Nov21 14 by Daniel Pearson

AUGUSTA

FREE T AKE-H OME C OPY!

recipe feature PAGE 7

HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS

AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

NOVEMBER 21, 2014

The right to choose

E A public hearing last week on a proposal to ban tobacco sales in Westminster, Massachusetts, was cut short by a noisy, unruly crowd of citizens.

Free markets? I

f you read this publication regularly, you know the Medical Examiner is 110 percent anti-tobacco. Why? Tobacco has been called the deadliest enemy of public health in human history. However, enacting governmental bans as a control measure — as one Massachusetts town has been considering — is a highly questionable strategy. As has frequently been noted near and far, the war on drugs is over. Drugs won. Why add more battles to a war which can’t be won? The U.S. went down this road during Prohibition, another unsuccessful campaign against substance abuse. Laws definitely have their place. Murder should be illegal, and it is. But do you and I refrain from murder because it’s against the law — or because, plain and simple, it’s wrong? If you lived in Nevada, would you patronize a house of prostitution because Please see FREEDOM page 6

11/29/14

arlier this month, two remarkable women reluctantly made national and international headlines. It had to be reluctantly: they both were in the news because of terminal brain cancer. Lauren Hill, a 19-year-old freshman at Mount St. Joseph University in Cincinnati, achieved her dream of playing a college basketball game on Sunday, Nov. 2 The day before, some 2,300 miles away in Portland, Oregon, Brittany Maynard deliberately ended her life just days before her 30th birthday. To some, both women epitomize an amazing level of grace and courage. For others, that praise would only apply to Lauren Hill. Brittany Maynard, they feel, took the easy way out, and the last thing she ever did was commit murder. A Vatican spokesman, for example, said Maynard’s decision was “an absurdity,” and added “Suicide...is a bad thing because it is saying no to life and everything it means with respect to our mission in the world and toward those around us.” A California doctor feared Maynard was being exploited and coerced by various right-todie groups, and assured her that there was an alternative: “She could [have gotten] excellent whole-person care and be

Is assisted suicide death with dignity? Or murder?

THE SKINNY ON YOUR VIEWS ABOUT BRITTANY MAYNARD AND ASSISTED SUICIDE

I don’t want to die as long as I can work; the minute I cannot, I want to go. — Susan B. Anthony

assured of dying gently in her bed surrounded by her family.” Aside from the fact that that’s just about exactly how she did die, what do you think of her decision? We put out the word through e-mail and Facebook, and many of your comments are in the box at right. The feelings of those who responded seemed unanimous. Others (who did not respond) take the view that our puny opinions are not important. What counts is how The Higher Power (however you may label Him or Her) views the matter. For a word or two on that, see the box at the bottom of p. 10. From a strictly scientific standpoint, what is the worst way to die? Please see CHOOSE page 10

I absolutely believe people should be able to control their own death without shame or judgement. There are much, much worse things than dying. At the top of the list is staying alive while enduring the 10,000+ ways to suffer excruciating pain or a disability that keeps your quality of life at Level Zero. • I think she did herself and her family a kindness, and I would hope to be as brave and selfless if in her shoes. • All the people condemning this poor woman for what she has done, saying she is in Hell, and suicide is the unforgivable sin, etc., give me a break. How dare you criticize this poor woman whose very life was stolen from her. It is much too easy to say what you would do in that situation, when you in fact are not in that situation. • She did what was right for her. • My understanding is her health was steadily declining and there is no cure for her disease; any treatment would only delay the Please see YOUR VIEWS page 10

AUGUSTA MEDiCAL EXAMINER

NOVEMBER 21, 2014

by Ross Everett

OBAMACARE AT 1: THE GOOD, THE BAD, THE UNKNOWN

IN PA T IE NT

ealthcare exchanges are now open again for the second round of Obamacare (re)enrollment. Thus, while a few parts remain to be fully implemented or will change slightly in the years to come, many are saying that the Patient Protection and Affordable Care Act (PPACA) has officially turned 1 year old. So how is it doing? Has it lived up to its promises? Grab a plate and put on your party hats. I’ll attempt to give you a brief overview of what we know so far. As an overall proponent of the bill, let me start with the positives. First and foremost, the bill has had significant success regarding its primary objective: the number of uninsured Americans has been reduced by some 25%. Various research agencies offer slightly different numbers, but the total number of previously uninsured Americans who have gained insurance because of the healthcare law is estimated to be between 8 and 11 million. Additionally, through caps placed on the percentage of administrative costs, more money than ever before is actually going towards patient care. There are indications that this money is benefitting patients as well. For example, there appear to be increases in numerous health status measures, such as the number of preventive screenings performed and on the number of Americans who report having a regular source of care. A few quality measures also appear to be improving. For example, the number of re-admissions to a hospital within 30 days of being released has declined, likely due to incentives from the bill. Of course, our health system has not collapsed either. In fact, analysts have largely agreed that the health law has had a net benefit on the healthcare industry thus far. However, there have been some adverse effects as well. First and foremost, the bill took a big hit when the Supreme Court ruled that Medicaid expansion for states was voluntary. As a direct result, the Congressional Budget Office reduced its initial estimates of the law insuring 32 million new Americans to just 26 million. It is worth noting for those who scoff at the gap between even 26 million and the 8-11 million , no one thought those would become insured during the first year. This optional expansion has created other problems too. One such problem is that the bill did not include subsidies for private insurance for individuals who were expected to enroll in Medicaid. Thus we have a gap of individuals in many states who make too much to be eligible for the non-expanded Medicaid, but make too little to receive largely subsidized health insurance premiums in the private market. Another problem is that the hospitals in the non-expanding states are facing decreased reimbursements from Medicare that were supposed to be offset by the increased number of insured. After all, even Medicaid’s relatively low reimbursement rates are gold compared to the free care hospitals are stuck providing for many. However, when states did not expand, these hospitals are faced with providing the same amount of ‘free’ care and yet are making less on many of the paying patients. Another problem is that to conserve costs, many insurers are moving towards high-deductible plans. These may negate many of the benefits people stood to gain under new insurance and it has enraged many more who were satisfied overall with their old plans. Lastly, I’m sure I do not even need to go into the disaster that was the initial healthcare.gov rollout. Finally, a lot remains uncertain. Although premiums have increased in most markets—some have decreased—it is not clear whether this is due to the bill or just a continuation of a general trend. Premiums have been increasing for a while now, after all. In fact, many of the cost-containing goals of the bill are unclear at this See WHITE COAT page 15

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NOVEMBER 21, 2014

AUGUSTA MEDiCAL EXAMINER

A FLOW CHART Do you frequently read the Chronicle, Skirt, Metro Spirit or other area publications which have more pages than the Examiner? Yes

Do you usually read them from cover-to-cover, every page? No.

Yes.

Never?

You wouldn’t tell a story, would you?

What’s your story?

Nearly all of us — even doctors and nurses — are sometimes patients. Perhaps you were recently injured playing your favorite sport, or years ago you somehow got hurt without even leaving your favorite recliner. Maybe you were diagnosed with a dreaded disease, mugged in a dark and lonely parking lot, or you stubbed your toe in the safety of your own bedroom. On the other hand, perhaps you needed medical attention 5,000 miles from home. Whatever your medical experience, we’d like to hear your story for our Medicine in the First Person feature. It can be frightening or funny, ordinary or extraordinary, just a few paragraphs long or quite a lengthy tale, bylined or anonymous. We’ll publish your encounters with the medical profession as often as we receive them. + Send your submissions for Medicine in the First Person to the Augusta Medical Examiner via e-mail: info@AugustaRx.com or to PO Box 397, Augusta, GA 30903-0397. (The Medical Examiner reserves the right to accept, reject, or edit any submission at its sole discretion.)

AUGUSTA

Why is the Medical Examiner only 16 pages?

SEE PAGE SIX

MEDICAL EXAMINER

AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

Well, maybe.

Never.

Ok, yes.

Our point exactly.

BIGGER ISN’T ALWAYS BETTER 16 pages is just right. +

MEDICAL EXAMINER

AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

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

(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net Opinions expressed by the writers herein are their own and their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., or its agents or employees take any responsibility for the accuracy of submitted information, which is presented for 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. © 2014 PEARSON GRAPHIC 365 INC.

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TELL US YOUR MEDICAL STORY. SEE PAGE 6.

NOVEMBER 21, 2014

AUGUSTA MEDiCAL EXAMINER

OLD NEWS +

POINTS OF INTEREST TO FORMER KIDS by Trisha Whisenhunt, Senior Citizens Council

DOMESTIC ABUSE: NO AGE LIMIT

PruittHealth Hospice 620 Ponder Place, Suite 1A Evans, GA 30809 (706) 650-1522 • (800) 323-7007 www.pruitthealth.com

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ne in four women will be abused by husbands and boyfriends who have no legal connection to them. The Violence Against Women Act was passed in 1994 and abuse rates dropped by 64%. However, every day 3 women are murdered, and in 2010, 39% of all female homicide victims were murdered by their partner. We still have the highest domestic abuse rate of any industrialized nation. When most people hear about domestic abuse they usually think of physical abuse. Other abuses are just as damaging, including the control of finances and transportation, emotional and psychological abuse and domestic captivity. That last one may be new to some so let me give you a real-life example: A couple decides to move in together. Soon he exhibits all the hallmarks of an abuser: physically assaulting her, taking her phone, cutting up her clothes, breaking her possessions, stealing her money and keeping her away from her friends and family. It doesn’t take her long to decide to leave. When she starts to pack,

he panics when he can’t talk her out of it. Knowing he has to leave for work and won’t be there to control her, he beats her, drags her to the back of the house, ties her to the deck and throws a tarp over her. This happened right here in Georgia in the month of August. She screamed for help in the extreme heat for 6 hours before being rescued. That victim was a woman in her 20s, but the victim could easily have been an older woman, a mother or grandmother. In 3% of cases it’s a male victim. Statistics show that among our senior citizens, both drug abuse and domestic violence is on the rise. It goes under-reported

I WONDER IF I CAN TAKE UP TO 12 MONTHS TO PAY?*

because of embarrassment or not wanting to involve the police. This is a generational response and one the authorities and various agencies are attempting to change through education and outreach programs. The U.S. recognizes the need for resources for this problem, but a safe place to land may still be difficult to find. Nationwide we have 1,612 domestic violence shelters. This includes 8 in Hawaii and 17 in Alaska. There are 8 in the U.S. territories; 2 in the Virgin Islands and 6 in Puerto Rico. If it sounds adequate here’s a stat to gauge by: we have 3,500 animal shelters. That’s 1,888 more facilities for pets than for women and children. Domestic violence laws must offer better protection for those who are being abused whether they cohabit or not. There should be better followup and stricter sentencing guidelines. The man in the story told earlier was not a first offender. Unknown to the victim while she was with him, he had been in prison on two previous aggravated assault charges involving two former girlfriends. If the judicial system continues to let offenders out early and don’t track them through better probation methods they will continue to re-offend. Eventually, many commit murder. When you have a 6-foot-2, 205-pound male beating a 5-foot-2, 105pound female, it doesn’t take much for it to go very wrong, very fast. +

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NOVEMBER 21, 2014

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW ABOUT BEHAVIOR MODIFICATION, COUNTRY-STYLE

AUGUSTA

arl Ladson was 6 years old, limp, dehydrated, and flirting with death when his mother rushed him into my office. Grief overwhelmed her and sapped her soul. I grabbed Carl in my arms and literally ran through my crowded waiting room and across the street to the hospital. EMTs would have taken too long. Carl’s shock was secondary to systemic salmonella contracted from an injured turtle he found on the roadside. Makes one remember that no good deed goes unpunished for long. Carl responded to antibiotics, IV fluids, and the constant care of the nurses and his mother. He went home to a wooden shack in the backwoods for a normal life of country upbringing. A couple days later, Carl’s father, Charles, showed up in my office without an appointment. “I want to see the Doc. It’s personal. I’ll wait all day if need be.” Although I had never met Charles, my receptionist, Robbi, knew Charles to be a heavy-duty man of honor and action. “Come back to his private office. The doctor will see you immediately.” Robbi herded me in to see Charles. He stood immediately, shook my hand with intensity.

“Thank you, Doctor. I owe you. Carl is my boy. I was out of town and my wife didn’t know how sick he was. She said my boy would have died if not for you. Here’s some money.” He stuck some folded $100 bills in my surprised hand. “It’s not enough, but it’s all I have right now.” The amount was far more than I charged, but Charles refused to take it back. The set of his jaw, the emotion in his eye said don’t argue with Charles. His departure was immediate and without another word. A week or so later, Charles came back to see me. “Doctor, I don’t have any more money for you.” “You don’t owe me any more. You have paid more than enough.” “You’re wrong, Doctor. Carl is worth more than I can ever pay you. If you ever need anything, any body ever bothers you, you call me. I’ll take care of whatever troubles you. Believe what I say. I can ... and will … take care of anything for you. Anything.” My eyes dilated as belief in Charles permeated my soul. I called my Dad for some background. He enlightened me. Charles was a war veteran with steely nerves and a true eye who FREE T AKE-H OME C OPY!

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NOVEMBER 21, 2014

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t s e B believed in fidelity. Once the Sheriff had trouble with petty break-ins in an outlying community. The county could not afford regular patrols, so the Sheriff gave Charles a gun, a star, a uniform, and a mission: stop the low-lifes however you see fit. Charles took him at his word. Maybe Charles was the prototype Charles Bronson used for his character in his Death Wish movies. It took Charles about two days to identify and then locate some young hoods on their way to make things worse. He encountered them in the dead of night, gave them a lecture about man, stewardship, God, and law. Being young and bulletproof, they laughed in his face. Who was this old man to tell three young bucks what to do and not do? Charles kneed one in the groin, back-handed the second into the middle of next week, and with his left hand grabbed the third by the throat and gave him a heavy right punch to the gut. “Want some more? Or do you want to go home to your mother in one piece?” Struggling to breathe, he finally croaked, “Go home right now. Sir.” “Good. Take your friends with you. They will live, for now. I catch you messing up again, there will be hell to pay. Believe what I say.” Henceforth, my Dad said,

e n i c i d ME

genteel peace reigned supreme thereabouts. Sometime later a diabetic patient, Taylor, complained to me in passing that somebody was stealing tires and rims from his trailer-moving business. I told him to hire Charles to stop the thefts, no questions asked. The next visit, Taylor was the happiest he had been in years. The tire thefts had ceased and his girlfriend was as nice to him as she had ever been. She no longer nagged him about money or his occasional beer or watching football all the time. She had come to understand that football was a man thing, but she wanted to learn more about it. He said it all happened after he hired Charles, so he put Charles on the payroll permanently. Charles was now VP in Charge of Everything. The tire part I expected. I had no explanation for the girlfriend part. I called Charles. “What happened?” “His girlfriend was sleeping on the side with a young stud who’s too sorry to work. He was stealing the tires. I waited until they were in bed together, broke down the door, and beat that sorry SOB with a billy club. I took Polaroids of him and her. Then, I kicked him out the door naked ... in the middle of the day. I kept his keys and wallet.

Check out our pet health column!

“Then I told her to get dressed and to shut up with the crying and begging. “I told her that she was now a new-born Christian and would be the world’s best girlfriend, mistress, wife, whatever Taylor preferred. If I heard even a rumor about her being anything different, I’d blister her butt ‘til it glowed in the dark, then give Taylor the Polaroids. She’d be out in the street. Believe what I say.” Sweet Thing took Charles’ combination of Christianity and behavior modification therapy to heart. Her conversion was instant and thorough. Billy Graham can’t hold a candle to Charles. Neither could Dr. Phil or Dr. Laura for that matter. So what are things you ought to know about all this? 1. When your word has weight, people respect that 2. Political correctness is good in debates. It’s worthless in the real world 3. Behavioral modification works 4. Behavioral modification does not always require a psychotherapist 5. People tend to do what they are rewarded for doing 6. People tend to not do what they are punished for doing That being said, can anyone explain to me why the government takes money away from people who work (punishment) and gives money to people who will not work (reward)? + Bad Billy Laveau is a retired MD with a pointed sense of humor. Bad Billy speaks and entertains at public and private events for audiences not subject to cardiac seizure secondary to overwhelming laughter and glee BadBilly@knology. net or 706-306-9397 This column originally appeared in the Medical Examiner in 2009.

See page 10!

PET VET

+ I

M.E.

THE AUGUSTA MEDICAL EXAMINER AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

NOVEMBER 21, 2014

AUGUSTA MEDiCAL EXAMINER

FREEDOM… from page 1 it happened to be legal in your county? As with murder, your code of conduct and your personal ethics would have a far greater bearing on your answer than any law on the books in Nevada or anywhere else. Getting back to Massachusetts, there is no doubt that the local board of health has good intentions and the welfare of the town’s citizens at heart. So did officials in New York when they decided to ban bucket-sized servings of sugary drinks. There is an epidemic of diabetes and obesity in this country. But that initiative, like prohibition, was ill-advised and doomed to any early death. The fact that murders occur every day of the week (always in places where it is illegal to kill another human being) and the world’s oldest profession seems to be in no danger of extinction (despite laws against it nearly everywhere) does not mean those laws are a bad idea. If we keep rules based only on their complete and unanimous effectiveness, then we should abolish speed limits tomorrow. And do away with stop signs while we’re at it.

Of course, no law should be taken off the books simply because it is frequently violated. But it is a slippery slope to begin criminalizing unhealthy products and behaviors. As one resident of Westminster wondered, “What’s next? Sugar? Bacon?” At some point, personal accountability has to enter the picture, and when it does it must trump any and all law. If, as Martin Luther King said, “One has a moral responsibility to disobey unjust laws,” it could also be argued that we have a moral obligation to ignore law. Are we suggesting anarchy? Not even for one second. But in the same way that no decent, respectable citizen of Westminster (or Augusta) would steal, murder or rape if those actions were suddenly not illegal, no one who truly cares about his health needs a law telling him he can’t smoke cigarettes or drink a gallon of sugar water every day. That salubrious citizen would not practice those unhealthy behaviors no matter what law is or isn’t on the books. It’s an under-rated concept called personal responsibility. +

Who says cigarettes are harmful?

I’m 48 – and feeling half my age! I won’t be participating in the Great American Smokeout. +

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 21, 2014

AUGUSTA MEDiCAL EXAMINER

Southern Girl Eats Clean

Italian Green Beans: A Healthier Side Dish

Who doesn’t like green beans? Generally, even the pickiest eater won’t mind green beans on their plate. They are a safe side dish when you are trying to please everyone. This version of green beans is super simple and looks fancy enough to serve at a formal dinner party or for a weeknight meal. I first had these Italian style green beans at a Thanksgiving gathering several years ago. Everyone was to bring a side-dish to go with the turkey and dressing. At these pot luck functions, most people usually will bring dishes such as heavy fat green bean casseroles, mac and cheese, or sugar-filled congealed salads. My friend Jason, who is quite the foodie, brought to the Thanksgiving meal these wonderfully healthy and flavorful green beans. I was pleasantly surprised to find a cleaner vegetable option. I fell in love with these green beans and I have been serving them in our home since that time. pan. green beans, Haricot Verts) This side dish is Cover pan lightly with foil • 1-1/2 cups of chopped unbelievably quick. Olive and allow beans to steam tomatoes (I use Pomi brand) oil, garlic, green beans, a bit, checking often and • Real Salt or sea salt and chopped tomatoes, salt and stirring. Allow green beans cracked black pepper to taste pepper makes for a delicious to cook for approximately 5-8 combination of flavors. Even minutes until tender crisp. Directions: if you don’t consider yourself Pour in tomatoes and heat As always, begin by tying good in the kitchen you can through, approximately 1-2 on a cute apron in a tidy handle this. It will make a minutes. delightful complement to your kitchen. Then, heat oil in a sauté pan Add salt and pepper to + Thanksgiving meal this year. over medium heat. taste, and serve. Add crushed garlic and Ingredients: soften slightly, stirring and Alisa Rhinehart writes the blog • 1 to 2 Tbsp. of organic extra www.southerngirleatsclean.com making sure not to burn the virgin olive oil She is a working wife and mother garlic. • 3 or 4 cloves of garlic, living in Evans, Place green beans in the crushed Georgia. Visit her sauté pan and toss to coat • 1 to 2 Tbsp. of water blog for more recipes with oil and garlic. • Organic green beans, and information on Reduce heat to medium-low enough to fill a sauté pan, clean eating. and add 1-2 Tbsp. of water to trimmed (I like to use French

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OUR NEWSSTANDS Medical locations: • Department of Veterans Affairs Medical Ctr, 15th St., Main Entrance • Dept. of Veterans Affairs Medical Center, Uptown Div., Wrightsboro Rd., main lobby • Doctors Hospital, 3651 Wheeler Rd, ER Lobby Entrance • Eisenhower Hospital, Main Lobby, Fort Gordon • George C. Wilson Drive (by medical center Waffle House and mail boxes) • GHSU Hospital, 1120 15th Street, South & West Entrances • GHSU Medical Office Building, Harper Street, Main Entrance • GHSU Medical Office Building, Harper Street, Parking Deck entrance • GHSU Hospital, Emergency Room, Harper Street, Main Entrance • GHSU Children’s Medical Center, Harper Street, Main Lobby • GHSU, Laney-Walker Boulevard transit stop, Augusta • Select Specialty Hospital, Walton Way, Main entrance lobby • Trinity Hospital, Wrightsboro Road, main lobby by elevators • Trinity Hospital Home Health, Daniel Village, main lobby • University Health Federal Credit Union/ University Hospital Human Resources, 1402 Walton Way, Main Lobby • University Hospital, 1350 Walton Way, Emergency Room lobby area • University Hospital, 1350 Walton Way, Outside Brown & Radiology/Day Surgery • University Hospital - Columbia County, 465 N. Belair Road, Main Lobby • University Hospital Prompt Care, 3121 Peach Orchard Road, Augusta

Around town: • Barney’s Pharmacy, 2604 Peach Orchard Rd. • Birth Control Source, 1944 Walton Way • GRU Summerville Student Bookstore • Blue Sky Kitchen, 990 Broad Street • Columbia County Library, main branch lobby, Ronald Reagan Drive, Evans • Enterprise Mill (North Tower), 1450 Greene Street, Augusta • Daniel Village Barber Shop, Wrightsboro Road at Ohio Ave. • Hartley’s Uniforms, 1010 Druid Park Ave, Augusta • International Uniforms, 1216 Broad Street, Augusta • Marshall Family Y, Belair Rd, Evans • Mellow Mushroom, 12th and Broad Streets, Augusta • Parks Pharmacy, Georgia Avenue, North Augusta • Southside Family Y, Tobacco Road, Augusta • Surrey Center, Surrey Center Pharmacy, Highland Avenue, Augusta • Top-Notch Car Wash, 512 N. Belair Road, Evans • Wild Wing Cafe, 3035 Washington Road, Augusta

Plus... 500+ doctors offices throughout the area for staff and waiting rooms, as well as many nurses stations and waiting rooms of area hospitals.

NOVEMBER 21, 2014

AUGUSTA MEDiCAL EXAMINER

Very little if anything about healthcare is inexpensive, and that includes medicine. Tiny pills can command large prices. Over-the-counter medications may be less expensive, but are they also less effective? Find the answers to lots of your drug store questions in this column written by Augusta pharmacists Chris and Lee Davidson exclusively for the Medical Examiner.

PICK ONE. ANY ONE.

ne day when our daughter was about five years old, she wanted to get up from her meal since she was full. No problem. A few minutes later, she said she was ready for dessert. But I thought you just said you were full. She had an explanation. Her “food stomach” was full, but her “dessert stomach” was empty. (Nice try.) It took a little while to convince this very smart and very persistent child that she really did only have one stomach to fill up. She was truly convinced they were two different things. As silly as that sounds, though, transpose that thought process to medication and you have a very real issue. The problem is not isolated to children. Whether pain medications or antibiotics, once we swallow them they all go to the same stomach, so the potential for drug interactions or drug duplication is very real. A fairly common scenario is for someone to see different doctors for different problems. They may have gone to one doctor for foot pain, another for headaches, the emergency room for a kidney stone, and have a regular prescription from their primary care physician for arthritis. All of these visits may result in similar prescriptions, but if the patient uses a different pharmacy and pays cash for each, the duplication would not necessarily be caught. The potential for very dangerous side effects would be immense. In an effort to save money on medication, perhaps using a $4 discount plan, potentially life-threatening choices may unknowingly be made. On the other hand, when a patient uses their insurance, even at different pharmacies, they have the benefit of potentially dangerous drug interactions being identified between stores. It is not always possible to see the same physician for everything, but it is almost always possible to use a single pharmacy. By utilizing the same pharmacy time after time, the pharmacists and the staff get to know their patient. It is not necessarily about which pharmacy a person chooses so long as

they choose one and stick with it. When someone is comfortable and trusts their pharmacy, they are more likely to talk about details they may have found insignificant or forgot to talk about with their doctors. The allergy they forgot to mention, a reaction to a medication years ago, or a medication they forgot they were taking can all end up being very significant. Something that seems very innocuous (vitamins, for example) may have a huge impact on an antibiotic prescription or how it should be taken. That antibiotic may be the perfect drug for the condition it’s prescribed for, but when added to other drugs already being taken, concerns about serious side effects arise. A trusted pharmacy can be invaluable over the years, especially when multiple diseases or conditions are in play. When the physician’s office cannot be reached for answers to last-minute questions, the pharmacist is usually available. That is not to say that all questions can be answered by the pharmacy. Sometimes the pharmacy will still have to defer back to the physician when appropriate. So pick a pharmacy — any pharmacy — and stick with it. Get comfortable talking to the pharmacists and the technicians. While a “food stomach” and a “dessert stomach” might be a really great concept, unfortunately medications are not made that way. The bottom line is to make sure that all medications are safe and appropriate, not just for each individual body part or system being treated, but for the whole you. Choosing and staying with one pharmacy means they will get to know you, your history, and your medications, and that can be an invaluable tool in your healthcare arsenal. + Questions about this article or suggestions for future columns can be sent to us at cjdlpdrph@bellsouth.net Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson (cjdlpdrph@bellsouth.net )

Stop by soon if you’d like a dose of your own medicine.

William E. Durrett, Jr., M.D. Pain Management, Anesthesiology & Perioperative Medicine www.aikenpain.com / email: thepaincenter@aikenneuro.com

P / 803.642.6500 F / 803.649.7551

We’re real particular about not giving you doses of anyone else’s medicine.

410 University Parkway, Suite 2360 Aiken, SC 29801

ARKS

HARMACY

Hometown. Not big box.

437 Georgia Avenue, North Augusta, SC

803-279-7450 parkspharmacy.com

your

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440 Society Hill Drive Suite 201 Aiken, SC 29803

NOVEMBER 21, 2014

AUGUSTA MEDiCAL EXAMINER

DON’T LICK THE BEATERS

Voted “BEST BARBER SHOP” in Augusta Magazine many times!

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Useful food facts from dietetic interns with University Hospital’s Augusta Area Dietetic Internship Program

The healthy buzz on holiday baked goods

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Tue - Fri: 9:00 - 6:00; Saturday: 9:00 - 3:00

IMPORTANT GROOMING NOTE: We’re closed the week of July 4.

Instructions Preheat oven to 350 degrees. Line bottom and sides of an 8-inch square baking pan with foil, leaving a 2-inch overhang Combine chocolate and oil in a medium heat-proof bowl. Set bowl over a pan of simmering water; stir until chocolate has melted. Remove from heat; whisk in sugar, egg, egg white, prune puree, vanilla, and salt until smooth In a medium bowl, combine flour and cocoa. Stir lightly into chocolate mixture. Spread batter in prepared pan. Bake about 40 to 45 min. or until top is firm and a toothpick inserted comes out with a few moist crumbs. Using foil, lift brownies from pan after they cool completely. Remove foil. Cut into 12 rectangles with a serrated knife. + by Katie Ochwat, Dietetic Intern, August Area Dietetic Internship University Hospital

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This holiday season, why not create an easy brownie recipe with healthier alternatives! Recipe courtesy of yummly.com.

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Alternatives Uncovered • Applesauce: Can replace oil, butter, or margarine in brownies, cakes and cookies; substitute half of oil for applesauce. • Prunes: Store-bought prune purees are a great fat substitute for oil in chocolate brownies; they have the same taste consistency because of the fiber. • Date Paste: Used most often in dark chocolate brownie recipes because of its strong flavor. • Fat-Free Yogurt: Can substitute for all or part of a recipe’s oil or butter because it contributes to the moisture and texture of the baked item; a 1/4-cup yogurt can also be a replacement for each large egg called for in a recipe. • Milk: Replace with any nondairy milk such as almond or rice milk with a 1:1 substitution ratio. • Flour: Oat flour and whole wheat flour can be replaced with a 1:1 substitution ratio. (simplysugarandglutenfree.com)

Double-Chocolate Brownies Ingredients • 8 oz semisweet chocolate (broken into pieces) • 4 tbsps canola oil • 2 cups turbinado sugar • 2 eggs • 2 egg whites • 1/2 cup prune puree • 4 tsps vanilla extract • 1 tsp salt • 1-1/2 cups oat flour • 2/3 cup unsweetened cocoa powder

Highland Ave.

Here’s a short list of creative tips to help you get started on healthier, mouthwatering desserts without sacrificing taste and enjoyment!

Ohio Ave.

ust as everyone is getting into the holiday swing of things, it’s time to think about what to bring to those ever-popular holiday parties and gatherings. Baked goods should bring you happiness, not stress during the holiday season. But eating one brownie serving is on average 200 calories, so you would need to go shopping and walk around the mall for over an hour (estimating a 150 pound person burns approximately 215 calories) to cancel out that one treat. One tip: when you’re going holiday shopping, park farther away from the store than usual, carry many bags, and walk briskly from car to store to store. Another important point is to make sure you eat a well-balanced meal beforehand, so you don’t get tempted by food court snacks and treats. Back to the kitchen, here are a few easy tips for baking delicious holiday goods to maintain your well-being. Get creative with a new spin on old recipes by adding nutrient-dense ingredients that family and friends won’t even notice! Easy alternatives will help benefit everyone without feeling like you overindulged on the desserts this year. Baked goods don’t have to be completely healthy, but you can focus on small doable changes that will make them healthier. Think about lowering the oil or butter content, which can significantly reduce calories, fat, saturated fat, and cholesterol in a recipe. Fat alternatives, such as fruit purees, can have an array of health benefits, like fiber, vitamins, and minerals. How about using healthier, whole grains instead of white flour? Whole grains such as oat flour and whole wheat flour provide fiber and nutrients while adding an interesting flavor and texture.

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NOVEMBER 21, 2014

AUGUSTA MEDiCAL EXAMINER

PET VET

TOP TEN QUESTIONS FOR YOUR VET

ere, courtesy of the FDA (Food & Drug Administration) are 10 questions you should ask your vet when medication is prescribed for your pet. As it turns out, they aren’t all that different from questions people should ask when a new drug is prescribed. It’s easier for us to ask questions than for our pets to, of course. 1. Why has my pet been prescribed this medication and how long do I need to give it? Your veterinarian can tell you what the medication is expected to do for your pet and how many days to give it. 2. How do I give the medication to my pet? Should it be given with food?

YOUR VIEWS

… from page 1

inevitable. And while medical treatment may have drawn out her days, how would her quality of life have been? Feeling horribly sick and in pain, feeding tubes, intubation, vegetative state, and knowing your family is watching you slowly, painfully die? • How is assisted suicide any different from unplugging a respirator, something that happens all the time with no fanfare? • I liked the news reports that said she “accelerated the dying process” rather than state she committed suicide. • I believe we should always have a choice if we are terminally ill. • I agree with her. I feel if one has an incurable and painful disease which also might rob one of his or her faculties and dignity, it would be humane to end one’s suffering. It’s not a decision to be made lightly, and there should be deep discussions with family members and loved ones before making that decision. • In regard to it being a religious issue, it seems it would only apply to the religion that person belongs to. For example, I don’t feel a Catholic religion (or Continued, far right

Your pet may have fewer side effects, like an upset stomach, from some drugs if they are taken with food. Other medications are best to give on an empty stomach.

5. What should I do if my pet vomits or spits out the medication? Your veterinarian may want to hear from you if your pet vomits. You may be told to stop giving the drug or to switch your pet to another drug. 6. If I forget to give the medication, should I give it as soon as I remember or wait until the next scheduled dose? What if I accidentally give too much? Giving your pet too much of certain medications can cause serious side effects. You’ll want to know if giving too much is a

cause for concern and a trip to the animal emergency room. 7. Should I fi nish giving all of the medication, even if my pet seems to be back to normal? Some medications, such as antibiotics, should be given for a certain length of time, even if your pet is feeling better. 8. Could this medication interact with other medications my pet is taking? Always tell your veterinarian what other medications your pet is taking, including prescription medications, over-the-counter medicines,

3. How often should the medication be given and how much should I give each time? If it is a liquid, should I shake it first? Giving the right dose at the right time of the day will help your pet get better more quickly.

9. What reactions should I watch for, and what should I do if I see any side effects? Your veterinarian can tell you if a reaction is normal or if it signals a serious problem. You may be asked to call your vet immediately if certain side effects occur. FDA encourages veterinarians and animal owners to report serious side effects from medications to FDA’s Center for Veterinary Medicine at 1-800-FDA-VETS. For a copy of the reporting form and more information on how to report problems, visit the Web site, 10. When should I bring my pet back for a recheck? Will you be calling me to check on my pet’s progress, or should I call you? Your vet may want to examine your pet or perform laboratory tests to make sure the medication is working as it should. +

4. How do I store the medication? Some medications should be stored in a cool, dry place. Others may require refrigeration.

CHOOSE… from page 1 What comes to your mind? Perhaps beheading, the hot new craze in killing people at home and abroad. Maybe something you’ve always feared comes to mind: drowning, being stabbed to death, or dying in a fire. Perhaps the pages of history come alive when you think of the worst ways to die: lynching, medieval torture, the rack, being drawn and quartered or stoned to death. An online article by Alexandra Ossola at Motherboard revealed what physicians, palliative care experts, grief counselors and assorted experts say about the worst way to die from a scientific standpoint. Quoting: “It seems that the scientifically worst way to die is the way we’re all most likely to die: in a hospital room after a protracted illness.” Granted, even the consensus of experts amounts to nothing more than an opinion, even if a well-informed one. The “worst” is by definition a subjective term, open to various definitions. But as you ponder the article’s conclusion, think about how many times you’ve heard someone say (or have thought yourself), “I just hope I go quickly.” Everyone, it seems, accepts the inevitability of death. What people don’t want to accept is the possibility that their end might be a long, painful, miserable, lingering death.

Medical science has achieved a level of success which makes long-term survival of a terminal illness not only possible but likely. By contrast, for victims of fire, murder, drowning, and even beheading, it’s all over in a matter of minutes. Even victims of officially sanctioned torture in the Middle Ages had at most a few hours of sheer agony to endure. Today we have perfected the arts of pain management, hospice, and palliative care. Some want all of that and more. They will claw at the last straw life offers and fight to stay alive beyond what seems humanly possible. God bless them. Others think, what’s the point of delaying not just the inevitable but the imminent? My condition is terminal. I have been given a 5% chance of surviving more than 6 months, and a 95% chance of spending my final days, weeks, and even months in my choice of a.) wrenching, unrelenting pain; or b.) a drug-induced haze. One thing is certain. Well two, actually. Death and taxes. But beyond that, it’s a certainty that right to die opponents would hate to be pushing daisies against their consent about as much as right to die supporters want their life to be artificially lengthened in the face of misery and pain and an inevitable outcome. +

Does the Bible condemn those who commit suicide? The website deathwithdignity.org lists what it claims are the official positions of dozens of religions on the topic of suicide and euthanasia. The positions are varied, even among different bodies of the same religion (American Baptist Churches versus the Southern Baptist Convention, for instance). There are certain factors that even the most casual pew-filler would think

and herbs or other dietary supplements. You may want to write these down and take the list with you to the vet’s office.

are relevant to determining the Bible’s actual viewpoint, however. For example, repentance, mercy and forgiveness are major Bible themes. Since suicide is often an impetuous act, can anyone state with certainty that the person might not have had a change of heart (“repented”) had their attempt failed? As for murder, some notorious murderers of Bible record were

forgiven, even though they had killed many. Jesus forgave the thief hanging alongside him, and is said to have died “for all,” “for every man.” The Bible says God does something humans cannot do: read the heart. He alone can make the correct judgement call in every situation. As a telling account in Genesis 18 asks, “Will the Judge of all the earth not do what is right?” +

YOUR VIEWS hospital) should impose its rules on a Baptist patient, etc. • I don’t think her death should be ruled a suicide; if she hadn’t been given the death sentence from her disease, I doubt she would have been contemplating killing herself. • I support her decision. • I honestly think what she did is okay. I may do the same thing if I was in her position after I got the things taken care of that needed to be done. I don’t think that in her situation it was morally wrong. If someone committed suicide when they weren’t terminally ill, that would be wrong in my book. I don’t think that assisted suicide should be legal. • When you have the do not resuscitate (DNR) order when someone cannot be brought back by EMTs or whomever, that is a way of legal assisted suicide if you think about it. • Although it may be construed as a legal, moral/religious, and/or medical issue, I believe that only the individual can judge the issue as a matter of individual choice. • The right to die depends on the situation. If a person is terminally ill they should have that right. +

NOVEMBER 21, 2014

11 +

AUGUSTA MEDiCAL EXAMINER

From the Bookshelf The blog spot — Posted by Paul Levy at runningahospital.blogspot.com on Nov. 16, 2014

“DENY AND DEFEND” HAS BECOME AN INDEFENSIBLE APPROACH TO MEDICAL ERROR In our research on communication and resolution approaches to malpractice, patients and families who have been victims of medical errors tell us that without hearing an explanation or apology, every hour that passes after the initial harm event feels like an additional injury. Fortunately, there is now a viable alternative. Several hospitals around the country, notably the University of Michigan and the University of Illinois at Chicago, have adopted the so-called communication and resolution approach to unexpected patient harm. This approach emphasizes rapid reporting of harm events, rapid communication with patients and families, and rapid investigations to identify possible system failures and to determine whether or not the patient was harmed by inappropriate care. When an investigation reveals inappropriate care, the health professionals who were involved meet with the patient and family, admit liability, describe in detail what happened, apologize and offer emotional support, and maintain contact for ongoing communications. Depending on the nature and severity of the harm, the hospital will often waive fees and charges related to the care that caused the harm, waive fees for subsequent care to remedy the harm, and offer financial settlements to compensate patients and families for pain and suffering and for the cost of ongoing care — all without litigation. Research shows that communication and resolution programs have many benefits. Those include fewer claims and lawsuits, increased reporting of near misses and errors, more rapid settlements for patients, lower malpractice insurance costs, lower legal fees and expenses for hospitals, and less defensive medicine being practiced by physicians. More importantly, telling the truth to patients after they have been harmed by medical errors is the right thing to do. It is more just, equitable, and humane. It is better for providers too, who are often traumatized by unintentionally harming the people they were trying to heal, and who are prevented from apologizing or even speaking to patients and families. “Deny and defend” has become an indefensible approach to medical error. The time has come to abandon it. +

“Telling the truth is the right thing to do.”

Speaking of blogs, the Medical Examiner’s blog is found at www.AugustaRx.com/news It features new content daily.

The Mystery Word is always hidden in one of our ads. Hidden. In an ad.

If the topic of this issue’s cover story hits home with you and yours for any reason — perhaps there is a suicide in your family’s history or you’re currently worried about someone’s precarious hold on the will to live, this book might be among the key places you seek information. Here is Amazon.com’s review: “Suicide is a particularly awful way to die: the mental suffering leading up to it is usually prolonged, intense, and unpalliated,” writes Kay Redfield Jamison. “There is no morphine equivalent to ease the acute pain, and death not uncommonly is violent and grisly.” Jamison has studied manic-depressive illness and suicide both professionally and personally. She first planned her own suicide at 17; she attempted to carry it out at 28. Now professor of psychiatry at Johns Hopkins School of Medicine, she explores the complex psychology of suicide, especially in people younger than 40: why it occurs, why it is one of our most significant health problems, and how it can be prevented. Jamison discusses manic-depression,

suicide in different cultures and eras, suicide notes (they “promise more than they deliver”), methods, preventive treatments, and the devastating effects on loved ones. She explores what type of person commits suicide, and why, and when. She illustrates her points with detailed anecdotes about people who have attempted or committed suicide, some famous, some ordinary, many of them young. Not easy reading, either in subject or style, but you’ll understand suicide better and be jolted by the intensity of depression that drives young people to it. And an excerpt from from the

review by Publishers Weekly: “Providing historical, scientific and other helpful material on suicide, Jamison, a Johns Hopkins psychiatry professor, makes an excellent contribution to public understanding with this accessible and objective book. There is, she asserts, a suicide every 17 minutes in this country. Identifying suicide as an often preventable medical and social problem, Jamison focuses attention on those under 40 (suicides by those who are older often have different motivations or causes). [She cites] research that suicide is most common in individuals with mental illness (diagnosed or not), particularly depression and manic depression. JJamison presents fascinating facts about suicide in families and in twins, gender disparities, and the impact of the seasons and times of day. She also provides poignant portraits of those who have committed suicide. Copyright 1999 Reed Business Information, Inc. +

Night Falls Fast, by Kay Redfield Jamison, 448 pages, published in October 2000 by Scribner

Research News Unexpected risk factor? Last week a study was published in the Journal of Clinical Oncology which found that southern states have more preventable colorectal cancer deaths than northern and western states. In fact, half of premature colorectal cancer deaths (defined as deaths among patients aged 25 to 64) are linked to ethnic, socioeconomic and geographic inequalities. Across the nation, states with the lowest levels of education among their citizens had “significantly higher” colorectal cancer death rates. Among the measurable disparities affecting cancer rates are income, education, and insurance status. The prevalence of such nonbehavioral risk factors, say researchers, suggests that thousands of cases of this third-leading cause of cancer death are preventable. Among behavioral risk factors, obesity, cigarette smoking and red meat

consumption increase risk, while physical activity and anti-inflammatory drug use lower risk. Sealed with a kiss The journal Microbiome published surprising findings this week from researchers in the Netherlands. The subject: kissing. According to the clinical study, a 10-second kiss can transfer as many as 80 million bacteria from the kisser to the kissee. Couples who kiss often (nine intimate kisses per day) were found to have a significantly shared salivary microbiota. “The more a couple kiss, the more similar they are” in terms of their shared oral biota. The study said the mouth plays host to more than 700 varieties of bacteria which contribute to digestion, synthesizing nutrients, and preventing disease. Cash for quitters Another study released

this week, conducted by The University of Texas Health Science Center at Houston, found that financial incentives doubled the quit rates for subjects enrolled in a smoking cessation program. The program offered participants a $20 gift card for smoking cessation by the established quit date, an amount increased by $5 for each week of continued abstinence. This continued up to $40, meaning participants could earn up to $150 in gift cards over the four weeks of the program. Tobacco abstinence was tested and monitored for 12 weeks following the quit date. A control group that was not financially rewarded had a 25 percent success rate four weeks after the quit date versus a 49 percent success rate for the gift carded group. At the 12-week mark, abstinence had fallen to 14 percent for the control group compared with 33 percent of the incentivized group. +

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NOVEMBER 21, 2014

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS +

by Dan Pearson

Well why didn’t you I’m going to get That won’t be easy. Deer Antler Spray. say so in the first rid of this stubborn What’s the plan? belly fat too. Diet changes? Exercise? I saw it on Dr. Oz. place? Break out the skinny jeans.

I hate to be I can lose weight, I know I can. Debbie Downer, but...

EXAMINER CROSSWORD

PUZZLE

ACROSS 1. Big ____ 4. Son of Abraham 9. 40-all tennis tie 14. Metal-bearing mineral 15. Judge’s seat (with “the”) 16. Moses’ brother 17. Tongues are said to do this 18. Break off (as a relationship) 19. Aspirin category (abbrev) 20. English private school (founded in 1440 by Henry VI) 22. Orchestral interlude between arias 24. Well-known 26. Walker lead-in 27. Inflammation (in general) 29. Twitch 30. Medicine 34. ____ Tour 36. Each 38. Very small quantity 39. New area store 41. Sub___________ 43. ______ Auditorium 44. Drowsy 46. Female pronoun 47. Toy that rarely gets used in Augusta 48. Faucet 49. Exam 51. Boundary 53. Hawks and Falcons 56. Lemon juice component 61. Adjoin 62. Audibly 63. Graduated glass tube 65. Half of two 66. Exhausted 67. Stallions’ type of football 68. Athens univ. 69. Father of the Blues 70. Degenderize; spay 71. Thumb’s name

25 27

Click on “READER CONTESTS”

46 49 52

S N E T Y G D Y H M W A K ’ Y M O U T Y W P N A S B O N E A O H K N O O

50 53

N L Y H M O Y L H A I E T I P

DOWN 1. Richmond County coroner 2. Muse of lyric poetry 3. Open to discussion or modification 4. Abdominal discomfort ltrs. 5. Prophet 6. Middle ear bone 7. Transparent film 8. Augusta daily 9. Judge Craig 10. Relaxation 11. River that empties into the Caspian Sea 12. Spiral 13. Internal prefix 21. Open mesh fabric 23. Transaction documentation 25. ______ tone 28. Colon adjective 30. Excavate 31. Oil rig worker 32. Western state 33. Very strong wind

VISIT WWW.AUGUSTARX.COM

51 57

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

40 44

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

QUOTATION PUZZLE 30

The Mystery Word for this issue: EPAINTINT

34. Chemicals whose production was banned in the US in 1979 35. Celtic speaker 37. Capital of Pakistan 40. Olden times (literary) 42. No in Moscow 45. Connoisseur of food and drink 50. Large body of water 51. Watergate figure 52. Most cars have five of them 54. Cloth made of reused wool 55. Water vapor 56. _____ lab 57. Hip bones 58. Undecided between two options 59. Regretted 60. Northwest Canadian/ Alaskan tribe 64. Word before code or bracket

— David Geffen

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

X A M I N E R

3 7

3 4 1

4 3 2

5 7

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

Solution p. 14

U D O K U

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

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.

P 1 2 3 4 U 1 2 3

1 2 1 2

1 1 2

1 2 3 4 5 6 7 8 9 S D — Francis Bacon 1 2 3 1 2 3 4 5 6

1 2 3 4 1

1.AIABBBIGIHS 2.ROOSSTUUA 3.PPTODE 4.DAPE 5.EK 6.FR 7.A 8.S 9.T

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

NOVEMBER 21, 2014

13 +

AUGUSTA MEDiCAL EXAMINER

THE BEST MEDICINE ha... ha...

“Madam, please,” the doctor calmly responded. “Can’t you be a little patient?” “It’s so convenient to have a 24-hour weather channel,” said the young man. “It’s one of the best innovations of modern life.” “We had that when I was a boy,” replied the old man. “We called it a window.”

man driving erratically down the road at 2 o’clock in the morning was pulled over by police. “Where do you think you’re going, mister?” asked the patrolman. “Well since you asked, I’m on my way to a lecture about alcohol abuse and the ill effects it has on the human body, as well as the dangers of smoking and staying out late.” “Oh really? And who is giving a lecture like that at this time of night?” “That would be my wife,” said the man. A man who hated his job was badly hurt after falling down the stairs at his place of employment. He is taken to the hospital where he remains in a coma for several days. At the very moment he finally opens his eyes, a doctor happens to be standing by his bedside. “What happened, doc? Where am I?” “Let me cut to the chase,” the doctor begins. “My friend, I have bad news and I have good news. First of all, you will never be able to work again.” “Okay,” said the man. “What’s the bad news?” A woman rushed into a doctor’s office and shouted, “Doctor! Help! I think I’m shrinking!”

“There is no need for all this anxiety,” the psychologist told his patient. “I’m sure you realize that none of these things you worry about will ever come to pass.” “But then I worry about why they didn’t happen.” “Mommy, why are old people so wrinkled?” asked the young boy. “You ever try to iron one?” A traveling salesman got back to his hotel after a long day and got a message from the front desk that his wife had given birth. He rushed to a phone, called the hospital and was connected to his wife’s room. “Honey, I’m so happy!” he cried. “So tell me: is it a boy or a girl?” “Irving, Irving,” she said wearily. “ Is that all you ever think about? Sex, sex, sex?” What do Pete Rose and the Mafia have in common? Three thousand hits. Why is the second day of a diet always easier than the first? Because by the second day you’re off it. +

Why subscribe to the Medical Examiner? Because no one should have to make a trip to the doctor or the hospital just to read Augusta’s Most Salubrious Newspaper.

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SUBSCRIBE TO THE MEDICAL EXAMINER

The Patient’s Perspective by Marcia Ribble

ately my legs have been giving me trouble, swelling and then bursting cells, leading to very unsightly oozing. This is not an uncommon problem for aging diabetics, but it is one which, unchecked, can lead to deep ulcers and amputations. Because of this my office visits have become quite frequent lately as the doctor and I work together to heal, debride, and create healthy new skin. These frequent visits have become useful because they give the doctor and me the opportunity to negotiate the “rules.” Raised in old-school days, at first I did not dare to touch my multi-layered dressings. First is a nice pink Unna boot, like a semi-soft cast with calamine lotion in it. Then it’s wrapped in gauze. Finally, compression bandages help to reduce the swelling and internal pressure on my skin that forms extensive blisters which then pop and ooze a fluid that crusts over and must be removed, leading to more oozing, more crusting, and more debriding. Gross! Sometimes the oozing slows down a lot and it doesn’t seep through the dressings, but sometimes it’s so plentiful that it leaks through. At first when that happened, I just put towels on the floor so I wouldn’t slide and fall because the oozy liquid is very slippery. Then I added a second layer of pressure bandages to catch more of the dripping. When I told the doctor about doing that, she advised me that it was OK for me to take off the yucky layers except for the Unna boot, and add a new layer of compression bandages. Over time, we talked while she replaced the dressings and I was able to learn more new things about what I could decide for myself. One time

Talk is cheap. Not talking can be deadly.

the fastener for the pressure bandage, a Velcro strip, hit on the tender skin under my knee and it hurt a lot. She told me that I could change its location so I would be more comfortable. There were also times in hot weather when my leg swelled and the skin at the top of the dressing got puffy enough to form bruises where skin and dressings met. Again, I could simply open the pressure bandage, release it a little, and make myself more comfortable. I wonder how many patients believing in the old rules would just suffer in silence and fail to address those kinds of comfort issues with the doctor until secondary injuries to the skin would occur. For me this has been another object lesson in the small as well as very important and larger issues that can be fixed by the doctor and patient communicating with one another. In addition, it gives me a kind of support and comfort many patients with chronic issues seldom receive. The support prevents depression, and makes it possible to go through weeks of care without losing hope. Sure is nice! + Marcia Ribble received her PhD in English at Michigan State and retired from the University of Cincinnati. She taught writing at the college level, most recently at Virginia College in Augusta, and loves giving voice to people who have been silenced. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.

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

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NOVEMBER 21, 2014

AUGUSTA MEDiCAL EXAMINER

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

EXAMINER CLASSIFIEDS Roman Realty 706-564-5885

HOMES, APARTMENTS, ROOMMATES, LAND, ETC.

MISCELLANEOUS

WEST AUGUSTA Luxury 3 bdrm, 2 bath townhouse. Garage, quiet neighborhood off Pleasant Home Road. $795/mo. Call 706228-4655.

6.7.8

...cleverly hidden (on the nurse) in the p. 7 ad for COMFORT KEEPERS Congratulations to HOLLIE DARLEY, who scores a coveted Scrubs of Evans gift card, 2 movie passes courtesy of Health Center Credit Union, and a $20 Wild Wing Cafe gift certificate. Want to find your name here next issue? The new Mystery Word is on page 12. Start looking!

The Celebrated MYSTERY WORD CONTEST ...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then be the first to 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. 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.

The new scrambled Mystery Word is found on page 12

ROOMMATE WANTED! 3 bdrm, 2.5 bath house with pool, 2 minutes from colleges. Perfect for medical or grad students. $425+share utils. 706.993.6082 WEST AUGUSTA House for rent. 3 bdrm, 2 bath, 1500 sqft, 1-car garage, 3024 Sterling Road, located off Stevens Creek at Riverwatch Pkwy. $850/mo. Call 678467-7187. FOR SALE: GORGEOUS, immaculate, never occupied townhome located mins from Medical District. 2 bed, 2 bath, master en suite, walk-in closets, office. 1450 sq ft. hardwood floors throughout, fabulous upgrades, custom kitchen and baths. Floor to ceiling windows, fenced yard. Partially furnished! 120k OBO. 803-507-6621.

CEMETERY PLOTS Side-by-side cemetery plots for sale located at the Heart Section of Hillcrest Cemetery. $3600 for BOTH. (706) 798-8495

SERVICES HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706.267.9947 HEALTH CARE - CNA offering in-home care: companion/assist with daily activities, light housekeeping, meal prep, assist with ambulation, medication reminders, grocery shopping, Dr. appts, errands, etc. Since each person’s needs are different, I will consult with you one-on-one to discuss your needs. CALL 706.833.9787 BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673)

Augustagahomesearch.com Foreclosures • Rentals • MLS

NOTICE! ATTENTION! If any current or past employer has failed to pay you min. wage or time and a half overtime pay, you may be entitled to an order from US Federal Court awarding you twice the amount of your unpaid wages plus atty. fees. For info, call Arthur H. Shealy, Attorney at Law, 803-278-5149, 1010 Plantation Rd, North Augusta SC 29841. You may be entitled to a similar award for unpaid wages if your employer required you to perform duties during your lunch hour, before clocking in, or after clocking out. BUSINESS ASSISTANCE Ridiculously affordable and highly visible advertising available through the pages of Augusta’s Most Salubrious Newspaper, aka the Augusta Medical Examiner. Have you heard of it or seen a copy? Rates can be reviewed at AugustaRx.com. Questions? Send an e from the site, or call the publisher directly: Dan Pearson at 706.860.5455. E: Dan@AugustaRx.com

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(OURS IS COFFEE)

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F. E. GILLIARD, MD FAMILY MEDICINE Acute & Chronic Illnesses Occupational Medicine PROMPT APPOINTMENTS 706-823-5250

THE PUZZLE SOLVED B

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A T E

.75

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QUOTATION QUOTATION PUZZLE SOLUTION: Page 12: “Anybody who thinks money will make you happy hasn’t got money.”

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The Sudoku Solution 2

3.25

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NOVEMBER 21, 2014

15 +

AUGUSTA MEDiCAL EXAMINER

WHITE COAT… from page 2 point. One year is not really sufficient. For example, total health expenditures increased, but this is partially expected. Again, you have 8-11 million newly insured people that have started consuming care and getting all of those appointments and tests that they pushed off for so long. How this will translate in the long term is hard to predict. Other questions revolve around Medicaid expansion. Some states that initially declined are more interested now. However, of those who do expand, there is still uncertainty regarding how they will handle even the relatively little portion of the cost, 10%, that they will be responsible for in the future as the federal government phases down its current share of 100% of the cost. Finally, previous studies have shown that those with health insurance have better health outcomes than those without. However, it will take a few years to see if the same holds true for the newly

Ask the Doctor

insured millions. This is likely to be the most important question. Get an opinion here. Or a second opinion. Or a third. As this law continues to age, we will have more and more data by which to grade it. For now, the bill has largely succeeded at reducing What is an enlarged heart? the number of uninsured without significant negative effects on the industry. However, When the heart works extra hard pumping blood through veins many Americans feel like it has only hurt their and arteries — perhaps due to vascular problems elsewhere in wallets. Patients are being protected. Whether the body — the left ventricle may become thickened (LVH or or not care is affordable and if this care is left ventricle hypertrophy) and that enlarges the heart. Another improving health…well, we’ll probably have to form of enlarged heart is when the heart muscle is stretched to wait until the PPACA is at least out of diapers. + the point it is no longer efficient and results in congestive heart failure (CHF) and is associated with edema of the feet and legs or lungs filling Ross Everett is a medical student at the Medical with fluid. These conditions are treated with diuretics, vasodilators, College of Georgia. He graduated from the beta blockers, digitalis, restricting salt intake, decreasing body weight, University of Georgia in 2011. Currently, he is and physical conditioning. An enlarged heart is a negative longevity taking a year of leave from medical school to pursue and health indicator. An enlarged heart must be treated seriously. + a Master of Public Health degree in Health Systems — by F. E. Gilliard, MD Family Medicine and Policy from Johns Hopkins University. Please 639 13th St Augusta, GA 30901 706-823-5250 contact him at wideeyedwhitecoat@gmail.com

Q A

PROFESSIONAL DIRECTORY DERMATOLOGY

ALLERGY

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

CHIROPRACTIC

DEVELOPMENTAL PEDIATRICS

Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A Evans 30809 706-860-4001 Poppell Chiropractic Clinic 1106-A Furys Lane Martinez 30907 706-210-2875 Most insurance plans accepted

COUNSELING Resolution Counseling Professionals 3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866 www.visitrcp.com

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

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

Karen L. Carter, MD 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com

DRUG REHAB Steppingstones to Recovery 2610 Commons Blvd. Augusta 30909 706-733-1935

EMPLOYEE BENEFITS Group & Benefits Consultants Inc. 3515 Wheeler Rd, Bldg. C Augusta 30909 706-733-3459 www.groupandbenefits.com

FAMILY MEDICINE F. E. Gilliard, MD Family Medicine 639 13th Street Floss ‘em or lose ‘em! Augusta 30901 706-823-5250 Industrial Medicine • Prompt appts.

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

Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Thomson: 706-595-7825 Primary Care Rates

HOSPICE

SENIOR LIVING

Medical Services of America Hospice 4314-E Belair Frontage Rd. Augusta 30909 706-447-2626

LASER SERVICES Ideal Image 339 Fury’s Ferry Rd Martinez 30907 1-800-BE-IDEAL • www.idealimage.com Schedule a FREE Consultation

MEDICAL MASSAGE Medical Massage Stuart Farnell L.M.T. 803-646-1846 jsfarnell@att.net www.FarnellClinic.com

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

PHARMACY Medical Center West Pharmacy 465 North Belair Road Evans 30809 706-854-2424 www.medicalcenterwestpharmacy.com Parks Pharmacy 437 Georgia Ave. N. Augusta 29841 803-279-7450 www.parkspharmacy.com

If you’d like your medical practice listed in the Professional Directory, call the Medical Examiner at 706.860.5455

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

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

THERAPEUTIC MASSAGE Centered in Georgia Diane Young L.M.T. 4488 Columbia Rd Martinez 30907 706-251-2244

VEIN CARE Vein Specialists of Augusta G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 501 Blackburn Dr, Martinez 30907 706-854-8340 www.VeinsAugusta.com

WEIGHT LOSS Medical Weight & Wellness Specialists of Augusta Maycie Elchoufi, MD 108 SRP Drive, Suite B Evans 30809 • 706-829-9906 www.mwwsAugusta.com PHC Weight Loss & Wellness Centers 246B Bobby Jones Expwy Martinez: 706-868-5332 Thomson: 706-597-8667 www.phcweightloss.com

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AUGUSTA MEDiCAL EXAMINER

NOVEMBER 21, 2014

Lost in the maze? Why enter in the first place?

We know the way. EMPLOYEE BENEFITS • COMPLIANCE • WELLNESS • CONSULTING • EXCHANGES • PARTNERSHIPS • TECHNOLOGY

RUSSELL T. HEAD, CBC, CSA-PARTNER • 706-733-3459 • E: RTHEAD@GANDBC.COM • WWW.GROUPANDBENEFITS.COM