May11 18 by Daniel Pearson

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MAY 11, 2018

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NUTRITION Julia from Aiken asks, “As a parent, what can I do about the childhood obesity epidemic?”

Julia, thanks for shining a light on the very serious issue of childhood obesity. It is particularly worrisome, since most studies show that overweight and obese children grow up to be overweight and obese adults. Parents need to know that feeding children is not just about nourishing them; it is also about helping kids learn how and what to eat, helping them establish lifetime eating habits. Here are some general guidelines that parents and other child caregivers can follow when feeding children: 1. Parents and caregivers need to buy healthy food. The definition of a “healthy food,” should be

one which fits into the USDA Dietary Guidelines. The term “healthy” should not be defined by advertising fi rms, food companies, stores or manufacturers. Instead of being distracted by buzzwords such as organic, natural, clean, free-range, cage-free, hormone-free, etc., parents need to focus their attention on the Nutrition Facts label. Make sure that the food does not contain excessive calories, fat, saturated fat, sugar and salt, and that it is an important source of vital nutrients, such as protein, calcium, fiber and vitamins. Did you know that the identical dietary guidelines apply to both adults and children over 2? That means that what is considered healthy Please see NO NONSENSE page 8

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s most of us have heard by now, a new hands-free driving law will take effect in Georgia July 1. What do you and I need to know about this law? The bill prohibits drivers from physically holding a mobile phone or any stand-alone electronic device (like an iPod, iPad, Kindle, etc). That’s why it’s called a “hands-free” law. Making or receiving (or ending) phone calls must be accomplished with the use of at most a single button, and requires an earpiece or Bluetooth connection (or may be on speaker). Reading, writing or sending a text message or instant message or email while driving is also illegal. Using any kind of internet data streaming is banned, which means driving along listening to Spotify or Pandora is not a lawful activity in Georgia. But as the bill’s sponsor, Rep. John Carson of Marietta told the Examiner earlier this week, that prohibition came from Georgia’s 2010 anti-texting law, not Carson’s HB673. Why the need for this stricter law? In short, distracted driving has become a major public health issue. People simply aren’t paying attention behind the wheel. Statewide accident reports from the Department of Public Safety compiled by Georgia Department of Transportation (GDOT) yielded two alarming statistics: 1.) Please see HANDS-FREE page 2

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This will be the only way to go in Georgia (legally, at least) as of July 1. But why wait? You can go cell-phone free or hands-free at the wheel starting today.

HANDS-FREE… from page 1 74 percent of fatal accidents in Georgia during 2015 were blamed on impaired driving, driving too fast for conditions, and distracted driving; and 2.) fully 60 percent of fatalities in the Peach State that year involved drivers who failed to maintain their lane. A Georgia House Committee on Distracted Driving found that highway accidents in Georgia rose 36 percent between 2014 and 2016, with a corresponding 34 percent increase in fatalities. That is huge. It’s more than a one-third increase. Three types of crashes led the way: rear-end collisions, single-car crashes, and wrecks involving 15 to 25 year-old drivers. And three groups are bearing the brunt of fatalities: pedestrians, motorcyclists, and bicyclists. Unfortunately, they aren’t the only ones. Georgia Governor Nathan Deal signed HB673 surrounded by the families of five nursing students killed in 2015 when they were struck by a speeding big rig as they were stopped in an I-16 traffic jam, a tragedy linked to texting while driving. In another infamous recent case, a Chattanooga school bus accident in 2016 killed six children, the driver guilty of excessive speed and talking on his cell phone when the crash occurred. And while last week’s hit-and-run death of a Columbia County investigator may not prove to be a distracted driving accident when all the details are revealed, it has all the earmarks of one: running a stop sign in broad daylight by a 16-year-old driver. Furthermore, Georgia’s law banning texting has been a failure for a number

of reasons. First, it was impossible for police to determine if a driver they observed phone in hand was texting (which was illegal) or dialing a phone number (which was legal). Under the new law it won’t matter: both are banned. Another proof of its ineffectiveness: Georgia’s traffic fatality rate was higher in 2016 than before the texting law was passed in 2010. Additionally, people are largely unaware of the 2010 law’s parameters: likely you did not know, as mentioned above, that it made data/music streaming illegal while driving. From observation alone, many drivers seem to think it’s A-Ok to text, check Facebook, Google something, or check email as long as they’re stopped at a red light. But all of those activities have been against the law since the 2010 law went into effect — mostly to no avail. So countless thousands have simply ignored the law — through ignorance or willfull disregard — doing all of those things on a daily basis while stopped at lights and while hurtling down the highways and byways of Georgia. As a result of such factors, Georgia leads the nation in auto insurance premium rate increases as of 2016 (12.2 percent in Georgia vs. 5.6 percent nationally). The Medical Examiner predicts the day will come when people will react in disbelief to learn that at one time people were legally permitted to talk on the phone and type messages while zipping along at 50 or 60 or 70 miles an hour. As the caption above suggests, no one needs to wait until July 1 to implement the new law. We can do it today. +

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Kid’s Stuff

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

Let’s talk about STDs I know, sexually-transmitted diseases are a touchy subject, and most people prefer to not even think about it. However, sometimes because of this unwillingness to talk about STDs and acknowledge how serious they are, they are continuing to make people (primarily teenagers) very sick. And it is a huge problem that really should not be happening still in this day and age. Most people can name a few STDs: gonorrhea, chlamydia, herpes, HIV, syphilis... these are the most common and the most frequently tested for by doctors who are suspicious that STDs could be present in a patient. Many people also assume if they test positive for an STD, the doctor can just give them a prescription and they won’t have to worry about it anymore. True enough, gonorrhea, chlamydia, trichomonas, and syphilis can be treated with antibiotics. However, contrary to popular belief, not all STDs can be cured, and many infections will have lasting effects and risks. What’s more, most STD risks can be very easily reduced by practicing safe sex, using condoms, getting tested periodically if sexually

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MAY 11, 2018

active and encouraging partners to do the same. Let’s break down what everyone should keep in mind when it comes to the dangers of unprotected sex and some of the sobering truths of infections with STDs. There is no cure for HIV. HIV, especially if untreated, devastates the immune system and can progress to AIDS, which usually results in the patient dying of infection. HIV can also be transmitted from mother to baby during delivery, and neonatal HIV can be even more serious in a newborn than in an adult. With proper treatment, the outcome and life with HIV is improved, but still limited and complicated. There is no cure for herpes. Herpes is more than a painful outbreak of blisters. It can cause horrendous infection of the brain and nervous system than can leave a patient with permanent damage. Babies can also acquire a herpes infection from the mother during pregnancy or delivery, which can cause sepsis and/or meningitis that is frequently deadly. Chlamydia and gonorrhea

frequently cause abdominal discomfort, vaginal or penile discharge and odor, and pain with urination in some cases. However, many patients can be asymptomatic and have no idea they are infected until the infection has been present for some time. In girls, this can be very dangerous as it can lead to Pelvic Inflammatory Disease (aka PID, a serious infection of the female genital tract including uterus, ovaries, Fallopian tubes, etc) and/or Fitzhugh-Curtis Syndrome (infection that includes the liver and causes severe pain). If left untreated long enough, abscesses can develop and the patient can become extremely ill. PID can cause severe scarring of the female reproductive system and make pregnancy impossible. If a woman is already pregnant, acquiring an STD can be deadly to the growing baby, or increase the risk of the baby becoming ill after birth or being permanently affected (for example, infection with HIV). While this discussion is not meant to scare anyone or come across as preachy, it should encourage readers to be careful and aware of these infections and risks. Readers can in turn educate themselves, friends and family who may benefit from learning more about safe sex. It is my hope that the more we learn and educate ourselves about our health, the more we can reduce preventable illness and avoid suffering their long-term consequences. +

Is it really possible to predict the weather based on a feeling in your bones? This sounds like the stuff old wives tales are made of, but there may be some solid scientific evidence behind granny’s bone-based weather prognostications. That’s not to say that researchers have all the answers, or that everyone agrees with the ones who claim to have some of the answers. With that caveat, here are some of the theories. Joint pain seems to have a logical connection to meteorology. Every weather report includes plenty of stuff we don’t need a forecaster to inform us about: rain, snow, clouds, blistering heat, clear skies. etc. But something vital yet imperceptible is also included: barometric pressure, a measure of the weight of the air above us. Most of us cannot consciously sense this pressure even though it can be powerful enough to affect massive weather systems. Falling barometric pressure and bad weather travel together. Less pressure on joints means that they can expand, even if microscopically, and in the confined spaces between bones that can cause pain. Higher barometric pressure that accompanies good weather compresses joints, reducing pain. The same phenomenon can be experienced in flight. Someone sits all day at work with little discomfort, but flying for a few short hours causes them pain and discomfort. Why? Lower air pressure at high altitudes. You would think that it’s a warm and toasty 98.6° in and around joints all the time, but a 2007 Tufts University study found that arthritis pain goes up as the temperature goes down. The Arthritis Foundation even has a joint pain index on their website (arthritis.org) which factors in local temperature and barometric pressure. Some experts think we experience joint pain when it’s cold and rainy because we stay inside and hibernate. We don’t move around as much, so we get stiff and achy. Other researchers think it’s all in our heads: if a cold, dreary day makes us feel similarly down and dreary, then perhaps that psychological mood can affect the body too. +

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INER

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www.AugustaRx.com The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of salubrious news within every part of the Augusta medical community. Submit editorial content to graphicadv@knology.net Direct editorial and advertising inquiries to:

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(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net Opinions expressed by the writers herein are their own and/or their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., nor its agents or employees take any responsibility for the accuracy of submitted information, which is presented for general informational purposes only. For specific medical advice, diagnosis and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2018 PEARSON GRAPHIC 365 INC.

MAY 11, 2018

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#66 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

f all the doctors who lived and died in centuries past, this one, Justinus Kerner (1786-1862), may have been the most unusual, the most daring, and the most visionary. From his distant era he became what a writer in the journal Neurology called “the intellectual instigator” of one of today’s most versatile and popular medicines. Look up the man on Wikipedia, however, and you might not even realize he was a doctor: his medical legacy seems to have been hijacked by his lofty reputation as a poet. If Kerner had combined his writing skills and medical knowledge to write his autobiography, the resulting work might have been entitled Death by Sausage. That curious title is suggested by Kerner’s research, which came on the heels of the devastating Napoleonic Wars that ravaged much of Europe for a dozen years (1803-1815). As is the usual case in warfare, everyone suffers, not just direct combatants. Marauding armies need tremendous amounts of food and yet, ironically enough, often destroy crops. One Napoleonic Wars encounter, the four-day Battle of Leipzig in October 1813, involved 600,000 soldiers; at the time it was the largest battle ever fought in Europe, a record that stood until World War I. One can only imagine what it took to feed that many soldiers. Against this backdrop, poverty and hunger spread like cancer across Europe. Hygienic conditions in general and specifically in food production suffered. Cases of fatal food poisoning in and around one city, Stuttgart, got so bad that an edict was issued warning people about the suspected culprit: sausage. Stuttgart resident and medical officer Justinus Kerner had a radical idea: something organic and biological in the sausage was causing the problem. This was radical thinking because, as Discover magazine pointed out about Kerner, his era was a scant 50 years removed from the belief that witches cause of food poisoning, and a century away from the eventual discovery of bacteria as a cause of sickness. In 1820, Kerner published a detailed study of “sausage poison,” the first clinical description of food-borne botulism. Then in 1822 he published a second monograph reporting on an extensive series of experiments he conducted involving sausage poison, even administering a few drops of the isolated toxin to his own tongue. From his observations, he concluded that sausage poison was similar to other neurological toxins such as snake venom. He wrote that “the capacity of nerve conduction is interrupted by the toxin.” Considering how many had died from “sausage poison” — which was actually botulism, an extremely lethal toxin — it is rather amazing that Kerner theorized correctly that small doses could be employed to effectively disrupt overactive neurological systems. Nearly 200 years after Kerner’s prediction, Time magazine’s January 2017 cover story called Botox (a drug derived from the botulin toxin) “the drug that’s treating everything,” listing depression, wrinkles, back pain, erectile dysfunction, sweaty palms, migraines, heart trouble, “and 793 other problems.” Kerner’s expertise in “sausage poisoning” was so well-known that when the actual sausage poison, Clostridium botulinim, was finally recognized and isolated in 1895, it was given a name that includes the Latin word for sausage: botulus. +

by Marcia Ribble

One activity my fellow senior citizens could engage in is to record parts of their lives that would help their children remember the sound of their voices. Most of us write the same way we talk, so our rhythms of speech are contained in our stories, the way we use words, the particular habits of speech we have. Some people find writing too difficult, but cell phones that take movies can replace writing. Many older Americans who have lived quite modest lives might ask “What do I have to say that’s important enough to write down or tell?” The answer is lots of important things, more than most might realize. One simple but important thing to record is the names of relatives who have passed away, and how they are connected to one another. Where did they come from originally? What kind of work did they do? How many children did they have? Our children often have assignments in school to report on their ancestors, but in today’s fast-paced world where families may be separated by many miles, children find it difficult if not impossible to recall who their great-grandparents are because they aren’t around large family gatherings where elders tell stories about the family’s past. Another reason for writing down one’s history is that it creates an important piece of America’s historical record. Historians are often able to use family letters and stories to uncover the past. Most history is dreadfully incomplete because it tends to focus solely on wealthy

white men or warriors, not everyday folks. That has begun to change, but researchers often find it hard to get anything of substance about how it used to be because so few folks think their lives are important enough to write down. In the span of our lifetimes, so much has changed. Our children and grandchildren often haven’t heard about World War II’s red paper pennies to save copper for the war effort, or rationing shoes, gasoline, tires, and even butter. When people believe their lives have no importance, these kinds of important and very relevant experiences can become lost. People often post lists online that start with “you must be really old if you can remember...” The lists include things many of today’s youngsters know nothing about, and can offer valuable historical information. I first gained my sense of the importance of inventions to American society at Michigan’s Henry Ford Museum and Greenfield Village. They display more than cars, like implements used to wash clothes that developed from washboards and other simple tools into today’s washers and dryers. But those things only gain realism when we can picture someone actually using them. I began my married life using a wringer washing machine with a washboard for especially dirty clothes. Wet, clean clothes were hung on a line to dry. Those facts don’t come to life without knowing that wringers broke buttons by the gazillions, and that it hurts enough to cause a nice lady to utter language not acceptable if she got her finger caught in one. Record even those small facts because they are important. +

MYTH OF THE MONTH “My diet isn’t great, so I take a multi-vitamin.” The capsule you see to the right — and its contents — should be your fi rst clue as to whether or not taking a multi-vitamin is the best option for you. It is commendable that you recognize the true quality (or lack thereof) of your diet, and it’s also admirable that you want to do something about it by taking a vitamin supplement. What you are doing, however, is a little bit like reading Cliff’s Notes instead of a great classic novel. One is A-B-C, the other is A-to-Z.

One is the real thing; the other is a poor substitute for the real thing. Food should always be the primary source of our nutrition. Foods naturally contain all kinds of vitamins and minerals, and some suspect even yet-to-bediscovered nutrients. That is not to say that vitamins are unnecessary. They are beneficial to some people. Just remember to believe one thing on the label of a vitamin supplement: it is intended to supplement a healthful diet, not provide it. +

MAY 11, 2018

Musings of a Distractible Mind

by Augusta physician Rob Lamberts, MD, recovering physician, internet blogger extraordinaire, and TEDx Augusta 2018 speaker. Reach him via Twitter: @doc_rob or via his website: moredistractible.org

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want to tell you my story now,” a patient recently told me, a woman who suffers from many physical and emotional ailments. She had the diagnosis of PTSD on her problem list along with hospitalizations for “stress,” but I never asked beyond that. “OK,” I answered, not knowing what to expect. “Tell me your story.” She paused for about 30 seconds, but I knew not to interrupt the silence. “I killed my husband,” she finally said. That was unexpected. She went on to explain a horrible set of circumstances involving alcoholism and physical violence that resulted in shooting her husband in self-defense. She spent the two following years on trial for murder, eventually being cleared on all accounts. Despite this, the rifts in her family continue, and she (obviously) still relives this terrible moment. Deep breath. How could I hold any emotional instability against this woman? Who wouldn’t struggle? It brings me back to my oft-repeated mantra: everyone has a backstory. Not all backstories are so dramatic. One patient, very lovely and vibrant, revealed that it had been ten years since she was intimate with her husband. She does her best to hide the pain, but the toll of feeling unloved and rejected over ten years has taken its toll. In some ways, her skill at hiding the pain causes even more pain, as she faces the daily need to screw up happy emotions she doesn’t have. This pernicious rejection has made her walk through life feeling distant from everyone. She smiles to everyone, but the pain doesn’t leave. How can I ever know what

this is like? But in a way, I do know. Backstories are not limited to the patient side of the equation. I know physicians and nurses dealing with empty marriages, the demons of addiction, rebellious children, and deaths of parents and children. As professional as I try to act, there is no way I cannot bring my own pain to my relationships with patients. Perhaps there’s a mention of something by a patient that triggers memories, or perhaps the pain in my life drives me to seek emotional harvest from the praise I get from my patients. As hard as we all try to do otherwise, our encounters between doctors and patient are human to human, frail to frail, broken to broken. We strive for objectivity, but are always looking up from our own valleys of circumstance. So is this a bad thing? Is the ultimate ideal one of objectivity and clinical impassivity? Does it hurt me to feel deep compassion for those people in such pain? As always, the answer is probably “yes and no.” Clinicians often don’t know how to handle patients who don’t act predictably. The noncompliant patient is stupid, apathetic, lazy, or out to waste the doctor’s time. I’d probably be less mad at the guy who cuts me off in traffic if I knew that his wife had just died. In the same way, compassion gives slack to the rope when dealing with our patients. The very word “compassion” suggests feeling emotion alongside another person. I can only truly understand their pain through the lens of my own pain. In this way, bringing our own pain to the exam room can be a great asset. Obviously, there is a limit to this. My emotions,

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negative or positive, should not cloud my clinical judgment. Regardless of the severity of my bad day, I must try to hear what the patient is saying and try to understand it. This doesn’t mean I always give in to their demands or protect them from pain. Sometimes the confession, “I can’t do anything more” hurts to say, but it is better than giving false hope. The worst over-prescribers of pain and anxiety medications probably do so because they hate for people to be mad at them, and can’t refuse people’s inappropriate requests for these medications. This not only puts the patient at risk; it legally and professionally puts the physician’s career in jeopardy. But when I rebuff requests for unnecessary treatments, testing, or inappropriate medications, I must be aware of the patient’s emotional state. It sucks to have pain. It hurts to be anxious. Loneliness makes us look for escape. I find that, more than anything, people want understanding. People accept my answers much better when I show that I understand their pain, and hence their desire to get rid of it. My patients listen to me because I listen to them. My patients believe me because I know them. I can tell the person they don’t need more narcotics because they know I care about their pain (even if I can’t do anything about it). This takes time. It can’t be measured. It is not a computerized task; it is a human relationship. That’s what good care is: human to human, frail to frail, broken to broken. If my patients know I am human, they don’t ask for me to be superhuman. It’s that simple. And it’s that difficult. +

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BONUS BLOG SPOT

How to be the meanest mom Once, I walked out of a store without giving into my child’s tantrum for a cookie. A woman stopped me in the parking lot and told me I was the best parent in the shopping center. My daughter wasn’t so sure. When your kids tell you you’re mean, take it as a compliment. It scares the best of moms. It’s easy to want to throw in the towel. After all, don’t we all want to be the cool mom? Don’t give up. They’ll thank you later. Here are 12 ways to be the meanest mom in the world: 1. Make your kids go to bed at a reasonable time. Is there really anyone who hasn’t heard how important a good night’s rest is to a child’s success? Be the parent and put your kid to bed. No one ever said the kid had to want to go to bed. Now enjoy some quiet me or couple time. 2. Don’t give your kids dessert every day. Sweets should be saved for special occasions. That’s what makes them a treat. If you give in to your child’s

demands for goodies all the time, he won’t appreciate the gesture when someone offers a sweet gift or reward. Plus, imagine the dentist and doctor bills that may result from your over-indulgence. 3. Make them pay for their own stuff. If you want something, you have to pay for it. That’s the way adult life works. To get your kids out of your basement in the future, you need to teach them now that the gadgets, movies, video games, sports teams and camps they enjoy have a price. If they have to pay part of that price, they’ll appreciate it more. You may also avoid paying for something your child only wants until he has it. 4. Don’t pull strings. Some kids get a rude awakening when they get a job and realize that the rules actually do apply to them. They have to come on time and do what the boss wants. If you don’t like your child’s teacher, science partner, coach or placement of the bus stop, avoid the temptation to

make a stink or pull strings until he gets his preference. You are robbing your child of the chance to make the best of difficult situations. If children never learn to handle it, you’re setting them up for failure. 5. Make them do hard things. Don’t automatically step-in and take over when things get hard. Nothing gives your kids a bigger self-confidence boost than sticking to it and accomplishing something difficult. 6. Give them a watch and an alarm clock. Your child will be better off if he learns the responsibility of managing his own time. You’re not always going to be there to remind her to turn off the TV and get ready to go. 7. Don’t always buy the latest and greatest. Teach your children gratitude for and satisfaction with the things they have. Always worrying about the next big thing and who already has it will lead to a lifetime of debt and unhappiness.

8. Let them feel loss. If your child breaks a toy, don’t replace it. He’ll learn a valuable lesson about taking care of his stuff. If your child forgets to turn in homework, let him take the lower grade or make him work out extra credit with his teacher himself. You are teaching responsibility — who doesn’t want responsible kids? 9. Control media. If all the other parents let their child jump off a bridge, would you? Don’t let your kids watch a show or play a video game that is inappropriate for children just because all their friends have done it. If you stand up for decent parenting, others may follow. Create some positive peer pressure. 10. Make them apologize. If your child does something wrong, make her fess up and face the consequences. Don’t brush rudeness, bullying or dishonesty under the rug. If you mess up, set the example and eat your humble pie. 11. Mind their manners. Even

small children can learn the basics of how to treat another human with respect and dignity. By making politeness a habit, you’ll be doing your kids a huge favor. 12. Make them work — for free. Whether it’s helping Grandma in the garden or volunteering to tutor younger kids, make service a part of your child’s life. It teaches them to look outside themselves and realize that other people have needs and problems, too — sometimes greater than their own. With all the time you spend being mean, don’t forget to praise and reward your children for their stellar behavior. And always, make sure they know you love them. With a little luck, your kids can turn the tide and make their generation one known for its hope and promise. + by Megan Wallgren, a freelance writer and mother of four energetic children. She blogs about how to wear them out at kinetickids. blogspot.com.

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

“The cause was a mystery for a long time.” “And that’s when I fell.” nearest hospital “He doesn’t remember a thing.” “The was 30 miles away.” “I was a battlefield medic.” “He was just two when he died.”

“OUCH!”

“It was a terrible tragedy.” “She saved “I sure learned my lesson.” “I retired from medicine my life.” “It seemed like a miracle.” seven years ago.” “We had triplets.” “It was my first year “I thought, ‘Well, this is it’.” NOTHING SEEMED of medical school.” “They took me to the hospital by helicopter.” TO HELP, UNTIL. . “It took 48 stitches.”

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

“This was on my third day in Afghanistan.” in three places.” “I lost 23 pounds.” “Turned out it was just indigestion.” “At first I thought it was something I ate.” “The smoke detector woke me up.”

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

MAY 11, 2018

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Southern Girls Eat Clean Dementia Care Fresh & Creamy Avocado Salad Dressing Avocados are all the rage these days. They are delicious, and with their many health benefits they are nutritious as well. I keep avocados on hand all of the time and use them in our meals about every other day. They are amazing on salads or sandwiches and we love them for breakfast with eggs, on toast or in a smoothie. I ran across this recipe a few months back when I was going through my cookbooks. I needed a new dressing recipe to pump up my taco salad. It is so creamy, but has no dairy or mayo included. It was the absolute perfect addition to my salad. The tangy lime and fresh cilantro are complemented by the spicy jalapeno and make this clean salad dressing deliciously flavor fi lled. If you haven’t already included avocado to your diet here are a few reasons you may want to consider doing so: • High nutrient value with 2 grams of protein and 15 grams of healthy fats • A low-carbohydrate friendly plant food containing 9 grams of carbohydrates, 7 of those are fiber and only 2 are carbohydrates. • Avocados can lower cholesterol and triglyceride levels. • They’re loaded with certain antioxidants that can protect the eyes. • Avocados may help you • 1/4 cup of fresh cilantro lose weight. You’ll stay more the dressing the correct • 1 jalapeno, seeds removed, + satisfied after eating a meal consistency. It will be thicker coarsely chopped (use less if containing avocados due but you should be able to pour you prefer) to their higher healthy fat the mixture. • 3 Tablespoons of fresh lime content and fiber. Taste and adjust seasoning juice as necessary. This salad dressing is super • 1 Tablespoon of white wine Serve immediately at room vinegar easy to make and will store temperature. • 1/2 tsp. of sea salt in the refrigerator for about 4 Store leftovers in the • 1/4 Cup of extra virgin olive refrigerator in a sealed glass days in a sealed mason jar. I oil hope you’ll enjoy this yummy container for up to 4 days. + • 1/4 - 1/2 Cup of fi ltered salad dressing. water Tip: If your avocado is too Note: This recipe is a variation

Fresh & Creamy Avocado Dressing

fi rm you can speed up the ripening process by placing avocados in a brown paper bag. Simply pop the avocados in the bag and close the top. The next day they will be perfect and ripe enough to use. Ingredients: • 1 ripened avocado, peeled, seed removed and coarsely chopped

Instructions: Place all ingredients except the fi ltered water into a high speed blender. Blend on high for approximately 30 seconds to 1 minute or until all ingredients are incorporated. Remove the lid of the blender and add 1/4 cup of fi ltered water at fi rst. Blend again for 10-20 seconds. Add more fi ltered water if necessary to make

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of one found in Danielle Walker’s book, Meals Made Simple. Alisa Rhinehart writes the blog www.southerngirlseatclean. com She is a working wife and mother living in Evans. Visit her blog for more recipes and information on clean eating.

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NO NONSENSE… from page 1 for parents and caregivers is also healthy for children. 2. Parents and caregivers need to prepare food in an attractive and healthy manner. That means that instead of frying, try baking, broiling, microwaving or sautéing. Preparing foods in a healthy manner also means making sure that all the food groups are present at each meal and that the food is presented in ways that appeal to both you and your children. You can’t simply put some peas on a plate and expect that a kid (or adult) will eat them. However, try

fi lling up a large platter with cut up tomatoes, lettuce, onions, soft shell tacos, salsa, etc., and put the platter in the middle of the dinner table. Then, step back and watch the fun begin! 3. Parents and caregivers need to eat and drink healthy food themselves. This is crucial. Adults need to model good eating behavior. If you think that kids are going to eat the apple wedges in a fast food kid’s meal while you are chomping on the French fries, dream on. If you think that telling kids to drink their milk while you drink a soft drink and announce that you are an adult and don’t need dairy products, well, forget that too. 4. Parents and caregivers should keep quiet and let kids eat without prompting or bribing. What studies show is that when you tell kids “if you eat the tomatoes, you can have dessert,” you are simply making dessert more appealing while making tomatoes less appealing. Kids who live in a home where they are prompted or bribed about food grow up to be adults who hate veggies more and love desserts more. This is exactly the opposite of the parents’ intentions. A better parenting approach might be this: the next time you serve spaghetti (which most kids

love), chop up more tomatoes, green peppers, etc. and add them (quietly) into that store-bought spaghetti sauce. Then heat everything up and serve. You might also serve this “enriched” spaghetti with a “pizza salad,” a salad that has oregano, basil and rosemary sprinkled on top. Another idea: serve fruits with lemon or a vanilla low-fat yogurt dipping sauce. Serving fruit with a chocolate dipping sauce is not a good way of encouraging kids to eat fruit. 5. Parents and caregivers need to forget the “clean-your-plate” routine. Kids should stop eating when they are full, not when the plate is empty. This does not mean that food should be wasted. It means that smaller portions of food are put on a plate and served. It means that a child is taught to 1) only take an amount of food that they feel they can eat and 2) to stop eating, once they feel full. It is important not to override a child’s feeling of fullness or satiety. Once the satiety cue is lost, the child goes on to be an adult who uses external cues to stop eating (the plate is empty), rather than internal ones (I’m full). 6. Parents and caregivers need to be within their reasonable weight ranges and create a culture of health for the entire family and community. The fact is that children need to

see models of healthy behavior in their parents, their teachers, their friends and their relatives. Being overweight, obese, or physically inactive is not inherited. What is inherited is a family and social culture of eating high fat, high salt, high sugar and high calorie foods. What is inherited is a culture which encourages inactivity, instead of ACTIVITY. 7. Parents and caregivers need to eat with children at HOME, reserving “going out to eat” for infrequent occasions. It is cheaper and healthier to eat at home. You cannot control the calories, salt, fat, sugar and other nutrients in foods prepared in a fast food place, a restaurant or a buffet. Is it possible to find “healthier” selections on restaurant menus? Yes. Are the “healthier” options all that healthy? Usually not. What is the “No-Nonsense” nutrition advice for today? Parents and other child caregivers need to “step up to the plate.” The plate I am talking about is the plate on the table in your own home. Yes, it is true: being a good nutrition- and health-conscious parent takes time and effort. That’s what parenting is all about. And understanding that when you feed a kid, you are not only nourishing the child, byou are also teaching the kid what to eat for a lifetime...so make it healthy. +

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 fi nd 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 fi nancial 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 intended to be used to diagnose, manage or treat any patient or client. The views and opinions expressed here are Dr. Karp’s alone and do not reflect the views and opinions of Augusta University or anyone else.

Dr. Karp

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AUGUSTAMEDICALEXAMiNER

DON’T LICK THE BEATERS Useful food facts from dietetic interns with the Augusta Area Dietetic Internship Program, Augusta University

SPRINGTIME: FRUITS & VEGETABLES! by Christine Swearingen, MS-Dietetic Intern

As the weather finally begins to warm up, spring has us putting our coats away and reaching for short-sleeves once again. It can be a great time to make changes and start healthy habits, such as increasing physical activity and enjoying more fruits and vegetables as a wider variety becomes available. Many fruits and vegetables are also at their peak maturity during this time of year. An improved diet quality and physical activity are important steps to adopting a healthy

lifestyle. Eating enough fruits and vegetables is a vital part of a well-balanced diet. However, some may have the misconception that eating healthy is expensive. Choose locally grown or in-season produce as they are cheaper and are usually of high quality in relation to taste and texture. Most grocery stores and markets will have seasonal produce at reduced prices, making it easier to enjoy more fruits and vegetables. This is a good

time to select more fruits and vegetables such as broccoli, kale, asparagus, blueberries, and strawberries. These are ideal for freezing so that they can be used throughout the year. Freezing is an excellent way to benefit from lower prices and extend the shelf life of them with minimal nutritional value loss. According to MyPlate, the USDA recommends that half of your plate be filled with fruits and vegetables. Fruits and vegetables are loaded with nutrients and other compounds that are necessary to reduce the risk of chronic diseases and for disease management such as diabetes, hypertension, and heart diseases. Fruits and vegetables are low calorie nutrient dense foods that may be beneficial for weight management and they are important sources of nutrients such as vitamins A and C, folic acid, potassium and fiber. The health and nutrient benefits of fruits and vegetables are numerous. They are low fat, cholesterol free and high in fiber all which Please see FARM-FRESH page 10

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FARM-FRESH… from page 9 promotes cardiovascular health. Potassium helps to regulate blood pressure and folic acid is needed for the formation of red blood cells. Vitamin A protects against infection and vitamin C is necessary for wound healing and the absorption of iron. Both vitamins are powerful antioxidants that helps the body to destroy proinflammatory compounds that may cause cancers and other chronic diseases.

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The warmer weather also allows for more opportunities for outdoor activities. If you’re looking for walking areas, visit a park and other recreational areas. Many parks are dog- and kidfriendly making them ideal for family outings. Visit your local historical sites for sightseeing and to learn new things. If you are looking for an excuse to get outside, check out a local farmer’s market on the weekends Farmer’s markets are places to purchase locally grown foods that are freshly harvested. Many Farmer’s Markets have recently reopened for the 2018 season. Participate in food demonstrations at the markets and samples different vegetables, fruits, and herbs while getting extra steps in. Try a new fruit of vegetable and explore your creative side by incorporating them into a favorite recipe or finding new ways to prepare them. + For additional information on a healthy lifestyle contact a Registered Dietitian Nutritionist (RDN) or visit the Academy of Nutrition and Dietetics website at www.eatright.org for credible information. Registered Dietitian Nutritionists are the food and nutrition experts.

THE THRILL IS GONE

MAY 11, 2018

M E D I C I N E

I N

T H E

F I R S T

P E R S O N

False alarm H

elp! Call an ambulance! Hurry! My son is bleeding! There’s a lot of blood in his diaper! Help!” My mom was frantic. I was about two or three years old, still in diapers and not yet potty-trained, and we had been walking through a YouPick-Em strawberry patch in South Miami all afternoon, fi lling up several pint cartons of ripe, plump red, juicy strawberries. At some point my mom noticed that my diaper appeared to be full. Laying me down on my back in a chair to change me, she was shocked and horrified to find several mysterious blood-red masses about the size of a nickel among the poop. My

The masses were blood-red dad rushed over from several rows away to see what the screaming was all about. Worried at fi rst, he quickly determined that the masses were much more likely to be squashed strawberries than massive blood clots. As a family, our pick’em method was to pick the fi rst one, and it would go in the carton. The next one picked we would eat. I had apparently added a third step to the process: eat one, one

in the carton, and then the next one would be stuffed in my diaper. It soon became obvious I’d fallen down on my seat a couple times during the afternoon and had mushed some of them into pulp. My dad told that story for years with huge guffaws, much to my mother’s chagrin. I vaguely remember that day, mostly a lot of excited screaming by my mom but I really didn’t know what it meant. My dad, however, could always be counted on to fill in the gaps in my recollection, much to my mom’s embarrassment. + by Mel Johnson Augusta, Georgia

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The blog spot From the Bookshelf — posted by Jenny Hartsock, M.D. on September 7, 2017

7 WAYS FOR DOCTORS TO STAY SAFE AT WORK As we in the medical community continue to grapple with the risk of workplace violence, is there anything that we as individual providers can do to help protect ourselves? I would offer the following: 1. Be clear immediately and up front with patients about what their expectations should be. Many PCP offices have instituted policies where they never prescribe controlled substances, or at least never on the fi rst visit. Knowing this information as soon as possible, ideally before the appointment, can help to diffuse the tension or lead the patient to seek care elsewhere.

This is certainly good news

2. In the hospital setting, there are on-call police and security teams and special codes to raise the alert for violent patients and to trigger a response team — know what your policies are! In the outpatient world where this response team is usually not possible, have a clear safety plan in place with your staff and a pre-planned method to alert them to a dangerous patient. 3. Be alert to the risk of violence before you enter the room. Has the patient been violent in the past? Past violence is the single greatest predictor of future violence. Do they have mental health, addiction or chronic pain issues that place them at a higher risk for violent behavior? Consider flagging patients’ medical records to alert the staff of the risk for violence. If you know that risk is present, do not go into the patient’s room unattended. 4. When a patient starts to become agitated and violent, either in the hospital or office setting, do the following: a. speak softly and do not raise your voice b. listen actively and maintain positive nonverbal communication with eye contact and nodding c. acknowledge that you can see the patient is frustrated and upset d. reassure the patient you are listening to his or her concerns e. let the patient talk without interrupting them f. ask what you can do to help resolve the issue. 5. If you sense the situation is going to escalate and cannot be resolved, move slowly toward the exit. Keep as much physical distance between yourself and the patient as possible. Alert the surrounding staff and call the police as soon as is feasible.

The cover blurb from the 2006 edition of this book, originally published in 1863: Before her wider fame as the author of Little Women, Louisa May Alcott achieved recognition for her accounts of her work as a volunteer nurse in an army hospital. Written during the winter of 1862–63, her lively dispatches appeared in the newspaper Commonwealth, where they were eagerly read by soldiers’ friends and families. Then, as now, these chronicles revealed the desperate realities of battlefield medicine as well as the tentative fi rst steps of women in military service. Writing under a pseudonym, Alcott recounted the vicissitudes of her two-day journey from her home in Concord, Massachusetts, to Washington, D.C. A fiery baptism in the practice of nursing awaited her at Washington Hospital, were she arrived immediately after the slaughter of the Army of the Potomac at the battle of Fredericksburg. Alcott’s rapidly paced prose graphically depicts the facts of

hospital life, deftly balancing pathos with gentle humor. A vivid and truthful portrait of an often overlooked aspect of the Civil War, this book remains among the most illuminating reports of the era’s medical practices as well as a moving testimonial to the war’s human cost. AMAZON READER REVIEWS The Civil War has many sides. From Lousia’s viewpoint it was a personal tragedy for her and the men she cared for. A must read for anyone.

Fresh and compelling, this novelette was drawn from Louisa May Alcott’s short stint as a hospital nurse during the Civil War. It’s delivered with a strong dose of Victorian morality and Victorian prose style, but Alcott’s experiences are vividly recorded. So is her sympathy for the wounded and with the African Americans she meets. This is the Civil War as seen through a distinctly New England view, strongly abolitionist and strongly moralistic, but also practical, self-reliant, and positive. I only wish there was more about the hospital. One thing that jumped out at me was the central character’s familiarity with death; she is only thirty, but she says she has already been called to several deathbeds. The Victorians may have been repressed, but they knew a lot more about the facts of life than we do. + Civil War Hospital Sketches by Louisa May Alcott; 80 pages, published in February 2006 by Dover Books. Originally published in August, 1863

will work for YOUR PRAC TICE

6. Report any violent encounter according to your hospital or clinic protocol. Always report any incidence of violence, we cannot allow it to become an expected part of our workday. + 7. Talk to your administrators about workplace violence policies that are in place or under development at your hospital or practice. Advocate for policy improvements where necessary to improve staff safety. Let your voice be heard. Violence in our workplace is an ongoing issue. We can each help by reporting all violent incidents as they occur, and having fi rm policies and procedures in place. Always trust your intuition, if you are fearful of a patient take precautions before you enter the room to protect yourself. + Jenny Hartsock is a hospitalist.

That’s what our Professional Directory is for. See page 16. Doctors, we can help you reach new patients and make it convenient for current patients to connect with your office. Call us today — 706.860.5455 — to add your listing to the Medical Examiner’s Professional Directory.

OUR NEXT ISSUE DATE: MAY 25

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AUGUSTAMEDICALEXAMiNER

THE EXAMiNERS

MAY 11, 2018

THE MYSTERY WORD

How are you today?

Absolutely miserable.

by Dan Pearson

Maybe if you thought about I suppose you’re about all the people less right. Well how fortunate than you, are you? you wouldn’t feel so miserable.

Maybe if you thought about about all the people happier than you you wouldn’t feel so great.

Absolutely great

EXAMINER CROSSWORD

PUZZLE

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

Click on “READER CONTESTS”

QUOTATION PUZZLE

W E O M S N N A A N I B D I A O H O I I A B M M R Y O T E K F F A A U D L R O E N T T N T

—H. L. Mencken

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once. Black squares indicate spaces between words, and words may extend onto a second line. Solution on page 14.

X A M I N E R

4 3 2

9 2

2 7

4 9

8 6

1 4

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.

1 2 B 1 2

3 3

S S 1 2 3 4 1

W C 1 2 3 4 1 2 3 4 5 6 7 O B 1 2 3 4 5 1 2 3 4 1 2 3 4

— Writer Hilaire Belloc

1.RBBSSWWHH 2.IUEEIOICE 3.STSORRANA 4.SEEKRD 5.SL 6.E 7.T

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

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.

NUMBER SAMPLE: BY

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

VISIT WWW.AUGUSTARX.COM 1

ACROSS 1. A famous Hillary 5. Smack 9. Big tree in Canada 14. Capital of Norway 15. It can follow Capitol 16. Many-_____ (like a ranch) 17. Never used by a poet 18. Notion 19. Fragrant resin 20. Miscellaneous items 23. Humble dwelling 24. Like half of all Braves games 25. Not these 27. Columbia County Commission candidate by Daniel R. Pearson © 2018 All rights reserved. Built in part with software from www.crauswords.com 30. System of aircraft navigation 63. Finished 27. Duct intro 32. Made a mistake 64. Feat 28. Exhort 33. Lateral curvature of the 65. Shut with force 29. Hybridize spine 30. SC util. 36. It can appear between DOWN 31. ___, Rinehart and Winston “whiskey” and “go” 1. “First, __ __ harm” school textbook publisher 37. Like dry flaky skin 2. Secondhand 33. Surgery reminder 38. Muckraker Tarbell 3. Ran away 34. Ancient Roman days 39. The R of MRSA 4. Abandon 35. Scarf 42. Rattling breath sound 5. Land where the tower of 37. Surgical _____ 44. The white of the eye Babel was built 40. It can precede 57-D 45. Beat grain with a flail 6. Watergate figure 41. Cut 46. It’s near where Mike 7. On sheltered side 42. Ostrichlike bird Padgett Hwy and River 8. Scheme 43. Laborious Road meet 9. Symphony conductors 45. Tried out 48. Reproductive part of a 10. Knee injury ltrs. 46. Bullwinkle, for one plant 11. Adapted for grasping, 47. Mamie’s _________ 49. Paddle as a tail 48. Glide along smoothly 50. Heinz 57 and others 12. Arboreal primate found 51. Mild oath 56. Belief involving sorcery only in Madagascar 52. Example of 50-A 58. Capricorn 13. Prepares for publication 53. Cry out 59. Solemn promise 21. Impressed 54. Sicilian volcano 60. Surround; blockade 22. Dawgs coach (1964-1988) 55. Fraud 61. Poker stake 26. Ni ___ (Chinese greeting) 57. It can follow 40-D 62. Forearm bone Solution p. 14

WORDS

The Mystery Word for this issue: AUVLIS

MAY 11, 2018

13 +

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE

Advice Doctor

Moe: You got arrested? What happened? Joe: Actually, it was a case of mistaken identity all the way. Moe: But what happened? Joe: When we got to the station they asked me if I had a police record. That’s when they let me go. Moe: What did you tell them? Joe: I told them the truth, that I don’t have a police record, but I do have a couple of Sting CDs.

ha... ha...

hree spies were captured, a Frenchman, German and an Italian. Their captors come into the cell where the spies are being held, grab the French spy, take him into the next room and tie his hands behind a chair. They torture him for 2 hours before he finally gives up all of his secrets. The captors throw the French spy back into the cell and grab the German spy. They tie his hands behind the chair in the next room too. It takes 4 hours of torture before he finally cracks and tells them everything they want to know. Finally they grab the Italian spy. Like the others, they tie his hands behind the chair and begin their interrogation and torture. Four hours go by and the spy isn’t talking. Then eight hours, then 16. After 24 hours they give up and throw him back into the cell. The German and French spy are impressed and ask him how he managed to not talk. “I wanted to,” the Italian spy says, “but I couldn’t move my hands!”

Moe: What did the judge ask his dentist? Joe: I give up. What? Moe: “Do you swear to pull the tooth, the whole tooth, and nothing but the tooth, so help you God?” Moe: With all this Trump-Russia business, I hope our countries end up with better relations. Joe: Why? Moe: Because I love bread. Joe: Bread? What does bread have to do with anything? Moe: Russians make the best bread in the whole world, that’s what. Joe: Says who? Moe: I read in a book that Russians will stand in line all day for just one slice. Moe: How did your job interview go? Joe: Not too good. Moe: What happened? Joe: The interviewer asked me to describe myself using three adjectives. Moe: So what did you say? Joe: “Lazy.” +

Moe: What do you call a 98-pound weakling who finally stands up to his bullies? Joe: An ambulance.

N E A H

The

Why subscribe to the MEDICAL EXAMINER? What do you mean? Staring at my phone all day has had no affect on ME!

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

Dear Advice Doctor, Our daughter has had the goal of being on a summer softball league team. She’s really good and my husband and I have been her biggest fans. We just found out she will be on the team, but she thinks it’s beacuse we lobbied the coach (and made a donation for equipment). How can we reassure her she made the cut on her own? — Soccer (and softball) Mom

Dear Mom, This is for many a completely baffl ing issue, but it’s a growing problem, especially among teen and tween girls. The practice behind your question - cutting - means deliberately making cuts, marks or scratches on the skin deep enough to cause bleeding. It might be done with a knife, razor blade, scissors, a pen or paper clip, or something else. It can become addictive, so it isn’t in most cases a suicide attempt. Even so, it’s often a symptom of mental health issues. Physically, infections can result, or deep and serious cuts can accidentally be made that result in a medical emergency. Cutting is usually difficult to understand for those who don’t do it — friends, siblings, teachers, and especially parents. There are a number of theories about why it occurs. In some cases a teen is experiencing a considerable amount of emotional pain. It’s vague or complex or unrelenting, and impossible to relieve. Compared to that, the physical pain from cutting is preferable, even desirable. It offers a distraction from emotional pain; its source is not complicated; stopping or treating the cuts can offer a sense of soothing comfort; unlike emotional pain in some complicated family dynamic, this pain is 100 percent within the control of the cutter; and although sometimes cutting is a secret addiction, for others it is a way to get attention and reassurance. Cutting is a complex issue that can differ in dramatic ways from one person to the next, but it’s definitely not something to ignore. Getting help can be a difficult process, since self-harm is often an automatic ticket to hospitalization (not necessarily voluntary). There can be a social stigma associated with that, but that should be the least of a family’s concerns. Ignoring the problem or hoping it will go away on its own holds the threat of even greater troubles down the road. Counseling or therapy can offer a solution. Start by talking to your doctor. Best wishes to you and your family. + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will only be provided in the Examiner.

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

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AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED D

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MAY 11, 2018

“His sins were scarlet but his books were read.” — Writer Hilaire Belloc

The Sudoku Solution 5

QUOTATION QUOTATION PUZZLE SOLUTION: “A man may be a fool and not know it - but not if he is married.” — H. L. Mencken

The new scrambled Mystery Word is found on page 12

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MAY 11, 2018

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AUGUSTAMEDICALEXAMiNER

#11 IN A 13-PART SERIES

The vitamin alphabet All the vitamins are unique, but vitamin D is in a class all by itself. It’s the only vitamin we can manufacture on our own. Only a few foods contain vitamin D, so the major supply comes from a complex chemical reaction between sunlight and our skin which produces cholecalciferol, another name for vitamin D3. Cholecalciferol is further converted into other forms of vitamin D by both the liver and kidney. Yes, the human body is one giant chemistry set. Speaking of which, as mentioned above, very few foods contain vitamin D, yet it’s listed on the Nutrition Facts label of a number of

foods. How is that possible? For the answer to that we have to visit Harry Steenbock, biochemistry professor at the University of Wisconsin back in the 1920s. He discovered that exposing foods to radiation, like the UVB radiation in sunlight, increased its vitamin D content. He patented the process and started the fi rst university technology transfer office. The university’s fi rst client was the Quaker Oats company, which used its licensing of Steenbock’s process to fortify its breakfast cereals with vitamin D. The main use of Steenbock’s irradiation technique is fortifying milk. Tuna, sardines, and salmon

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areother good sources. Vitamin D is essential to life and health. Without it, impaired calcium absorption results in abnormal bone growth, lower mineral density in bones, softening of the bones and increased risk of fractures. In adults this condition is called osteomalacia (osteoma-LAY-she-uh), and when it presents in a child it is called rickets, a word that most dictionaries say is of unknown origin. In rickets, the bones are so soft that when the child begins to stand and learn to walk the bones of the legs bow outward, unable to support even a child’s body weight. The same inability to support the body’s weight

can result in deformities of the spine. Vitamin D deficiency is uncommon in this country, but it is a global problem among children and the elderly with some surprising causes, among them wearing a burqa. By completely covering the skin and being everyday garb, it makes non-exposure to sunlight a chronic condition. There are any number of health claims about vitamin D made by vitamin sellers, ranging from fighting depression to preventing cancer and diabetes, but the only current labeling permitted in the US is that adequate vitamin D intake may reduce the risk of osteoporosis. +

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AUGUSTAMEDICALEXAMiNER

IT’S A QUESTION OF CARE What should I do if my loved one needs extra care but refuses to accept it?

This is a question we are asked frequently. As someone who cares about your aging loved one, you are in the best position to observe their health and any decline, whether it be physical, cognitive or a combination. You know they need assistance, yet they are convinced they are totally fine. You can use a few scenarios to help you encourage or convince them otherwise: • You can suggest that their friends or neighbors, whom they know and trust, are beginning to use care from a specific caregiver or an agency, and tell them that person has had great

success. This is an example of something not coming across as your idea, but instead from someone else they know and trust who is utilizing a similar service. They may seem more neutral, and that can make it easier to accept. • You can hire an Aging Life Care Manager to be the intermediary to make the suggestions for care. An Aging Life Care Manager can also do a thorough assessment of your loved one’s cognitive status to determine if he or she understands the implications of refusing care. We cannot force someone to accept care if they fully understand

MAY 11, 2018

the detrimental effects of trying to do everything on their own. If they do not understand this, then we have an obligation to push them in the correct direction. • You can utilize another outsider such as their pastor or doctor to gently direct them and suggest that they may want to accept someone coming into the home a few days per week to give them some support. This could be suggested by the doctor to ensure they take their medications correctly and are eating in a healthy manner. Often people will accept what the doctor has to say before anyone else.

• If you cannot use any of the above scenarios, if you have tried to suggest hiring care on your own and believe your loved one is truly in danger or might endanger someone else, and you cannot convince them otherwise, you can reach out to Adult Protective Services. This is an attempt to get your loved one the care they need, as they’re often self-neglecting and do not understand the harm they are doing to themselves. + by Amy Hane, a licensed Master Social Worker in South Carolina and Georgia, an Advanced Professional Aging Life Care Manager and also a Certified Advanced Social Work Case Manager.

PROFESSIONAL DIRECTORY +

ALLERGY

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

AMBULANCE SERVICE

AMBULANCE • STRETCHER • WHEELCHAIR

706-863-9800

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

FAMILY MEDICINE

DENTISTRY

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

Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Floss ‘em or lose ‘em! Thomson: 706-595-7825 Primary Care Rates

Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048 Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

DERMATOLOGY

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

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

SENIOR LIVING

Augusta Gardens Senior Living Community 3725 Wheeler Road Augusta 30909 SENIOR LIVING COMMUNITY 706-868-6500 www.augustagardenscommunity.com

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

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

Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Parks Pharmacy Augusta 30904 437 Georgia Ave. 706-733-3373 SKIN CANCER CENTER N. Augusta 29841 www.GaDerm.com Vein Specialists of Augusta Resolution Counseling Professionals 803-279-7450 G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 3633 Wheeler Rd, Suite 365 www.parkspharmacy.com 501 Blackburn Dr, Martinez 30907 Augusta 30909 706-854-8340 706-432-6866 Karen L. Carter, MD www.VeinsAugusta.com www.visitrcp.com 1303 D’Antignac St, Suite 2100 Psych Consultants Augusta 30901 2820 Hillcreek Dr 706-396-0600 www.augustadevelopmentalspecialists.com Augusta 30909 Augusta Area Healthcare Provider (706) 410-1202 Your Practice Prices from less than $100 for six months www.psych-consultants.com And up to four additional lines of your choosing and, if desired, your logo. CALL 706.860.5455 TODAY! Keep your contact information in Steppingstones to Recovery this convenient place seen by tens of 2610 Commons Blvd. If you would like your medical practice listed in thousands of patients every month. Augusta 30909 the Professional Directory, Literally! Call (706) 860-5455 for all 706-733-1935 call the Medical Examiner at 706.860.5455 the details

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