Nov16 18 by Daniel Pearson

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NOVEMBER 16, 2018

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DIGEST THIS BODY PARTS: THE OCCASIONAL SERIES

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NOVEMBER 16, 2018

PEDIATRICS101 TIPS, TRICKS & TALKS TO KEEP TOTS TO TEENS HAPPY AND HEALTHY

BY CAROLINE COLDEN, MD, PEDIATRICIAN

Flu season is upon us. The time for pestering patients to get their annual flu vaccine is happening. It is annoying, we know. But why all the fuss about getting flu shots ? The answer is because the flu - short for influenza - is a big deal. It has already killed children this year (2018), and it’s only been flu season for a few weeks. For the record, the flu shot does NOT cause the flu. It may cause a post-vaccination reaction, including body aches, low grade fevers, and

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pain in the injection site, but NOT the actual flu. What are symptoms of the flu? Most people think of vomiting and diarrhea (the “stomach flu”), which happens more in kids than adults. More common symptoms include runny nose, congestion, sore throat, chest pain, coughing, generalized body aches or weakness, and fatigue. It’s important to note that the flu may or may not be accompanied by fever, so lack of fever does not mean lack of flu. Personally, I think the flu feels like an elephant sitting on my chest. Why do we care so much about the flu? The flu in a healthy, robust individual still has the capability of causing bad disease, and it’s unpredictable when a patient will take a turn for the worse,

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or when they will recover without issue. Moreover, it is the less healthy, less robust patients that we as pediatricians worry about to an even greater extent. Little babies or kids who have chronic illnesses such as asthma or other lung disease, can become dangerously ill from the flu and potentially die. Other patients we worry about include those with weakened immune systems due to medications, cancer, or other illnesses. Those patients often cannot even receive the flu vaccine, and the only way to prevent them from getting sick is to minimize their exposure to the virus. By vaccinating and containing the spread of the virus, we can accomplish many goals in pediatric populations, most notably: 1.) we keep kids healthier overall and decrease their risk of getting sick, and 2.) by vaccinating the healthy kids and preventing them from getting sick, we reduce the chances that they will in turn expose other kids who cannot be vaccinated and protected directly. How is the flu spread? It is spread the same way other respiratory viruses are, mainly via droplets in the air or on surfaces. Washing hands is a fantastic way to protect oneself against the flu in addition to the flu vaccine. Everyone should discuss the risks and benefits of vaccination with their doctor on an individual basis, but overall, the flu vaccine is an excellent way to help kids stay healthy during flu season. +

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BODY PARTS: THE OCCASIONAL SERIES

DIGEST THIS W

hat better way is there to keep Eating Season celebrations going than to talk about the digestive system? Most of us share some basic misconceptions about our digestive systems. Let’s agree that we all know where the whole thing ends, but ask the Average Joe where it starts and he’s likely to say the stomach. And he would be oh-so-wrong. By almost a foot. What would you say? The correct answer: our mouth is where the process of digestion gets started — or where it can be short-circuited. Specifically, our 32 teeth play the first crucial role. Without chewing, the food we did manage to swallow would be difficult to digest, so we would gain relatively little nutrition from it. When we take a bite — actually, even when we’re hungry and merely smell the aromas of delicious food — salivary glands go into overdrive. Saliva contains enzymes and antibodies that begin the process of breaking down food into the nutrients we need. Chewing breaks boulders Cecum down to rocks, rocks down to sand. The digestive chemicals in A saliva can only do so much with boulders and rocks, but sand is a different story. Someone who hurriedly gobbles food down is largely skipping this vital Step 1. Once food is ready to go down the hatch, a small but vital body component is automatically triggered. Without it we would be in a world of trouble. This valve — the epiglottis — is a little like a flapper in an arcade video game, diverting what passes it to either the trachea (windpipe) or the esophagus. Considering that we simultaneously chew, inhale, exhale, swallow, talk, drink, laugh and more at every meal, the epiglottis is one alert and flap-happy little flap. It rarely fails us. And its surface contains taste buds too. Having passed the epiglottis, our wellchewed food enters Common Misconception #2 of the digestive system, sometimes called the esophagus. The misconception is that the esophagus is just a laundry chute for food, kind of a thrill ride for chicken nuggets, tater tots, and all the other components of the modern balanced diet. There is a simple test you can try at home to dispel this common myth. You’ll need a plate full of tater tots, chicken nuggets (or both) for this experiment. With the plate close by, simply stand on your head and begin to eat. You know what? On second thought, do not attempt that. Please just take our solemn word for it that you can eat and drink while upside down. The digestive system is not gravitydependent. If you don’t believe us, ask any astronaut. They have dined many times in weightless zero-gravity conditions. It’s all possible through the miracle of peristalsis. From Greek root words meaning “wrap around,” peristalsis is a series of wavelike constrictions and relaxations, in this

case of the esophagus (but not limited to the esophagus), that keeps its contents moving along in the right direction. After being safely conducted past the fi rst five essential components of the digestive system (teeth, tongue, salivary glands, epiglottis and esophagus), food now enters what many people call Stage 6, a.k.a., the stomach. Again, there are misconceptions aplenty, the biggest of which is probably that the stomach is merely a holding tank where food sits around impatiently waiting to be digested. Like it has someplace else to go, right? The truth is that the stomach is less like a holding tank and a little more like a cement mixer. Food does not simply sit in the stomach; it is bathed in chemicals designed to break it down into components the body can use. To make sure everything gets its fair share of chemicals, the stomach too has gentle rhythmic contractions to mix things up. In the stomach, then, as in pretty much the entire digestive system, digestion is both a chemical and a mechanical process. Speaking of chemicals, if you got some stomach acid on your hand, it would burn your skin. It’s prime ingredient, after all, is hydrochloric acid. It helps dissolve food and activates various digestive enzymes like pepsin to further break down food. Why isn’t the stomach itself dissolved? Its primary defense is a thick lining of mucus that prevents any contact between it and the acid which fi lls it. Meanwhile the liver, conveniently located nearby, is making bile, an alkaline fluid that the liver stores slightly downstream in the gallbladder. How do the intestines avoid acid burns? If the process of digestion was a conveyor belt, a couple hours after eating the digested food leaving the stomach as chyme (pronounced “kime”) would be sprayed with bile as it exits the stomach and enters the first stage of the small intestines (the duodenum), reducing the acidity of the chyme. Mere inches farther along the conveyor belt (call it a dis-assembly line if you will), sodium bicarbonate (yes, the same stuff we take for excess acid) produced by the pancreas is squirted all over the passing chyme to neutralize its acidity and protect the next stop, the small intestine, from acid damage. In the final two stages before our food reenters the world, 95 percent of the absorption of nutrients occurs during chyme’s journey through the small intestine (small in diameter, long in length: 15 to 35 feet). Then in the large intestine (larger in diameter, short in length: 5 feet or so) water and minerals are absorbed. Naturally, this overview is an extremely oversimplified description of an exquisitely complex process, some of which scientists still don’t fully understand. The one thing you and I can understand... Digest this: eat good food and chew it well. +

HOW IS WINTER FRUIT GROWN? Once upon a time, grocery stores carried seasonal fruit. Period. If it wasn’t in season, it wasn’t available. As the world shrank in size courtesy of speedy jets and massive cargo ships, it was possible to ship summer fruits and vegetables from one hemisphere at harvest time to the other hemisphere that might be in the throes of a frigid winter. But that would still only allow for two seasons: when our blueberries or strawberries, for instance, come in, and then six months later when Southern Hemisphere berries come in. So how is it that we can buy fresh (not frozen) green beans, corn on the cob, raspberries, apples, grapefruit, oranges, bananas, grapes and more virtually any month of the year? There are a number of tricks food producers use to make produce available year-round. Some plants have been engineered to produce two crops a year instead of one. We see this routinely in Aiken and Augusta as hybrid versions of azaleas bloom as they always have in springtime and then a second time again months later. Food plants have been similarly retooled. Another strategy even home gardeners know about is forcing fruits and vegetables, which is a method of artificially hastening the maturity of a plant so it bears fruit sooner. This can be done in stages, so that multiple “seasons” of fruit are produced. Some crops can be grown indoors in truly massive greenhouses, making seasons and outdoor weather irrelevant. Another factor to consider is that the world isn’t uniformly “if it’s summer up here it must be winter down there” and vice versa. There are micro-climates all over the world where because of elevation above sea level, as one example, cooler or hotter or dryer or wetter climes are enjoyed compared to areas even just a few miles away. Those micro-climates allow crops to be raised on a different timetable than other nearby areas. Finally, one other method used to provide us with fresh fruits and vegetables that aren’t in season locally is storage. Using refrigeration and sometimes altered atmospheres (low oxygen, high carbon dioxide) apples, for instance, can be stored for six months or longer. +

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(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. © 2018 PEARSON GRAPHIC 365 INC.

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

by Marcia Ribble

es, Eating Season is about to begin in earnest. What better time to salute Dr. William Beaumont, the doctor who enjoyed quite possibly the weirdest doctor/patient relationship in the entire history of medicine. And he has some distant connections to Augusta to boot. It all started 233 years ago when Beaumont was born in Connecticut. In 1806, at the age of 21, Beaumont moved to New York for a teaching job, then four years later to St. Albans, Vermont, to train to become a physician. In 1812, just in time for war, Beaumont earned his M.D., and spent the years from 1812 to 1815 as an assistant surgeon in the Army. He went into private practice in Plattsburgh, New York, after the war and there, in 1821, married Deborah Greene Platt, the divorced niece of Plattsburgh founder Zephaniah Platt. Her father, Israel Greene, was a cousin of Revolutionary War hero Nathanael Greene (for whom Augusta’s Greene Street is named). It was the following year when Beaumont’s medical career took an interesting turn. He treated a man named Alexis St. Martin who had suffered an accidental gunshot wound at close range, injuring his stomach and ribs. Despite Beaumont’s best care, he didn’t expect the man to live. As things turned out, St. Martin outlived Dr. Beaumont by almost 50 years. That is surprising, because St. Martin’s gunshot wound never really healed. He was left with a fistula, a permanent open wound in his stomach. Unable to return to his previous job, Beaumont eventually hired St. Martin as his handyman. The details of exactly how their unusual relationship began are lost to history, but one day Beaumont got the idea to take advantage of St. Martin’s open stomach wound to perform experiments. He tied pieces of food to a string and inserted them into St. Martin’s fistula, then pulled them out at measured intervals to make observations of the digestive process. He also extracted samples of the gastric juice from St. Martin’s stomach for analysis and additional experiments. If you think being a human lab rat for a doctor was no fun, you’re in agreement with St. Martin, who moved to Canada against Beaumont’s objections. The two had previously inked a worked contract which Beaumont held to be binding, so he had him returned against his will to continue working and being subject to further tests. The unusual partnership led to a number of groundbreaking discoveries, among them that gastric juices contained hydrochloric acid secreted by the stomach lining, and that in addition to chemical digestion, mechanical digestion was fostered by the stomach’s churning motions. The two finally parted ways when Beaumont moved to St. Louis and St. Martin returned to his native Canada. Until his death after a fall on icy steps in 1853, Beaumont tried in vain to persuade St. Martin to move to St. Louis. When St. Martin died at age 78 in 1880, his family deliberately delayed his burial until he started to decompose to prevent grave-robbing resurrectionists from stealing his body and selling it to a medical school. Famed physician Sir William Osler tried (and failed) to get St. Martin’s stomach placed in the Army Medical Museum in Washington, DC. +

Lately I’ve been fighting hard to fi x a nagging issue—cramping in my groin due to a pulled muscle. So far it’s winning and I’m losing, but I’m not about to give in to it. What this has meant in purely pragmatic terms is that I can’t lift my left leg enough to safely drive my car. I’ll be frank. Not being able to drive is one of the biggest issues of aging I’ve had to confront so far. It affects everything about my health. Absolutely everything! This past week I’ve had what would normally be minor problems. My blood pressure is up. My blood sugars are elevated. I have a rash on one foot and leg that may indicate a clotting problem (petechia—little spots of abnormal bruises). My doctor wanted me to come in, a sensible request — if I could drive. But not being able to drive means finding someone to drive me. No nearby relatives who can do it. Cab? A few weeks ago I took

one and the round trip was $80. That alone could have given me a stroke or heart attack! Senior transport is $6 round trip, which is certainly affordable, but those rides must be scheduled weeks in advance. The ultimate solution was to send a nurse over here to collect a urine sample and take some blood. Now it means a wait until those labs are read, and then what? Suppose the doctor sends in a prescription. I can’t drive to pick it up. I guess I’ll figure out a solution to that problem when I must, but it’s already aggravating me to no end. If I were the only person facing this and similar issues as I age, it could fit into the category of “don’t bore me with your little problems when there are so many far more complex problems facing the human race,” but I’m not alone in needing a ride for medical purposes, or for employment, or just to do some grocery shopping, banking, or getting a haircut. Thousands of seniors, perhaps millions, are in the same frustrating situation, and countless more people lack personal means of transportation when it’s necessary for whatever reason. I don’t have a solution in mind as I write this, but perhaps others who have faced and resolved these issues would be kind enough to email me (at the address above) with what has worked for them. I’d love to hear from you. +

A FLU SHOT WORKS BY GIVING YOU A MILD CASE OF THE FLU WHICH WILL IT BE? Think about this one for a moment. It’s a very common belief, but in today’s lawsuithappy society, would any drug company voluntarily and willingly and deliberately seek to infect millions of people with the flu? The answer: no. In truth, the flu shot does not contain active flu virus and cannot infect a person who gets it with the illness. Its actual job is the opposite

of that: helping you avoid getting the flu. Flu shots work by stimulating the body to create antibodies that will attack and destroy the flu virus if you happen to come into contact with it. Sometimes (rarely) a person will become mildly ill after receiving a flu shot. Why? One of the reasons may be that you have been exposed to the flu virus but your body hasn’t yet had time to create the antibodies necessary to fight it. In other words, you were already coming down with the flu

before your shot. However, the shot itself cannot be the source of the flu; that is physically and scientifically impossible. As a final note in closing: flu season is here now. And a flu shot that’s a little late is better than no flu shot at all. +

NOVEMBER 16, 2018

Musings of a Distractible Mind

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

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was really anxious. My father’s legs were getting weaker and his pain was worsening. He had been having pain for quite a while, and that pain was often disabling in its severity, but the weakness was alarming. Dad saw a neurosurgeon who was also alarmed at the weakness, but didn’t feel that the solution was surgical in nature. When I heard that I broke one of my most tightly-held tenets: don’t get involved in my family’s care. I wrote a letter explaining the narrative of my dad’s condition and why I was concerned. It did the job; he is now 1 day post-op for the treatment of his severe lumbar stenosis (narrowing of the canal). It’s just Day 1, so the jury’s still out, but he’s doing great. The obvious question that arises with this story: why did I see greater urgency than the neurosurgeon? What did I hear that he did not? The answer is that I was a spectator to the whole story as it unfolded. I saw the sudden onset of weakness that was almost immediate after Dad had a procedure on his back (kyphoplasty). I was sure the kyphoplasty had worsened my dad’s condition. This was a mechanical problem that needed fi xing. But my father downplayed the importance of this connection to the neurosurgeon if he mentioned it at all. It was only a meddling son that raised this point. This case, which is obviously very close to me, is a clear illustration of yet another important aspect of patient-centered care: the patient narrative. As a writer, I’ve long loved the idea of narrative. The patient has a life story that we enter. They

don’t walk into the exam room, ER, OR, or radiology suite de novo. They have a narrative that has gone on for their whole lives, and even has extended to previous generations. We enter the patient’s narrative when they need us. They need us for help with their current situation or to make sure their future is not threatened. They come to us with pain, with illness, with disease, wanting us to help them to go back to the nonmedical narrative of their life.

Patient-centered care? It’s almost non-existent. Doctors should enter the patient’s narrative to steer it in a positive direction. We treat and prevent problems so that the person can go on with their non-medical life. This is not the whole of the care we give, but it is the foundation. That foundation determines the choices we make and the care we give. If we clinicians believe the doctor-patient interaction narrative is about us (as is often the case), we give worse care. We see the job as a bunch of check-boxes and tasks to complete so we can pay our mortgage. I think a lot of healthcare’s problems are due to loss of the narrative. Care has become about data and check-lists. It has become far too analytical and too little about the narrative. We focus on the office visits, when what really matters is what happens between them. The overwhelming burden of documentation and dealing with the financial side of care has stripped us of the time necessary to engage

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that narrative. Doctors no longer have time to listen. Medical records are the most egregious assault on the narrative. Instead of being a written account of the care given to the patient (i.e. Narrative), they are an avalanche of data that buries the narrative. I often wonder what patients would think if they saw their medical records. They are more about what the doctor did in the visit than about the patient. Finding valuable medical information in the chart is, consequently, very difficult. I get 15 pages of computer vomit from the local hospital whenever a patient of mine visits the ER, and am often left guessing what really happened. It’s all data and no narrative. My dad’s case illustrates just how critical knowing the narrative is. I don’t fault the neurosurgeon’s decisionmaking; the problem was in the incomplete communication of the narrative by my father. It just happened that there was a doctor son paying close attention who got freaked out about the symptoms and caused a ruckus. But most folks don’t have meddling kids with MD after their names. What do they do? How do they get their narratives heard? My hope is that somehow we are able to return to care that really is patientcentered. People want their narrative to be a good one, and doctors need to be able to enter that narrative as a positive influence. Our goal should be to push people out of the medical realm and back to living the rest of their narratives with as little contact with the healthcare system as possible. That’s what patient-centered care really is. It’s their story, not ours. +

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NOVEMBER 16, 2018

MEDICALEXAMINER

NOWWITHEASIERSUDOKUS! Because really, how much fun is a puzzle you can never solve?

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

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

“OUCH!”

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

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

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

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

NOVEMBER 16, 2018

AUGUSTAMEDICALEXAMiNER

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GARDENVARIETY

Pumpkin Cheesecake is sure to become a holiday gathering favorite with its rich dairy-free creamy fi lling flavored with warm fall spices and a gluten-free, naturally sweetened nutty crust. Just don’t tell them it’s good for them. Pumpkin is one of the best-known sources for beta-carotene which is a powerful antioxidant our bodies need. According to MedlinePlus Beta-carotene helps prevent certain cancers, heart disease, cataracts, osteoarthritis, and age-related macular degeneration. It further can be used to reduce symptoms of breathing disorders such as asthma and exerciseinduced asthma, cystic fibrosis, and COPD. Beta-carotene is also used to improve memory and muscle strength. Some people use betacarotene to reduce toxicity associated with chemotherapy, including the development of white patches and ulcers that occur inside the mouth. It is also taken by mouth to prevent the development of new moles on the skin. I personally drank cold pressed carrot juice, which is high in beta-carotene, daily while going through my treatments for colon cancer. I genuinely feel juicing helped my body destroy my colon cancer and rebuild itself to a healthy state after surgeries. For the crust, I used dates to create a sweet, nutty flavor without added processed sugars. Dates are rich in potassium which gives this crust a bonus because it is good for Vegan Pumpkin Cheesecake you. According to MedlinePlus, potassium is a mineral that the body needs to work until they form a smooth sticky ball. Remove properly. It is a type of electrolyte that and set aside. Add pecans and salt to blender helps nerves function, muscles contract, and puree until they form a meal. Break date a heartbeat to stay regular; it helps move ball into pieces and add back into the food nutrients into cells and waste products out of processor and process until smooth. cells and offsets some of sodium’s harmful Line an 8-inch springform pan with effects on blood pressure. parchment paper in the shape of the bottom. Divide crust evenly into bottom of closed Vegan Pumpkin Cheeseake springform pan, pushing the mixture into a smooth, even crust with the palm of your CRUST hand. • 1 cup packed Medjool dates, pitted before Add soaked and drained cashews and the you measure rest of the ingredients into the food processor • 1-1/2 cups pecan pieces and puree until very smooth, about 3 or 4 • 1/2 teaspoon pink Himalayan salt minutes. If you have trouble blending add a little coconut milk a few tablespoons at a FILLING time. • 1-1/2 cups raw cashews (soaked in hot Pour fi lling into springform pan. Tap a few water for 3 hours) times to release any air bubbles and then • 1 lemon, juiced place in freezer for 5 to 6 hours. • 1/3 cup unsweetened coconut milk Remove from springform pan and serve • 3 tablespoons melted coconut oil with topping. Visit my • 1/2 cup Grade A maple syrup website (below) for non-dairy • 1/3 cup pumpkin puree whipped topping recipe. + • 1/2 teaspoon pink Himalayan salt • 3/4 teaspoon pumpkin pie spice by Gina Dickson, Augusta wife, • 1/4 teaspoon cinnamon mom and grandmother, colon cancer survivor, passionate INSTRUCTIONS about creating a community to Cover cashews with hot water and allow to help women serve healthy meals to their family. set for 3 hours. Then drain and set aside. Visit my blog at thelifegivingkitchen.com Add dates to a food processor and blend

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Without a doubt, the biggest factor preventing addicts from using drugs in a controlled way is the fear of pain from withdrawals. Everybody I encounter who knows they need to quit is hoping for a magic carpet to carry them off into some LaLa Land of “detox” with a lot of rest, relaxation and good food, where they’ll have no pain and emerge in a few days, free from any cravings for drugs! Wouldn’t that be nice! That calls for an LOL! The fantasy is: “If I can get the drugs out of my body they’ll be out of my mind.” Good luck with that. Getting them out of the body is the easy part. Getting them out of the mind is a long term challenge. Furthermore, they want their insurance company, the Department of Family and Children’s Services (DFCS), the judge, mom, dad, their church, the “government,” or you to pay their detox bill!

THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional Another LOL! I mean, it’s only going to cost about $10,000, give or take! As we have said previously, unless you are in very risky physical/emotional shape, or withdrawing from alcohol or benzodiazepines, the best insurance company around will not pay for your detox. So what now? Well, here’s about what to expect from withdrawals from various popular drugs: ALCOHOL: Several days of anxiety, sleeplessness,

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cravings, and possible seizures. The rule of thumb is this: if you can go 3 days without a drink without crashing and burning, then you probably won’t need inpatient detox. The same is true for BENZODIAZEPINES, what we in the treatment field sometimes call “Alcohol in a pill.” Caution: do NOT try to go it alone with these chemicals! Many a wellmeaning addict or alcoholic has tried to “sweat it out” and ended up dead from seizures from these 2 drugs. Yes, alcohol IS a drug COCAINE and CRACK: Because cocaine is an “upper,” as we have said previously the withdrawal effects from this class of drugs is opposite from the initial effect of the drugs. In other words, because cocaine makes you feel SO good & energetic (initially at least), the withdrawal effect is going to be the opposite: a feeling of sadness, “long-face,” lack of interest in eating, Please see FEAR page 15

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

POMEGRANATE PEARLS by Shainece Miller, MS, Dietetic Intern Happy fall y’all! Nothing yells autumn louder than hot apple cider, pumpkin carving, bonfi res, and corn mazes. Often known for its festivities, autumn ushers in the harvest season. The word “harvest” originates from the Old English word hærfest, meaning “autumn.” Later, the term became known as the season for gathering mature agricultural crops such as berries, grains, and vegetables. In ancient times harvest season was often celebrated, signifying the end of famine brought about from the inability to store foods from the previous season. Roman, Chinese, and Greek entities used to host elaborate rituals consisting of songs, prayers, and special dishes celebrating the gathering of food in abundance. One of the most important seasons in the agricultural year, autumn is celebrated worldwide with social gatherings on a smaller scale today, such as Thanksgiving. A variety of fruits, vegetables, and grains remain as the centerpiece of fall, like squash, cranberries, potatoes, and pumpkins. One food in particular, pomegranate, has increased in consumption for

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AUGUSTAMEDICALEXAMiNER

its versatility – eaten fresh by itself or in nut mixes, or imbibed in teas or juice blends. Pomegranate is a sweet and tangy fruit originating from the Middle East. Historically known as the “Jewel of Autumn,” pomegranate is nutrient-dense – rich in antioxidants, potassium, fiber, vitamin K, and is believed to possess anti-inflammatory properties. Major diseases such as heart disease, cancer, and Alzheimer’s disease are influenced by chronic inflammation. Pomegranate has potent anti-inflammatory properties that work to combat detrimental health conditions. Pomegranates

The word grenade, as in hand grenade, comes from its resemblance to a pomegranate.

contain antioxidants – compounds that inhibit oxidation, a chemical reaction that produces cell damaging species called free radicals. Antioxidants donate electrons to inactivate dangerous free radical components. Vitamin C is an example of an antioxidant prominent in pomegranates. It is necessary for the growth and repair of collagen, a protein that makes up tendons, bones, and teeth. Vitamin C also aids in the absorption of iron. Lacking antioxidants such as vitamin C may influence aging, as free radical species build up over time, damaging human cells. Another type of antioxidant, called polyphenols, has been proven to negate age-related cognitive deficits commonly observed in individuals with Alzheimer’s disease and dementia. Polyphenols protect the brain from injury, suppressing inflammation, and preserving memory, motor, and cognitive function. Pomegranates also contain potassium, the third most abundant mineral in the body, which makes up 98% of all cells. As an electrolyte, potassium influences muscle contractions and regulates fluid balance. Consuming a diet high in sodium and low in potassium leads to vascular water retention and may lead to hypertension (high blood pressure). Serum potassium levels are regulated primarily by the kidneys. When potassium is consumed in abundance, the kidneys work extra hard to excrete excess amounts. High potassium is a characteristic of chronic kidney disease, a condition characterized by a gradual loss of kidney function. Why should you

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170

POMEGRANATE… from page 9 try pomegranates this fall? The answer is simple! Pomegranates provide a multitude of health benefits that are guaranteed to keep your mind sharp, heart healthy, and they can be eaten in a variety of ways. Try pomegranate on your favorite salad, in a sparkling cider, or braised meats this season! For additional health and nutrition information, contact a Registered Dietitian Nutritionist (RDN). Registered Dietitian Nutritionist are trained and credentialed to provide credible information about nutrition and health. +

NOVEMBER 16, 2018

The number of back issues of the Examiner available at issuu.com/medicalexaminer

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welp

Find elbows ™

Organs

Glands

Near Augusta GA Bones

Joints

d Other

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5.3 million reviews

The joints between shoulder and wrist Working now? Yes, adjusting newspaper distance Take-Out Available? No Good for: Doing pushups, eating and drinking

John L. Wrens, GA

H H H H H 11/6/2018 I’m trying to quit smoking this month for the Great American Smokeout. A friend of mine suggested I try a patch, so I figured two will be even better. I found a sportcoat at Goodwill with elbow patches. I sure hope it works! +

Vicki G. Aiken, SC

H H H H H 11/6/2018 We’re so excited to finally be moving to a new house for our growing family. The realtor asked us if we needed elbow room, but we told her, no, just a house that’s a lot bigger than the one we’re in now. +

Nicholas J. Augusta, GA

Dan A. Thompson, GA

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This one restaurant has a dish made from elbow macaroni. I have to wonder how they make that. + H H H H H 11/8/2018 Don’t look to me for a nice review of elbows. It’s by far the rudest body part. People elbow past others, they elbow their way through crowds... forget gun control, what about elbow control? +

Have you heard?

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H H H H H 11/7/2018

Eric D. Graniteville, SC

H H H H H 11/9/2018 We ate at a place where the server told us the owner was also the cook. “He’s such a hard worker,” she said. “He puts a lot of elbow grease into everything he does.” After that, we couldn’t finish our meals. That’s just plain nasty. +

Barbara O. Evans, GA

H H H H H 11/10/2018 I think I was at the same restaurant as one of the previous reviewers. The server told us we might have to wait awhile for food. She said they were — and I quote — up to their elbows in food prep back in the kitchen. We walked out and called the health department on the spot. +

Tim W. Waynesboro, GA

H H H H H 11/10/2018 Did you know more than just people have elbows? It’s true. For example, there are pipe elbows. +

Cherie K. N. Augusta, SC

H H H H H 11/10/2018 I used to be married to a serious elbow bender. Never again, thank you. +

Bradley T. Augusta, GA

I was recently elbowed in the ribs. The more I think about it, the more I think maybe elbow is the only body part that’s also an action verb. Well, other than knee and head and eye and shoulder. +

Augusta>

Tom W. Martinez, GA USC AIKEN

H H H H H 11/11/2018

H H H H H 11/12/2018 I’m so happy today. For weeks my arms have been so sore, especially my elbows. I made an appointment with a doctor and although I had to wait about 6 more weeks, I finally got in to see him today. He told me I have tennis elbow. Well, at least now I know what I DON’T have: tennis elbow. I haven’t played tennis in twenty years. +

NOVEMBER 16, 2018

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The blog spot From the Bookshelf — posted by Suneel Dhand, MD, on Nov. 11, 2018 (edited for space)

3 THINGS PHYSICIANS CAN LEARN FROM POLITICIANS Shock. Horror. Did you just read the title correctly, or are you seeing things? Well, after you recover from the shock of reading a line you probably never thought you could possibly see in writing — let me tell you this: Physicians and politicians are probably as opposite as you can imagine in terms of their daily work life, guiding principles, and yes, level of respect shown to them by the general public. Doctors dedicate their careers to helping people and like to pride themselves on always being models of honesty and high morality. Politicians, well, I’ll let you decide. There are some bad politicians out there, and some reasonably good ones ... likely dependent on your own worldview. Successful ones however have succeeded in large part because of their savviness and ability to communicate. Here are three lessons that may be relevant for physicians: 1. Keep the message short and simple. Doctors, being scientists at heart, frequently communicate in overcomplicated technical jargon when they talk to patients. They forget that most people out there (even otherwise highly educated folk) are not familiar with most of the everyday medical lingo we use. I’ve seen highly experienced and well-recognized physicians, have some pretty shocking conversations with patients and their families! They mean well, but just forget to keep things simple. Successful politicians understand that whatever angle you are coming from, human understanding on important topics is best reinforced by very simple and straightforward messages. People also have short attention spans in general. Oh, and catchy soundbites totally do work, whether we admit it or not. 2. Use emotions in the right way. Human beings are highly emotional animals. Politicians unfortunately frequently play into this in the wrong way for the benefit of their own ambitions. But keep this in mind: Emotions can actually be harnessed for tremendously positive effect as well. Whether it’s reinforcing a reason why weight loss needs to occur for their own health, why they need to take their medicines on time, or the absolute necessity of following up with you in one week — there is an effective and sensitive way to do this. 3. Know that you are always on stage and your words matter. Politicians know that when they step out in public or go on camera, everything about them is going to be analyzed. Every single word, their body language, and what they wear. Their language is going to reverberate across the country and perhaps all over the world too, depending on how important they are. How many doctors have this level of self-awareness too? We are actually viewed as leaders in our hospitals and clinics at all times, even if we don’t have any other title beyond MD. From the housekeeping staff to the cafeteria cashier — our fellow professionals know that we are the people who make the final call in clinical situations. The buck stops with us. We owe it to everyone to be aware of this and strive to be role models. I hope you have recovered from the shock of the title by now. It’s a privilege to be a physician, despite all the challenges we face in health care. There are few more important jobs to society, and when we make it all about our patients, there is never a wasted moment. Rarely can we ever come home feeling like we haven’t done anything meaningful with our day. +

I should have said, “No, it’s doctor.”

Suneel Dhand is an internal medicine physician and author. He blogs at his self-titled site, Suneel Dhand.

A compendium of excerpts from reviews of this book:

The outstanding feature of Do No Harm is the author’s completely candid description of the highs and lows of a neurosurgical career. ... For its unusual and admirable candor, wisdom and humor, Do No Harm is a smashing good read from which the most experienced and the most junior neurosurgeons have much to learn. (AANS Neurosurgeon) This thoughtful doctor provides a highly personal and fascinating look inside the elite world of neurosurgery, appraising both its amazing successes as well as its sobering failures. (Publishers Weekly (Starred Review)) One of the best books ever about a life in medicine, Do No Harm boldly and gracefully exposes the vulnerability and painful privilege of being a physician. (Booklist (starred review)) When a book opens like

Henry Marsh describes the soaring triumphs and the shattering tragedies that are part of every surgeon’s life. A remarkable achievement. (Michael J. Collins, author of Hot Lights, Cold Steel)

this - “I often have to cut into the brain, and it is something I hate doing” - you can’t let it go, you have to read on, don’t you? (Karl Ove Knausgaard, Financial Times) Marsh, one of our leading neurosurgeons, is an eloquent and poetic writer. Do No Harm offers a rare behindthe-scenes look at the most mysterious part of human life. His descriptions of neurosurgery are at once fascinating and illuminating; a gripping memoir of an extraordinary career. (Daniel J. Levitin, PhD, author of The Organized Mind and This Is Your Brain On Music)

A soul-baring account of a practical-minded neurosurgeon who admits that a surgeon’s ultimate achievement is marked by patients who ‘recover completely and forget us completely.’ Readers, however, will not soon forget Dr. Marsh. (Katrina Firlik, author of Another Day in the Frontal Lobe: A Brain Surgeon Exposes Life on the Inside) Each story invites readers into the private thoughts of a neurosurgeon and astonishes them with the counterintuitive compassion required in the operating room. (Michael Paul Mason, author of Head Cases) + Do No Harm: Stories of Life, Death, and Brain Surgery, by Henry Marsh, M.D., 288 pages, published in May 2015 by Thomas Dunne Books

Research News Too good to be true? In a very small study (3 people) planned intermittent fasting was able to reverse type 2 diabetes. Doctors writing in BMJ Case Reports say doing this enabled the three patients to cut their need for insulin treatment altogether. The three patients, men between the ages of 40 and 67, all had type 2 diabetes, high blood pressure and high cholesterol. One of the men fasted 3 days a week, the other two fasted for 24 hours every other day. On fast days they were allowed low-calorie drinks like tea and coffee, water or broth, and to eat one very low calorie meal in the evening. The men followed this pattern for 10 months, at which time blood sugar levels, their A1Cs, weight and waist circumference were all re-measured. Based on their blood

sugar readings during the 10 months, none of the three still needed insulin injections one month into the study; one of them stopped after just 5 days. Two of the men were able to discontinue all their diabetic drugs, and the other man was able to stop 3 out of 4. All three lost weight, ranging from 10 to 18 percent. Although a micro-study, the research adds to the evidence that lifestyle changes are the key to managing type 2 diabetes. It should be noted that before beginning their fasting, the men attended a 6-hour nutritional training course tailored for their upcoming lifestyle changes. Armed with positive results and positive feedback from the three participants, researchers are looking to expand the research and the possible application of their findings to a disease associated with early death

and an annual US economic impact approaching $250 billion a year. Too bad to be true? According to research released last week by the American Heart Association, women in cardiac arrest are less likely to receive CPR from bystanders. The reasons are surprising: • fear that chest compressions will be viewed by bystanders as innappropriate touching • fear of being accused of sexual assault • fear of causing physical injury • the perception that women may be overdramatizing a minor incident • the misconception that breasts make CPR more difficult In the US, more than 350,000 cardiac arrests occur outside hospitals annually. While the survival rate is low, CPR can double or triple the victim’s chances of survival. +

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AUGUSTAMEDICALEXAMiNER

THE EXAMiNERS +

These people with one name are a bit pretentious.

What do you mean?

by Dan Pearson

You know, like Cher and Yoda.

He does? What is it?

I beg your pardon, but Yoda has a last name.

PUZZLE

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

VISIT WWW.AUGUSTARX.COM

15 18

Click on “READER CONTESTS”

QUOTATIONPUZZLE H O Y O Y O R A N A V E O B T A T N O I H S V E I N H A D D E U T U I H O W W Y S P G L T — Epicurus

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.

E X A M I N E R

3 2

9 1 2

6 8

7 7 6

8 9 5

7 8 5

1 3

S U D 3 O 4 K 9 U

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

Use keypad letters to convert numbers into words suggested by the definitions provided. Sample: 742 (body part) = RIB. Solution on page 14. 1. 278 ___

6. 822537 ______

2. 727 ___

7. 687737 ______

3. 767 ___

8. 72843687 ________

4. 2627 ____

9. 624294637 _________

5. 242477 ______

10. 63342463 ________

All the words used in this week’s TEXT ME are things often found in doctors offices.

! K A E R B N O

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

19 20 21 22 ACROSS 1. Oxidant can start with this 23 24 5. Dental focus 25 26 27 28 29 30 8. Duration 31 32 33 34 35 36 12. Dreg 13. Swelling 37 38 39 40 41 15. Avenue in downtown 42 43 44 45 46 medical district 47 48 49 50 16. False god 17. Soviet forced-labor camp 51 52 18. Great Lake 53 54 55 56 57 58 59 60 19. Put in order 21. Flower secretion 61 62 63 64 23. Bethesda agcy. 65 66 67 24. Medical prefix 68 69 70 25. Loiter 28. Postal products by Daniel R. Pearson © 2018 All rights reserved. Built in part with software from www.crauswords.com 31. Obamacare acronym 32. Bird description? DOWN 36. Grand add-on 35. Oozes 1. Sin City star 38. Registered 37. Silent 2. At one’s elbow 40. Removal 39. Prepare a jet for winter 3. Duct type 43. Pacific diet staple takeoff 4. Beech follower 45. Component 41. Metal fastener 5. Castrate 48. Gilbert Islands atoll (and 42. Tubular support for a vein 6. Kill Bill star capital of Kiribati) 44. First Indian prime 7. Type of school 50. Crown adjective minister 8. Sample for testing 53. Cut to required size 46. Healthcare wrkr. 9. Savannah is one 54. Helper 47. List of mistakes 10. Capital of Western Samoa 55. Bulldog’s school 49. Blue Cross now 11. Never (in poems) 56. Prepare a gun for firing 51. Type of hygiene 13. Brainiac 57. Diving bird 52. Title of a knight 14. Owing 58. First name of a Tulsa 53. Augusta’s famous Dub 20. It goes through Sudan university 56. Warns 22. Epochs 59. Type of star 61. Monetary unit of Iran 24. ______ ward 60. Variety of dive 62. Love affair (from L “love”) 25. Hoover and others 63. Disfigure 64. Bow 26. Severe/sudden 65. Doing nothing 27. Held by 25-Ds 66. Low-grade sandstone 29. Orchard starter 67. Molten rock 30. {Blank] chilling 68. Reward (archaic) 33. Kidney-related 69. Noah’s craft 34. Recline 70. Dash Solution p. 14

TEXT

THE MYSTERY WORD The Mystery Word for this issue: REMUNST

EXAMINER CROSSWORD

NOVEMBER 16, 2018

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AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE

The

Advice Doctor

Moe: When I was a kid I wanted to be a brain surgeon. Joe: What happened? Moe: I guess I was just too young.

ha... ha...

Moe: How do you get Donald Trump to change a lightbulb? Joe: I give. How? Moe: Tell him Obama put it in.

Moe: I wonder what vegan zombies eat. Joe: GRAAAINS!

couple from New Jersey was traveling through rural Georgia when they noticed a sign by the side of the road that said “Entering Taliaferro County.” Intrigued (and hungry), the turned in to a fast-food restaurant a mile farther up the road and, after placing their order, asked the server, “Would you mind telling us how to pronounce the name of this place? And please, take it slow.” “No problem,” said the server. “It’s Burr... gerr...King.”

Knock, knock! Who’s there? Dwayne. Dwayne who? Dwayne the bathtub! I’m dwowning! Moe: I was reading about a Nazi soldier who became an animal doctor after the war. Joe: Oh yeah? Moe: Yeah, he was a veteran Aryan.

“Do you honestly believe your husband is telling you the truth when he claims to be off fishing every weekend?” a lady asked her friend. “He could be having an affair.” “No,” replied her friend. “I’m sure he’s telling me the truth.” “How can you be so sure?” “Because he never comes back with any fish.”

Moe: Back in the day, I used to really enjoy political jokes. Joe: Not anymore? Moe: No. Too many of thm are getting elected. Moe: I don’t often tell Dad jokes. Joe: Thank goodness for that. Moe: But when I do, he usually laughs.

Moe: My wife prefers to take the stairs, but I like to take the elevator. Joe: Why is that? Moe: We’re just raised differently.

Moe: People, please stop with the hate of lazy people! Joe: I know! What did they ever do? +

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

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

Dear Advice Doctor, For the past 15 years I have slaved for the company I work for. I wanted to climb the corporate ladder with every fiber of my being, and that’s just what I’ve done. I’ve been given a huge promotion and raise — but I don’t want it! The problem is the promotion involves moving overseas, not something my family signed up for. I can’t do this to them. I want the job, just not the move that comes with it. Any advice would be appreciated. — Wanting to move up, not out

Dear Wanting, You certainly raise an important subject, and one more people should be interested in. I applaud your commitment to fiber, a curiously vital part of our diets. I call fiber a curious component because it isn’t even digestible. The body can’t absorb it either. It passes relatively intact from our plates through our digestive system. So how can it be so important that we’ve all read, heard or been told: “eat more fiber”? Fiber is always plant-based, which is one clue to its value in the diet. High-fiber foods tend to be more filling than lowfiber foods and as a general rule have fewer calories than the same quantity of low-fiber foods. A person who fills up on low-fiber foods will require more food to feel full, and will be hungry sooner than someone eating the same amount of high-fiber foods. A high-fiber diet helps to maintain good digestive health, lowering the risk of diverticular disease, diarrhea, constipation, and hemorrhoids. Studies have also shown that high-fiber foods lower cholesterol levels and help reduce blood pressure. Fiber helps slow the absorption of sugar, which helps avoid spikes in blood sugar. A fiber-rich diet may even help prevent a person from developing type 2 diabetes. And there is some evidence that dietary fiber may help lower the risk of colon cancer. Fiber is easy to add to your diet. Choose whole-grain foods, fresh fruits and vegetables, beans, peas and other legumes, and nuts and seeds. Avoid low-fiber refined or processed food, and likewise avoid fiber supplements. Get your fiber from delicious foods, not some prepared concoction. I hope this answers your question. + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.

SUBSCRIBE TO THE MEDICALEXAMINER +

Why read the Medical Examiner: Reason #22

By popular demand we’re making at-cost subscriptions available for the convenience of our readers. If you live beyond the Aiken-Augusta area or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house! NAME ADDRESS CITY

STATE

ZIP

Choose ____ six months for $20; or ____ one year for $36. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

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

...cleverly hidden on the roof in p. 9 ad for OVERHEAD DOOR COMPANY OF AUGUSTA

ON BRE AK!

THE WINNER: ANDREW FELAK 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!

THE PUZZLE SOLVED A L B A

N E A R

D A M S

A C U T E

T R I M

A I D E

T E A R

I S E L G A N G N I H W D L E A E A T E D E N T R R A T O R A Y L O R A L A L E W E D A

G U M D E M A U L A G E D N E P E R S T A R L Y S E I C E N E H R U A A N L S I C A U T M O U R A C K E R K

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.

1. ART 2. PAS 3. RNS 4. CNAS 5. CHAIRS

P O R T

A P I A

N E E R

P E A C T H R I O P R L A E L

S P I N E

S L A M

N O V A

S W A N

6. TABLES 7. NURSES 8. PATIENTS 9. MAGAZINES 10. MEDICINE

TheSUDOKUsolution 6 8 9 2 5 1 3 4 7

7 5 1 4 3 6 8 9 2

3 4 2 9 8 7 1 6 5

2 6 5 3 1 8 9 7 4

4 1 3 7 2 9 6 5 8

9 7 8 6 4 5 2 3 1

8 9 4 5 6 2 7 1 3

1 3 7 8 9 4 5 2 6

5 2 6 1 7 3 4 8 9

QUOTATION QUOTATION PUZZLE SOLUTION “Do not spoil what you have by desiring what you have not.”

READ EVERY ISSUE ONLINE

— Epicurus

The new scrambled Mystery Word is found on page 12

Love to stare at your phone? Visit issuu.com/ medicalexaminer and stare away.

S P E C I M E N

SEE PAGE 12

The Celebrated TEXT ME ! MYSTERY BRE AKCONTEST ONWORD

...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!

NOVEMBER 16, 2018

AUGUSTAMEDICALEXAMiNER

WWW.ISSUU.COM/ MEDICALEXAMINER

NOVEMBER 16, 2018

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FEAR… from page 8 craving more of the drug, a nd wanting a long, long nap. I’ve known people who have slept 24 hours or more after spending a few hundred to a few thousand dollars on a cocaine binge! OPIATES: These are tricky. I know of no insurance company these days who will allow inpatient benefits from withdrawals from this drug! We are told “it’s not life-threatening to withdraw from heroin or pills.” True. However, if you’ve ever attempted try-it-at-home detox from opiates, you certainly feel like your life is about to end! Because opiates are a “downer,” then of course the withdrawal effects are opposite: hyper-anxiety, sleeplessness, aches and pains, stomach/abdominal rebellion, and flu-like symptoms. A good medical doctor who is willing to take the risk for your at-home detox from this drug might prescribe a blood pressure medication such as Clonidine

in its pill or patch form, and maybe hydroxyzine, plus some Imodium for loose bowels and ibuprofen for aches and pains. I say might. Finding such a medical professional to help you with this is like finding a needle in a haystack, but they are out there...and if it is a doctor who knows you and trusts that perhaps a family member will administer the medication as prescribed, your chances are all the better. Interestingly, in a hospital setting these are the same meds given that you might be able to obtain on an outpatient detox basis. Might. MARIJUANA: feelings of lethargy and “amotivational syndrome” are the most common withdrawal effects. Cravings for sure. And then restlessness and anxiety. Those are the common ones, anyway. Whatever the cleansing quest, hey, have some compassion okay? Do you

want to know what it feels like? An addict in withdrawal feels like you do when you are SO hungry that you feel you cannot go another minute without a pick-meup...that feeling just before lunchtime when you missed breakfast and maybe haven’t even had a single cup of your own fi x, coffee! And just like with your intense hunger pain, the addict knows that all he or she needs to be out of discomfort is their drug! Even just a little bit and their pain will go away. Wait wait...did you say it’s like being hungry?!!! I can solve this! Even though it isn’t lunchtime yet, I’m going to cheat and have the energy bar in my pocket! ‘Cause I hate pain! We ALL do! See how hard it is? And how easy it is to slip? Congratulations to every addict who is willing to go through short-term discomfort in exchange for long term freedom! +

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Dr. Judson S. Hickey 2315-B Central Ave Augusta 30904 PRACTICE CLOSED 706-739-0071 Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048 Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

DERMATOLOGY Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Augusta 30904 706-733-3373 SKIN CANCER CENTER www.GaDerm.com

Resolution Counseling Professionals 3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866 Karen L. Carter, MD www.visitrcp.com 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com Your Practice And up to four additional lines of your choosing and, if desired, your logo. Keep your contact information in Steppingstones to Recovery this convenient place seen by tens of 2610 Commons Blvd. thousands of patients every month. Augusta 30909 Literally! Call (706) 860-5455 for all 706-733-1935 the details

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