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CAN WE NOVEMBER 20, 2020
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TALK? {
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It’s a sad fact that in November — thousands of co-conspirators (at a eight months after the World Health bare minimum). Organization’s March 11 official And what is that conspiracy? It declaration of the virus outbreak all depends upon whom you ask. as a pandemic — For some it’s the millions of people are invention of death still in some stage of The truth doesn’t care and case numbers out COVID denial. Just last if you don’t believe of thin air, or their week in response to a gross exaggeration it’s the truth. Facebook post by this from inconsequential very newspaper about numbers up into the mask wearing, someone replied millions. Why? There’s more money that all of the basic prevention in COVID deaths than non-COVID strategies recommended by public deaths, they say. Others accept the health experts (mask wearing, hand numbers at face value but believe washing, and physical distancing) it’s all being done deliberately for are “media hype,” and referred to the political gain, population control, vaccine (the one that isn’t even fully military superiority of one country developed yet) as “toxic.” over another, to train people to accept It’s a challenge to comprehend severe restrictions on their freedom, the mindset of people who envision or some other reason. conspiracies so vast that they That is one seriously jaded and would have to involve hundreds of Please see CAN WE TALK? page 3
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AUGUSTAMEDICALEXAMiNER
NOVEMBER 20, 2020
THE FIRST 40 YEARS ARE ALWAYS THE HARDEST
PARENTHOOD by David W. Proefrock, PhD
You know that children are supposed to start walking at around 12 months, but your 12 month-old son is not walking yet. He crawls and pulls himself up on things, but he doesn’t stand by himself and doesn’t even try to walk. He has met his other milestones, but you are concerned that there is something wrong with him. What should you do? A. Take him to his pediatrician and find out why he’s not walking yet. B. Work with him by holding him up and encouraging him to walk. C. Don’t worry about him. He’ll walk when he’s ready. D. This is a sign of a developmental delay. Have him evaluated. If you answered: A. There’s no harm in taking this option, but the pediatrician will tell you to give him some time. On average, children begin to walk at around 12 months. Many will walk sooner and many will walk later. Most likely, there’s nothing wrong with him. B. This is a good plan as long as the interaction with him is positive. It may help him to walk a little sooner, but it’s not really needed. He will walk when he is ready. C. It’s impossible to tell most parents not to worry about their children. Of course you will worry; that’s natural. Most children walk somewhere between 9 and 15 months. Yours seems to be on schedule. D. This is not a sign of developmental delay, especially when he is meeting other developmental milestones on time. Give him a little more time. The ages at which children meet various developmental milestones are approximations and it is not necessarily a bad sign if each of them is not met by those times. It is only when a child is very, very late developing that you should begin to worry. +
DEARREADERS Dr. Proefrock is a retired clinical and forensic child psychologist.
As mentioned in our cover story, the Great Pandemic of 2020 is definitely living up to its name. And it seems to be getting greater almost by the day. Early last week, the virus made headlines when 100,000 new cases were recorded in a single day, a new record. But then the next day that record was eclipsed, and the day after that saw yet another all-time daily peak, and then another and another. The U.S. started this month with a daily count of 69,499 new cases on Nov. 1, and within less than two weeks (Nov. 12), the CDC’s daily count of new cases had reached 194,610. That’s not far from tripling within 12 days. Remember when people predicted (or feared) that as many as a million Americans could eventually contract this disease? Over this past weekend the CDC reported 1,009,420 new U.S. cases in just the past 7 days. Back in the good old days, we temporarily suspended publication of the print edition in April at a time when daily new cases reached the low 30,000s. The pandemic seemingly peaked in mid to late July after reaching daily peaks of nearly 75,000. The day we sent the first “post-pandemic” issue to the printer (Sept. 28) the daily count was back in the low 30,000s. Things were looking semi-good. If current trends continue their meteoric rise, we could be forced to return to an online-only presence once again. Covid-19 is still a very fluid situation. Things can change overnight, or in just a few days. If we disappear from your mailbox or favorite newsstand, this new viral wave will be the reason. The Medical Examiner’s Facebook page (www. facebook.com/AugustaRX) is always a good place to keep up with our latest news. +
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AUGUSTAMEDICALEXAMiNER
NOVEMBER 20, 2020
CAN WE TALK?… from page 1 twisted world view. If this all really is some sinister plot, consider where it stands on the list of man-killing events: • Pearl Harbor: 2,400 deaths • Sept. 11: 3,000 deaths • 1906 San Francisco earthquake: 3,000 deaths • Korean War: 36,300 deaths • Vietnam War: 58,200 deaths • World War I: 116,500 deaths • COVID-19: 250,000+ deaths • World War II: 405,500 deaths If COVID-19 is deliberate (yes, plenty of people believe that), it belongs on this list of man-made mass casualty events. The one thing that sets this outbreak apart from every other entry on the list: all the others are fixed numbers, but the final COVID-19 death toll is still uncertain. No one knows what the future holds, but this week at least, COVID-19 seems destined to add untold thousands to its deadly sweep across the globe and the U.S. in particular. After all, last week alone more than a million new cases erupted across the U.S. Next week or next month, things might be different. And the vaccine news seems to indicate better times may be ahead. But right now, there is danger lurking all around
While it might be tempting to observe upcoming family holiday traditions — or heartbreaking not to — the course of wisdom recommended by health experts is to forgo large family gatherings at this time. Some families’ viewpoint is, Our goal is to be cautious this year so that everyone will still be around next year. +
every one of us, even the people who think it’s all an elaborate hoax. Correction: especially the people who think it’s all an elaborate hoax. Although those unmasked people you see in the store might have some legitimate respiratory issue that makes mask wearing impossible for them, the automatic thought
most of us probably have is, “ah, there’s one of those hoax people, a COVID doubter.” Or, “there goes a guy who thinks wearing a mask infringes on his freedom and violates his constitutional rights.” Constitutional scholars are so silly sometimes! In other words, danger isn’t solely from the coronavirus itself. Other people we come into contact with can pose a threat. Yet another risk we all face is the one looking back at us in the mirror. Pollsters, public health experts and plain old friends, co-workers and neighbors have all noticed that many among us (perhaps the vast majority of us) are so over this virus and everything about it. We’re sick and tired of the restrictions and inconveniences, and the temptation to cheat a little — just a little — by having a few friends over to share a meal or play cards or watch TV can be great. The plea, if it reaches no other audience than readers of this little newspaper, is this: please don’t give up. Stick with the advice of experts. You don’t even have to agree. We all do plenty of things we don’t necessarily want to do. Doing this particular thing could save lives. +
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Storing a vaccine at 90° below zero? What? Close, but no cigar: the Pfizer vaccine in development against COVID-19 (and another similar vaccine Moderna has just announced very promising results with) must be stored at even colder temperatures: -94°. To put that into perspective, consider the difference in how you would feel standing in the blazing sun in Death Valley on a day when the mercury hit 126°F versus experiencing a temperature of 0° (the reading inside many a kitchen freezer), a full 32 degrees below freezing. That may not be easy to imagine, but the vaccines making the news right now have to be stored at a temperature 126 degrees below freezing. Why? These are vaccines unlike any that have been developed before. The technology involved didn’t even exist ten years ago, and is in some respects still theoretical. As they undergo further testing and possible approval they will, if successful, gradually merge into the reality of treating disease in the 21st century. Simple drugs have often been concoctions of chemicals designed to achieve a desired effect on target cells or symptoms; vaccines in the past have been biological preparations made from (or biologically resembling) other cells, prompting a response from the body’s immune system. What makes these new vaccines different is that they employ DNA’s first cousin RNA, specifically messenger RNA (mRNA) to target specific cells. Once they get there, their job is to cause that cell to produce a protein or other agent that can act to kill invading cells or render then harmless. In effect, these new vaccines trick the body into making its own vaccines, an extremely complicated undertaking. All of this is preamble to the very simple answer to the temperature question. Ultra-cold storage is needed due to the mRNA. Unlike DNA, which is extremely stable, RNA is unstable and easily degrades. The only way to keep a vaccine containing RNA lab-fresh is to keep it stored at super-cold temperatures, colder than the vast majority of drug stores or even hospitals can keep it. Fortunately, once these vaccines leave a minus 90° environment for an ordinary freezer they’re still good for several days, but shipping and long-term storage in a cooler filled with dry ice is perfectly acceptable. +
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NOVEMBER 20, 2020
#127 IN A SERIES
Who is this? ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE
O
ver its past 126 installments, this space has seen quite a few medicine men and women whose life stories call to mind the acronym GOAT: greatest of all time. Here, however, is probably the only doctor whose legacy invokes GOAT in the literal sense. You know, the farm animal. That’s not to say that John R. Brinkley was a veterinarian. In fact, he wasn’t even a doctor, although that minor detail didn’t stop him from practicing medicine for decades and amassing millions of dollars in the process. And he owed it all to goats. John Romulus (later changed to Richard) Brinkley was born July 8, 1885, in Beta, North Carolina, the only son of John Richard Brinkley, a poor mountain man who practiced medicine in North Carolina and served as a medic for the Confederate States Army during the Civil War. Perhaps inspired by his father, Brinkley’s dream had always been to practice medicine, and without the benefit of any training he began his career in 1907, traveling around North Carolina posing as a Quaker doctor with his new wife Sally, holding medicine shows in rural towns where they sold various tonics and patent medicines. Later that year they settled in Chicago, where Brinkley enrolled at unaccreditted Bennett Medical College. He never graduated, and in fact, left behind his unpaid tuition when he abandoned the school to return to North Carolina to work as an “undergraduate physician.” Finding success illusive, Brinkley opened a storefront clinic in Greenville, South Carolina, with a man named James Crawford. Despite charging $25 a pop for injecting water and food coloring into the arms of unsuspecting patients, the pair fled town leaving behind bounced checks, unpaid rent and utility bills. They ended up in Memphis where Crawford had once lived. His marriage to Sally perennially on the rocks, Brinkley met the daughter of a Memphis physician, and four days later they were married. Never mind that he was still married to Sally. After a two-month stint in the Army Reserve Medical Corps and living briefly in Arkansas, Brinkley took a job as the company doctor for a Swift meat packing plant in Kansas City. Fortuitously, he there learned that goats were considered the healthiest animals slaughtered at the plant. Responding to an ad for a town in Kansas without a physician, Brinkley found himself heading a 16-room clinic where he put his slaughterhouse knowledge to work. How? Why, implanting goat testicles into men lacking virility, of course. Demand was great, and Brinkley used the profits to launch a massive advertising campaign promoting goat glands as the cure for impotence (ad slogan: “the ram that am with every lamb”) and more than two dozen ailments ranging from emphysema to flatulence. Brinkley also owned a radio station which he used to hawk patent medicines at drug stores who were members of the “Brinkley Pharmaceutical Association.” This alone was said to generate some $14,000 in weekly profits. Despite the millions he earned, Brinkley died penniless in 1942 at age 56, his fortune drained by numerous wrongful death, fraud and malpractice lawsuits. +
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 I talked with my daughter today and she told me that she already had put her Christmas decorations up. She said the bright colors and twinkling lights help with the depression from it being dark so early. I laughed because I leave my tree up year round for the same reason. Whatever time of year it happens to be, it feels good to be able to take a few seconds from life’s craziness to simply enjoy something. What that something is usually is less important than the fact that it lifts one’s spirits without any (or with only minimum) effort. There is also the fact, for me at least, that my great granddaughter has loved seeing my tree since she was tiny. She learned her colors from the colors of its lights. She is allowed to take ornaments off and move them around. Now she is almost six and she still notices the tree every time she comes to visit. She still loves the balls, the angels, the crocheted snowflakes. The tree makes me happy and it makes her happy too. I am lucky during this long lockdown to be an introvert who learned at a young age to value silence and to find enough things in my home to keep me contented most of the time. I can happily spend time just noticing how the wind often doesn’t move all the trees simultaneously but plays among them, stirring one branch or one tree before moving on to other trees and other branches. I can watch to see how the clouds cast shadows on the ground and then move on. One time I wrote a poem
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about how it seemed that the shadows were swallowing cars and spitting them out. The other day when it was raining so hard, I watched as the water ran down the street and wondered if it would capture the trash cans and send them scurrying down the street in a row. That actually happened a number of years ago when my granddaughter Sara and I were sitting on her front porch watching it rain, and suddenly a whole line of trash cans paraded down the street in front of us. There must have been five or six of them, like tall green soldiers, marching on their wet parade grounds. We sat there snuggling against the wet chill in the air and giggled. Life is like that, isn’t it? Here we were sheltering from the storm when nature threw a parade of trash cans into our view and set us laughing. It is hard to be quarantined, like it was hard for her to be restricted from running and playing by the downpour. But if we pay attention, life will throw unexpected delights in our direction. Yesterday I noticed that what was only a wee smidgen of a tree last year had not only grown much taller over the summer but was sporting a profusion of canary yellow leaves. This year, thanks to the rain we’ve had, my trees haven’t just turned brown and fallen off the trees, there are actually colors is them. That’s a real treat for a former northerner used to spectacular fall colors. So find a little joy in the everyday, the ordinary, the commonplace, because there is true value and delight there. +
NOVEMBER 20, 2020
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AUGUSTAMEDICALEXAMiNER
ADVENTURES IN
Middle Age BY J.B. COLLUM
ing time with our father. That was the plan anyway. I thought I was prepared. I expected more difficulties than the previous trip with my father just because his conditions, both the Alzheimer’s and some physical ailments that impair his ability to walk, have continued to
going in. I asked him if he was cold and he said no, so I convinced him to wait for my brother to arrive. He agreed and we only had to wait a few more minutes. As soon as my brother arrived, he started talking about going inside. He ended up spending only about 20 minutes out on the porch. Once inside, he started asking when his wife (my mother) would arrive. He calls her his “girlfriend” most of the time, but that isn’t an Alzheimer’s thing. He’s been doing that for years. If I had to pick one important thing my father has taught me about being a husband and father, it is to love your wife deeply. I try to live up to that and, fortunately, my wife makes it easy. But back to the story, there was never a plan for mom to be there at all and we had told him that before the trip on multiple occasions of course. It was a guy trip. Mom was with our sister that weekend instead. I told dad that each time he asked. He rarely asked the question in the same way either. He also would call mom every few minutes. We would catch him doing it and remind him that he had just talked to her. Usually, he would accept that and put the phone down, but as soon as we left the room he would call her again. It got to the point where she asked us to take his phone and hide it somewhere, which we did, which caused other issues. He looked for it constantly and kept asking us about it. Other times, when we reminded him not to call mom again, he would get angry. He never was an angry person, but Alzheimer’s has changed him in ways besides being forgetful. It has changed his personality. It got worse from there. How bad? I’ll share the conclusion in the next issue. +
What: In addition to the virtual celebration of a successful Walk, a music therapy organization in Atlanta — The George Center — will give a special performance and lead a discussion of music therapy. Their “Singing with Parkinson’s” group will perform songs, and music therapists will explain how music therapy works and how it benefits people with Parkinson’s. The meeting will be streamed live on Facebook. com/parkinsoncsra and on Zoom. For the Zoom meeting link, meeting ID and passcode, visit www.parkinsoncsra.org. When: Tuesday November 24, 2020 at 3:00pm Where: Virtual on Facebook Live and Zoom Contact: Mary Ann Navarro, (706) 364-1662 Note: This event is free and open to the public. +
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Empathy can be tricky. Just when you think you have it mastered you find out you don’t. Once I reached middle age I thought I had it figured out. After all, hadn’t I seen it all? I had wrapped up being a parent quite well. I was well along into grandparenting with three grandchildren. I had been through some adversity related to my health, my parent’s health, even a grandchild’s health. I had experienced taking care of my parents. I knew how to walk in another’s shoes, or so I thought. I fooled myself into believing that my empathy was fine-tuned. I try to strike a balance between having empathy and not being taken advantage of and, of holding people accountable and having high expectations, while understanding how their situation might keep them from doing as well as they would like to or as I expect them to. I try to assume the best, but I want to avoid being a sucker too. Apparently, my empathy needed some adjustment, as a recent trip with my father so clearly and painfully exposed. You might recall from previous columns that my father was diagnosed with Alzheimer’s a few years ago. You may also remember where I shared how difficult it was alone with him on a trip, but that was over two years ago. I now have a more recent experience with him that I want to share with you while it is fresh on my mind. It helped me to better appreciate what my mother goes through every day. Even though my parents live in an apartment that is part of our home and I see them multiple times a day, I still didn’t know enough to have the proper level of empathy for my mother. It all started a couple of months ago when my brother came up with the idea to take our father to a cabin in Mistletoe State Park the last weekend in October for a three-day weekend of fishing, sitting by the fire, watching college football, eating grilled meat, sitting in rocking chairs on the porch, and just enjoy-
CSRA Parkinson Support Group
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That was the plan anyway.
get worse. My brother had to drive separately, so it was just my father and me on the drive to the park. It was less than an hour though, and it went well enough, but there were warning signs even then. Every few minutes, he looked around as if he just woke up and looked concerned. Some of those times he asked where we were going and when I told him, he got excited. I didn’t really mind repeating myself since I saw the delight in his eyes each time. After a while, though, it did get irritating, though I hate myself for getting irritated about it. That was the first time on the trip that I started thinking about what my mother goes through all of the time. My visits with him are usually less than an hour. Most less than 20 minutes. I can manage repeating myself a few times without too much difficulty. An hour is a lot worse, it turns out. How does mom handle it for multiple hours at a time? I suddenly understood why she likes it when he takes naps. Once at the cabin, I helped him get to his walker and into the cabin. I suggested that we go straight out to the back porch where there were rockers and a beautiful view of the lake. He suggested we just sit inside and watch TV. That is not typical of my father, so I insisted, and he acquiesced. Once we both sat in rockers and peered out at that beautiful vista, he said he was glad that we had done it. But after less than ten minutes he started talking about
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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TRYTHISDISH NOVEMBER 20, 2020
AUGUSTAMEDICALEXAMiNER
by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author
BANANA BROWNIE WAFFLES
This waffle batter is chockfull of goodness. n addition to cocoa powder, we used whole wheat flour, wheat germ, bananas, and eggs, and canola oil instead of butter. Top with sliced bananas or berries and a dollop of light whipped cream or a drizzle of maple syrup and your kids won’t be hungry ‘til lunch. • 1 cup all-purpose flour • ½ cup whole wheat flour • ½ cup cocoa powder, sifted • ¼ cup wheat germ • 3 Tbsp. granulated sugar • 1 Tbsp. baking powder • ¾ tsp. ground cinnamon • ½ tsp. salt • 1-½ cups 1% low-fat milk • 2 ripe bananas, mashed (1 cup) • 2 large eggs, beaten • ¼ cup canola oil • 2 tsp. vanilla extract • Pure maple syrup or light whipped cream, optional. Preheat the waffle iron according to the manufacture’s instructions. Whisk together the all-purpose flour, whole wheat flour, cocoa powder, wheat germ, sugar, baking powder, cinnamon, and salt in a large bowl. In a separate bowl, whisk the milk, bananas, eggs, oil, and vanilla until well blended. Pour over the dry ingredients and stir until just combined.
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Lightly oil or coat the hot waffle iron grids wit nonstick cooking spray. Pour the batter onto the center of the lower grid (about 2 cups or the amount specified for your waffle iron) and cook on medium to medium-high setting until done, 2 to 4 minutes. Repeat with the remaining cooking spray and batter. Top with maple syrup or light whipped cream as desired.
Yield: 8 (4 ½ x 4 ½-inch waffles) Nutrition Breakdown: Calories 270, Fat 10g (1.5g saturated, 0.7g omega-3), Sodium 330mg, Carbohydrate 37g, Fiber 4g, Protein 8g. Percent Daily Value: 15% Calcium, 15% Iron + Recipe re-printed with permission from the Meal Makeover Moms, HYPERLINK “http://www. mealmakeovermoms.com” www. mealmakeovermoms.com
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RELATIONSHIPS OR RECOVERY? PART 2
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Last month I painted a word picture that described the mine-field of relationships in early recovery but ran out of space before suggesting some solutions…so here they are. Let’s agree that relationships are challenging enough without adding recovery to the equation. And they don’t seem to be getting any easier in this age of Covid, either. One fact that is head and shoulders over other considerations in the newly recovered person is the reality that abusing alcohol and drugs halts personality and characterological development at the age of onset. When I see a 30-40 year old who started seriously drinking/drugging at age 13, for example, they are often still functioning on the maturity level of a 13 year old. And how do 13 year olds act? (You don’t remember?) Well, they rebel of course! When such a one comes into recovery they revert to where they were before starting to drink/drug: rebelling! If age 18-20 was their onset of using, when they get sober in their 30s they’re still deciding what they want to do when they grow up! So, very few in early recovery are ready to make the plunge into a relationship until they achieve the basic level of maturity which is necessary to navigate a successful relationship. The reality is that the potential of relapsing in the first year of sobriety is high. It
is a fragile time of 180-degree turns in many facets. In early recovery (under 12 months), many simply switch addictions. They go from alcohol to the infamous “marijuana maintenance program,” or turn their energies from illegal drug addiction to relationship addiction, or even to religious addiction or work addiction. It is a shaky recovery to lose oneself in finding another activity to make one feel good, even if for the proverbial “minute.” Often, a minute it is. Another issue for the new person in recovery is being able to be physically intimate with another person without the aid of alcohol or drugs. Untold thousands have never had sex while sober! They suffer under the illusion that chemicals will help their performance. Regrettably, a video of the encounter would probably prove otherwise! The fact is, alcohol and drugs can increase desire but they decrease performance. (Go ahead and ask her, if you dare!) Of course, trying to tell the newly recovered these points is often futile. Emotions and chemistry usually overrule reason. And that is all the more reason to determine ahead of time what your first year of recovery will look like. So here are some ideas to help you step around the live grenades out there in the relationship field. • Involve yourself in group recovery functions vs. with one person alone. • Learn to spend weekends
THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional
and holidays alone or with family members instead of a new love. Early on my sponsor required me to do this for one year, and I wish I could say I didn’t slip up a time or two. The skills I learned then have helped me immensely during Covid, too. • Read about relationships. I recommend pp. 80-120 or so of The Road Less Traveled by M. Scott Peck. It is the very best treatise about true love I’ve ever read. Also, In The Meantime by Iyanla Vanzant. • Go to therapy with someone who is knowledgeable about recovery. Not all are! Every dollar you spend on this kind of healing will return hundreds back to you. Break-ups often characterize the first year of relationships… they are miserable to go through. I’ve had a few myself and would’ve paid any amount of money to stop feeling the grief. I wish I had chosen recovery first. +
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Have you ever caught yourself saying, “I don’t want to spend a lot of money at the grocery store. I’m just going through the drive-thru”? Whether you have a family or you’re just feeding yourself, it is possible to access healthy foods on a budget. The average American in 2019 making $25,000 a year spent 9.5% of their income on food based on the USDA Food Prices and Spending Report. That is about $198 per month. With that being said, there are other ways to set a budget. Go online to the USDA Food Plans: Cost of Food for more tips and resources on budgeting. Find the method which works best for your household and start there. Healthy Food The Dietary Guidelines for Americans 2015-2020 states that healthy eating is where you focus on fruits, vegetables, whole grains, and low-fat milk products. Include lean meats, poultry, fish, beans, eggs, and fish. Lastly, avoiding saturated fats, trans fats, foods high in cholesterol, salt, and sugar is
Meat/Seafood • Whole chicken, chicken thighs, ground turkey, ground beef, bone in pork chops. • Tofu • Canned tuna, canned salmon, frozen white-fleshed Fish (ex. Cod) Dairy • Store-brand over namebrand dairy products will generally be more affordable • Buy bulk container yogurt over small packaged yogurts to save money More Tips & Tricks • Repurpose your food or freeze the extra to eat later • Pay attention to expiration dates to limit food waste • Write out a grocery list to help stick to budget • Be brand neutral, focus on what is on sale for the week Grocery shopping can be daunting, but with a budget, a plan, and a positive attitude you can be successful in shopping for healthy foods. +
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Fruits/Vegetables: • Apples, bananas, citrus, cantaloupe, and pineapple • Dried beans such as pinto, black beans, & black-eyed peas • Dried Lentils, fresh carrots, romaine lettuce, canned green beans, frozen mixed vegetables, and fresh potatoes
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HOW TO EAT HEALTHY ON A BUDGET by Natalie Romano Smith,
THAT OLD GARAGE DOOR HAD A GOOD RUN
ns he te
Useful food facts from dietetic interns with the Augusta University MS-Dietetic Internship Program
important. So how does this translate to grocery shopping on a budget? Shopping the perimeter of the stores where the fruits, vegetables, dairy, and meat are located first before going to the snack/ convenience food aisles is a smart first step. Next, focus on items that are within your budget. Here is a list of food items that are considered less expensive.
nt Joi
DON’T LICK THE BEATERS
Budget Creating a weekly grocery store budget is the first step. Whatever your financial situation is, having a budget can help keep your spending in check. The United States Department of Agriculture (USDA) publishes an electronic weekly & monthly average food plan based upon four cost plans from Thrifty to Liberal. They include average cost for family of 2 to a family of 4. For a family of 2, the average weekly costs of food at home are: Thrifty: $84-94 Low-Cost: $110-118 Moderate-Cost: $130-150 Liberal-Cost: $165-190 For a family of 4, the average weekly costs of food at home are: Thrifty: $130-150 Low-Cost: $165-197 Moderate-Cost: $207-248 Liberal-Cost: $255-300
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CRASH
COURSE
More Americans have died on US roads since 2000 than in World Wars I & II combined
W
unchanged for older drivers, while the rate for middle-aged drivers has increased. How do highway safety analysts account for the improved numbers? A lot of it is guesswork, but it’s careful and logical guesswork. Among the suspected factors: across the board improvements in highway design and construction is one. Remember decades ago when many highways didn’t have white lines painted along the shoulder-edge of the pavement? Remember construction zones marked with pots of burning kerosene instead of flashing lights and reflective cones? Road design improvement trends are ongoing. One of the recent options gaining momentum is the gradual conversion of intersections to roundabouts, a design that keeps traffic moving while slowing everyone down. When collisions do occur, they’re low speed fender benders, not full speed T-bones. Another possible factor: multiple improvements in the design of cars and their safety systems, including more and better airbags, backup cameras, lane deviation warnings, and less obvious changes like construction that incorporates internal crumple zones to absorb impacts. One mitigating aspect of this factor is that older adults tend to keep their vehicles longer than younger age groups, meaning they may lag behind in benefiting from the latest vehicle safety design advancements. On the negative side, although they’re healthier than ever, drivers 70 and over are still more fragile than younger people, so they’re more likely to die than middle-aged drivers if they do crash. Even so, highway safety experts expect the trend of progressively lower accident figures for older drivers to continue as improved cars and roadways become more common. +
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hat are your thoughts on the question posed in the brackets? Do you think older drivers — let’s define that as those in their 70s — are driving accident rates and insurance premiums up? Or are they helping to bring them down? The answer is important because in the past two decades the number of older drivers has skyrocketed. Just between 2013 and 2018 alone, the number of drivers in their 70s rose by about 5 million. And the number of older licensed drivers rose almost twice as fast from 2010 to 2018 as it had in the previous decade. Another potential threat to older drivers: during this time period their average annual mileage also continued to grow. Those factors are actually a reflection of improved healthcare and better quality of life. Older adults are healthier than their predecessors were at the same age, often staying in the workforce, so naturally they are keeping their licenses longer and driving more miles too. Historically, however, says the Insurance Institute for Highway Safety, older drivers were more likely to crash than other age groups, and they were less likely to survive if they did crash. With the Baby Boom generation getting progressively older, a potential highway safety crisis loomed on the horizon, the National Academies warned in 1988. True enough, fatal crashes involving older drivers peaked at more than 4,800 in 1997. Since then, the news is much better. For drivers 70 and over, fatal crash rates per licensed driver fell 43 percent between 1997 to 2018, compared with a decline of only 21 percent for drivers ages 35-54. Most of those improvements for older drivers occurred during the first half of the 20-year study period. More recently, the rate of fatal crashes per driver has remained more or less
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Are older drivers safe? Or a menace on the highways?
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IT’S A QUESTION OF CARE
How can my parents afford quality care if they did not save or plan appropriately?
There are options for providing care for an aging person either in their home or in an assisted living sort of environment. One option that is often considered is the VA Aid and Attendance Pension for wartime veterans and/or their surviving spouses. This is a monthly monetary benefit awarded to the veteran or his/her spouse based upon the amount of care they prove they need on a monthly basis. This benefit can be used to pay for care in the home environment or for an Assisted Living setting. You can apply for this through the VA, through your local county Veterans Affairs office, or you can hire an attorney who specializes in assisting with these applications and guiding you through the process. If someone owns their home and the property on which it sits, they can consider a reverse mortgage. These are controversial in that they’re not always as ideal as they are presented to be, but in certain circumstances, they can be the answer to the question of how to generate funds to pay for care? Medicaid is the fallback program that provides care for people who have not saved, invested, purchased long-term care insurance, or acquired other means to pay for their care. Medicaid in South Carolina and Georgia both offer programs that offer limited services in the home to help care for an aging or disabled person. They also have programs that help pay for personal care homes and nursing homes. There are physical and financial requirements the person must meet to be eligible and awarded Medicaid to pay for services. Lastly, family, friends and church members are often the only feasible resource to provide the care that many aging or disabled people need when they do not have the savings to pay for it on their own. Family members in particular provide an uncountable number of hours that equate to a significant financial benefit for their loved ones. Often, families will work together to create a rotating schedule of relatives who provide care, and they will sometimes even supplement out of their own pockets to hire care intermittingly to give family members a break. You can also utilize grants through the Parkinson’s or Alzheimer’s associations to provide small but vital sources of money for respite care services. + 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.
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NOVEMBER 20, 2020
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AUGUSTAMEDICALEXAMiNER
The blog spot From the Bookshelf — posted by Anonymous, MD, on March 21, 2020
RAW THOUGHTS FROM A CRITICAL CARE PHYSICIAN Physician burnout. Physician suicide awareness. Buzzwords. Words that get tossed around. People in leadership seem to be concerned. Institutions say they care. “Solutions” get created. Solutions that look great on paper. Sometimes under the guise of the employee assistance program. The brochure says we care about your mental and emotional health. We get that life is hard. So we’re here to help. We’ll set you up with a counselor for five sessions. It’s easy. Just fill out this form, and we’ll send you the info. Sounds great, right? What could go wrong? It took me over six months to find the courage and mental fortitude and ask for help. To reach out. It took another month to schedule an appointment. For a month out. Eight months. The appointment was refreshing. An hour-long intro. I shared stories. Finally thought maybe it is OK to ask for help. Someone will be there. To listen. Not judge. To support. Maybe there is space for me and my story. I scheduled another appointment for three weeks out. In the evening. Because I work 70 to 80 hours a week. In the ICU. During these three weeks, a pandemic arises. COVID-19. The mental stress and anxiety of preparing for this. Taking care of the patients. Of this community. Isolating myself from my family and friends. For the greater good. The knowledge of there being a time. For me. Knowing that there is a time and space that I can process this provides light. Until that light gets taken away. She calls, and says I have to reschedule. No “how’s it going? How are things?” No empathy or compassion. She offers 1 to 5 p.m. I express that I am an ICU physician. In the middle of a rising pandemic. 1 to 5 p.m. doesn’t work. It can’t work. Her counter-offer: reschedule for a month later. Or start over with another provider. No understanding that I can’t plan for what my work life will look like in three days, much less a month. That’s it. Those are the choices. No empathy. No “thanks for what you’re doing.” No understanding of how much this appointment meant. No expression of connection. I wasn’t looking for special treatment. Just some understanding and a human connection. Please world. Do better. Show up. +
That light was taken away
From an online Amazon.com review: Over the years, I have had a number of people confide in me that either they or their spouses were considering divorce. My advice has always been to read Wallerstein’s series to learn the variety of outcomes that can arise post-divorce. Those considering divorce are all well advised to “do their homework.” These books are also a must read for anyone involved in family and/or divorce counseling - religious or secular counselors. In “Unexpected Legacy of Divorce,” the authors address the myth that the children will do fine if the parents are happy - divorced. Children, no matter how amicable and settled the parents are after divorce, suffer greatly. They lose their family, they lose control of their life (to the whims of parents and rules of courts), and they lose their childhood. All of these combine to provide a series of struggles as they move into adulthood and beyond.
Important subject areas covered in this book include: * The ghosts of childhood the bottomline after 25 years * The exploitation of children by divorcing parents * The path to adulthood being thrown out of sync * Children dealing with the loss of THEIR nuclear family; the family that created them just vanishing - a loss that will be quietly or openly mourned throughout their lives * Children living with and coping with chaos * The missing father or mother after divorce * Children growing up lonely
The Unexpected Legacy of Divorce by Judith Wallerstein, 400 pages, published in 2001 by Hyperion
BINGEREAD
The author is an anonymous critical care physician. NOTE FROM THE MEDICAL EXAMINER: Although it is impossible to get precise figures for physician suicides because of inaccurate cause of death reporting and coding, the number most often used is 300 to 400 physician suicides a year, or about a doctor a day. Of all occupations and professions, the medical profession consistently hovers near the top of occupations with the highest risk of death by suicide. Equally alarming is that, after accidents, suicide is the most common cause of death among medical students. +
* Relationships with the “steps” (step-parents) * The loss of mom - whether or not she is physically available * Court ordered visitation and its disruption of a “real” life for the children to make mom and dad complete * Children of divorce taking the leap in relationships and marriages - the return of the relationship ghost * The role of an intact family for modeling and shaping children whether their parents marriage is good or bad * Other residues of divorce for children - fear of loss, fear of change, fear that disaster will strike, especially when things are going well * And the need for all involved in divorce, directly or indirectly, to be educated on all the issues that emanate from the divorce for children over their life as well as in the short term. This will not be an easy read for many. It was not intended to be. +
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The Examiners +
This is a scary article about the rise in pedestrian accidents.
So many drivers are distracted these days.
by Dan Pearson
Where do you think the most pedestrian/vehicular accidents in the CSRA happen? Where?
I would guess Ft. Gordon.
PUZZLE ACROSS 1. Daniel Village has one 5. Swollen (usu. a body part) 10. Snare 14. “ ____ Calling” 15. Dodge 16. The old days 17. Opened the windows 19. Loop; spiral 20. Swallow up, as in flames 21. Self-service restaurant 23. British Prime Minister from 1997-2007 26. “Friendly confines” team 27. Sponge 30. Flow back 31. Negative reply 33. Long narrow cut 34. Break 36. Type of code 37. Exclamation of fear or surprise (often plural) 38. Section starter (at times) 39. Sushan today 40. Stroke ltrs. 41. Soft, light color 44. Plot of ground 45. Masculine pronoun 46. Porcini mushroom 47. Friendly 49. Type of opera 50. Party of 23-A 51. Pensioner 54. Ceremony; rite 58. Hygiene adjective 59. The way something looks 62. Latin word or prefix that means “Before” 63. Amendment to an insurance policy 64. Store opening hour? 65. Brave or noble feat 66. Squamous
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Simply unscramble the letters, then begin exploring our ads. When you find the correctly spelled word hidden in one of our ads — enter at AugustaRx.com
Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, NOV. 30, 2020
We’ll announce the winner in our next issue!
E X A M I N E R
S U D O K U
8 7 7 4 5 9 3 8 2 8 6 9 7 5 9 8 4 1 6 5 4 9 5 3 8 2 2 1 by Daniel R. Pearson © 2020 All rights reserved.
DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.
by Daniel R. Pearson © 2020 All rights reserved.
67. Latin abbrev. for “Let it stand” DOWN 1. Jazz musician Brubeck 2. A person wronged may want to get this 3. Georgia’s famous Crawford 4. Artificially open an airway 5. The Bell is on it 6. A black light emits this (abbrev) 7. It can be welcoming 8. Notion 9. Figures out 10. Baseball legend with local ties 11. Chambers 12. Operatic melody 13. Throw stones at 18. Evils 22. People soak in these 24. Word on express lane sign 25. Piano ________ 27. Intimidate (with “out”)
28. Living 29. TV’s Kelly 31. Type of cavity 32. Deliver a speech 35. Swelling 36. Reservoir of a traditional thermometer 39. Glenn Hills High School athletes 41. A fruit whose name is its shape 42. Becomes visible 43. The Greenblatt is one 46. Wound 48. Material for 7-D 49. Condition 51. Highway 52. Sea eagle 53. Heroic 55. Single entity 56. Skin eruption 57. English court (historical) 60. Handheld organizer (abbrev. from the 1990s) 61. Snakelike fish Solution p. 14
QUOTATIONPUZZLE S N E T Y G D Y H M W A K ’ Y M O U T Y W P N A S B O N E A O H K N O O
N L Y H O Y L H I E T P
5 7 6 2 M 1 4A 8I 9 3
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— David Geffen
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. by Daniel R. Pearson © 2020 All rights reserved
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.
D L A 1 2 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 9 1 2 3 1 2 3 4 N’ ’ K 1 2 3 4 5 1 2 3 4 1 2 3 1 2 3 4 1 2 3 4 5 1 2 3 4
— Daniel J. Boorstin
1.WEEDDLIKKYY 2.HENNISIVOOD 3.AAUUUDDEOO 4.WWCRTNNN 5.ANTT 6.IT 7.IN 8.GO 9.N
SAMPLE:
1. ILB 2. SLO 3. VI 4. NE 5. D =
L 1
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by Daniel R. Pearson © 2020 All rights reserved
WORDS NUMBER
1
THE MYSTERY WORD The Mystery Word for this issue: CAVECIN
Oh right. The camo. © 2020 Daniel Pearson All rights reserved.
EXAMINER CROSSWORD
NOVEMBER 20, 2020
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NOVEMBER 20, 2020
AUGUSTAMEDICALEXAMiNER
THEBESTMEDICINE ha... ha...
The
Advice Doctor
set of tracks and began debating about what animal they were from. “These are definitely deer tracks,” said the first. “No, they’re elk tracks,” said second “You’re both blind,” said the third blonde. “These are obviously moose tracks.” Right then the train hit them.
Two bored casino dealers are waiting at a craps table when a very attractive lady walks steady rain was pouring down outside up and bets $20,000 on a single roll of the O’Riley’s Irish Pub. An old bearded man, dice. She adds, “I hope you don’t mind, but I drenched to the bone, stood in front of the pub feel a lot luckier when I play topless.” With that she strips to the waist, rolls the holding a stick with a piece of string hanging dice, and yells, “Come on, this girl needs down into a big puddle. A passer-by stopped money!” As the dice bounce and come to a and asked him, “What are you doing?” stop, she jumps up and down and squeals, “I “Fishing,” replied the old man. won! I won!” She hugs each of the dealers, Feeling sorry for the old guy, the man says, picks up her winnings and her clothes and “Come in out of the rain and have a drink.” In the warm ambiance of the pub as they sip quickly leaves. The dealers stare at each other dumbtheir whiskeys, the gentleman couldn’t resist founded. Finally one of them asks, “What asking the old man, “So how many have you did she roll anyway?” caught today?” “I have no idea,” the other answers, “I “You’re the eighth,” replied the old man. thought you were watching.” Moe: I like my mortgage interest rates like my Moe: Why did the man always quietly conmilk. fess his sins to a flock of crows whenever one Joe: Oh yeah? How’s that? landed in his yard? Moe: 2 percent. Joe: I give up. Why? Moe: Never have phone sex. Moe: So that no one would hear him confess Joe: Why not? to a murder. Moe: You could get hearing aids. Moe: What’s worse than finding a worm in Three blondes were walking along a path your apple? through some woods when they came across a Joe: This joke. +
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A
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, I was watching a horror movie recently...come to think of it, it was on Halloween night. My husband had to work that evening, so I was home alone — or so I thought. During one scene that was a particular nail-biter, my husband (who had come home without me hearing him), yelled “BOO!” right behind me. The scene was already so frightening and so intense even before that moment, it made me wonder: can a person actually be scared to death? — I Think I Almost Was Dear I Think, You raise an intriguing question, one that happens to be especially relevant right now. Admittedly, nail biting is quite common. It is not a healthful habit any time, but it poses additional risks during this pandemic. We’re told to avoid touching our faces and wash our hands frequently. The compulsive nail biter isn’t just touching his face; he’s putting his fingers in his mouth. Wearing a mask is also highly recommended. That’s not happening for people who obsessively bite their nails. The problem is that nail biting is usually compulsive behavior. It can be the most obvious outward sign of a number of emotional and behavioral disorders. No one’s nails need biting. In fact, the fingernails of many who have this affliction (officially called onychophagia, pronounced on-i-ko-FAY-jee-uh), aren’t just bitten down to a nub; they are gnawed well into the nail bed. It is not uncommon for excessive nail biting to result in infections in the fingers, deformed cuticles, and oral infections. Aside from physical problems, many people are ashamed or embarrassed by this obsessive-compulsive habit, leading to social and psychological impacts. There are a number of strategies to help people who want to quit. Like any addictive or compulsive habit, the true first step is a strong desire to stop. Without that, long-term success is unlikely. Most drug stores carry spicy or bitter tasting liquids and nail polishes that help discourage nail biting. But without step one (the desire), it’s easy enough to stop applying the solutions. Medical Examiner columnist Ken Wilson (see page 8) has in past columns shared a tactic many substance abusers have found useful: when the urge strikes, so something else — anything else — for 15 minutes. It’s simple, but it works. I hope this answers your question. Thanks for writing! + Do you have a question for The Advice Doctor about health, life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.
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THE MYSTERY SOLVED The Mystery Word in our last issue was: CHRONIC
...cleverly hidden in the patio arbor of the p. 15 ad for ROLY POLY
THE WINNER: NOAH BOWERS! 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!
NOVEMBER 20, 2020
AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED D A V E
E V E N
L O N G
I N T U B P A R A S L I T Y I P E C V A H E C S O R E T I O R A L A N T E D E E D
I L L S P E A R
T E L F A I R A P P E A R S
U M I D V A D E A T E D A U I R C T E E E C E S M I D S T E L A M I L A B E R P P E A I D E R C A L Y
T Y C T O U B B B S S P C A O R I T R A N S
R O O M S
A R I A
P E L T
B U L B
N A S A L
O R A T E
U N I T
A C N E
L E E T
SEE PAGE 12
The Celebrated TheSUDOKUsolution MYSTERY WORD CONTEST 5 2 8 7 9 6 4 3 1
...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.
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Love to stare at your phone? Visit issuu.com/ medicalexaminer and stare away.
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QuotatioN QUOTATION PUZZLE SOLUTION “Anybody who thinks money will make you happy hasn’t got money.” — David Geffen
WORDS BY NUMBER
Education is learning what you didn’t even know you didn’t know. — Daniel J. Boorstin
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NOVEMBER 20, 2020
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3626 Walton Way Extension (Walton’s Corner) Phone: 706.736.1099 Fax: 706.736.4401
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2610 Commons Blvd. Augusta GA 30909
706-733-1935
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PROFESSIONAL DIRECTORY +
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
Georgia Dermatology & WOODY MERRY www.woodymerry.com Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Long-Term Care Planning I CAN HELP! Augusta 30904 (706) 733-3190 • 733-5525 (fax) 706-733-3373 SKIN CANCER CENTER www.GaDerm.com
DEVELOPMENTAL PEDIATRICS
PHARMACY
SLEEP MEDICINE
Sleep Institute of Augusta Bashir Chaudhary, MD 3685 Wheeler Rd, Suite 101 Augusta 30909 706-868-8555
TRANSPORTATION AMBULANCE • STRETCHER • WHEELCHAIR
706-863-9800
VEIN CARE Vein Specialists of Augusta G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 501 Blackburn Dr, Martinez 30907 706-854-8340 www.VeinsAugusta.com
Karen L. Carter, MD Medical Center West Pharmacy 1303 D’Antignac St, Suite 2100 465 North Belair Road Augusta 30901 Evans 30809 706-396-0600 Your Practice 706-854-2424 www.augustadevelopmentalspecialists.com www.medicalcenterwestpharmacy.com And up to four additional lines of your choosing and, if desired, your logo. Parks Pharmacy Keep your contact information in this 437 Georgia Ave. ARKS convenient place seen by thousands of HARMACY N. Augusta 29841 patients every month. Steppingstones to Recovery 803-279-7450 Call (706) 860-5455 for all the details! 2610 Commons Blvd. www.parkspharmacy.com Augusta 30909 706-733-1935
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Proudly affiliated with Dr. John Cook of Southern Dermatology in Aiken
John Cook,
NOVEMBER 20, 2020
M.D.
Pictured above (from left to right), John Cook, MD; Lauren Ploch, MD; Jason Arnold, MD; Caroline Wells, PA-C; Chris Thompson, PA-C
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2110 Woodside Executive Court Aiken, South Carolina • 803-644-8900
SKIN CANCER CENTER
2283 Wrightsboro Road Augusta, Georgia • 706-733-3373
Skin Cancer Removal • Mohs Surgery • Routine Skin Exams • Mole Removal • Botox • Dermal Fillers
GENERAL, SURGICAL & COSMETIC DERMATOLOGY
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SOOS BENEFITS GROUP Email: srsoos@yahoo.com SERVING GEORGIA AND SOUTH CAROLINA
706-399-1989
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