Nov4 16 by Daniel Pearson

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Where do new diseases come from? And why do they keep appearing? I A better question might be why aren’t more new diseases popping up?

f you read that headline and asked yourself, “What new diseases?” here’s a brief refresher course: the Ebola virus was unknown until 1976; SARS (Sudden Acute Respiratory Syndrome) popped up out of nowhere in 2002; West Nile Virus appeared for the fi rst time in 1999; MERS (Middle East Respiratory Syndrome) affected Patient #1 in the United States in 2014; AIDS was fi rst recognized by the CDC in 1981; the swine flu pandemic known as H1N1 dates only to 2009. The list could go on. It wasn’t supposed to be this way. In 1967, then U.S. Surgeon General William H. Stewart said, “It’s time to close the book on infectious diseases and pay more attention to chronic ailments such as cancer and heart disease. The war on infectious diseases has been won.” That pronouncement wasn’t just incorrect; it was wildly incorrect: More than twenty new viral diseases have appeared on the scene since 1967, including AIDS, “the worst pandemic humans have ever faced.” One source says infectious diseases now account for one-fourth of all deaths globally each year. Why are deadly new diseases popping up at a time of great medical advances? A better question might be why aren’t more new diseases popping up? Yes, we’re living in a time of great medical advancements, but we — the human race collectively — are making the task of

infectious disease control monumentally difficult. Consider travel as one aspect. In past centuries it was impossible to quickly travel across the globe. It could take months to travel between continents. Today, Europe and Asia are mere hours away from Augusta — or anywhere else on the planet. Sir Francis Drake, the second person to circumnavigate the globe, spent from 1577 to 1580 doing the deed; it took Steve Fossett just 67 hours to do it in 2005. The epidemiological impact is significant: because of the delay between exposure to a disease and the onset of symptoms — known as the incubation period — an infected person can literally travel around the globe, unknowingly leaving a trail of other infected individuals in his wake. SARS is a perfect, if ironic, example. The disease fi rst appeared in 2002 in China’s Guandong Province. From there it was carried to Hong Kong in February 2003, ironically enough, it was later discovered, by an infected but unsuspecting physician, who subsequently infected a number of Hong Kong residents and fellow travelers. In short order SARS spread to thirty countries, causing about 800 deaths before it was curtailed. Right this minute, an estimated 500,000 people around the world are on board a commercial aircraft speeding to a faraway destination. Any one of them could be the carrier of the next pandemic. Population growth is another key factor in the spread of disease. Alongside the greatest mobility in human history is the greatest population density in human history. We’re rubbing elbows with our fellow humans as never before, which greatly facilitates the spread of disease. And it isn’t just humans we’re elbow to elbow with. All those people have to live someplace, and they Please see NEW DISEASES page 3

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AUGUSTA MEDiCAL EXAMINER

NOVEMBER 4, 2016

Part D of a 26-part series

Give me some sugar Just about everybody loves a little sugar. Maybe in your coffee or tea, maybe in the form of cookies, a candy bar, cake or a scoop of ice cream. It’s all good, right? One of the places where sugar can be a problem, however: blood sugar levels. There are misconceptions about this danger. Here is an excerpt from a usage note about the word sugar from an online dictionary: “Sugar may even be part of a warning: this food contains sugar, a substance which can cause diabetes.” That statement is exactly backwards: sugar can’t cause diabetes, but diabetes can cause sugar, “sugar” being what country folks sometimes call diabetes, a shortened version of “sugar diabetes.” The confusion is probably understandable: you really can’t talk about diabetes without talking about sugar. And what better source of sugar is there than dessert in all its many tempting varieties? There seem to be three distinct schools of thought when it comes to diabetes and dessert. The strictest group holds that your dessert days are over the day you’re diagnosed with diabetes. Another camp believes diabetics can still enjoy desserts as long as they don’t go overboard. Moderation is the key. The motto of the third

IS FOR DESSERT group could be summarized as “Dessert? Bring it on! That’s what I’m taking insulin for!” (Subgroup #3 motto: “Insulin? What’s insulin?”) For starters, type 1 diabetes is caused, not by consuming sweets, but by the pancreas not producing enough insulin, or by the body being unable to properly respond to the insulin produced. Since the body uses insulin to synthsize or process or metabolize carbohydrates (sugars), its absence or mere shortage can cause a serious buildup of sugar levels in the bloodstream. Untreated, that can be fatal. Simple sugars like those in the goodies listed in paragraph one are digested quickly, meaning they can affect blood sugar levels quickly. That doesn’t mean a diabetic can’t enjoy dessert on occasion. The key is information. Question #1: what is your

blood sugar level right now, as you’re considering having a bowl of ice cream? A diabetic who tests his blood sugar once a day might just as well not test at all; there are blood sugar fluctuations throughout the day. If you’re about to eat something sweet, what if your blood sugar is already high? The answer could mean you need insulin, you need to skip dessert this time, or both. Question #2: what does the food label tell you? How many grams of sugars and carbohydrates are in a serving? For that matter, what is a serving? Are there 4 cookies on your plate, only to discover the nutrition label defines a serving as 1 cookie? View the nutrition label info as your key to being able to enjoy dessert sometimes — and avoid trouble from dessert other times. Diabetes is serious business, and no one who has it should take it casually. Being a model patient can add years to your life, and a tremendous amount of quality to those years. Oh, and for those who don’t have diabetes, many of the same warnings apply: enjoy desserts in moderation; know and observe serving sizes; skip dessert when it’s prudent to do so. For many of us, that should be a lot more often that we’re doing now. +

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NEW DISEASES… from page 1 have to eat. of times every year. But Translation: land needs to along with transplants be cleared for housing and come immunosuppression agriculture. Worldwide, at least drugs. The huge worldwide 50,000 square miles of forest population of AIDS/HIV and jungle are cleared each patients (36.7 million at the year (much of it in Third World end of 2015, according to climates where population the UN) offers another huge growth is especially high), immunocompromised group. bringing workers into regular Over-prescribed antibiotics contact with mosquitoes, ticks, and/or their improper use by bats, and other vectors of patients give rise to the threat Remember 2009’s swine flu disease. of drug-resistant superbugs. outbreak? Officially that flu was As you may have noticed, Amazingly enough, the designated H1N1. The 1997 Hong many outbreaks of new diseases Kong flu strain was called H5N1. economy can even contribute At their most basic, all flu strains carry animal names: avian flu, to the spread of disease. At the are labeled either A, B, or C, with swine flu, mad cow disease, peak of the mortgage crisis in equine encephalitis, and others. A and B the most serious. 2007, some parts of California Both A and B viruses have One recent case illustrates the experienced a 300 percent route a new disease can take: in spikes covering their surfaces increase in home loan defaults late 1998 a previously unknown which they use like grappling and repossessions, and an hooks to attach themselves to illness appeared in Malaysia, almost equally high increase receptor cells. The spikes are and upon investigation it was (276 percent) in cases of West hemagglutinin (H) and there are found that 93 percent of those Nile Virus. Aerial photographs 17 different kinds of them, H1 affected reported contact of the affected area revealed through H17. Neuraminidase (N) with pigs before getting sick the connection: large numbers disengages viruses from cells so it (including a number who of vacant and abandoned can move along and infect more worked in a slaughterhouse). properties featured pools that cells. There are 9 different types Further investigation discovered of neuraminidase, N1 to N9. had turned green and stagnant another link in the chain: large through lack of maintenance, 2009’s H1N1 was the same tracts of Malaysian rainforest offering an attractive and strain as 1918 Spanish flu. This in the area had been cleared convenient breeding ground year, will it be H7N9? H3N2? Or for agriculture, including for the very mosquitoes that H5N1? Time will tell. orchards and pig farms. Fruit transmit West Nile. bats attracted to the orchards Mankind’s history contaminated nearby pig pens — right up to the present, with their droppings, infecting unfortunately — demonstrates pigs, which then infected clearly that we haven’t humans. yet conquered disease. In urban areas, particularly Disease still threatens to Do you think of measles (above) as a in Third World countries, conquer us, 1967 predictions minor disease? Before its announced population growth and notwithstanding. HIV/AIDS eradication in 1963, measles claimed 200 million lives over the centuries. + migration from rural areas alone has killed 39 million often lead to explosive growth since it fi rst appeared, says in already sprawling urban slums where poor the World Health Organization, a number that sanitation and unsafe drinking water invite rivals 1918’s Spanish flu pandemic. Plain old disease. And when it appears it runs rampant garden variety flu still strikes 3 to 5 million in the densely populated neighborhoods. people every year, causing 250,000 to 500,000 In the developed world, various human deaths. The United States figures alone for the behaviors make the emergence of new 2014-2015 flu season included 970,000 fludiseases an almost forgone conclusion. Organ related hospitalizations and more than 36,000 transplants, for example, once amazing deaths. miracles of medical science, are now routine What’s a body to do about all this misery? A procedures happening tens of thousands body is to read “Protect Yourself!” below. +

Advice Doctor ©

WHAT’S IN A NAME?

Amazingly enough, each and every one of us can (and probably should) play a role in preventing the next pandemic virus to sweep the globe. That one equivocation — the word probably — stems from the fact that some people reading this article might be less than six months old. Yes, some very smart people read the Examiner. Others know through hard experience that they can go into anaphylactic shock, a severe allergic reaction, from getting a flu shot. If you have concerns, discuss them with your doctor or pharmacist, but for the vast majority of us, a flu shot is safe protection, and any side effects would pale in comparison with having the flu. It’s not too flattering to be compared to a bunch of cattle, but when enough people are immunized against the flu, what is called “herd immunity” comes into play. That means that those protected are numerous enough that the flu can’t spread like wildfire. Instead, it will encounter roadblocks at every turn. Considering the millions of lives lost to flu epidemics, the simplicity and quickness of getting a flu shot is a nobrainer. Other prevention strategies are equally painless: washing your hands regularly; covering your nose and mouth when you cough or sneeze, not with your hands but with your sleeve. And for those who do get the flu, don’t be a hero and keep going to work, to church, the gym, et cetera, leaving a trail of germs in your wake. Stay home! +

Dear Advice Doctor, I recently joined a gym after being swept off my feet by their amazing introductory offer. Unfortunately, I failed to read the fine print, and I now know the amazing deal was too good to be true. I’m trying to cancel this raw deal, but it seems that I signed my life — and half my wallet — away. Any advice on how I can get out of this mess? — Unfit, and fit - to be tied Dear Unfit, I get this same question quite often. It’s good that many of us are interested in improving our health, but let me focus on just one of your main points: the word “raw.” Some people seem to think raw is synonymous with healthy. The closer our food can get to its natural state, goes their argument, the more healthful it is. After all, they say, no animals out in nature cook their food, and they seem to do just fine, thank you. Of course, these same people have no problems making a fruit smoothie, and as I like to remind them, no animals out in nature use blenders, and they seem to do just fine, thank you. The truth is that many of us should eat more raw foods: salads, fruit, and garden vegetables. So much of today’s diet are foods that are heavily processed. Fresh and natural and raw is good — sometimes. Some natural food fans think raw milk is healthier. The truth is that raw milk can harbor dangerous microorganisms, bacteria that are killed in pasteurized milk without reducing milk’s nutritional value in any way. Another myth: a raw egg is a great addition to a power shake. That is true — if you’re making a salmonella shake. Otherwise it’s a bad idea. For the same reason (raw eggs in the recipe) eating raw cookie dough, as suggested by the title of the Examiner’s regular “Don’t Lick the Beaters” column, is another no-no. If you really want to eat raw food, opt for oranges, nuts, celery, apples, carrots, radishes and strawberries, to name a few choices. + 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 Examiner issues.

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#32 IN A SERIES

Who is this?

NOVEMBER 4, 2016

AUGUSTA MEDiCAL EXAMINER

OLD NEWS +

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

ORGAN DONATION: RISKY BUSINESS

ichael Servetus, the gentleman shown here, was a medical pioneer of some note who died almost exactly 463 years ago. And it wasn’t exactly a peaceful death. Far from it. He is thought to have been born on September 29, 1511 in Spain and died a mere 42 years later, on October 27, 1553. He was a renowned as a polymath, a person of wide-ranging knowledge or learning, versed as he was in several languages, astronomy, mathematics, pharmacology, meteorology, human anatomy, law, geography, poetry and the Bible. He lands on this page for his pioneering writings in medicine, but it was religion and the Bible that led to his demise. Servetus was the fi rst European* to correctly describe pulmonary circulation. In his day it was thought that air in the lungs flowed to the heart for distribution to the body. Servetus correctly noted in his 1553 book, Christianismi Resitutio, that it was the other way around: blood flow from the heart to the lungs to deposit oxygen-depleted blood and pick up oxygenated blood. The trouble was, Christianismi Resitutio wasn’t a book about medicine. As its title suggests, it was a theological treatise, and it included some radical departures from the accepted dogma of the church. Servetus was against infant baptism, for example. If it was such a great idea, why wasn’t Jesus baptized as an infant? He also taught that Jesus was the son of God, not God, running afoul of the trinity doctrine the church had held dear since the 3rd century. Servetus stated the teaching was based on the teachings of Greek philosophers, not the Bible, and that trinitarians had turned Christianity into a form of “tritheism.” For these blasphemous offenses Servetus was denounced as a heretic, with influential theologian John Calvin leading the charge. Both Servetus and the craftsman who printed his book were arrested in March of 1553. Three days later Servetus escaped, but in June he was tried in absentia, convicted and sentenced to death on the strength of 17 letters sent to the court by Calvin. Despite his fugitive status, Servetus attended a sermon delivered by Calvin in Geneva in August and was promptly arrested after the service. Tried again and convicted of two charges, denying the trinity and infant baptism, the sentence was death by burning, although Calvin argued that “the severity of the punishment be mitigated.” Calvin preferred beheading. The sentence was carried out on October 27 in Geneva, with copies of Servetus’ book being used to fuel the fire. His last words were recorded as being, “Jesus, son of the eternal God, have mercy on me.” As the result of the execution, only three copies of Christianismi Resitutio survive and still exist today. Historians call Servetus’ death a monument to the civil right to exercise freedom of belief and conscience. + * Long before Servetus, the Arab physician known as Ibn al-Nafis (1213-1288) was the fi rst to correctly describe pulmonary circulation.

hat is involved with making the decision to donate an organ? To do it for a family member is a nobrainer, but other than that what would make a person take on a challenge like that? It should be noted that organ donation is major surgery and the recovery process takes weeks. Loss of wages, unexpected outof-pocket costs and/or time away from school or work are a few of the lesser issues to be considered when going through the decision-making process. Will the donor’s insurance cover post-op complications that may arise? A person is putting his or her life on hold for a long period of time to help someone in such a profound way. It’s a huge risk and the consequences can be life changing. I wouldn’t even know where to start with questions. To accept such a risk for a family member can be easily understood, but to do it for a complete stranger would take a level of altruism and bravery I cannot fathom. I read an article from The Washington Post last week

written by a medical student who had donated a kidney at the age of 18. At the time of the donation he believed he had made an informed decision based on the best information available. Five years later while working in a research lab he was looking at evidence of donors who had developed kidney failure.

The results showed the risks to donors are far greater than he was lead to believe. In 2014, a study looked at the long-term risks for kidney donors and found they had a greater risk of developing end-stage renal disease than non-donors. An additional study that same year raised the possibility they may face an increased risk of dying of cardiovascular disease. Donors are often not told the reality of donation risks nor the scarcity of data that is available. The truth is, it is hard to

get sound numbers about what happens to donors since hospitals are only required to follow them for two years post-donation; this does not capture longterm complications such as chronic kidney disease, cardiovascular issues or psychiatric problems. There is no national registry for kidney donors or other large scale means of tracking longterm outcomes. While sound information is frighteningly incomplete, the need for donors is great since more than 120,000 people in the U.S. are awaiting kidney transplants. Three thousand are added to the list every month. In 2014, only 17,000 kidney transplants were performed with just a third of those coming from living donors, the rest from deceased donors. The concept of “informed consent” is imperfect and doctors work with the data they have. Patients are not always told it may not be solid. The system is not necessarily designed to protect the donor because they may not be told about the lack of research on the long-term health implications. To say the decision to donate an organ is the decision of your life is not overstating the issue. +

MYTH OF THE MONTH Thaw frozen meats on the kitchen counter Let’s send this myth to an early grave before it can send us. “Never thaw or marinate foods on the counter.” That is a direct quote from foodsafety.gov, the US Department of Health & Human Services website. It goes on to state, “Since bacteria can multiply rapidly at room temperature, thawing or marinating foods on the counter is one of the riskiest things you can do when preparing food for your family.” What is the proper way to thaw foods? the simplest and most basic way is to transfer the food from the freezer to the refrigerator, although this can take up to 24 hours. A quicker options is to thaw foods using a microwave, although this is not appropriate

for every food. An intermediate step is to place the food — steaks, or frozen meat, let’s say — into a sealed plastic bag and then submerge the bag in cold water. Foodsafety.gov offers a short video with tips on how to thaw foods properly, ending with an invitation to call the US Department of Agriculture’s “Meat and Poultry Hotline” at 1-888MPHotline with any specific food safety questions for which you need answers. + — by F. E. Gilliard, MD, Family Medicine 4244 Washington Road, Evans, GA 30809 706-760-7607

NOVEMBER 4, 2016

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW res? ABOUT MURDER, EXTRA-CRISPY STYLE

k good eno r skin can ugh cer? son.”

o k

wo out of three children in the United States are overweight or obese. An obese child will most likely develop into an obese adult. In fact, 85% all the adult people in United States are overweight. In 2009, $147 billion was spent on the obesity problem in the United States. A few billion more and pretty soon we would be talking about some serious money. Never in the history of the world has any other society seen obesity as such a predominant medical problem. Never before in world history have the poor and destitute been obese. Prior to 1900, it took the work of 50 percent of the US population to provide food for the whole country. Now fewer than 2 percent produce food for themselves and the other 98 percent, and for export to countries that cannot feed themselves. Advanced mechanical technology and food production management has turned the American

farm into the greatest food producing factory in world history. I grew up on chicken farm in south Georgia. Every eight weeks we produced 20,000 broilers that weighed four and a half pounds each. That was 90,000 pounds every two months. My brother runs the operation now and every eight weeks produces 200,000 8-pound chickens. That’s 1,600,000 pounds of chicken. That is enough for 6,450,000 chicken plates. He has one fulltime employee and one part-time helper. When was the last time you heard President Obama announce Fried Chicken Day and hand out awards to farmers? Never. Hollywood and the movie industry never portray farmers as intellectual, polished, honored or exalted. Can you name one movie where the protagonist hero is a farmer? Use God’s Little Acre as measuring stick. And yet without the American farmer we would have even more starvation,

t s e B famine and wars around the world. The American farmer is the world’s greatest peacekeeper. Using the present day logic of gun bans because of shootings, then my brother and my family should be branded mass murders for growing all those chickens. We ought to put in prison. Had my brother gone on disability when he herniated a disc in his back 10 years ago and then had a heart attack the next year, every eight weeks we would have 6,450,000 fewer chicken dinners. Obesity might have been slowed. Countless people would not died of premature deaths due to obesity. How dare he not be

e n i c i d ME

prosecuted! And he is not even a Democrat. Why not prosecute Colonel Sanders and KFC or Chick-filA for indiscriminately killing innocent people? By today’s politically correct logic, it makes sense. Or should we prosecute parents who overfeed their children and produce obese children who then grow up to obese adults? Obesity shortens lives by 5 years as a rule, all things otherwise being equal. Not one word has come out of the mouths of Hillary or Donald about these murders. Why are they silent on this obvious disaster in the making? Maybe they are closet fried chicken lovers and

don’t care if our children and our poor are too fat as long as they get the votes. Why do I tell you all this? Because the old saying, “Healthy as a fat baby,” just ain’t true. So for you and your family’s well being, your credo should be: “Thin is in; fat ain’t where it’s at.” How do we heal this? Simple. Eat what you want. Just don’t eat as much. There will be another meal tomorrow. Less eating leads to more tomorrows. And I like tomorrows. You should, too. + Bad Billy Laveau is a formerlyretired MD who wields a pointed sense of humor - and now, tongue depressors too. He speaks and entertains at events for audiences not subject to cardiac arrest secondary to overwhelming laughter and glee. BadBilly@knology.net or 706306-9397.

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Will he ever get one right? Probably not. Questions. And answers. On page 3.

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 4, 2016

Southern Girls Eat Clean Kale and Apple Slaw I recently had lunch at The Tropical Smoothie Café, a fabulous new area restaurant. On the menu are various healthy and nutritious food options. They serve wraps, sandwiches, and delicious smoothies made with fresh fruits and real ingredients. One item in particular caught my eye: the Kale and Apple Slaw. I gave the slaw a try and it was absolutely delicious. One bite and I was hooked. I simply had to try and recreate this at home. I have no idea what ingredients are included in the restaurant’s version of this slaw, but I put together something very close and it turned out fab, if I do say so myself. Of course, the combination of kale and apples always tend to compliment each other in any dish. With curly kale, Granny Smith apples and carrots, this slaw is packed with nutrition. Kale itself is full of antioxidants, calcium and iron and is low in fat and calories. The dressing I chose to use for the slaw does include some dairy. As a rule, I try to limit dairy in my diet due to the fact that it has been proven to cause inflammation inside the body, and inflammation leads to disease. As Americans, we consume large amounts of dairy and with the increase of dairy Kale and Apple Slaw in our diets, our disease rate has gone up as well. In a small bowl, whisk • 2 Tbsp. of Dijon mustard Occasionally though, I will together the remaining • 2 Tbsp. of apple cider add a small amount of dairy ingredients to make the vinegar to a recipe if I feel that a dressing. • 1-1/2 Tbsp. of local honey substitute would not lend Pour the dressing over the • The juice of 1 lemon itself well to the flavor of the kale, apples and carrots. Toss • 1/2 tsp. of celery seeds dish. I used a low fat Greek to coat well. • 1/2 tsp. of kosher salt yogurt to dress the slaw Place in the refrigerator • 1/4 tsp. of cracked black but there are many other for about an hour, stirring pepper options out there that may occasionally to help tenderize work well. Non-dairy yogurt the kale. Instructions: is available and Veganaise Remove and serve slightly Wash Kale and drain to dry (Vegan Mayonnaise) might be + chilled. then remove stems and chop another choice. the kale into small pieces and I hope you’ll give this recipe ***Information about dairy in the place in a large bowl. a try. American diet found at http:// Without peeling the apples, Enjoy! www.forksoverknives.com/thecut them into thin julienned pieces and place into the bowl film/ Ingredients: Alisa Rhinehart is half of the • 1 bunch of curly kale, stems with the kale. Wash and peel the outer blog southerngirlseatclean. removed and chopped into layer from the carrots and com She is a working wife small pieces discard that layer. Then using and mother living • 2 Granny smith apples, the veggie peeler, create thin in Evans, Georgia. julienned ribbons of carrot by running Visit her blog for • 2 carrots, use a veggie the peeler down the carrot. more recipes and peeler to create thin ribbons Place into the bowl with the information on • 1/2 cup of organic plain kale and apple. clean eating. Greek yogurt

+ I

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IS THERE A BETTER WAY TO TREAT HEAD LICE?

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NOVEMBER 4, 2016

AUGUSTA MEDiCAL EXAMINER

here are many treatments for head lice available today. Some are prescription only and some are available overthe-counter. Prescription options should be reserved only for cases not responsive to over-the-counter treatments. This lessens the development of drug resistant strains of head lice. Unfortunately though, there are head lice that are resistant to some over-the-counter treatments, so sometimes the prescription route is the only way to go. Those require a doctor’s visit for a prescription, so today we will discuss primarily the over-the-counter options. Nix, a 1 percent permethrin solution, is and has been the mainstay of over-the-counter head lice treatment. There is also Rid (pyrethrum) that is available over-the-counter. This product seems to be slightly less effective than Nix due to resistance of lice to its active ingredient. Another lice therapy promoted by one author involves applying olive oil to dry hair on certain days over a twenty-one day period. The olive oil is applied and covered with a shower cap overnight since the mechanism is to suffocate the lice. This would require time, patience and persistence, but does come with one thing that some people prefer and that is a chemicalfree method of killing head lice. There is even a method promoted of using heat to eradicate head lice. This involves direct heat from a blow dryer to kill the nits and live bugs. This is the least effective option available and works more on the nits (the eggs) and less on the actual lice themselves. Another ineffective treatment that has been promoted is a hair dunk. Both bath water and pool water has been tried but both are ineffective against head lice. Other options that are mostly ineffective and that are promoted to work via

suffocation include mayonnaise, styling gels and Vaseline. Usually dishwashing liquid is then employed to remove the suffocating agent from the hair. One study shows a product that does not use a pesticide-style chemical and still demonstrates equal or better eradication rates compared to the standard over-the-counter treatments. This product is known as Licefree, and is a sodium chloride based product. Sodium chloride is another word for table salt, so it is a natural product, not a chemical pesticide. Licefree dehydrates both the nits and the live bugs. It has a better than average rate of cure even in one dose, but two doses are recommended. The other over-the-counter product you may find on store shelves is Clearlice. This product is plant based and involves a complex mixture of plant ingredients which is reported to work in one application to kill both nits and live bugs. I have only the manufacturer’s website as a source of information, so I cannot give information comparing this product to others on the market. Use your own best judgement about which product to use but remember that good supportive care is necessary with any treatment. All bedding, stuffed animals and other household items in contact with the affected person must be cleaned and the lice eliminated. All nits should be combed out, even if the treatment says it is not necessary. Err on the side of caution when it comes to getting rid of head lice. Only one louse left alive can cause a re-infestation. + 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 )

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

THANKSGIVING 101 by Katie Elder

hanksgiving is right around the corner and many families are already preparing for a gathering of family and friends. Since Thanksgiving is such a foodcentric holiday, it is a great time to refresh your food safety skills. Here are some easy tips to cooking a safe meal that can be enjoyed by all your guests. Whether you are cooking for a group of twenty-five people or just a few, food allergies or preferences that your guests might have are often overlooked. Even if you or one of your guests are lactose intolerant, allergic to nuts, or vegan, many favorite Thanksgiving foods can still be enjoyed. When in doubt, ask your guests for more information on his or her allergy or preference. If you are a guest with a food allergy or specific food preference, offer to bring a dish that you know has been prepared safely. When cooking for allergies or food preferences, it is often easier and safer

to cook from scratch and to keep foods simple. If you are using packaged foods or mixes in your recipes, be sure to read the labels carefully. Many ingredients can be swapped out in recipes to make the food safe to eat. For example, almond milk can be substituted to make a recipe lactose free and vegan, and ground flax seed or applesauce can be used in place of eggs. Once you have your recipes planned out and your supplies bought, let’s talk about actually cooking the food. When preparing multiple food items, crosscontamination can be a risk. Cross-contamination is when bacteria from one food gets transferred to another. If you are cutting meat on a cutting board, for instance, and then you cut vegetables on the same board without washing it, this can transfer

bacteria from the raw meat to the vegetables and they are now contaminated. This may sound obvious, but when there is a lot going on, it can be very easy to mix up kitchen tools! Cutting boards, knives or anything else used to prep food should be washed with warm soap and water and then allowed to air dry. An easy way to avoid any cross-contamination is by only preparing one food at a time and by cleaning dishes and counters in between preparation. Now we come to (arguably) the most important item of Thanksgiving dinner: the turkey. If you are going to be cooking turkey (or really any meat), you’ll want to make sure that it is stored properly before cooking. If it’s already frozen, keep it frozen until 1-2 days before cooking. You can thaw it in the refrigerator (below 41°F!), making sure it is covered and stored below any raw or prepared foods. Another option is to put your meat in a container of cold water and change the water every 30 minutes. The most important thing to remember regarding thawing meat is to not leave it out to thaw at room temperature. Thawing meat this way keeps it in something called the “Danger Zone” (temperatures between 40° F and 140° F). In the Danger Zone, bacteria grows at a much faster rate. The goal in thawing food is to keep it out of these temperatures as much as possible. Once the meat is thawed and ready to cook, be sure to have an accurate thermometer to

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check the temperature. Any poultry must be cooked to a temperature of 165°F before serving, beef and pork must be cooked to 145°F, and ham and fish must be cooked to 145°F. One of the most popular Thanksgiving sides, the turkey stuffing, can present a problem here. Since the stuffing absorbs some of the turkey juices, it also must be cooked to 165°F, and because it’s inside the turkey, it is easy to overcook the outside of the bird before the stuffing is safely cooked! So if you are going to be cooking a turkey and want to serve stuffing with it, keep in mind that it is safest to cook your stuffing separately from the turkey. By doing this, you will still have a moist turkey and

safe stuffing. Thanksgiving, almost inevitably, will leave you with way more leftovers than you know what to do with. There are some simple strategies you can take to enjoy your delicious food in the coming days without having to waste any. While it may seem like a hassle at the time, leftovers should be put back in the refrigerator as soon as possible after mealtime. Food should not be left out for more than two hours. If taken care of, you can use your leftovers to have multiple Thanksgiving feasts! After all the cooking you’ve done, a few days of leftovers will be much appreciated. Have a wonderful and safe Thanksgiving! +

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AUGUSTA MEDiCAL EXAMINER

The blog spot From the Bookshelf — posted by Jonathan Kanevsky, MD on July 9, 2015

WHAT A PLASTIC SURGEON LEARNED FROM A PATIENT HE COULD NOT SAVE You could hear a pin drop. The awkward silence at a dinner table after my pager went off. Eyes locked on me. For a split second the laughter ceased, forks held in mid-air. The nervous system of every doctor adapts to the sound of his or her pager during residency. Early in training, widening pupils and hairraising palpitations fade to become a quiet groan and deep exhale before reaching for the phone to find out what major disaster or small question awaits. I swallowed my food and excused myself from the table to answer the page. “50-year-old male, trapped in a burning car with major trauma. He would likely require amputations and serious resuscitation.” “I’ll be there in 10 minutes.” I left the restaurant amidst the hum of conversation and clattering cutlery. As plastic surgery residents on call, we manage burns. I was called in to assess the patient for the surgeries he would need to save his limbs and his life. Driving to the hospital, I thought through the various options and operations that might be necessary. Intubation, central line, escharotomy, skin grafts. The scene was worse than expected. The trauma surgery team was huddled in one corner, in the other corner a stretcher with a still human form under a drape. Peering from beneath the drape was a black, charred foot. The smell of burned flesh hung in the air. With each breath, everyone in the trauma bay was reminded of the pain this man suffered. The injuries sustained were incompatible with life. He was destined to die that day no matter what we did. Although there was nothing I could do to save his life, I was determined to learn from his suffering. There in the trauma bay, with the chorus of the trauma team in the background and the soft glow of the OR lights, was this man’s fi rst memorial. He had not yet been identified, no family had been found, and yet I was there admiring this stranger. I lifted up the sheet to reveal his charred arms, fi xed, reaching out. His skin had melted, revealing the bones and tendons trapped underneath. While algorithmically scanning his body to survey the damage my eyes paused. Left hand, ring finger. A faded patch of gold. A wedding ring. The medical flowcharts in my head stopped running, and I fi xated on the melted ring. Deep breath in and out, the smell of burning. For a moment, this man was no longer teaching me medicine but instead the valuable reminder to stop and be present. Indeed, inspirational quotes, “every day is a gift” posters, and daily mantras strive to remind us how precious life is. But without the human connection, they are nothing but ink or pixels on pages. The trauma surgeon recounted the details of how his team attempted to resuscitate the patient. “He never had a chance ...” While he rattled off the list of procedures his eyes drifted around the room. He was programmed to deliver concise medical information and yet his eyes said something else. They were heavy, tired, and couldn’t wait to be home looking at those he loved. I looked at the body, paused in gratitude, and covered him with a blanket. No charred feet exposed. His fi rst memorial complete. The digital clock in the corner flashed 1:07 a.m. The medical teams went their separate ways, and I went home. I climbed into bed. My pager went off again. Deep breath in, deep breath out. I could still smell the burn. +

“He would likely require amputations.”

Jonathan Kanevsky is a plastic surgery resident.

Excerpts from Amazon.com reviews of this book

READER: This book is amazing from every angle! Anyone who’s searched through Amazon or any bookstore knows there are mountains of self-help books out there. How do you choose? As a practicing psychotherapist (and someone who’s had years of my own therapy), I’ve tended to steer my clients away from self-help books because they usually oversimplify issues and promote unrealistic expectations which actually sabotage growth. At last, here’s a self-help book I can heartily recommend to clients, friends, family, or anyone who asks! This is a one-of-a-kind book which addresses the depth and complexity of human psychology in astonishingly clear, graspable language which the everyday reader will relate to. Along with providing a pretty fascinating review of the most powerful ideas in psychoanalytic thought, it also gives the reader concrete and effective exercises that promote growth and change. The book keeps getting better as it goes on. It ends by giving the reader a picture of what it

is to be “healthy,” as opposed to “perfect.” Dr. Burgo goes out of his way to show the reader that a person never arrives at personal perfection. He acknowledges change is hard work, but that the rewards of getting out from under the oppression of one’s defenses are well worth the effort. Likewise, you’ll fi nd this book is well worth the read! READER: As a practicing psychoanalyst, I found that this book tackles complex matters of the human condition and the workings of our minds in a highly sensitive and forthright way. Its pages are full of clear and detailed understanding of the many extraordinarily human ways we undermine our own emotional growth

and instead adhere to selfdeceptions. Dr. Burgo brings much compassion as well as a gentle but fi rm nudge to take any new self-understandings gleaned while reading, and with his helpful and probing questions and exercises, to actually develop in new ways. The candor and wisdom found in this well crafted and jargonfree book will be an immensely useful tool for growth as an adjunct to those already in psychotherapy or for those who can not access or afford quality treatment. AMAZON REVIEW: Why Do I Do That? is a self-help book for people who don’t usually buy self-help books. Instead of offering cognitive-behavioral techniques for dealing with anger, or affi rming strategies to boost self-esteem, this self-help book adapts the basic methods of psychotherapy to a guided course in self-exploration, highlighting the universal role of defense mechanisms in warding off emotional pain. + Why Do I Do That?, by Joseph Burgo, Ph.D., 242 pages, published in 2012 by New Rise Press

Research News Help for “Low-T” Guys, you know those ads for “male enhancement” — whatever that is — by treating the problem of “low-T”? Well, there is news. If the companies selling these products are run by men, they are the once getting male enhancement, and it’s in their bank accounts. Supplements for low testosterone, says the FDA, offer no benefits and the risk of harmful side effects. That isn’t breaking news: the FDA put the brakes on the unbridled marketing of these products over a year ago. Last month, however, researchers from Tulane, Georgetown, the University of South Florida and the University of Illinois—Chicago reviewed previous studies and investigated the claims and counter-claims. When the smoke cleared, the facts showed that testosterone helps to increase muscle mass — but curiously, without

having any effect on actual muscle strength. Researchers found no evidence that testosterone was helpful for erectile dysfunction or loss of libido. There are what one source called the “illusory” or placebo effects of testosterone. And there was evidence that testosterone treatments pose a risk to cardiovascular health. The best bet if you’ve been taking a supplement for “low T”: have an open and frank discussion with your doctor. The Cranberry Juice Uncure Folk and home remedies have a lot going for them: the force of tradition handed down from generation after generation. Unfortunately, they don’t always have any basis in fact. That’s the case with recent studies for a long-standing traditional cure (or at least a treatment) for urinary tract infections (UTI). Plaguing women more than men, UTIs are a certified

source of misery when they occur, and many a mother, girlfriend — and even doctor — has recommended drinking cranberry juice to help alleviate the symptoms and fight the infection. But a study at Yale University treated a group of patients at a nursing home, an environment where UTIs are the most commonly diagnosed infection. Half the women received a placebo, the other half a capsule containing as much active ingredient as 20 ounces of cranberry juice. After almost a full year, the women were tested for bacteria and white blood cells in their urine, the two most common symptoms of UTI. The tests found no difference in the urine samples between the capsule group and the placebo group, nor any differences in reported UTIs over the preceding year between the two groups. The verdict: cranberry tastes good. Beyond that... +

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NOVEMBER 4, 2016

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS +

Do you follow the news?

by Dan Pearson

Then you’re uninformed.

Not really.

Do you follow the news?

Then you’re misinformed

Absolutely.

THE MYSTERY WORD The Mystery Word for this issue: S TILL BLEATT

EXAMINER CROSSWORD

PUZZLE ACROSS 1. Reviews (with “up”) 5. He was president after Monroe and before Jackson 10. Peak 14. Scheme 15. Emesis 16. It can follow J. 17. Swear in 19. Sharpen 20. One who destroys property for recreation 21. Lockjaw 23. Some golfers throw them 26. Quarry 27. Dance of Cuban origin 30. Meadow 31. “Before noon” (abbrev.) 33. Having wings 34. ° 36. To’s opposite 37. Outer covering 38. Word with iron or bronze 39. Sandals are often open ___ 40. Tent holder 41. Late diet guru 44. It can be white or red 45. Functioning; in operation 46. In ____ Shoes (2005 film) 47. Word after Augusta, often 49. It opens chute (sometimes) 50. Stare angrily 51. North Augusta is building one 54. Neighborhood tienda 58. Type of car or road 59. How medicine can be administered 62. Look at amorously 63. Bay window 64. Therefore, in Latin 65. Partum start

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 1

Click on “READER CONTESTS”

QUOTATION PUZZLE

U T E N P T E O U R

A P R E A T R G N T M B H I D G S M I L E H T O E E O O N G H T R A N H L

66. Carlo’s first name? 67. Medical measure DOWN 1. Petty criminal (British) 2. Elbow-to-wrist bone 3. Whine 4. American Idol winner Ruben 5. Torn away injury 6. Type of dung beetle 7. Doc’s org. 8. His bumper stickers are still on some cars from 4 years ago 9. Spire that’s chased in Aiken? 10. Ancient district in S Greece 11. Close friend (oft. derogatory) 12. List from which to choose 13. Female sheep 18. Increase, as weight 22. Palm, for example 24. Harsh squeaky sound 25. Droopy 27. Marx brother 28. Extraterrestrial

29. Sudden explosive noise 31. Coliseum 32. Type of train 35. Pertaining to the kidneys 36. Direct thrust (in fencing) 39. Like many swords 41. Nautical prefix 42. Where a motorboat’s engine is attached 43. Abstract sculpture that isn’t mobile (but looks like it is) 46. Small village 48. Remove wrinkles 49. Buckets 51. Fall 52. The villain in Othello 53. Former currency of Spain 55. Current currency of Spain 56. Jokes 57. Common lotion ingredient 60. Storage container 61. Permit Solution p. 14

— Henry Rollins (1961 — )

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

X A M I N E R

4 3

5 2 3 1

5 8

7 2 2

8 2

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.

F 1 2 3 4 1 2 3 A 1 2 3 4 5 1 2

I 1 2 3 4 A ’ 1 2 3 4 5

1 2 3 4

1 2 3 4 — Yogi Berra

1 2 3 4

1.TTTMATHLA 2.IBREERHHA 3.LLEEEEOU 4.SLUFENY 5.TT

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

N Vletters, ACATthen Simply unscramble the exploring ION begin : ( our ads. When you find the correctly spelled word hidden in one of our ads — enter at AugustaRx.com

NOVEMBER 4, 2016

AUGUSTA MEDiCAL EXAMINER

13 +

THE BEST MEDICINE ha... ha...

addy,” a little girl asked her father, “do all fairy tales begin with ‘Once upon a time’?” “No, sweetheart,” he answered. “Some begin with “And if I am elected...’”

Moe: Why did the dinosaur cross the road? Joe: Hmm... probably because chickens didn’t exist yet. Moe: What do you call a cow with a twitch? Joe: Beef jerky. Moe: What do you call someone who points out the obvious? Joe: Someone who points out the obvious. Moe: When I was growing up, cosmetic procedures were supposed to be hush-hush. Joe: These days if you mention Botox no one raises an eyebrow. Moe: I bought my wife a new refrigerator for our anniversary. Joe: Uh oh. I bet she wasn’t too crazy about that. Moe: Are you kidding? You should have seen her face light up when she opened it.

A man absolutely hated his wife’s cat and decided to get rid of him one day by driving 20 blocks across town and leaving him at a park. After doing that, he drove straight home, only to find the cat sitting on his front porch licking his paws. The next day he drove the cat 40 blocks away, put him out of the car and headed home. Pulling into his driveway, there was the cat! Each day he took the cat further and further away, but the cat would always beat him home. At last he decided to drive miles from home, turning right, then left, past the bridge, then right again and another left at random until he reached what he thought was a safe distance from his home and dropped off the cat there. Two hours later the man calls home to his wife. “Hon, is the cat there?” “Yes,” the wife answers, “he’s right here. Why do you ask?” Frustrated, the man answers, “Put him on. I’m lost and need directions.” A politician is walking down the street when he is mugged. “Give me all your money!” says the attacker. “Do you know who I am?” asks the politician. “I am an important government official.” “Ok,” the mugger says. Give me all my money.” “I work with animals every day,” said the guy on a first date, hoping to impress the girl. “That is so sweet,” she said. “What do you do?” “I work in a butcher shop,” he replied. +

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ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble wrote a long-time column in this paper entitled The Patient’s Perspective reincarnated in this new format. Feel free to contact her at marciaribble@hotmail.com Some people may not know that AARP offers free tax preparation every year for seniors. April 15 will be here before we know it, so keep this in mind. I keep a little notebook to place reminders in so I don’t forget them. A while back I was bemoaning the lack of good maps to interesting local places, events, and eateries. Before the Master’s Tournament, I discovered a small booklet in the paper on the Sunday before the tournament began. It was full of small maps locating various venues which might be of interest to visitors—and people like me who didn’t grow up here. For next year they might add a little indicator of places which are handicap- friendly. It doesn’t make much sense going someplace where you have to use stairs when you can’t go up and down stairs. New buildings are built according to Americans with Disabilities Act accommodation rules, but we have many older buildings that were built before the ADA took effect. Even those buildings which have some degree of access may require folks to go up or down stairs to use the bathrooms, and not have elevators. Today I went to the Columbia County Library. The building itself has good access, but parking is too far from the building for many individuals with physical handicaps who use canes or walkers (or neither, but for whom walking any distance is too much for them). I met a woman today who was getting out of her car and trying to figure out if she had the stamina to walk from the parking lot to the building. She looked at me and said, “Why don’t they let us park in the circle up by the building?” I am stronger now, so I can walk much farther then I could last year, but I remember having exactly those same thoughts a year ago. At that time, pneumonia and fluid in my lungs and around my heart had made even getting up and walking into the kitchen a major undertaking. I would have to stop every few feet to catch my breath. Standing, even for the minute it took to heat up water for instant coffee, was enormously challenging. The woman continued, “The handicapped parking is the same distance to the building as all the other parking.” She was right: the distances are the same. In addition, people using walkers or non-motored wheelchairs that require curb cuts are invited to take a path that meanders around, increasing the distance one must travel to get in to the library. That distance is not just bothersome to people with some handicaps, it can also be quite dangerous for them. Back in the days before my knee replacements, the pain I experienced walking that far was not only excruciating, it also compromised my balance, making it more likely that I would fall. If parking near the building can’t be arranged, for people with handicaps it would be great if some seating could be placed to give them places to stop and rest. They would need to have taller seats than those benches in the building now for people who have trouble sitting and then standing from a seated position. Libraries are wonderful places. They should be available to all our Columbia County citizens. +

OUR NEXT ISSUE DATE: NOV. 18

+ 14

NOVEMBER 4, 2016

AUGUSTA MEDiCAL EXAMINER

THE MYSTERY SOLVED

119

IONissue was: Tlast The Mystery Word VinAour A C N S TILL OTABLET

...very cleverly hidden (in the bricks) in the p. 16 ad for AUBEN REALTY APARTMENTS However, we had no winner! 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 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!

This is how many back issues of the Medical Examiner are available at issuu.com/medicalexaminer You can subscribe to the online edition free!

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

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EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC. FREE CONDO Hilton Head. No joke. Owners old and tired. 2 bdrm, 2 bath, ocean view. First week of March. (706) 738-2292 FOR RENT 1827 McDowell St., 1 mi to MCG. 2 bdrm, 1.5 bath, LR, DR, den, kitchen. Tile/hardwood floors. New roof. (706) 738-2331 ROOM FOR RENT with private bathroom and full house privileges. Martinez $600/mo (706) 840-6860 FOR SALE 3 bedroom/2 bath, single garage Townhouse in Martinez. Master/ bath down, 2 upstairs bedrooms share bath, large loft for office, playroom, den; wood-burning fireplace, covered back porch. Freshly painted with new flooring, lighting and ceiling fans. Easy access to Riverwatch Parkway, Washington Rd, I-20, Augusta. 1987 sq.ft. $147,900. 706-836-7001. ROOM FOR RENT 1 room, private bathroom, 2bdrm MH on private lot. Clean quiet neighborhood. Non-smoker. $600 monthly. Must be stable, verifiable references and income. Cable and Internet included. Warrenville, 5 min from Aiken, 20 min to Augusta. (803) 270-2658 POND VIEW! Evans all-brick 2-story with solar panels. Avg. electric bill $170 in Northwood, 3,400 sqft. Call 1-800401-0257, ext. 0043 24/7 for price and details.

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AUGUSTA MEDICAL EXAMINER, PO BOX 397, AUGUSTA, GA 30903-0397

SERVICES

CELIA DUNN, DMD 584 Blue Ridge Drive, Evans GA 30809 (706) 650-9700 HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706-877-0421 F. E. GILLIARD, MD FAMILY MEDICINE Acute & Chronic Illnesses Occupational Medicine PROMPT APPOINTMENTS (706) 760-7607

MISCELLANEOUS SUNSET MEMORIAL GARDENS Opening and closing at Sunset Mem. Gardens in Graniteville. Sale: $760 (Value: $1520+) Call 706-736-0596 ANTIQUE maple dinette set with buffet corner cabinet table with pull-out leaves. Four chairs with two captain’s chairs. Excellent condition. $300. Double bed early 1930s with mattress spring coverlet shams $150. Call (706) 860-2170 CEMETERY SPACES (2) Sunset Memorial Gardens, Graniteville SC adjacent to lighted military flagstaff, includes granite bench with urn space, installation and inscription. All $4700 ($8600 value). Spaces only: $2700. Call (803) 2953033 FISHING CLUB wants more grey-haired members. Meet 2nd Thurs of month at Harbor Inn Restaurant, 12 noon. “Adventure Before Dementia” Info: (706) 736-8753

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QUOTATION QUOTATION PUZZLE SOLUTION: Page 12: “Nothing brings people together more than mutual hatred.” — Henry Rollins

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The Augusta Medical Examiner publishes on the 1st and 3rd Friday of every month. Your ad should reach us no later than 7 days prior to our publication date.

PETS Dogs walked, cats sat, in the comfort of your home by retired pharmacist. No kennel noise, fleas, disease, transport cost/time. Avail 7 days/wk in Martinez/ Evans. $15 per visit. References. Call Buddy for your buddy: (706) 829-1729

WORDS BY NUMBER “Half the lies they tell about me aren’t true.” — Yogi Berra

NOVEMBER 4, 2016 Look in the pantry as well: Are there random cans of food but nothing to put together to prepare a simple, but decent meal?

IT’S A QUESTION OF CARE Q: How do I know when my elderly parent needs additional care? 1. Observe the foods in their home. Look in the refrigerator. Are there foods that have expired? Open packages of luncheon meat or cheese that perhaps your parent thinks are still edible, but look questionable.

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AUGUSTA MEDiCAL EXAMINER

2. Investigate their mail or bill situation. If you see mail that is unopened or stacks of bills that appear to be unpaid, dig deeper. Often, people are unsure what is a bill and what is junk mail. Your parent might not be paying their bills on time, and instead, they may be sending donations to every solicitation they receive. 3. Monitor their laundry and housekeeping skills. Often, as people age and begin to decline cognitively, they will go through the motions of doing laundry but fail to add any detergent to the washer, so their clothes are not clean. They may also claim they are performing

housekeeping duties, but you notice their kitchen, bedroom or bathroom is becoming cluttered and very dirty, and you know this isn’t their typical standard. This is common when they either cannot keep up physically with the demands of the home or cognitively cannot keep track of what has or has not been accomplished. Often, their ability to judge an acceptable standard is compromised. 4. Look at their personal care habits. If they were always a fastidious person about their hygiene and you note that they are not bathing regularly or brushing their teeth or combing their hair, there’s often a problem. 5. Seek feedback from others. You can attend social activities with your parent

and inquire if the people there are regularly seeing your mother and/or father. Many times, people who live alone or are beginning to experience symptoms of dementia, will claim they are still going to church, meeting friends as normal, or grocery shopping regularly, when this is actually inaccurate. Casually asking others if they have seen your parent(s) can provide a gauge for you to know if they are keeping the schedule that they claim they are keeping.

residential zone or perhaps the opposite: 25 mph on a busy road? If you notice any of the above observations, it might be time to consider hiring Non-Medical In-Home Care or begin investigating Assisted Living. The decision should be based upon your parents’ needs and their financial situation, in addition to your availability and willingness to check on them and provide some of the help that they are beginning to require. +

6. Assess their driving skills. If Mom or Dad still insists on driving and you are beginning to think it is unsafe, then if you are brave enough, ride with them and observe for yourself! In addition you can ask neighbors to report as to what they have seen of your parent’s driving habits near their home. Is the elderly person driving 55 in a 25 mph

— by Amy Hane, who holds both bachelor’s and master’s degrees in social work from the University of South Carolina. She is a member of the National Association of Social Workers and is an Advanced Professional Member of the Aging Life Care Association. Amy is a licensed Master Social Worker in South Carolina and Georgia, an Aging Life Care Manager and is also a Certified Advanced Social Work Case Manager.

PROFESSIONAL DIRECTORY ALLERGY

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

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

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

DENTISTRY

DERMATOLOGY

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

DEVELOPMENTAL PEDIATRICS 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

FAMILY MEDICINE

F. E. Gilliard MD, Family Medicine 4244 Washington Road Evans, GA 30809 706-760-7607 Industrial Medicine • Prompt appts. Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Thomson: 706-595-7825 Primary Care Rates

OPHTHALMOLOGY Roger M. Smith, M.D. 820 St. Sebastian Way Suite 5-A Augusta 30901 Practice closing 706-724-3339 in December 2016

PHARMACY

YOUR LISTING HERE

SENIOR LIVING

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

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

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

VEIN CARE

Medical Center West Pharmacy 465 North Belair Road Evans 30809 Vein Specialists of Augusta Dr. Judson S. Hickey Your Practice 706-854-2424 Periodontist And up to four additional lines of your www.medicalcenterwestpharmacy.com G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 501 Blackburn Dr, Martinez 30907 2315-B Central Ave choosing and, if desired, your logo. Floss ‘em 706-854-8340 Augusta 30904 or lose ‘em! Keep your contact information in Parks Pharmacy www.VeinsAugusta.com 706-739-0071 this convenient place seen by tens of 437 Georgia Ave. thousands of patients every month. N. Augusta 29841 Jason H. Lee, DMD Literally! Call (706) 860-5455 for all 803-279-7450 116 Davis Road the details www.parkspharmacy.com Augusta 30907 Medical Weight & Wellness 706-860-4048 Specialists of Augusta THE AUGUSTA Maycie Elchoufi, MD MEDICAL EXAMINER Steven L. Wilson, DMD 108 SRP Drive, Suite B Psych Consultants Family Dentistry Evans 30809 • 706-829-9906 AUGUSTA’S 2820 Hillcreek Dr 4059 Columbia Road MOST SALUBRIOUS YourWeightLossDoctor.com Augusta 30909 Martinez 30907 NEWSPAPER (706) 410-1202 706-863-9445 www.psych-consultants.com

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Kid’s Stuff NOTES FROM A PEDIATRIC RESIDENT by Caroline Colden, M.D., Children’s Hospital of Georgia Let’s talk about the chickenpox, also known as Varicella Zoster Virus (VZV). Chickenpox is an infection that can affect patients of any age but very commonly affects children, as it is highly contagious and can spread like wildfire in school, daycare and playgroup settings. It is most well-known for the itchy-itchy-itchy rash it causes, as well as fever, headaches, and generally feeling ill. The rash can start anywhere, but usually starts on the chest or back, sometimes fthe ace, and spreads to the rest of the body (including the genital region). The rash starts out as blisters (the liquid inside is chocked full of virus and infectious), which eventually pop and scab over. It can take 1-3 weeks for all the blisters to finish scabbing. Messing with the scabs too much or pulling them off too early — which is difficult to avoid given how itchy the rash is and how tempting it is to scratch — can result in permanent scarring of the skin (hence the name, from “pocks” or pockmarks). A person with chickenpox is VERY contagious, and can spread the virus two days before the rash starts for up to two or more weeks after all the blisters scab over. How can the virus be spread? Direct contact with the blisters or an infected person is definitely one way to contract the disease; breathing airborne droplets/etc can also spread it. What is the big deal with the chickenpox if it’s only a rash and some other minor symptoms we are talking about? For one thing, the blisters can get infected with skin bacteria in addition to the chickenpox infection. Using the entryway of the blisters, bacteria can also enter the bloodstream to cause infection, especially when there is lots of scratching. The chickenpox (varicella zoster) virus itself can also enter the bloodstream and cause infection elsewhere in body, aside from the rash. Blood-borne infection can then cause pneumonia in the lungs or a brain infection called encephalitis, which can leave lasting effects and/or damage. Chickenpox infection by itself - even without these above-listed complications - can cause serious illness and even death. Patients may require hospitalization, become frighteningly dehydrated, or have other serious problems. Before the chickenpox vaccine existed, approximately 11,000 patients per year required hospitalization for the chickenpox, and approximately 100 people died per year, according to CDC figures. People especially at risk for these serious risks include tiny babies, elderly, immunocompromised patients (those HIV+ or being treated for cancer) and pregnant women. How can we prevent chickenpox or at least reduce the risk of transmitting it (especially to our children, and other at risk individuals)? Step 1 is to vaccinate (with the Varicella vaccine by itself, or as part of the MMR vaccine). Children typically

may receive the vaccine at 12-15 months of age, and 4-6 years. Patients over 13 years of age can be caught up easily as long as the 2nd shot is given >28 days after the fi rst. Pregnant women should not get vaccinated with the chickenpox vaccine until after delivery. Vaccinated individuals may

still potentially develop the chickenpox, but the severity and duration of their illness is very decreased compared to nonvaccinated individuals. The benefits and protection associated with the chickenpox vaccines by far outweigh potential risks of the shot, which generally accompany any vaccine. Allergic reaction is among the top concerns, and patients should be monitored for swelling of face, hands, eyes, lips, difficulty breathing, extensive rash or hives, or other concerning symptoms. Children may have temporary pain in the area where the shot was given, mild fever and fussiness. High fevers, changes in behavior, abnormal movements or seizure-like activity are all abnormal and should be brought to medical attention, as well as any other symptoms that concern family members. Discuss your questions beforehand with your doctor. Even with a few possible side effects, it is better to get the chickenpox vaccine than the actual chickenpox. +

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