Medical Examiner Nov. 6,2020 by Daniel Pearson

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NOVEMBER 6, 2020

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Life is sweet, except when it isn’t, and it isn’t for many people right now. There are a thousand factors contributing to the current situation, and most of them start with the word coronavirus. Many people have had their life’s plans derailed or destroyed, at least for the foreseeable future. Millions have lost their jobs or a portion of their income, and millions more are grieving the hundreds of thousands of deaths attributed to the virus. Harvard University’s somewhat awkwardly named Human Flourishing Program, established in 2016, has been attempting to use empirical data to scientifically chart the elements that help humans thrive and flourish, things as diverse as health (physical and mental), financial and material stability, personal safety, friendships and relationships, housing, and people’s current perceptions of their own happiness and life satisfaction. They conducted their most recent surveys in January and June of this year. In other words. pre-pandemic and several months in. As you might guess, the yardsticks show some significant drops in the things humans need to flourish. The health, happiness and financial stability scores each dropped by about a third, indicating overall increases in psychological distress are common. Of course, many people don’t need a Harvard study to tell them life is extra challenging in 2020. The more important question is, what can we do individually to get back to flourishing, and help others do the same? Here are a few suggestions. • As suggested by our lovely mask-wearing friend, there are some key ways we can protect our mental health. Start by raising your defenses: don’t let just anything into your mind. Strictly limit your news consumption to an hour a day, or perhaps to one of the three major network’s evening newscasts only. They only have 30 minutes, so there’s no time for endless debates, arguments, and analysis. If you want COVID updates or health information, get it from respected and impartial scientific sources, not the open mic world of social media. • We reported in this newspaper a few months ago that the World Health Organization was against social distancing. They still are; they say physical distancing is the way to go. Social distancing is the last thing we should be doing right now. Isolation and loneliness are not good for people who want to flourish. Good Please see ARE YOU OK? page 3

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THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

NOVEMBER 6, 2020

The path I have chosen by Kimberly Savage

PARENTHOOD by David W. Proefrock, PhD

At this age, it is important for you to help your child pursue goals without closing the door on other options. Most high schools offer a vocational track and most technical school have programs that include receiving a diploma or a certificate if students don’t already have one. + Dr. Proefrock is a retired clinical and forensic child psychologist.

answer to it with dignity and grace as I believe people simply don’t know the difference. This year more people

In a few months I have seen a lifetime of sadness.

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If you answered: A. It is never a good idea to refuse to listen to your child’s career plans. However, a high school diploma is essential. There are ways for him to move toward his goals and still get a diploma. B. His goals are positive, but his plan to reach them needs some work. He may or may not act negatively if you refuse to let him quit school, but it is not impossible to both learn mechanics and get a diploma. Start by having a talk with the school counselor. C and D. Both of these choices are positive options for a child not interested in a traditional academic education. Actually, both of these choices should be explored. They are not mutually exclusive.

This month’s article for the Medical Examiner comes at the end of National Respiratory Care Week. In September of 1983, President Ronald Reagan issued a proclamation declaring the last full week in October as National Respiratory Care Week. Every year respiratory care week means something special to me because it honors those of us who have chosen this mostly unknown (until recently) career and all that it entails. There are a lot of different ways respiratory therapists are addressed and I answer to many of them any given week. For example, I am referred to as a nurse almost daily. I consider that a compliment until a patient says, “Oh, you can’t give me pain medicine?” To which I have started answering, “No ma’am/sir, but I can and will make sure you are breathing and that’s kind of important!” I seldom get an argument. I occasionally get referred to as a “respiratory tech.” I don’t know why I consider that bothers me other than a respiratory technician is a 2-year or associates degree and I worked hard for my 4-year bachelor’s degree in respiratory care. Regardless, I

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Your 16 year-old son has announced that he wants to drop out of high school and go to work as a mechanic. His grades have been passing but not great, and he has not been interested in schoolwork for some time. On the other hand, he has been very interested in cars and works on his in all his spare time. He seems to be very good at this kind of work. What should you do? A. A high school education is vitally important to his future. You should refuse to even listen to such an idea. B. You may as well go along with his idea to. If you refuse to let him quit school, he will just stop working and fail all his subjects anyway. C. Encourage him to talk with his high school counselor and arrange to take courses more suited to his interests. D. Work with him to explore vocational or trade schools that will provide a high school diploma or an equivalency exam along with his technical education.

to do when there is family around because the emotions are overwhelming, as a care provider I would never want my family member to die alone. I have always felt at peace with withdrawing from patients who have family around as they have a chance to say good-bye and there is a sense of closure for the family. This year it has not been like that. This year it has been very difficult to coordinate FaceTime calls with family to say good-bye — if at all. This year it has been acting as stand-in family for someone I recently met, hoping that I give them some sense of peace, offering to pray with complete strangers, hold their hand without a glove on just to let them know that another human being is with them. I have learned life is short and tomorrow is not a guarantee for any of us, so I do not take a single second for granted, not even one. Those patients or their family may not have realized that the last time they spoke with their loved one was the final time they would get a chance to tell them they loved them. I have learned not to miss an opportunity to tell people what they mean to me. Regret is hard pill to swallow and I do not want to regret not saying “I love you.” I am the person who always has a smile on my face. It puts people at ease and lets face it, it’s hard to be in a bad mood when someone with a big smile walks into your room and greets you with positivity and warmth. Of course, I have a mask that covers my smile now. There have been days when I feel like there is no point in smiling; no one can see it. That said, I have learned it changes my mood and my perspective as much as it changes my patients, so even though

know what I am and what I do. That is one of the few good things that has come from a year that has been incredibly trying for a plethora of reasons. This year’s Respiratory Care Week means something a little different for me. I do not know how to put into words how this year has changed me both as a person and as a therapist, but I am going to try over the next few paragraphs. I have watched more people die alone than I ever imagined I would in my entire career, let alone in less than a year. As a respiratory therapist, it is my responsibility to withdraw care on patients whose end of life is imminent and the decision to stop intervention has been made by the family. Although it is harder

Please see THE PATH page 3

NOVEMBER 6, 2020

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DEARREADERS

If you’re a regular reader of this paper you may have noticed that from time to time here and there on our pages we encourage you to Like or Follow the Medical Examiner on Facebook. One of the reasons we recommend this is to keep you up to date on breaking news, or to put it another way, on news when things are broken. Last week’s issue, unfortunately, was a good example. Facebook followers were alerted to two mistakes we made: We hid the Mystery Word in a way that made it impossible to see and read, but our Facebook friends got a clue that made it much easier to find. There was also a glitch with the Quotation Puzzle. We let Facebook followers know that it had been fixed in the online version, which could then be printed out and solved. In addition to being alerted to our occasional errors (ok, our frequent errors), we regularly post entertaining and informative content that you’ll never see in the Medical Examiner. It’s only on the Examiner’s Facebook page. Our goal is always to have zero mistakes to announce and undo, so when we reach that day, the only thing we’ll ever post will fall into the aforementioned “entertaining and informative” categories. Let’s keep our collective fingers crossed. In the meantime, you can find that M.E. Facebook page at www.facebook.com/AugustaRX +

ARE YOU OK?… from page 1

ways to stay connected include phone calls, letter writing and emails, video conferencing, texting, and through social media. And it’s not completely out of question to actually socialize in person. Imagine that! All it takes is careful observance of the precautions we’re all quite familiar with: wear a mask, stay at least six feet apart, and do it outdoors whenever and whereever possible. • Don’t throw in the towel on healthful habits. Public health agencies say the pandemic and working from home has resulted in many people completely abandoning their schedules and routines. They’re eating more (and more often). Their normal bedtime that had been like clockwork went out the window; ditto for getting up in the morning at the usual time. Working in pajamas meant everything from toothbrushing to exercise wasn’t happening like it used to. Instead of all that, here’s a reminder to keep the good routines in place (or establish them in the first place) and banish the bad ones. For those who have lost their jobs altogether or whose hours have been severely cut, it’s all the more important to

THE PATH… from page 2

I wear a mask every day, I smile the biggest toothy smile I can because what I have also learned is if I smile big enough it travels to my eyes and my eyes are not covered up. There is so much sadness in the world today, every day I am blessed enough to get out of bed on my own I will smile and spread joy as much as I can. I could go on and on about all the ways coronavirus has changed me. It seems like every day I recognize something else that I

establish regular routines that create mileposts throughout the day: the morning walk, the daily job-seeking period, the regular pursuit of something that is educational or upbuilding (learning a new skill, taking an online class, pursuing a hobby, writing in a journal, meditating, etc.). When these regular activities and time slots are not created, every day can be an interminable stretch of procrastination and unaccomplished tasks. Daily to-do lists are a valuable and useful tool. • Remember that virtually no one is able to accomplish what they need to do in life single-handedly. The same is true of life, liberty and the pursuit of happiness (and health). If crippling depression, anxiety, panic attacks, or thoughts of suicide arise, it’s important to immediately reach out for help and support. It is available from a plethora of sources including your doctor, family and friends, spiritual communities, United Way agencies, neighbors, 24/7 national help hotlines, and many more. Sometimes it’s ok to not be ok. What’s not ok is to fail to do something about it. +

took for granted before. I cherish things like health much more than I did because I have seen people leave this world entirely too young due to this virus or from complications because of the virus and other comorbidities. So this year, Respiratory Care Week was a little more special because of the coronavirus. Or maybe despite it. Take that COVID-19! +

— Kimberly Savage is a respiratory therapist who works at two Augusta-area hospitals

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Why do I jerk right after I fall asleep? Statistically, only about 30 percent of the population has no idea what this question means. The other 70 percent want answers. Officially, these twitches are known by various labels: hypnic jerks, hypnagogic (hip-na-GAH-jik) jerks, myclonic jerks, and more informally as sleep starts or night starts. Here at Medical Examiner World Headquarters we call them nap jerks. For most people these jerks are not a nightly occurrence, and neither are they usually grounds for medical concern or a symptom of any serious problem or disorder. The biggest health issue associated with hypnic jerks is sleep interruption. Some people sleep right through them, others are awakened only briefly, but still others wake up because of them and have a hard time falling back to sleep. Sleep researchers have yet to figure out the exact cause of these sudden spasms. There are several working theories. One is that nerves in muscles misfire as muscles switch from daytime activity and possible tension to nighttime inactivity and relaxation. Other sleep scientists theorize that consumption of alcohol and/or caffeine too close to bedtime can interfere with the transition from wakefulness to deep sleep. Another theory is that vigorous exercise during evening hours or too soon before bed could be a cause. And finally, other researchers speculate that being overly fatigued or sleep deprived leads to a greater likelihood of hypnic jerks. Without a clearly defined cause, treatment would obviously be difficult, but in any case, treatment is rarely necessary. Side effects and complications are unlikely. These jerks are normal and natural, even if their exact cause is unknown. For anyone whose life and sleep habits are seriously affected by hypnic jerks, the best advice might be to avoid busy evenings which ask the body to abruptly transition from activity time to sleep time. An effective approach to improve the odds of avoiding jerks might be to avoid alcohol and caffeine during evening hours and pursue calmer and more relaxing pursuits in the final couple of hours before going to bed. +

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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. Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397

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

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#126 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

ne of the unexpected things about this doctor is that he isn’t dead; he’s Canadian. There is a difference. In the United States, living people have not normally appeared on postage stamps, although the rule is gradually being relaxed: at one time the rule for non-presidents [U.S. presidents have typically been honored by a stamp the year following their death] was that any consideration for depiction on a stamp had to be at least ten years after death. In 2007 the rule was amended to five years after their death. More recently a number of living, if anonymous, people have been pictured on U.S. stamps. (A notable exception to the rule: the famous World War II-era stamp depicting the raising of the American flag on Iwo Jima by soldiers who, for the most part, were still very much alive when the stamp was issued in July, 1945.) Ah, but we digress. Let’s return to our featured physician. As you can see on the stamp, his name is Balfour Mount, and he’s being honored for his contributions to palliative care. That is a bit of an understatement. He actually coined the term “palliative care.” He is, in fact, considered to be “the father of palliative care in North America.” What’s noteworthy about anyone who is the father of some branch of medicine is that by definition that branch didn’t exist until they came along. Pursuing that new branch often requires a fundamental change in one’s outlook on life and the pursuit of their chosen career. And so it was with Dr. Mount. In 1973 a chance meeting where Elisabeth Kübler-Ross’ book On Death and Dying was being discussed became a life- and career-changing event. The chain of events set in motion by that meeting lead him to abandon his established surgical oncology career and practice. At the time, Mount was affiliated with Montreal’s Royal Victoria, one of the leading teaching hospitals in Canada. As an oncologist, he assumed he knew all there was to know about death and dying. He was soon to discover that, as he later put it, “I knew absolutely nothing.” He remembers doing enough research to come to the uncomfortable conclusion that “to die at the Royal Vic was a catastrophe. And the Royal Vic, I would say, was one of the flagship academic hospitals in North America.” Doctors there had no idea of the scope of their inadequacies. That was illuminated by a week Mount spent being tutored by Dame Cicely Saunders at the pioneering St. Christopher’s Hospice in London. The visit highlighted the “abysmal” failures of Mount and his colleagues to control pain and relieve the sometimes dreadful symptoms suffered in terminal situations. Born in 1939, Balfour Mount continues to advocate for humane and compassionate “whole-person” care to alleviate suffering and enhance dignity for terminally ill patients and their families. +

by Marcia Ribble I am enjoying these cooler days of fall. It is so much easier to get out even if it’s only down the driveway to my mailbox and back. I’m noticing too that the drier air means less huffing and puffing from the exertion. I know that for many, these are laughable statements because you can manage a five-mile run with little challenge to your body. But good health is not a competition! It’s a more solitary me-and-myself set of accomplishments, no matter how long it takes, or how slight the accomplishments might be. A mere year ago I couldn’t get out of bed, or into it without help. I couldn’t put any weight on my right leg. A broken hip had resulted in a plate holding my hip bone together, and a titanium rod down the length of my femur. The prognosis was grim. They said things to me like you’ll never walk again, you’ll be in a nursing home for the rest of your life, there’s no way you can go home and live independently. I took it all in and some part of me said, you’re all a bunch of stupid morons and you are absolutely, positively out of your minds if you think you’re going to make an invalid out of me! That all makes walking out to my mailbox at the end of the driveway of my own home where I am living very independently, thank you, so much sweeter! But it is time for me to turn up the heat a bit on my achievement record. Beating the odds has been great, but it’s not enough. What more do I want to accomplish? What is still left for me to achieve? Next year at this time what do I want to be able to do? Well, there’s driving. If I can walk out to the end of the driveway, I could also walk to a car and get in it. That would expand my universe a lot. It would mean I could

drive myself to get a haircut. I could go to restaurants with pick up at the curb options and cut my costs almost in half from ordering through Door Dash. I could go for a ride on a nice day to see whatever fall colors exist in Georgia. I could order groceries and pick them up myself and again save a substantial amount of money. So many options are out of reach for someone needing others to do things for them. As I write this I’ve already voted, so that’s not something I needed to drive to accomplish. It would be fun to be able to drive to the Y and get into the pool for folks with handicaps and exercise there. With Christmas approaching, I’d enjoy being able to go for a drive to see the lights and other decorations. But there are other things I could do that don’t involve driving. My neighbor asked me this week if I’m getting up and around, even at home. I must confess that I could and probably should challenge myself to get up more often and move around the house more. Why haven’t I done more? Fear of falling has really limited me from doing things I want to do. It is really aggravating to realize that I’m limiting myself from enjoying my life more. But I know how to challenge myself to do more. It’s been a few weeks now since I prayed every time I stood up and used my walker to go out to the mailbox. The move from being terrified to feeling competent is a slow one. And a big part of the battle to improve my health is to recognize when I have surmounted an insurmountable barrier and it’s time to face another obstacle and win the challenge of bypassing that one too. For the time being it might mean putting on my mask and seeing if I can walk a bit past the end of my driveway, just a bit, not a mile. A couple driveways down would be great. Even at 77, I can always work toward a goal of better health.+

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first eased a bit, we did eat inside a couple of times, but after reading some studies about the exceptionally large risk of eating inside versus eating outside, we made the switch. Some people don’t go out to eat at all and some are choosing to eat inside. I respect their right to make that choice. Why is that so hard for some people? Why do we care about lives.” What some feel the need to try to an insulting way to look at control or vilify other people it. Is it true that people who when it has no real impact on want the economy opened up don’t care about lives and them? The other thing that some only care about money? I people don’t seem to be able don’t think so. Not for most to grasp is the risk posed by of them anyway. Maybe it COVID-19. I have read numeris because they know that it isn’t an easy black and white ous social media posts from friends and family essentially issue. It is a balancing act. saying that you have a 99% I’d hate to have to be the or higher chance of surviving the virus, so we should just ignore it or not worry about What if we tried it at all. I believe this exposes common sense and a very poor understanding basic math. Even if the plain old decency? of survival rate were 99.9%, that would mean 328,000 dead Americans before it was all over, and nearly 8,000,000 person who has to decide dead humans all over the what the right level of restrictions needs to be. I don’t globe. Does that sound like an think anybody really knows. acceptable loss of life to you? Does that help convince you For some children, school to make the tiny sacrifice to is a lifeline. They don’t get put a mask on when you are enough food at home or are suffering abuse. Some young in public places near other people? people need the association It is laughable to me that with schoolmates in order a lot of these same people to avoid the depression that can lead to suicide. School is seem to flip the logic around when it comes to other safety their escape from that. Doprecautions in their lives. mestic violence is up during They aren’t being consistent. the pandemic too. It seems like being stuck at home with Here is a good example. I was talking to a friend who an abusive mate or parent is conservative and who has doesn’t improve their mood or their behavior. Put that in a concealed weapons permit. He has it because he sincerely the “not shocking” category worries about himself, his for me. Because of our age, the fact family, and other innocent that my parents live with us, bystanders if faced by a bad and other health-related risk guy with a gun. He isn’t a bad person or bloodthirsty. factors, my wife and I try to He wants to take that precaube cautious, yet still try to live our lives in an enjoyable tion. I appreciate him being willing to bear that heavy and reasonable fashion. We responsibility, both literally still go grocery shopping inside the store, while others and metaphorically speaking. He went through the expense only use curbside pickup. and trouble to get trained and I don’t fault those people. licensed, and then to carry They get to make that decision for themselves. I respect a heavy gun around all the time to mitigate a very small that. We also still go out to eat, but we only eat outside, potential (not real) risk. Yet, he sees mandates for masks so our choices are limited. as an unnecessary encroachOf course, we don’t go out ment on his rights. He is in nearly as often as we used the camp I mentioned above to. When the restrictions

Middle Age BY J.B. COLLUM

We’ve all been subjected to an untold number of videos of people acting like spoiled brats pitching a fit about being told they have to wear a mask in a store. These are the same conservative, private-property-rights-loving people who would tell you that the government had no right to make non-smoking laws for private property, like bars and restaurants. Now they are claiming some constitutional right to not wear a mask, and finding specious “scientific” data to support claims about the mask dangers, sometimes even printing the pseudo-scientific “facts” about their so-called condition on little cards they would hand out when confronted about not wearing a mask in a place where it was mandated. The owners of the stores made their rules, usually based on guidelines from state or federal governments, and the protesters were trying to claim the same government has laws that give them the right to go in there with no mask on and endanger all those other people and ignore the rights of the store owners. Some even called the police to come enforce their rights. Then you look at the other side of the aisle. Some of these folks are making people wear masks when they are nowhere near any other people. The announcers on Sunday Night Football were isolated in a booth but were required to wear masks by the State of California. I see these type people alone in their cars with masks on. What is up with that? Many of these same people want everything to remain shut down until a vaccine is found and distributed. Do they not realize that poverty from a destroyed economy can also kill? I have heard comments like, “others only care about money and the economy, but

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I am not a political person, so I am trying to understand how a pandemic and the way we handle it has become so political and so contentious. I realize that in a presidential election year especially, any minor disagreement can be turned into a no-holds-barred, vicious fight that is more like WWE wrestling than civilized public debate. I realize it, but I don’t get it, and I don’t like it. I am fortunate to have mostly non-political friends and family, but I also have quite a few friends and family who are staunchly left-wing or right-wing. Thankfully, very few of them are the contentious extremists I will describe in this column. I get along fine with them all most of the time, even the very few that I consider a little bit unhinged at times, and even when they say things that are nonsensical. I have my limits, and the teeth marks on my tongue are proof. Take just one part of the equation: the part about wearing masks. Early on, we were told by the authorities not to wear masks, and my liberal friends mostly went along with this advice without a problem. My conservative friends, on the other hand, rejected this advice and were seeking masks wherever they could find them. Fast forward a few weeks when we were then told to wear masks, and the roles reversed. I think the switch is mostly about how the two sides currently see government. One side sees it as a benevolent friend to mostly be obeyed, even though they don’t always like the person or people at the top; the other side sees it as a frenemy. They like the way it protects them from outside enemies, they are proud and patriotic about it, but they are suspicious enough of it to have a loaded backup plan in their safes and cabinets.

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who doesn’t seem to understand the risk, and certainly is inconsistent when it comes to weighing one risk against another. He won’t put a mask on inside a store until he is told he has to, and from my experience some stores aren’t really enforcing it beyond asking once or twice (if at all). In all of this talk of risk, it seems that people are looking at it subjectively. They say, “I don’t know anyone who died from it personally.” Because of that, it isn’t real to them. We need to be more objective and scientific about it. Even so, I must admit that for me it was a personal loss that made me be even more cautious. I lost a dear friend to COVID-19 about a month ago. Before that, I was going through the motions, mostly taking the precautions because it made people around me feel better. This is because I cared about their feelings and I knew I was no expert, so I allowed for the possibility that I could be wrong. Some people don’t seem to think that’s an option. I am still living my life, but I am being more careful and thoughtful. I wish it hadn’t taken a personal loss to get here. Folks, I am not trying to advocate for the loss of your rights. Nor am I trying to say that we don’t need some restrictions and rules enforced to help stamp out this pandemic. I am just advocating for us to try to balance all the variables in this equation, to be considerate of others, not impute bad motives, and not turn a health crisis into a political war. Let’s see if we can encourage common sense and decency instead of being focused on our rights or, conversely, stepping on the rights of others. Of course, by the time you read this, we will likely have found out who the winners and losers are in this year’s elections. Who knows what new hatred and vitriol this will spawn? At least we will not have to see political ads again for a while. + 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 6, 2020

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by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author

Roasted Beets & Sweets

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CRAVING THE WING?

WITH CASHEW CREAM

This recipe is the perfect way to celebrate the bounty of fall and winter produce. These two root vegetables partner with the cashew cream sauce beautifully to elevates this already delicious recipe to swoon-worth status. Ingredients • 3 medium-large beets, peeled and diced into 1 inch cubes • 2 large sweet potatoes, diced into 1 inch cubes (peel or keep skin on, either works) • 1 sweet yellow onion, chopped • 1 clove garlic, minced • 1/2 teaspoon dried thyme leaves • ¼ teaspoon salt • 1 tablespoon extra-virgin olive oil • 2 teaspoons chopped fresh parsley (optional) • Cashew cream (see below) Instructions Preheat oven to 400º. Line a large baking sheet with parchment paper. In a mixing bowl, combine beets, sweet potatoes, onion, garlic, salt and oil. Toss so vegetables are well coated in oil. Spread beet mixture evenly on baking sheet, and bake for 35-40 minutes. Toss mixture halfway through baking. Garnish with fresh parsley and cashew cream.

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Enjoy warm or cold – it tastes delicious either way! Yield: 6 Servings (serving size: ½ cup vegetables 1 tablespoon cashew cream) Nutrition Breakdown: Calories 120, Fat 4.5g, (1g saturated fat), Cholesterol 0mg, Sodium 20mg, Carbohydrate 18g, Fiber 3g, Protein 2g. Diabetes Plate Plan: 1 Starch, 1 Vegetable, 1Fat Cashew Cream: • 1 cup raw cashews • 1 cup water • 1 teaspoon lemon juice

• ¼ teaspoon salt Put all of the ingredients in a food processor and process until creamy smooth, about 1 minute. Store in an airtight container in the refrigerator for up to 7 days or in the freezer for up to 3 months. + Yield: 2 cups (serving size: 1 tablespoon) Nutrition Breakdown: Calories 25, Fat 2g, Cholesterol 0mg, Sodium 20mg, Carbohydrate 1g, Fiber 0g, Protein 1g.

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ASK DR. KARP

NO NONSENSE

NUTRITION Pete, a friend from Savannah, GA, asks, “What is the ideal healthy breakfast?” Glad you asked. There is actually no such thing as one ideal, healthy breakfast. However, there is such a thing as applying ideal, healthy principles to help you choose what to eat for breakfast. Regardless of whenever or whatever you eat, your food should fit into the definition of “healthy” as defined by evidenced-based health science organizations. A few examples of these organizations include The Academy of Nu-

trition and Dietetics, The Nutrition Board of The National Academies, The American Heart Association, and the USDA, to name a few. Do not use a definition of “healthy” as defined by a food company or store. Since the word “healthy” has no standard legal definition, there are many uses of this term. The word can be exaggerated to support a specific product or food. Also, be aware of sub-standard “scientific” and accrediting organizations that appear to meet scientific criteria, but are nothing more than advertising and marketing arms of a company promoting a specific product or idea. It is so important not to focus on this food or that food, or this meal or that meal. It is your overall eating and activity pattern throughout the day, week, month, year...your life, in fact... that is the most important. Focusing on specific foods (i.e., whole wheat cereal, orange juice, a Canadian “sunrise” bacon/egg biscuit, yogurt and fruit, etc.) is not a nutrition science approach. Instead of doing that, focus your attention on principles of healthy eating. In addition, pay attention to your own specific likes, dislikes,

ways of eating and your life patterns. Figure out how to make healthy eating fit into your life and the lives of your family, friends and coworkers (your food culture). Another important routine, pre- or post-breakfast, is to include physical activity. It turns out that what is healthy for breakfast is also healthy for lunches, dinners and snacks. You can eat anything for breakfast you want, whether the foods are traditional foods or non-traditional foods. One key to a healthy breakfast, or any other meal, is to have a large variety of food from all the food groups. Eat a variety of foods for your breakfasts and a variety of breakfasts during the week. Avoid getting into that “breakfast rut” that so many people fall into, eating

NOVEMBER 6, 2020 the same breakfast day after day, year after year. Someone asked me recently if oatmeal with fruit and low-fat milk was a healthy breakfast. He had heard it was healthy, so he decided to eat oatmeal, fruit and milk for breakfast every day…for 10 years! Is that a healthy breakfast? Yes. Is it healthy to eat it, forever, every day? No. And, remember that what you eat at any meal should be moderate in salt, sugar, saturated fat and calories and contain nutrients, like whole grain carbs, fiber, protein, vitamins, minerals and healthy fats. At our house, we have many different “routine” breakfasts, perhaps as many as 10 to 15 different types of breakfasts or more. For example, we may have a breakfast of half a bagel with a slice of low-fat cheese, smoked salmon, a big slice of tomato, cucumber and a side of fruit, like cantaloupe or strawberries. Or, some mornings, especially if we are in hurry, we may have low fat yogurt, mixed with fruit and sprinkled with some whole grain cereal. Some mornings

I may make an egg white omelet with sliced red and green peppers and scallions, with a broiled tomato and whole wheat toast. Some other mornings we may have pancakes made with low-fat Bisquick covered with lots of blueberries and seasonal fruit on top, with low sugar syrup, etc. If we are in a big hurry, we might simply toast a couple of whole wheat waffles or slices of bread and make a sandwich with peanut butter or low-fat cheese and have it with an orange, apple or pear. Honestly, I can go on and on. If you have some leftover spaghetti or other dinner or lunch foods from the a few days ago, that is fine for breakfast, too. The food police will not give you a “ticket” for eating non-traditional foods for breakfast. It is perfectly legal. What is the “No-Nonsense Nutrition” advice for today? It is simply this. There is no such thing as an “ideal” breakfast, but there are ideal principles for choosing what you eat, regardless of the meal. Use your creativity and think out of the (cereal) box! By the way, sometimes we have breakfast for dinner, especially if we have had a larger lunch. Guess what? We don’t get a “ticket” for that, either. +

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

Dr. Karp

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NOVEMBER 6, 2020

Ask a Dietitian

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AUGUSTAMEDICALEXAMiNER

WHAT GARAGE DOOR HEAVEN LOOKS LIKE

“I CAN’T AFFORD TO EAT HEALTHY!”

by Cathryne Buice, MS, RD, LD, CDCES Clinical Nutrition Manager at University Hospital 30% below national brand items. Here’s an example comparing name brand versus store brand: Quaker Oatmeal Store Brand Oatmeal $2.99 $1.70 18oz/13 servings 18 oz/13 servings $0.17 per ounce $0.09 per ounce $0.23 per serving $0.13 per serving

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Highland Ave.

Check store advertisements and fliers for sales and specials. Many stores do have predictable sales cycles. Use coupons for items you normally buy and use in combination with sales and double coupons. With planning, coupons can save on average $5-$20 dollars for every $100 spent. Join the shopper’s reward program where you shop. Look for “loss leaders” which are heavily advertised low-profit items designed to lure you into the store. Call the toll-free consumer center number on packages and request coupons. Ask for a rain check if the store is out of a sale item. By law the store has to provide a rain check so you can buy the item at the sale price at your next visit. Listen to upbeat music while shopping and you’ll be out faster, lowering your bill. Stores sometimes play soft soothing music to encourage you to shop slowly and therefore spend more money. If you only need a few items get a basket or small cart instead of the large, full sized cart. Use the unit price to compare the cost of different brands and package sizes. Compare edible serving cost. Price per pound is not always a good basis for comparing the costs of meats, fresh fruits and vegetables due to varying amounts of bones, fat, skin, cores, pits & other parts you can’t eat. Pick from the back – shelves are stocked back to front with the newest items behind the older ones. Be aware of marketing strategies. High traffic areas such as meat and dairy are in the back, so you have to go through the store to get to them. Foods that go together are grouped together to encourage impulse buying. Basic food items are placed across from an impulse item. Cartons of merchandise in the aisle slow you down and suggest bargain pricing. Expensive brands and impulse items are at eye level. Buy economy sized items only if you have the storage space and can use it before it spoils. Large packages may not be a better buy if a smaller package has been specially priced. Also buying in bulk may bulk you up; studies have shown we tend to eat more at each sitting when we have access to espe-

Ohio Ave.

In the 30+ years I have been a dietitian, a common concern expressed by many of my patients their inability to afford a healthy diet. It’s a legitimate concern. According to the USDA, food costs are often the second largest monthly expense after mortgage/rent payments. In addition, many face food insecurity, which means families uncertain of having or being unable to acquire enough food to meet their needs because of insufficient money or other resources for food. Nationally, the rate of food insecurity is 10.5% (2019), but locally it is higher: 11.8% in Georgia and 11% in South Carolina. Now we are faced with an additional burden of the coronavirus pandemic that has affected millions of people’s health and has added the additional financial burden of lost jobs. What can you do to make eating healthy more affordable? Let’s start with meal planning and its benefits. Shop from a list; most people spend twice as much without a list. Resist impulse buying. By knowing what you need and sticking to a list, you are more likely to avoid high priced/low nutrition food items. Save time, money and energy. No longer stress about what you are going to fix for dinner, which helps give some order to our time-crunched lives. Planning helps you do all your shopping at one time so you don’t have to make multiple trips to the store, which saves gas too. Plan breakfast, lunch, dinner and snacks incorporating store specials. Take stock of what you have on hand, then make a list of ingredients you need to buy. Look at your schedule. Prepare easy meals on your busy days and save those that take longer for days off. On the USDA’s Choose My Plate website (www.choosemyplate.gov), they have a “Create a Grocery Game Plan Worksheet” with menu plans and recipes. If planning a weeks’ worth of menus seems overwhelming, plan 5 meals. You can switch out foods in preplanned menus based on what’s on sale this week and you and your family’s food preferences. Next let’s look at shopping tips to make healthy eating more affordable. Start by creating your shopping list based on the menu you planned. Keep an ongoing list in your kitchen as you run out of items. Organize your list to make it fast when you go shopping. Keep your kitchen stocked with low cost staples. Shop alone and don’t go hungry so you are less tempted to buy items not on your list. Shop early in the day. Purchase store brands as they are often priced as much as

+ 10

AUGUSTAMEDICALEXAMiNER

CRASH

COURSE

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

footage of collisions involving trains. Even so, you might think a train doesn’t hit a car every day of the week — and you’re correct on that. Several trains hit several cars several times every day of the week, every day of the year. The latest U.S. figures might surprise you. The 2019 numbers are still unofficial, but the estimates are 2,216 collisions, 807 injuries, and 293 deaths. That’s an average of 6 crashes every day and more than 5 deaths a week. As bad as that sounds, we’re heading in the right direction. Here are the stats for a few select years over the past four decades:

{

et’s spend the space devoted to this installment of Crash Course on a somewhat rare but especially deadly type of collision: cars (and other vehicles) versus trains. Talk about an unfair contest. The average car weighs less than 3,000 lbs, while most pickup trucks and SUVs are closer to 5,000 lbs than 4,000. Take a guess what a train weighs. There are a ton of variables: how long is the train? Are the cars empty, or fully loaded? If they’re loaded, what are they loaded with? For starters, a single locomotive can easily weigh more than 200 tons all by itself. Even at a mere 200 tons, that’s 400,000 pounds. So a long train with three locomotives is well over a million pounds just in the engines. Hopper cars that carry coal and gravel can weigh 100 tons apiece. A single train wheel — one wheel — weighs over 2,000 pounds. If you recall, an SUV weighs 4,000-5000 pounds. A freight train of any decent length could top 40 million pounds of rolling weight. No wonder they flatten pennies when they roll over one. But more to the point, they do quite a number on cars and trucks too. There is not a car, bus, truck, or big rig that wouldn’t be tossed aside like a Matchbox toy in any encounter with a moving train. Do you use the Waze navigational app? If so you’ve noticed a recently added feature: if you’re within sight of a rail crossing the app will sound a loud alert chime. Does that change seem a bit unnecessary for crashes that are as infrequent as train/vehicle collisions are? As mentioned above, car-train and truck-train collisions aren’t exactly everyday occurrences. But they are nowhere near as rare as you might think — or as they should be. Places like Instagram and Facebook have hours of recent

{

Train/car collisions aren’t daily occurrences. Are they ?

Sparkle

YEAR

1981 1990 2000 2019*

COLLISIONS

DEATHS

INJURIES

9,461 5,715 3,502 2,216

728 698 425 293

3,293 2,407 1,219 807

* Preliminary statistics So 2019’s average of six crashes per day looks absolutely great compared to 1981’s nearly 26 crashes per day resulting in, on average, nine deaths per day. The thing about train crashes isn’t their frequency, it’s their severity. When a 4,000 pound vehicle is struck by a 40 million pound vehicle, it’s easy to pick the winner. Big dangers are presented by unmarked crossings, of which there are still a few in rural areas around the CSRA, and multiple rail crossings. One train passes and vehicles, pedestrians, and bike riders start to cross, only to meet a second train they couldn’t see before, barreling along on the second track. Of course, the biggest danger from trains is not posed by the trains. It comes from careless and impatient motorists who drive around dropped crossing gates, ignoring clanging bells, flashing lights, and those ear-splitting 100-decibel train horns. +

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cially large packages of food. Purchasing products that are discounted in special sale carts or damage product bins can save money, but check for freshness, package condition and expiration date. You may be paying the price for convenience if it has been grated, chopped, precooked, presliced or individually packaged. Convenience may pay off if you only need a small portion such as a small amount of broccoli for a salad; buying from the supermarket salad bar may be worth it over buying a whole head of broccoli. Bagged iceberg lettuce, cabbage & carrots costs about the same whether prepackaged or homemade, whereas one with more exotic greens like romaine and radicchio costs twice as much if prepackaged. Be flexible. Take advantage of in store specials by substituting them in your menu plan. Check your receipt before leaving the store. Many stores will give you the item free if the wrong price is scanned. Let’s look specifically at grains, beans and starchy vegetable which are the foundation of a healthy but inexpensive meal plan. They’re low in cost & fat and generally high in fiber. Have 6 or more servings per day. Best buys: cornmeal, flour, grits, ready to eat cereals, rolled oats, bread, saltines, popcorn kernels, dried beans, rice, pasta, corn, potatoes. Save 20-30% by buying generic or store brand cereals. Cooked oats are less expensive than instant oats. Rolls made from a mix or dough in the dairy case are cheaper than packaged rolls. Buy frozen bread dough to make pizza crust. Instant, quick cooking and seasoned rice mixes cost 3 times more than plain rice you cook and season yourself. For convenience, buy regular rice, cook more than you need and freeze the extra. Pasta is cheaper in bags, and shapes are interchangeable in recipes. Check the drained weight of a can of corn; frozen may be cheaper. Make your own cooking spray. Buy large bags of nuts when on sale during the holidays and freeze for later use. Sweets are not off limits, but should be eaten in small amounts. Instead of buying individual pudding cups, make your own. Special diabetic or dietetic foods are no bargain. Alcohol has no nutrients and should be limited. Sodas, carbonated fruit drinks and flavored waters are poor nutritional & economic choices; use water as main beverage. Make your own combination juice drinks; it’s cheaper to mix 2 juices together rather than buying a premixed juice like cranberry-apple juice. Bottled, canned or instant tea is more expensive than tea made from tea bags. When purchasing tea, figure the cost based on the number of quarts you’ll be able to make rather than the weight of the jar or box. Add a bit of ground cinnamon or a few drops of almond or vanilla extract to coffee grounds before brewing to make your own flavored coffee. Herbs: generic brands can cost up to 50% less. Buy less frequently used herbs & spices in small amounts. Fresh herbs such as marjoram, oregano, rosemary, savory & thyme freeze well. Grow your own. When it comes to snacks, pass on pricey, low fat cookies and chips. Avoid individually packaged snacks. Penny -pinching healthy snacks: unsalted pretzels, animal crackers, graham crackers, air-popped popcorn, fresh fruit, raw veggies, applesauce, unsweetened ready to eat cereal. Hopefully these tips will help you save money and be able to afford a more healthy diet. +

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11 +

AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf — posted by Clarissa Barnes, MD, on October 30, 2020

TO MY HEALTHCARE COLLEAGUES I see you, and I am honored every day I get to work alongside you. To the frontliners: As the hospital gets busier and busier, I can feel the anxiety. People are sicker than ever with COVID and non-COVID illness alike. Seeing the new diagnoses going up every day and knowing that portends an influx of increasing COVID cases 1-3 weeks later feels like watching an advancing onslaught you are powerless to stop. I know you say you’re ‘fine’ when I ask, but I can see the fatigue from extra shifts, higher volumes, and higher acuity. To the clinic physicians: I know you’re as busy as ever as care delayed earlier this year has finally come due. I see your heartache as you diagnose your patients with COVID and your anxiety as you wonder which of your long-term patients won’t be here come spring. To the specialists: I see you trying to navigate how to take care of your chronically ill patients in this new landscape where patients may be nervous to see you. Things like surgeries, oncologic care, and chronic disease management that was delayed need to be done, but how do you do it when COVID keeps taking all the resources? To nursing and other clinical staff: I know you are working SO. HARD. You’re picking up extra shifts and taking care of more and more patients. You may even be asked to work differently or do things you’re not accustomed to do. Often, you’re doing extra duty as emotional support for patients who can’t have visitors because of COVID. To nursing home staff: I know you’re terrified. You know what happens if COVID gets into your facilities. One small breach could be a tragedy. On the other hand, residents are lonely, and families are frustrated. To the students and the residents: I’m sorry your education has been interrupted. PPE concerns have put you further away sometimes than normal. You’re worried you’re not learning exactly what you thought you’d be learning and sometimes struggling to find your place. To the clinical leaders and administrators: I know you’re making difficult decisions every day. There’s no manual for the decisions you’re making, and only time will tell if you’re making the right ones. There’s no “off” when you’re the only person responsible for important operations decisions. To the non-clinical staff: I know so many of you are doing completely different things than normal. You’re having to reach completely new levels of flexibility in both what you do and how you do as many of you learn to work from home or on reduced hours. To our essential workers two times over (i.e., food services, custodial services, etc.): I see you showing up every day and keeping everyone going. You’re in the middle of a pandemic you didn’t expect, but you push on even though this means learning new techniques to get the work done around COVID. It isn’t going to get better anytime soon. It’s going to get worse. You know that. It isn’t fair. You all bear so much of the work and stress COVID brings. But, you show up every day and give everything of yourselves. How could you not? Not everyone can do what you do, and ultimately, you’re not caring for “patients.” You’re caring for family, friends, and neighbors. The deaths always hurt. It’s sometimes difficult to explain what we do at work to those who can’t see what we see. Some people will try to explain that it’s all been overblown, but you know it isn’t. I know you have an abundance of compassion (you don’t come to this work without it) but make sure it extends to yourself. While you’re taking care of everyone else, please take care of yourself. +

There is no manual for this.

Clarissa Barnes is an internal medicine physician

Fame and fortune are fickle things, and they can be even fickler when they are built upon sand. Former physician Andrew Wakefield found that out the hard way. He is the disgraced (in some circles) or revered (in some circles) British doctor who announced in 1998 that vaccines commonly given to children by the millions were linked to autism. He became the most famous doctor in the world virtually overnight. His study was published in The Lancet; he testified in Washington before congressional committees; he appeared on 60 Minutes. There was just one problem: a writer named Brian Deer. It was Deer who first uncovered the ethical conflicts upon which Wakefield’s results were built. Many of the children who were his research subjects had been supplied by an anti-vaccine group with assistance from a lawyer preparing to sue vaccine makers. Wakefield had been paid nearly $850,000 for results that would help advance the antivax litigation. Other researchers around the world, as is the usual custom to verify new findings,

raced to replicate his results. Time after time in place after place, they were unable to do so. It began to look as though the findings of Wakefield’s had been pulled out of thin air. When The Lancet retracted the paper, the house of cards began to collapse. In short order, Wakefield lost his job and his license to practice as a physician and became Pariah #1 in the medical community. But the damage had been done. Millions of people still believe that vaccines like the MMR shot cause autism. Not that this book examines the loud and proud proWakefield factions, but they are out there with the very unapologetic Andrew

Wakefield at the helm. Much of his venom is directed specifically at Deer, but Wakefield and his supporters also view his case as a clear demonstration of the power of Big Pharma, the mafia-like consortium of major drug makers who will crush anyone or anything that interferes with their profits. While most of us know the same general outline of the Wakefield case recapped in this review, Deer’s book is packed with additional details and behind-the-scenes information. This is an extremely timely book, arriving at a point in history when skepticism of the most basic and long-held scientific and medical facts and truths — wearing masks as one simple example — is running at an all-time high. The chaos of misinformation that has been sown during the pandemic has no doubt cost many lives. That too is part of the very tainted legacy of Andrew Wakefield. + The Doctor Who Fooled the World, by Brian Deer, 408 pages, published in Sept. 2020 by Johns Hopkins University Press

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+ 12

AUGUSTAMEDICALEXAMiNER

The Examiners

NOVEMBER 6, 2020

RHINCCO

I’m so sick of people in my neighborhood setting off fireworks.

by Dan Pearson

I know! New Years Eve is two months away!

No joke! And for what?

Right! It’s only the first week of November!

Every time they do it our dog goes crazy and knocks over the Christmas tree!

Same at our house!

The Mystery Word for this issue: HORCCIN

EXAMINER CROSSWORD

PUZZLE ACROSS 1. Mr. Hogan 4. Friend 7. Bethesda health inst. 10. Biblical high priest 11. Sticky situation (from Uncle Remus story) 15. Kill Bill star 16. Harbor craft 17. Ophthalmologist’s job 18. Rotational abbreviation 19. The son of Abraham and Hagar 21. Moses’ first book 23. Type of saw 24. Once more 26. Hue 27. Wicked 28. Sidereal plasma ball 29. Work a horse in a circle 30. Propagative part of a plant 31. I.M. _____ 32. Intro for beer or bread 33. Judge’s error 35. Part of an antigen 39. First cardinal number 40. Rounded protuberance 44. To no ______ 45. French clergyman 46. Indigo dye 47. One could go an extra this 48. Capital of Western Samoa 49. Move sideways 50. Arturo Toscanini, for one 52. Vexation and embarrassment 54. Last name of baseball great at 33-D 55. Waterproof fabric 57. Bush Field abbrev. 58. Negating word 59. Type of cross or falcon 60. Knight’s title

21 24

48 51

32 34

49 52

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, NOV. 16, 2020

We’ll announce the winner in our next issue!

E X A M I N E R

33 37

7 13

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

S U D O K U

60 62

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

61. Hip Hop doc 62. Eccentric 63. Speak

DOWN 1. Poet’s “early” 2. Hard to define (or capture) 3. Negligee 4. Bishops 5. WJBF affiliation 6. Encampment encircled by wagons 7. Common healthcare career 8. Encroach 9. Caged pet 11. Duct type 12. Affirmative vote 13. Make beer or tea 14. Monetary unit of Japan 20. Blend 22. English public school 25. Capital of Kenya 28. Whirl

QUOTATIONPUZZLE

29. Be in a horizontal position 32. Club devoted to singing 33. First name of baseball great at 54-A 34. Not endorsed or supported 35. Hills in North Augusta 36. Flier 37. Board for mixing colors 38. Offerings from The Boardroom 40. Alexander of Nixon years 41. Disrobe 42. Citizen army 43. Complete, absolute 45. Ancient Greek god 48. Operatic highlight 49. Having a sound mind 51. Cruise lead-in 53. Belonging to that guy 56. VD in 2020

S O O F R R F T N E N N I A O U S E G M A S T W P T C C T F U E I O T T Y E R E O E H A O

3 5 7 6 2N 9I 8I 4 N 1

2 4 9 7 1 8 5 6 3

8 6 1 4 3 5 7 9 2

— Thich Nhat Hanh

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

Solution p. 14

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

V 1 2 3 4 1

L 1 2 D 5 6

1 2 4 5 6 L 1 2 3 4 5 6

1 1

2 2

1 1

2 2

L 3 4

1 2 3

1 2 3 4 5 6 7

1.VUTTUBBBHLF 2.AAOOOLLSSIU 3.TTIVIRU 4.NRLTEN 5.DUDET 6.EDSSS 7.S

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

WORDS NUMBER

THE MYSTERY WORD

1 3 8 2 4 7 6 5 9

9 2 5 1 8 6 4 3 7

4 7 6 5 9 3 1 2 8

NOVEMBER 6, 2020

13 +

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

hich is more important,” the teacher asked her class, “the sun or the moon?” Johnny was the first one to raise his hand. “The moon,” he said with conviction. “And why do you think that’s true?” the teacher asked. “Because the sun gives light during the day when we don’t need it,” said Johnny, “but the moon gives us light when it’s dark and we really need it.” Accordion to a recent survey, replacing some words in a sentence with the names of various musical instruments often goes unnoticed. Lawyer: You claim my client bit off Tom Foley’s ear. Did you actually see this happen with your own eyes? Tell the truth. Yes or no? Witness: No, I did not see him bite Tom’s ear off. Lawyer: Then please tell the jury how you can sit there and claim he bit off Tom Foley’s ear when you did not see him do it. Witness (turning to face the jury): I saw him spit it out.

The

Advice Doctor

A couple getting divorced appeared before a judge, and because it was uncontested they were not represented by attorneys. As the details progressed to the kids, the judge said, “You have three children. How will they be divided?” The couple had a very long whispered discussion, but finally the judge’s patience ran out and he brought his gavel down and said he needed an answer. “Your honor,” said the wife, “we’ll come back next year with one more.” Joe: I feel great every Saturday and Sunday but lousy all week. I wonder why? Moe: Sounds like you may have a weekend immune system. Moe: Wow, I just saw a whole bunch of blackbirds that were all stuck together. Joe: Oh yeah, those are velcrows. Moe: Hey, what did the marching band member use to clean his teeth? Joe: Uh...tuba toothpaste? A guy is walking down the street when a homeless man approaches him and asks him for some change. The only money the man has is a $20 bill. He thinks, “Do I really want this money to be wasted on booze, cigarettes and drugs? Definitely not.” So he gave the twenty to the homeless man. Moe: What do you call a home school kid taking a selfie? Joe: A class picture. +

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’ll be surprised if I see my question answered in the Medical Examiner because it isn’t really a medical question. I guess it’s more of a legal issue pertaining to a car I bought that turned out to be a piece of junk. I’m not sure I understand my rights. Am I only protected under the lemon law from the date of purchase, or from the date I first (or even most recently) reported problems? — This Car Left a Sour Taste in My Mouth Dear This Car, I’m happy to answer this question. In fact, I have what might be a very unusual viewpoint on this issue: I wish more people would buy these lemons. Think about it: they are fat-free, cholesterol-free, gluten-free, sodium-free, and low calorie. They are also one of the best sources of vitamin C. A single small lemon delivers nearly 90 percent of the recommended daily dose of vitamin C, and studies indicate that a regular diet of fruits high in vitamin C is linked to a reduced risk of heart disease which, along with heart attacks and strokes, is the world’s most common cause of death. Low levels of vitamin C in the blood are also associated with increased risk of stroke, especially among people who are overweight or have high blood pressure. Citrus fruits have been shown to decrease blood cholesterol levels, helping to prevent LDL (bad) cholesterol particles from becoming oxidized. Although the evidence isn’t conclusive at this point, some studies have suggested that lemon juice and lemonade (the real thing) can be effective at preventing kidney stones. And other research indicates consuming lemons and lemon juice can aid digestion, and there are additional studies showing that lemons enhance the functioning of our immune systems. One easy way to enjoy all this abundant goodness is to drink lemon water a few times every day. The recipe is simple: squeeze juice from a lemon into a cup (8 oz.) of water and drink it as you prefer: hot or cold. Some people find the routine of regularly drinking lemon juice and its fresh, clean aroma and taste offers one more benefit: stress reduction. 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: ELBOW

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THE WINNER: JESSICA SAXON! 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 6, 2020

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED B E T I M E S

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...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.

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