Oct16 15 by Daniel Pearson

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AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

OCTOBER 16, 2015

BREAKING NEWS T his happened to a Medical Examiner reader. At a scheduled appointment with her ob/gyn, one glaring anomaly stood out after the various routine tests: her blood glucose reading was nearly 400, about four times higher than normal. She was referred to another doctor that same day, who read over the first doctor’s findings and then, by way of announcing the diagnosis, said “Welcome to the world of diabetes.” The doctor then placed a small box containing a blood glucose monitor on the counter as she (the doctor) prepared to leave the exam room. “What do I do now?” asked the bewildered patient, who had known she was a diabetic for less than fifteen seconds. “Call diabetic services,” said the doctor as she walked out. While that might be called a textbook study in how not to break the news of a permanent and life-altering diagnosis, it is hopefully something of a rarity. Then again, medicine today sometimes bears an uncomfortable resemblance to an assembly line. We know of a doctor who last month saw 93 patients in one day. Doctor’s schedules are often plotted out eight hours at a time in 10- or 15-minute increments, and there is little room for unplanned expenditures of time. Any deviation from the schedule can have a ripple effect that significantly impacts patients and staff all day. On the other hand, a professional whose bread and butter is helping people would not be expected to say, “I’m on a pretty tight schedule here, so let me just spit it out: you’ve got cancer, and probably won’t be around much longer. There’s nothing we can do. Goodbye.” What is a doctor to say? Many of them, unfortunately, have plenty of practice. For that matter, what about us patients? When someone discovers they have a serious medical situation on their hands, there are people who need to know (see box at right): wives, husbands, children, parents, brothers and sisters, employers, and others. (Continued, far right)

MY FATHER BROKE THE NEWS My mother had cancer my entire life. She was diagnosed with Hodgkins Lymphoma while pregnant with me. The obstetrician noticed a tumor while doing an ultrasound. As I grew older I realized how serious her cancer was. I watched her undergo numerous rounds of chemotherapy and radiation. She would lose her hair and be bedridden for months on end. When I was 7, she was transferred to Emory University in Atlanta for 3 months to undergo a bone marrow transplant. I remember she was very weak and had even more scars on her body when she came home. We thought she was cured, but a few years later the cancer returned. She went through more chemotherapy and more radiation yet never seemed to get better. We celebrated my 12th birthday at University Hospital. I will never forget the day I came home from school and my father called my brother and me into the living room. “Boys...I have something I have to tell you. Your mother is not going to make it through this time,” he said as he started to cry. I had never seen my father cry before. He grabbed my brother and me and hugged us tightly. I will never forget that moment as long as I live. + — Ryan, Augusta, Georgia

It’s not just what; it’s who, when, where and how Being the bearer of bad news is a difficult and unpleasant chore, indeed (see “From the Bookshelf,” page 11). Just ask any police officer who has had to inform family members of the tragic results of a highway accident. They don’t do it by mail or e-mail, by text or by telephone; they do it the old-fashioned way: in person, face to face. Therein lies a lesson for the medical profession, which sometimes breaks serious news to patients by sending them test results through the mail, or perhaps even worse, when a member of the doctor’s staff who knows nothing of the diagnosis calls to schedule an accelerated follow-up appointment. A patient’s imagination can run wild in such situations. No one expects doctors to resurrect house calls for delivering bad news, but face-to-face is good, and it’s recommended by medical journals (like Community Oncology) and professional organizations (like the American Academy of Family Physicians), along with a few other excellent pointers we can all use when there is difficult news to share. The picture at left is a good summary of the who, what, when, where and how, and it suggests the noted S-P-I-K-E-S strategy for delivering bad news. You’ll note, for starters, the private setting.

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The news isn’t being delivered in a crowded hospital hallway or by telephone. This element — Setting — is the opening S of S-P-I-K-E-S. It includes who is present. Dr. Robert Buckman, the developer of the S-P-I-K-E-S approach (as we said above, see page 11), recommends that the health care professional always have the person bring along someone else. It’s another, possibly less emotional set of ears, and may provide an alternate driver for the post-news drive home. P is for Perception. As in, the family’s perception. Establish where they are right now, and you might avoid hitting them with a bolt from the blue. Exploratory questions like “What have you been told so far?” or “What is your understanding of the situation?” can prevent needlessly covering ground that has already been covered, or inadvertently starting in the middle of the story. I is for Invitation. Some families want every last detail —the truth, the whole truth, and nothing but the truth — while for others the broad brush strokes of the big picture — just the facts, ma’am — is more than enough. It doesn’t hurt to ask, either directly or by offering only the broad strokes, then wait to see if additional information is desired. K is for Knowledge. The knowledge that the health care provider is about to share can be lifechanging. It can be earth-shattering. Dole it out sparingly and gently. Ease into it: “I wish I had better news to bring you” isn’t specific bad news, but it starts the process of preparing the patient or the family for what’s coming. Bad news is best delivered in short sentences, not long paragraphs. People who are good at this painful task say the more information they give out, the less is absorbed and remembered, so take it slow. E is for Empathy. If you (the health care professional) have been through this before, perhaps in your own family, you may be able to honestly say, “I know how you feel.” Otherwise it’s best to acknowledge how difficult it must be and then say something certifiably true (not just sympathetic), such as, “I know this is a very trying time, but I/we will help you as much as we possibly can.” S is for Summary & Strategy. This can be the most important part of the S-P-I-K-E-S protocol. After all, what is said last is often remembered first. It’s good to quickly and clearly summarize the situation as it exists at that moment, perhaps even asking the patient or family member to repeat back what you’ve just told them. Then briefly explain the next step in the process, whatever that might be — “We’ll take her into surgery and should be done in about an hour,” or “Can we contact a funeral home for you?”

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or “We’ll start physical therapy within the next couple of days, and by this time next month we’ll know a lot more.” Granted, much of this sounds like what happens when a doctor goes over big news with a patient or the family, but any and all of it can and should be applied when ordinary non-medical people pass along information to family members. One Medical Examiner reader told us her husband had a routine doctor’s appointment one day. He called her at her job and abruptly and unexpectedly blurted, “Your husband has cancer.” There was nothing particularly urgent about his news. He wasn’t, for instance, admitted on the spot. The beginning of treatment was weeks away. The news could have waited. At least a few letters of S-P-I-K-E-S (like Setting and Empathy) could have been employed. Another Approach The American Academy of Family Physicians suggests an ABCDE mnemonic for its recommended approach to breaking bad news: A = Advance preparation Know the relevant clinical information. Arrange for adequate time in a private, comfortable setting, and instruct staff and colleagues: no interruptions. Rehearse what you will say. B = Build a therapeutic environment & relationship Be personable (introduce yourself to family members present) and discreet. “I’m afraid I have some bad news to deliver, so is there anyone who would like to leave now, or someone still out in the hallway who should be included?” C = Communicate clearly Avoid medical jargon, but don’t use euphemisms. Be direct yet compassionate. Proceed at the patient’s/family’s pace. D = Deal with family and patient reactions They can range from inconsolable grief to denial to angry accusations. Now is not the time for arguments, criticizing or defensiveness on the part of the healthcare professional. Stick with the agenda. E = Encourage There is no situation that does not offer the opportunity to offer hope and encouragement. As illustrated in the photos above and on page 1, the power of touch and human contact can also be of great comfort. +

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AUGUSTA MEDiCAL EXAMINER

The Money Doctor Financial Planning Birthdays to Remember enrollment deadlines. It is important to note that if you are already receiving Social Security benefits, you will automatically be enrolled in Medicare Part A (hospitalization) and Part B (medical insurance). If you are still working, the required enrollment may be delayed, but you will want to review the specific rules for Medicare enrollment before delaying. Age 65 to 67 & Social Security Between ages 65 and 67, individuals can receive full Social Security benefits. The age of qualification varies depending on your birth year. Statistically most retirees opt to take Social Security retirement benefits early; however, waiting or delaying will allow you to take advantage of the 8% annual increase through age 70. Age 70 & Social Security If you have delayed taking Social Security benefits, you will want to file now. There is no additional benefit to postponing Social Security payments after age 70. Age 70 1/2 & RMDs Beginning in the year you turn 70 1/2, you must take required minimum distributions from tax deferred retirement accounts on an annual basis. The calculation of your required minimum distribution should be approached diligently as the IRS has numerous life-expectancy tables and penalties if done incorrectly. Age Based Tax Exemptions Many states, counties, and cities provide aged-based tax

exemptions for retirees. One people often forget to apply for is the property tax or school tax exemption for homeowners. Many counties will allow you to apply for an exemption after a certain age. It is always a good idea to check with your local government to make sure you are taking advantage of these. Your CPA can provide guidance for any aged-based income tax breaks you may qualify for, since many states — including Georgia and South Carolina — offer income tax breaks for retirees. There are also a few unique and more complex non-aged based rules for 457 and 403(b) plans regarding additional contributions and penalty-free withdrawals. Having a financial planner help you understand the above rules can help you save money and avoid unnecessary expenses and penalties along the way. We value and enjoy the longterm relationships we share with our clients which allows us to help them navigate the various rules along the way. + by Clayton Quamme, a Certified Financial Planner (CFP®) with Preston & Cleveland Wealth Management, LLC (www. preston-cleveland.com). Preston & Cleveland is a fee-only financial planning and investment advisory firm with offices in Augusta, GA and Columbia, SC.

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

n early childhood each birthday brings great anticipation and excitement. It is always fun to watch children track their half birthdays so they can tell everyone if they are getting closer to the next number. As we get older the excitement and rush to reach the next number diminishes, but several birthdays are critical milestones for financial planning and you can benefit from planning ahead and tracking half birthdays again. This list provides a summary of the important birthdays we track to help our clients with financial planning. Age 50 & Catch-Up Contributions Workers age 50 and older can contribute an additional $6,000 per year in 2015 to 401(k), 403(b), and 457 plans. You can also contribute an additional $1,000 to traditional or Roth IRAs. SIMPLE plan participants can contribute an additional $3,000. Age 55 & Early Withdrawals Workers in a 401(k) plan can withdraw money and avoid the 10% early withdrawal penalty if they meet certain requirements. The major requirement is that you must have retired, quit, or been fired from your employer after age 55. Age 59 1/2 & Withdrawals At age 59 1/2, participants are able to start making withdrawals from qualified retirement plans without incurring a 10% federal income tax penalty. It is important to consider the tax implications as distributions from traditional (not Roth) retirement plans are taxed as ordinary income. Age 62 & Social Security At age 62, workers have their first opportunity to take Social Security retirement benefits. Social Security offers many different filing options and strategies, so taking the time to understand all options before the oldest spouse reaches age 62 can increase your retirement income significantly. Taking benefits early can permanently reduce your monthly benefit up to 30% and if you are still working you will be subject to the earnings limit reduction if you earn above the annual limit ($15,720 in 2015). Age 65 & Medicare At age 65, individuals qualify for Medicare. The Social Security Administration recommends applying three months before your 65th birthday to make sure you meet the required

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www.AugustaRx.com The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of 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. © 2015 PEARSON GRAPHIC 365 INC.

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We are looking for people who: • are 30 years of age or older • have a diagnosis of type 2 diabetes • have kidney problems related to their diabetes • are currently taking medicines to control their kidney problems If you choose to take part in the CREDENCE Study, you will be looked after by an experienced study team who will carefully monitor your health and support your diabetes management. You will continue to take your current diabetes medications. TM

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OCTOBER 16, 2015

AUGUSTA MEDiCAL EXAMINER

#9 IN A SERIES

OLD NEWS

Who is this?

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

he man you see pictured above is responsible for the best-selling poster of all time. No, it isn’t the iconic Farrah Fawcett poster of 1976, which sold 20 million copies. The best selling poster, with far more than 20 million copies in print, was designed by a Dutch doctor, Herman Snellen. It’s the poster hanging in practically every doctor’s office in the known universe, the standard wall chart for vision tests featuring lines of progressively smaller letters beginning with a giant letter E. Developed in 1862, it’s still known by its inventor’s name: the Snellen Eye Chart. Born Feb. 19, 1834 in Zeist, Netherlands,, Snellen received his medical degree in 1858 from Utrecht University, specializing in ophthalmology. Back then, there was no standardized eye test. A doctor might hand a patient a book or newspaper and ask him to read a sentence or two at varying distances. Someone could easily be diagnosed as having vision troubles who was simply a poor reader. Snellen realized an improved method needed to be developed, and he began experimenting with charts using symbols. Finding that it was sometimes difficult for patients to describe the symbols accurately (and therefore difficult for the physician to determine how well the patient was seeing the symbols), Snellen quickly moved on to letters. But not just any letters. Snellen actually designed a specialized custom font with letters called opto-types, all of which are built on a 5 x 5 grid. There are no skinny letters like an L next to a fat letter like an M or a W. All have the same height (5 squares), width (5 squares) and line thickness (one square, or one-fifth of the grid). There are a number of newer versions of the Snellen Eye Chart featuring slightly different fonts, and versions for people who cannot read — the so-called “Tumbling E” for example, which has only the letter E facing left, right, up or down — but all of them are essentialy minor tweaks on Snellen’s original 153-year-old design. Snellen died in 1908, just a month shy of his 74th birthday. +

PAYING FOR WHAT YOU DON’T GET

t has been five years since my last move and things have changed. When I called to schedule the transfer of my satellite service, the pleasant customer service rep I spoke with offered me three months of free generic movies and three months of free Showtime, Encore and Starz. This deal began before the move and would continue until sometime in November. On moving day the installer called early, letting me know he was on the way. My helpers were already on site and joked that, of course, my TV would be the first thing in the door. The tech was not a man who was happy in his work. He was on site and gone quickly, and had me finger-sign his smartphone in three different places. I made the classic mistake of only asking what I was signing once. I was dealing with workmen finishing the bathroom while friends were painting the living room. If the Three Stooges had shown up, they would have retreated quickly; it was that chaotic. I later learned I had signed up

for a protection plan at $7.95 a month which is $95.40 over a year’s time. If I don’t have the plan, it will cost me $50 for a repair. When I called to complain I told the customer service rep I’d take my chances. After the tech left, I realized my promised free channels weren’t available. Even after several calls and two visits from techs, the channels were still not coming through. I finally asked them to discontinue the channels so I could be done with the frustration. I was told they would be glad to discontinue the channels I wasn’t getting, but because I hadn’t had the free service for a minimum of thirty days, there would be a fee. It took a call to a supervisor and a fair

amount of my time to get this fixed. How do you justify charging for discontinuing a free service?! When I told this story at my office, a co-worker shared her father’s experience with a cable provider. He had stopped the service and had a credit of $56. He asked when he could expect his refund. He was told they didn’t issue refund checks but he could use the credit toward his first billing period if he reinstated the service. He pointed out he severed his relationship with their company due to poor service and now they were stealing his money! As of this date, his situation is not resolved. I should have asked what I was signing on all three phone screens, but it never occurred to me the tech would sign me up for an optional service without my knowledge, just as it never occurred to me he wouldn’t do his job. I was wrong on both counts. My first clue should have been his poor attitude but I didn’t have the time to babysit his job performance given the situation. I guess I have only myself to blame for expecting to receive unsupervised, professional service from an employee of a major corporation. +

MYTH OF THE MONTH Cold weather means colds We have all heard this one: “As soon as the weather turned cool, I came down with a terrible cold,” or “Silly me: I went outside in cold weather with wet hair — and I forgot my jacket — and got my death of a cold!” This myth has persisted in the face of modern science that has clearly established that colds are caused by viruses, not thermometer readings. If this age-old myth is true, how and why would people get colds in the summertime? The answer? The same way they do in spring and fall and winter: by contact with a virus from airborne droplets unleashed when someone with a cold coughs or sneezes. You

can inhale their germs, or perhaps you shake hands with an infected person or touch a phone or door handle that someone who has a cold recently touched after coughing or sneezing. “But wait,” someone says. “If cold weather doesn’t cause colds, then why do people get more colds in the winter?” Simple. People spend more time indoors in the colder months in closer proximity to others, making it easier for viruses to be transmitted from one person to another. + — by F. E. Gilliard, MD, Family Medicine 639 13th St Augusta, GA 30901 706-823-5250

OCTOBER 16, 2015

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW res? ABOUT 27 INCHES

k good eno r skin can ugh cer? son.”

eading people and their body language is an important part of everyday life. Regardless of your profession or social standing, you consciously or subconsciously read body language all the time. You’ve seen the Texas Hold ‘Em poker tournaments on TV. A judge in Texas recently ruled that Texas Hold ‘Em is a game of skill, not a game of chance. k

So what is the skill? You can see only the two hold cards that you have, and you do not know what the other players have. Then in slow succession 5 more cards are turned up in the middle of the table and whoever has the best hand wins. The skill is in knowing what the other players are holding in their hands. How do you know? You don’t know for sure, so you must use fuzzy logic, which

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t s e B means you must make decisions without complete information. That’s where reading body language, facial expressions, vocal tones and unconscious tells all come into play. Let me give you an everyday example that you already use subconsciously. You see people from a distance talking at a church gathering or the mall. You are too far away to hear their tone of voice or their words. Your mind tells you whether they are friendly or hostile conversations based on facial expressions or hand gestures. Everybody knows that. What you may not know is that your mind has a subconscious builtin measuring device. Your American mind can immediately measure 27 inches. It is a cultural thing. (This does not work in certain foreign cultures.)

e n i c i d ME

Here is how it works: you see two people facing each other. If their noses are 27 or more inches apart, you get a subconscious mental read that is neutral. If their noses are closer than 27 inches apart, your subconscious mind says “affection or aggression.” Less than 27 inches says one is invading the others’ space. Was it invited? Or is threatening? Then you look for other subtle signs to decide which of the two is more likely. Are the lips smiling? Or clinched? Does one seem to want to move away? Does the other follow? Do both seem comfortable? Are fists clinched? The list of secondary signals is nearly endless. Certain professions require skill in reading body language. Who reads body language? Doctors, lawyers, teachers, police officers, judges, card players, athletes, and you. It is fun to practice at

the mall. Take a seat and read people. When you do it consciously, you will find that you get better quickly. Here are few tips to add to your reads: • People who lie blink more often. • People who lie avoid looking you in the eye. • People who lie fidget a lot. • People who want something from you smile too much and at inappropriate times. • People who stand too stiff have negative thoughts. Make your own list and learn that you really don’t have to hear the words to know how a person feels. Watch presidential debates without sound. At the end you will know whether or not you can trust the speaker. Unless you have already decided no politician can be trusted. + 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 706-306-9397.

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I prayed it wouldn’t happen to me. came into this world as a normal, healthy, bouncing baby boy. A few years later my twin brothers came along. Shortly after their birth David, one of the twins, began to exhibit weird behavior and was constantly crying in pain. It turned out that he had type 1 diabetes. If it wasn’t for the keen eye of a nurse who had seen this behavior before, we might have lost him then because neither of my parents knew anything about diabetes. A year later my other twin brother, Joel, was also diagnosed. Because of my brothers I witnessed diabetes first hand. Their treatments included shots, medication, and blood tests. I watched my brothers as infants taking insulin shots on a daily basis and saw the effort my mom had to go through to take care of them. I was just thankful that I didn’t have

diabetes and I prayed that I never would. Then it happened. Just before my 11th birthday, I was spending the night at a friend’s house when I became extremely thirsty. I dreamt of swimming and wanted to inhale the entire pool. Whenever I woke up, I kept asking for milk, basically the only liquid I drank as a kid. No matter how much I drank I was still thirsty, and the urge to keep drinking was uncontrollable. My friend’s mother raised concerns and informed my mother, who knew the signs after all the years she had been dealing with them. The next day my parents took me straight to a doctor. My blood sugar was over 600. (A normal glucose level typically falls between 80 to

WE’RE BEGGING YOU!

120 for diabetics.) Blood sugar that high was life-threatening for an 11 year-old. That was when the doctor told me: I had type 1 diabetes. The doctor commented that it was strange for it to happen like this, since there had never been any history of diabetes in our family. My brothers and I were the unfortunate first. While I was in the hospital, I lost a LOT of weight. Without natural insulin, my body broke down any source of energy it could find from fat deposits and muscle mass. I was hooked up to IV machines for fluids and gradually the doctor began to administer insulin in small doses to help my condition. Eventually, I was allowed to go home. Thus began many years with this life-long condition and all the ups and downs

And then it did.

that come with it. Here I am now, on the eve of my 30th birthday, still dealing with the condition. To say it hasn’t been a struggle would be untruthful. But I’ve been able to handle it with support from my doctors, family and friends. Since I was first diagnosed I’m proud to say I’ve never returned to the hospital for any kind of emergency related to diabetes. I’m not in perfect health by any means, and there have been several times where my blood sugar has gotten high or low, but I can say that I’ve been well enough to stand tall as a strong man. Thanks for reading my story. Stay blessed and stay healthy. + — by Hector Caceres, Jr Augusta, Georgia

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re you a New Year’s resolution fan? Or a resolution hater? Both sides in this annual discussion have their valid points. On the negative side, by the time you read this many carefully made resolutions may have already slipped a little. Statistically, by this date (January 9) 25 percent of all resolutions have already gone down in flames; that many usually fail within the first week. By the six-month mark the failure rate is about half. And by this time next year, the wreckage of 88 percent of all those shiny new intentions of last week’s New Year’s Day 2015 will lie strewn across the landscape. On the plus side, that means a fairly decent 12 percent of all resolutions are achieved after a full year. Building on that positive note, making New Year’s resolutions is evidence of one of the finest aspects of human nature — that we continuously evaluate ourselves and constantly strive to improve, to be better husbands or wives, better moms and dads, better employees, better bosses, and just better human beings. The typical resolutions reflect those basic desires: the #1 resolution every year is always some form of better health. Lose weight. Get more exercise. Eat less junk food or fast food. Eat less, period. Quit smoking. Drink less, or quit altogether.

-HOM E CO P Y! TM

• MED

JANUARY 9, 2015

ICINE

• WEL

LNESS

Who is this? See page 3.

S Specific

M A Measurable

Achievable

You really can’t fault anyone for such noble goals. After all, health is the ultimate wealth. It’s the currency that makes every other endeavor in life possible. Speaking of currency, improving finances is, broadly speaking, the second most popular resolution category. Common examples include establishing and/or sticking to a budget; saving more; cutting impulse buys; getting a better job, a raise, or a promotion. The third-most common resolutions might be categorized as self-improvement: read more; temper control/ anger management; reduce or manage stress; watch less TV; get more education: learn a new language, skill, or hobby; improve your marriage and other personal relationships, and so forth. All of these are worthy goals. They are well worth pursuing, even if that means getting past occasional setbacks. Since failure is always an option, it’s good to expect it and be ready to keep making progress. There is nothing magical about January 1. If you haven’t made some kind of self-improvement goal, it’s never too late. If you’ve started and failed already, restarts are always allowed. Whatever you set your sights on, keep the letters shown below in mind, as well as what they stand for. Please see RESOLVED page 2

Relevant

Time-specific

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OCTOBER 16, 2015

AUGUSTA MEDiCAL EXAMINER

Southern Girl Eats Clean

Tomato & Roasted Red Pepper Soup

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Cooler temperatures are finally here. Autumn always brings to mind hearty soup and stew recipes. There is something comforting about coming home to a warm house, a fire in the fireplace and a delicious soup for dinner. I have been craving tomato soup lately. You know, a really yummy, thick soup that you can dunk your bread down into? In my old life, I used to heat up a can of Campbell’s tomato soup and make cheese toast with white bread and that vile bright yellow American cheese. It was one of my favorites unfortunately. I have tried to find a good pre-made tomato soup at the supermarket, but many brands have gluten and milk products, and artificial ingredients or preservatives. This recipe is my own creation and it turned out amazing. I added other veggies to the tomatoes as well: carrots, celery, onion, basil and parsley ramp up the nutrition in the recipe. Roasted red peppers take this tomato soup over the top in flavor. The smoked flavor comes through in the Daniel Field finished product and is a 76 Circle K DANIEL VILLAGE great compliment for the San former BARBER SHOP Marzano tomatoes. Smile Gas Tomatoes have huge health benefits. Here are a few: Medical Complex Wrightsboro Road Augusta Mall • Lycopene, a vital antiTue - Fri: 8:00 - 6:00; Saturday: 8:00 - 2:00 oxidant that helps fight and pepper, stir well and Instructions: cancerous cell formation. simmer on medium/low for Roast the red peppers over • Lycopene works to 15-20 minutes. the flame of a gas range or neutralize damaging free Add in the chopped basil place in a baking dish and radicals in the blood stream. and stir well. Simmer another roast under broiler. Once • The large amount of Kennnel & Daycare 5 minutes and remove from the peppers are charred on Vitamin A in tomatoes may welcoming dogs heat. all sides, remove and place help to improve vision. 30 lbs and under Allow to cool slightly into a bowl, cover with cling • Eating tomatoes without and serve with a garnish wrap and let sit for at least 10 the seeds has been shown in 5873 Huntington Drive of crumbled goat cheese if minutes. some studies to lower the risk Grovetown, Georgia desired. + Once the peppers have had of kidney stones or gallstones. (706) 840-3141 a chance to cool, uncover and • Due to their potassium and * Some of the information on the health www.boardwalktobarkplace.com use a paper towel to wipe the Vitamin B, tomatoes help benefits of tomatoes from http:// charred outside skin off the healthmad.com/nutrition/10-healthlower blood pressure and pepper. It should come off benefits-of-tomatoes/ cholesterol levels. This can very easily. Cut the peppers in reduce the risk of stroke and Alisa Rhinehart writes half, remove seeds, chop into heart attacks. the blog www. 1 inch chunks and set aside. Happy Fall y’all! Enjoy! southerngirleatsclean. In a medium-sized sauce com She is a working pan, heat olive oil over + Ingredients wife and mother medium to high heat. • 1 Tbsp. of extra virgin olive living in Evans, Add the chopped onions, oil Georgia. Visit carrots, celery, garlic and • 2 - 28 oz. cans of San her blog for more recipes and 1/2 cup of vegetable broth Marzano tomatoes information on clean eating. to the sauce pan. Reduce • 2 red bell peppers Please support them. They make this newspaper possible. heat to medium/low and • 1 small yellow onion allow to cook, stirring often • 1/2 cup of carrots, chopped until all vegetables are done, • 1/2 cup of celery, chopped approximately 8-10 minutes. • 4 cloves of garlic, crushed Once vegetables are • 2 Tbsp. of fresh flat leaf softened, remove from heat parsley, chopped COMFORT IS SOLD BY THE FOOT! and place in a high speed • 1/2 cup of fresh basil, blender. • Comfort and therapeutic shoes, • Diabetic fittings chopped Add both cans of tomatoes • 2-1/2 cups of vegetable boots and sandals • Board Certified Pedorthist to the blender along with broth • Twenty major brands, the largest • Walk-ins welcome the roasted red peppers and • 1 tsp. of crushed red pepper chopped parsley. selection in the CSRA • M.D., Podiatrist, Chiropractor, (Less if you prefer) Blend the tomato/vegetable • Custom Orthotics and PT referrals welcome • 1 tsp. of onion powder mixture until well blended, • 1 tsp. of garlic powder 11th Street at Walton Way approximately 3 minutes. • 2 tsp. of salt (I use Real Salt) (on 11th between Johnson Motors and the new Integrity Medical) Pour the mixture back into • 1 tsp. of cracked black (706) 434-0129 the saucepan and add 2 more pepper MON-THUR: 9-4 • FRI: 9-2 cups of vegetable broth, the • Goat cheese crumbles for www.southerncomfortshoes.com crushed red pepper, onion garnish powder, garlic powder, salt

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OUR NEWSSTANDS Medical locations: • Children’s Hospital of Georgia, Harper Street, Main Lobby • 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) • Augusta U. Hospital, 1120 15th Street, South & West Entrances • Augusta U. Medical Office Building, Harper Street, Main Entrance • Augusta U. Medical Office Building, Harper Street, Parking Deck entrance • Augusta U. Hospital, Emergency Room, Harper Street, Main Entrance • Augusta U., 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... 800+ doctors offices throughout the area for staff and waiting rooms, as well as many nurses stations and waiting rooms of area hospitals.

OCTOBER 16, 2015

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.

INSURANCE PROGRAMS THAT CAN SAVE YOU MONEY

know it’s not normal to think about insurance companies saving the patient money, but it can be happen. Insurance companies are starting to use good health habits for the consumer to help everyone save money. The theory is that if people make changes that lead to a healthier lifestyle, then there will be fewer (and lower) medical bills for the insurance company to pay. This will save the insurance company money. In return the insurance company offers discounts to the consumer for making these healthy lifestyle choices. These savings can take the form of a reduction in the person’s insurance premium, or discounts on merchandise from an online store. So both sides can end up saving money and total healthcare costs in America can finally start to go down. Let’s take a look at how one of these health incentive programs is set up. One such program includes a health assessment followed by the establishment of specifically tailored goals designed to promote your health. Typical goals might be weight loss to improve your body mass index (BMI) or lower readings for total cholesterol, blood pressure or blood sugar. To achieve these goals you must make changes to your diet or exercise habits. By doing so you accumulate points. So what do you have to do to accumulate points? You get points by taking the health assessment as well for meeting your goals. You also get points for a variety of healthy activities. These activities may vary depending on the specific program, but can include anything from tracking your workouts to getting certified in CPR or first aid. Some programs will give you points for donating blood, being nicotine free or participating in health

screenings, as well as having a dental exam. From a pharmacy perspective you can gain points by taking your medicine on time. One of our patients was enrolled in an insurance program that used an electronic vial that tracked when the vial was opened to record when and if the medicine was taken correctly. So as you can see there are a number of ways to accumulate points, and if you accumulate enough points, you can earn a discount or savings as mentioned above. Make no mistake about these programs. They are designed by the insurance companies to reduce their healthcare costs — but they benefit patient health too. The number of points required are reasonable, but by no means easy to amass. They require you to meet your goals, but more importantly to maintain a healthy lifestyle throughout the year. If you want to work hard for a few months to meet your goals and then revert back to your old ways with the thought that you can still keep raking in the discounts, you may be in for a disappointment. These programs are designed for people who want to make long-term lifestyle changes to get healthy and stay healthy. That being said, there is no bad thing about getting healthier and getting savings on your insurance premiums, so many feel it is well worth the extra effort. So check with your insurance company about ways to save money on your premiums. In next issue’s article, look for specific information about the coming year’s Medicare prescription plans. + Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson. Questions, comments and article ideas can be sent by email to cjdlpdrph@bellsouth.net

Ah, Fall! Fall is a great season, but if you’ve taken “fall” a bit too literally, we have lots of ways to help you get back on your feet.

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OCTOBER 16, 2015

AUGUSTA MEDiCAL EXAMINER

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

SALT: WHAT’S THE BIG DEAL? by Courtney Ross, Augusta Area Dietetic Internship Program

We’ve all been hearing a lot about the current state of the American diet and the health of Americans in general. Sodium (salt) has been a hot topic as of late and it can be a tricky thing to cut out of your diet. Why should you care? High sodium diets can cause blood pressure to rise in salt-sensitive individuals, and this can put stress on your heart. With the increase in heart disease this country is facing, it is time to learn how to regulate our salt problem. Contrary to what most people believe, we get the majority of our sodium intake from sources other than the salt shaker. Sodium is already in many foods we eat before we add salt to them, which is where the problem with adding salt comes in to play: sometimes foods high in sodium don’t taste salty. Processed foods and restaurant foods are extremely high in sodium due to the preservatives that are in these foods to keep them shelf stable, and to increase the flavor profile to make us want to eat it. In fact, “value meals” from popular fast food chains usually have more than the entire daily recommended salt intake in just one meal! The recommended daily intake for sodium is about 2300mg per day, and 1500mg per day if you are at risk for heart disease. However, the average daily intake for Americans is about 3400mg, according to the American Heart Association, which is more than double the 1500mg recommendation for heart

health. This large gap between what we’re doing and what we should be doing is mainly due to the lack of knowledge about the sodium content of foods we eat every day. Any foods that are prepared in advance (think frozen or boxed dinners), or that is made in a restaurant is likely to be extremely high in sodium. Couple this with shaking some salt on top, and the sodium content of that meal is sure to be over the recommended amount. How can we cut back on the amount of sodium in our diet? Read your labels. Reading nutrition labels is a sure way to combat high sodium foods in the diet. If the nutrition label lists less than 140mg per serving of sodium, then it is considered a low sodium food. Shoot for foods that list less than 20% of the daily value of sodium. This is based on the average recommended sodium intakes. Look for the words “soda” or “sodium” when

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reading the ingredients list. Eat fresh. Fruits and vegetables are naturally lower in sodium, so eating more of these will help lower your sodium intake and help you follow a healthier diet. Frozen fruits and vegetables without added sodium are also great low sodium choices. Fresher meats are likely to have less preservatives in them- but check the labels. Make your own frozen dinners and soups. Although frozen meals and pre-made items are more convenient for our busy schedules, these items often have the highest sodium levels in the grocery store. Therefore, making your own versions will cut the sodium content way back. Not to mention it is usually cheaper. When eating out, check online first for the nutrition info to learn just how much sodium is in the food you are about to order. Shoot for grilled entrees that are light on sauce. With salads, beware of the dressings! Many of them can be loaded with sodium too. Order water as your drink—it’s free, as well as free of sodium. Use the salt shaker sparingly if at all. Even though the majority of America’s salt problem isn’t coming from the shaker alone, it is still contributing. Adding salt to foods that are already sodiumpacked is greatly increasing the sodium content of that meal. Considering that just 1 tsp of salt equals 2300mg of sodium, it is easy to imagine how the sodium content can pile up. That single teaspoon of salt will put you over the healthiest daily recommended salt limit. When it comes to salt/ sodium, awareness is the first step to cutting back. By following the tips above you will be able to cut excess sodium out of your diet and be healthier overall. + For more information, visit the American Heart Association’s website: heart.org

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OCTOBER 16, 2015

AUGUSTA MEDiCAL EXAMINER

NEW

FEAT

U RE

THE DOCTOR IS IN !

Curbside Consult: Urology Q & A by Darren Mack, M.D.

Q: Can Proscar or Avodart prevent me from getting prostate cancer?

that either transform low grade tumors or normal prostate cells into high grade tumors.

Q: If I am overweight and have Low T, will regular exercise boost my testosterone?

A: There are no established guidelines to prevent prostate cancer with any medication. To date, there are two placebocontrolled trials for preventing prostate cancer with 5 alpha reductase inhibitors. The “REDUCE” trial showed a 22.8% reduction in prostate cancer incidence and lower incidence of complications of BPH, and the Prostate Cancer Prevention Trial or PCPT showed a decreased incidence of low grade tumors as well. PCPT was stopped early, however, due to an increased incidence of higher grade tumors. This effect is thought to possibly be from honed detection of smaller tumors because the prostate was overall, smaller by using this medication. Despite some decreased incidence of prostate cancer, the lack of a survival benefit is enough to not recommend any medical treatment for prostate cancer. The crux of prostate cancer prognosis currently lies in identifying the genetic markers

Q: I have a kidney stone. Can I just dissolve it with medicine or my diet?

A: Yes, it likely will. Obese men are more likely to have low testosterone levels, and regular exercise diminishes excess fat, stimulates blood vessel growth, and assists the body’s hormonal processes. Exercise is good for those of us in good health, and absolutely crucial as a first-line treatment in those who have obesity and a host of other cardiovascular risk factors like high blood pressure and diabetes. It will not prevent the natural decline of testosterone, but it does maximize our potential to stay healthier longer. +

A: It depends. Non-obstructing uric acid stones have been successfully dissolved with medical therapy. One must see a physician or a kidney stone specialist such as a urologist to ascertain the type of stones they have, and correct the cause of any underlying metabolic disorders that can cause stones to recur. Sometimes medical dissolutive therapy can take several months, but it has the benefit of generally being less costly and carrying much less risk than surgical interventions. Follow-up imaging with a stone protocol CT or ultrasound is utilized to follow the response to both medical dissolutive and surgical therapies. Dietary changes are important in passing small calculi and in some cases preventing stones from recurring, but they do not have a role in dissolving existing stones.

Dr. Darren Mack is a graduate of the Medical College of Georgia at Georgia Regents University and is David Russell Photography a urologist with offices in Evans and Aiken. He may be reached at (803) 716-8712 The information provided in this article is not a substitute for an evaluation by a licensed health care provider.

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GUEST COLUMN

Creativity as a wellness strategy by Dr. Chuck Cadle, CEO Destination Imagination, Inc. October is National Bullying Prevention Month. As I begin to write this article and reflect on bullying as an inhibitor to learning, my eyes go to my library shelves full of books and research on educational practices and issues. Research on cognitive development, moral development, expert teaching, gifted and talented curriculum, motivation, behavioral modification, classroom management, diversity and creativity lines the shelves. I had learned from studying this information that psychology is the study of human behavior. Etiology is the study of causes. Ethology is the study of the evolutionarily significant behaviors of a species in its natural surroundings. Ecology is the study of how organisms relate to each other and to their environment. By aligning these theories to developmental psychology, we are attempting to study changes in the behavior of children as they travel through different stages in their lifecycle. Research into developmental stage theories is not new. In the seventeenth century, Jean-Jacques Rousseau discovered that for each stage of development, there were appropriate kinds of activities and learning that come naturally from the situational environment of the child. In the sixteenth century, Johann Amos Comenius and Jean Piaget are known for their research and “stage” theories related to developmental phases. Sigmund Freud and the psychoanalytic movement gave us awareness that life experiences at an early age influence emotional development and attitudes in later life. Erik Ericson’s theory added that children needed to reach a stage of cognitive readiness in order to develop from one stage to the next. These researched theories combine to suggest that neurodevelopment is shaped by the quality and quantity of a child’s learning opportunities and unique biological makeup. So is bullying a learned behavior or the expression of a genetic marker? Maybe the solution to bullying can be found in how we inspire and engage students. I think about the phenomenal opportunities students will have as they enter the new hyper-connected digital and human economy. Advancements in chemistry, pharmaceuticals, life sciences, materials science, computer science and cybersecurity, broadband, mobility, energy renewables, space science, nanotechnology, data storage and cross-border research are creating entirely new career paths for our future workforce. With so many opportunities to inspire and engage students, how is it possible that bullying could still exist? Could the solution be to teach creativity and collaboration by inspiring and engaging students with fun project-based activities such as those offered by organizations like Destination Imagination, First Robotics and Future Problem Solvers? The Partnership for 21st Century Learning has a framework that states “creativity” is both a key element of 21st century learning and a desired student outcome. A recent IBM survey found that chief executives viewed creativity as the key ingredient for future success. Mike Perry, Crayola’s CEO, recently stated, “Creativity is a skill that every child needs.” We must ask why creativity is not a key component of school curriculum. Is it due to the multidimensional and non-structured aspects of creativity? Creativity is the interaction among imagination, cognitive presence, egostrength, conation, aptitude, process, domain engagement and environment by which an individual or group follows the creative process to produce an accepted product that is both novel and useful as defined within a personal or social context. Neuroscience research has found creative thinking to be a whole-brain activity leading us to understand that neural responses to creative endeavors can originate anywhere in the brain. The strength of the neural impulses actively transform thinking and focus; otherwise, a person is just dreaming. These stronger impulses can lead students to persevere and to take educated risks. Creativity couples the environment, previous experience, and possibility thinking together in a connectionist or information processing strategy. Unfortunately, without training, students tend See CREATIVITY page 13

OCTOBER 16, 2015

11 +

AUGUSTA MEDiCAL EXAMINER

From the Bookshelf The blog spot — Posted by James Salwitz, MD, on May 11, 2012. Edited for space.

THE BREAST CANCER NO ONE’S TALKING ABOUT Not long ago a man in our practice died of a disease he never expected: breast cancer. His death was accented by the recent presentation of the largest study to date of male breast cancer. 13,457 men with this illness, more than 50% of all cases in the United States, were followed for the last 10 years. While breast cancer in men is uncommon, with a lifetime risk of 1:1000 versus 1:8 for women, these deaths are still tragic and it is worth a few moments to discuss this disease. The most disturbing finding of this new study is that contrary to what was previously believed, men with breast cancer have shorter average life spans than women. The lead investigator, Dr Jon Greif, who presented the study at the American Society of Breast Surgeons annual meeting, believes that the difference is not in the cancer itself. Rather it seems to be a lack of awareness of the illness. Many men do not even know they can be afflicted with breast cancer. Nonetheless, breast cancer affects over 2,000 men yearly in the United States, with approximately 500 deaths. There are several risk factors for male breast cancer. In men of Jewish background, there is an increased risk if there is breast cancer in the family. Men that carry the breast cancer gene (BRCA1 or BCA2) have up to a 15% lifetime risk (as apposed to 0.5% without). Men who have breast enlargement (gynecomastia), which is often related to medications, are more likely to be affected. Testicular problems such as recurrent infections, injury and undescended testes may increase the cancer risk, probably by changing hormone levels. It appears that cirrhosis increases male breast neoplasms. Men who have had breast cancer in one breast are more likely to get cancer in the opposite breast. Breast cancer cells in men are the same basic type as in women. However, while women get ductal, lobular and non-invasive breast cancer (in situ), men generally only get ductal malignancy. Female breast cancer is “estrogen receptor” positive 65% of the time, meaning estrogen stimulates its growth. In an apparent contradiction, male breast cancer is stimulated by estrogen 90% of the time, and not at all by testosterone. Male breast cancer grows, as in women, as a painless, hard mass. The tumor usually grows behind the nipple, while in women it often grows towards the outer edge of the breast. Unfortunately, because men are generally slow to recognize the problem and get assistance, the tumors are frequently large by the time they are treated. As in women, black patients have poorer prognosis than whites. There is little data on prognosis in the Latino population. Treatment for men follows the same basic rules as in women. While most men undergo removal of the breast (mastectomy), it is possible in some men with larger breasts (and smaller tumors) to treat with lumpectomy. All men who elect to save their breast must be treated with radiation. After surgery, men may require chemotherapy and/or hormonal therapy. This insurance or “adjuvant” treatment is to prevent the growth of microscopic cancers elsewhere in the body. More intensive treatment is given depending on the size and aggressiveness of the original cancer. At this time, there are no recommendations for routine screening using mammograms or monthly breast self-exams for men. If a man has any of the risks noted above, he should speak with his doctor and request professional breast examination as a part of routine checkups. If a man does feel discomfort, swelling or a lump in or near his breast, he should seek medical attention. While uncommon, this illness happens right here in our community and being aware of that risk is the best protection. +

The problem seems to be lack of awareness.

James Salwitz, MD, is an oncologist who blogs at sunriserounds. com. This article is from sunriserounds.com/cancer-101-male-breastcancer/

As this book candidly acknowledges, breaking bad news is not just difficult; unfortunately it’s an inescapable part of the job for just about every healthcare professional, not just oncologists and cardiologists. A podiatrist may have to tell a patient that an amputation is necessary; an ophthalmologist may have the unenviable task of telling a patient that blindness is looming and can’t be prevented; a home health nurse might need to inform a family that the time for hospice has arrived. Even so, practice doesn’t seem to make the task any easier, and there’s always the danger that someone who delivers bad news on a regular basis — an ER trauma surgeon, for instance — can become a bit immune to it all and come across as blunt, insensitive and mechanical. Enter How to Break Bad News — A Guide for Health Care Professionals. Author Robert Buckman, M.D. wrote this book with three primary objectives in mind. First, to reduce the occurrences of bad delivery.

ROBERT BUCKMAN, M.D.

No one is going to get it right every time, but neither does anyone want to be a bad bearer of bad news on a consistent basis. Let’s up our average as much as possible. Conversely, let’s reduce the dread factor. No more, “You tell them!” “No, I can’t! You do it!” Quoting from the book, “The professional’s level of comfort in doing his or her job is an essential part of the equipment and expertise required for the task. Increased confidence translates into increased competence.” Well said. Third, this book is designed to promote and enhance learning from each and every

news delivery experience. That can come from listening carefully to patients and their families, or sharing constructive feedback with colleagues after the fact and evaluating what worked and what didn’t. Those three objectives are addressed in a six-point protocol (see page 2 of this paper) that is offered as a general guide, not a rigid formula. This is a book that should be in the reference library of every medical practice and healthcare professional, including chaplains, psychologists, social workers, counselors, doctors, nurses, EMTs and medical students. Armed with a proven and tested plan of action and the confidence it inspires, what many view as the most disagreeable chore in the medical profession can be handled with skill and sensitivity. +

How to Break Bad News — A Guide for Health Care Professionals, by Robert Buckman, M.D. 240 pages, published in 1992 by Johns Hopkins University Press

Research News vascular health. Desk job antidote A small Univ. of Missouri School of Medicine study has shown that blood circulation in the lower extremities — sometimes called “legs” — is compromised after sitting at a desk or computer for hours. The study also demonstrated a very simple fix. In the study, 11 healthy young adult men spent six hours sitting at a desk. Afterward, blood flow in their popliteal artery — located in the lower leg — was measured and found to be “greatly reduced.” Participants then took a short (10-minute) walk at their own pace. After the walk their blood flow was again measured and found to be restored to a normal, healthy level. A growing body of research suggests that prolonged inactivity is not healthful, but this small study suggests that breaking up the workday on a sedentary job with short walks — whether job-related or purely for health reasons — is a quick and simple means of protecting

The best and worst beverage Got any guesses what they are? That was a trick question. The best and worst are the very same beverage: water. On the plus side: water is the healthiest beverage there is. It isn’t saturated with caffeine and sugar. Speaing of which, by 2017, bottled water sales are expected to surpass sugary soda sales. The downside: the environmental footprint of the bottled water industry is massive. Aside from the billions of empty bottles tossed each year, it takes 3 gallons of water to produce each gallon of bottled water. Municipal safety standards for tap water (the straight source of one quarter of all bottled water anyway) are far more rigorous than for bottled water. Miracle drug update The Medical Examiner has long championed aspirin as a true miracle drug. We even crowned Felix Hoffman, the German

chemist and Bayer employee whose work led to the 1899 introduction of aspirin, as our 2012 Man of the Year. And the proof just keep coming in. The latest evidence to support aspirin’s status as Wonder Drug comes in the form of a new study from the Netherlands. 13,715 patients diagnosed with a gastrointestinal cancer — colon, rectal or esophageal — were enrolled in the study beginning in 1999. Among other things, the study determined how many took aspirin before, during and after their cancer diagnosis and treatment versus those who didn’t use aspirin at all. In short, the study found that across all types of GI cancers, patients who used aspirin were twice as likely to survive at least five years compared with patients who didn’t use aspirin at all, or who stopped taking it after being diagnosed. The findings held up after controlling for various factors like age, sex, the stage of cancer, the type of treatment the patient received, and other non-cancerrelated medical issues. +

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OCTOBER 16, 2015

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS +

by Dan Pearson

Did you hear that As far as I’m What are you, a Nick Chubb only concerned, he shouldn’t Tennessee football fan had one carry or something? have had any. last Saturday?

I don’t follow football at all. Why?

EXAMINER CROSSWORD

PUZZLE

ACROSS 1. Intensive letters 4. Cancun cash 9. Classical composer Maurice 14. Typical brick quantity 15. Dryly amusing 16. Swelling 17. Mythical dwarf 18. Musical composition 19. Field first aid provider 20. Comedian Sahl 22. Bloodthirsty 24. Snee partner? 26. Cheerful; smiling 27. Produce or discharge 29. LPN helper 30. Sorenstam org. 34. ATL news pioneer 36. Less strong 38. Strategy 39. Roman emperor (117-138) 41. Exude; issue from 43. What angry people sometimes want to get 44. _________ Heart 46. Evergreen tree 47. Cincinnati nine 48. Top movie network 49. Indian Ocean sailboat 51. Small ornamental paper mat 53. Challenged 56. Futuristic 1927 film 61. Ready to eat 62. He of 755 home runs 63. Appears 65. State on India’s west coast 66. Statement of beliefs 67. Eskimo dwelling 68. One type of cholesterol (in brief) 69. Glacial gravel ridge 70. Covered with grasslike plants 71. Vietnamese New Year

22 25

27 34

VISIT WWW.AUGUSTARX.COM

Click on “READER CONTESTS”

46 49

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: CAMULAGO

E H T O E E T T I H N V T G ’ E T ’ I N R S T I E A G S E H ’ T T D H N A H H R A R E N E V I D G H N I R

50 53

DOWN 1. Things 2. Middle part of the large intestine 3. Severed ties on Facebook 4. MD’s Rx guide 5. Greek god of love 6. Echolocation 7. Traditional name for Satan 8. Person who creates catchphrases and mottos 9. Send in, as payment 10. Capital of Yemen 11. Most ancient Hindu scriptures 12. Islamic chieftain 13. Like a 51-A 21. Ted Turner’s movie station 23. Not carrying weapons 25. Flightless bird of New Zealand 28. Place to buy oolong 30. CNA supervisor? 31. Tennessee Williams, for one 32. Hinged barrier

— Lucille Ball

33. Afresh 34. Sonny’s co-star 35. Central part of a church 37. State of suspended animation or greatly reduced metabolism 40. LPN supervisor? 42. Poor concentration, impulsivity, etc. (Abbrev.) 45. Paine, for example 50. Rowboat power 51. Organ add-on 52. Traffic sign word 54. Lyric poem written in couplets 55. Distributed cards 56. Trademark defensive chemical 57. Heads of corn 58. Long difficult journey 59. Traveled by bike 60. Haze 64. Milk source? Solution p. 14

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.

3 6 6

X A M I N E R

2 7 8 9 1

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.

1 2 3 4 5 6 7 8 9 G 1 2 3 1 2 3 4 5

P 1 2

1 2 3 4 5 6 E 1 2 3 1 2 3 4

1 2 3 4 5 1 2

— John Ortberg

1.TURFTMEGG 2.VEEPIOHIO 3.TREVEGA 4.NIGHN 5.STIN 6.GV 7.I 8.N 9.G

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

OCTOBER 16, 2015

THE BEST MEDICINE ha... ha...

id you hear about the cannibal? He had a wife and ate kids.

How do Mexicans cut their pizza? Little Caesars. A very obese man went to the doctor, who examined him and then told him, “Don’t eat anything fatty.” The man asked “What, no bacon? No burgers?!” The doctor looked at him sternly and said, “No fatty, I said don’t eat anything!“ Moe: Why does Michael J. Fox make the best milkshakes? Joe: No, Moe. I’m not going there. Just stop. Moe: It’s not a joke. I promise. Joe: [sighs] Ok, Moe. Tell me. Why does Michael J. Fox make the best milkshakes? Moe: He uses the freshest ingredients. Customer: I want to return these musclebuilding pills for a refund. Health food store clerk: Why? Customer: They don’t work. Health food store clerk: Why do you say that? Customer: I couldn’t get the lid off.

Moe: What are you so sad about? Joe: My wife left me. Moe: I’m so sorry. What happened? Joe: She said she couldn’t handle my obsessive compulsive habits anymore, but I think that was just an excuse. Moe: Did you try to talk her into staying? Joe: No, I just told her to slam the door five times on her way out. What’s the difference between a hill and a pill? A hill is hard to get up and a pill is hard to get down. What’s the difference between a dirty bus stop and a lobster with breast implants? One is a crusty bus station and the other is busty crustacean. Guy: Damn girl, you must be an overdue library book cuz you have “fine” written all over you! Girl: Damn boy, you must be a smoke detector cuz you are super annoying and won’t shut up! Moe: Guess what? Joe: What? Moe: I just found out I’m color blind. Joe: That’s crazy! Did you have any clue beforehand? Moe: No, it came right out of the yellow. Two goats were wandering through a garbage dump when one found a large reel of movie film and proceded to devour it. “Was that any good?” the other goat asked. “It was okay, but I liked the book better.” +

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.

A little hope can lead to a lot of independence by Vicki Greene When Robert had a stroke this past January, his first response was, “Are you kidding me?” He’s the active one, the guy who bikes during his lunch break and works hard to eat right. A stroke at age 51? Inconceivable. Robert is also that guy who loves his job. As a promotions manager for a local TV station, his days were often long, but that’s exactly where he wanted to be. A stroke changes things, though. After a hospital stay, Robert’s new “workplace” was inpatient rehab, where he worked at daily physical, occupational and speech therapy. The guy who was used to riding 6 miles easy in 40 minutes was now working the left side of his body so he could walk and use his arm again. After a few more months at NeuroRestorative, a provider of postacute rehab to help people with brain injuries relearn activities of daily living, Robert returned to his own home in the spring. Home is supposed to be a place of safety and of comfort, but that’s not entirely the case when you’re challenged with a disability. A longtime supporter of the Walton Foundation for Independence, Robert now needed our help. Many people may not know that along with Walton Foundation’s fundraisers and adaptive sports and leisure programs, we also offer a Hope and Independence Fund that’s designed to help people with disabilities without insurance who have a financial need, offering them a helping hand after they’re discharged home. The name of the fund is no accident. Over Walton’s long history, we’ve found that just a little hope can go a long way to helping people achieve independence. And isn’t that what we all want? The independence to live, work and play successfully in our communities? Our fund helps achieve that by providing assistive technology, ramps and more. It doesn’t sound like much, does it? But when you’re living with a disability, it means the world. Through our fund, we helped Robert install hand railings to help him move around his home safely. We also helped him with plans to build and install parallel bars in his garage so that he can continue his therapy at home. Because Robert’s goal is to walk again. To drive and get back to work. But most of all, “just independence.” + Vicki Greene is the Vice President of the Walton Foundation for Independence, which raises funds to provide resources and programs for people with disabilities in the CSRA. To find out more about Walton Foundation’s Hope and Independence Fund or to donate, visit www. waltonfoundation.net/hope.

CREATIVITY… from page 10

+ +

SUBSCRIBE TO THE MEDICAL EXAMINER 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

13 +

AUGUSTA MEDiCAL EXAMINER

STATE

ZIP

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

to lose their ability for creative imagination the longer they are in school, and tend to learn to think only in practical ways and struggle in tasks requiring ideation. Frans Johannsen, author of The Medici Effect, used the example of a brick to make a point about practical thinking. When you ask people for uses of a brick, the typical first responses from people not trained in creative thinking are solely practical. It is only when you develop a person’s capacity for creative thinking that you receive imaginative or non-practical responses, which lead to new combinations or novel ways at looking at a problem or opportunity. Our world is becoming increasingly complex, and therefore the need to teach students how to think and how to use their creative juices to address change must be a priority for our society. Teaching creativity in a collaborative environment could be a strategy to solving the bullying crisis and be a way to prepare students for roles in the future workforce. If we teach children at an early age to think differently and to develop their curiosity, courage and creativity, then they will begin to see things not as they are but as they could be. This creative change in thinking applied to human beings — their peers and fellow students — could have a positive impact on such problems as bullying, obesity and self-esteem, and foster an ecological improvement. +

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OCTOBER 16, 2015

AUGUSTA MEDiCAL EXAMINER

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

...cleverly hidden (along the very left edge) in the p. 15 ad for GOLDILOCKS & THE MEDICAL EXAMINER Congratulations to JAN McCORKLE, 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 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.

EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC.

SERVICES

HOUSEBOAT FOR SALE Tradewinds Marina, 30 minutes from Augusta. Live at the lake - or have a second home there with NO grass to mow! Recently upgraded. $65,000 Text me at (803) 640-9732 for pics ONE BDRM COTTAGE FOR RENT with off-street parking/carport in Hill area 2 blocks from college. Washer/dryer. We furnish water, you pay electric. $675/$500 dep. No pets. (706) 736-7168; email: ronst79@gmail.com Pictures avail. AUGUSTAGAHOMESEARCH.COM Foreclosures • MLS • Rentals • Builders 706-564-5885 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.

HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706.267.9947

BEING PAID WHAT YOU ARE WORTH? Then make more money! Watch movie all out interview: ExtraMoneyInterview.net

BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673)

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) 295-3033

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

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 or (706) 829-1729

MISCELLANEOUS

PET CARE in Martinez-Evans area. Dogs to 40 lbs, $9.00. Cats (1-3), $9.00 For interview/information, phone 706-829-1729

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 WANT TO BE HEALTHY? (Energy, weight loss, mental clarity) Go to gethealthyat.le-vel.com See video and Facebook. Sign free as customer.

FIND SERVICE PROVIDERS • GET RID OF UNWANTED STUFF Place your classified ad in the next issue of the Medical Examiner. The cost? 25 cents per word. Call your banker to arrange financing, then mail your cashier’s check to the Medical Examiner. (Registered mail recommened for added security)

Thanks for reading the Medical Examiner! The new scrambled Mystery Word is found on page 12

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THE PUZZLE SOLVED C O L O N

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WHAT’S YOUR DRUG OF CHOICE?

I T E M S C H E R

N A V E

U N F R I E N D E D

Augusta Medical Examiner Classifieds

(OURS IS COFFEE)

M A C E

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T R E K

CLASSIFIED ADVERTISING FORM Name Address Work number (if applicable) ( ) Home phone ( ) Category of ad (leave blank if unsure):

.75

1.00

1.25

1.50

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2.25

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3.00

3.25

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3.75

4.00

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7.75

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AUGUSTA MEDICAL EXAMINER, PO BOX 397, AUGUSTA, GA 30903-0397 Total ad cost by number of words as shown above: $

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QUOTATION PUZZLE SOLUTION: Page 12: “I’d rather regret the things I’ve done than the things I haven’t.” — Lucille Ball

The Sudoku Solution

COFFEE IS GOOD MEDICINE

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T C M

P E S O D R O L R O N D S A N K R I I T C W E A K I A N S A C H B O D O I L O P O L N S E O I G R S E

VISIT DRUGOFCHOICECOFFEE.COM

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7 9 5 8 6 2 4 3 1

8 3 6 4 1 9 7 2 5

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OCTOBER 16, 2015

15 +

AUGUSTA MEDiCAL EXAMINER

PROFESSIONAL DIRECTORY DERMATOLOGY

ALLERGY

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

CHIROPRACTIC

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

Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

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

OPHTHALMOLOGY

EMPLOYEE BENEFITS

FAMILY MEDICINE F. E. Gilliard, MD Family Medicine 639 13th Street Augusta 30901 706-823-5250 Industrial Medicine • Prompt appts. Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Thomson: 706-595-7825 Primary Care Rates

CALLING ALL M.D.S!

...SENIOR LIVING

Cornerstone Compassion Center 420 Warren Road Augusta 30907 706-228-5359 or 706-394-6518 Assisted Living • Personal Care

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

THERAPEUTIC MASSAGE

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

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

Group & Benefits Consultants Inc. 3515 Wheeler Rd, Bldg. C Augusta 30909 706-733-3459 Floss ‘em or lose ‘em! www.groupandbenefits.com

Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048

Ideal Image 339 Furys Ferry Rd Martinez 30907 1-800-BE-IDEAL • www.idealimage.com Schedule a FREE Consultation

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

DRUG REHAB

COUNSELING

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

DEVELOPMENTAL PEDIATRICS

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

DENTISTRY

LASER SERVICES

PHARMACY

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

VEIN CARE

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

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

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

Medical Weight & Wellness Specialists of Augusta Maycie Elchoufi, MD 108 SRP Drive, Suite B Evans 30809 • 706-829-9906 www.mwwsAugusta.com

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OCTOBER 16, 2015

AUGUSTA MEDiCAL EXAMINER

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