STORY… from page 6

my throat with a tongue depressor and shine a light in my pupils. This esteemed ear, nose and throat specialist — a name I guarantee you know — had obviously just finished smoking a cigarette before entering the room. For the record, cigarette breath is not my favorite aroma under the best of circumstances. In the state I was in at that moment, it took all my considerable resolve not to barf in his face. He took my history starting with the moment I woke up and swallowed the pill, including the fact that I wound up taking it on an empty stomach. He was puzzled. “You haven’t had any reactions from this medicine before?” None. “It’s unusual to develop anaphylaxis mid-stream, but not unheard of. Discard the rest of those and I’ll write a prescription for a different drug.” He left, but the nurse stayed in the room with me. She tactfully and respectfully suggested the obvious: the entire episode was the result of failing to take the pill with food or milk. I took the remaining pills as prescribed, didn’t fill the new prescription, and lived happily ever after — until the next year’s attack. To that nurse (whose name I do not know), I say a most sincere and heartfelt thank you. + Editor’s note: This story has appeared previously in the Medical Examiner. Do you have a favorite nurse story? Please send it in (e-mail address: Dan@AugustaRx.com). It would be great to have a number of stories to share in our next issue.

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MAY 1, 2020

MAY HEALTH… from page 9 minimally processed protein options like chicken, turkey, or fish. • Sneaky Sodium: Sodium lurks in many foods we would not normally think of as “salty,” such as bread, cheese, and even sports drinks. Get into the habit of reading food labels. Aim for choosing food items with less than 300 mg of sodium.

• Potassium Perks: Potassium has been shown to help decrease blood pressure. Try including potatoes, sweet potatoes, beans, squash, oranges or orange juice in your diet (as long as you are not on a potassium restriction prescribed by your doctor or dietitian). Keep these tips in mind when grocery shopping or

ordering take-out/delivery to help make more mindful choices that promote better heart health. Decreasing sodium intake is a great first step to a happier, healthier, heart! + Resources: American Heart Association American Stroke Association Eat Right.Org CDC

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