Oct19 18 by Daniel Pearson

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THEDEATHISSUE OCTOBER 19, 2018

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WHY DO PEOPLE COMMIT SUICIDE?

This worldwide scourge claims around 800,000 lives worldwide every year. There are no easy answers: every case is different. People often try to answer the inevitable “Why?” in simple terms. Depression is one of the most common pat answers, but only about 5 percent of people suffering from depression take their own life. And plenty of people who are not depressed commit suicide. No matter what the cause, Ralph Lewis, a Canadian psychiatrist and author who has treated many suicide survivors said about them in Scientific American, “They say, ‘I don’t know what came over me. I don’t know what I was thinking.’” He went on to stress why suicide prevention is so important: people who are convinced their life is not worth living can feel radically different months, weeks or even mere days later, cherishing their life as precious. Experts say if you’re having suicidal thoughts, do two things. 1. Wait it out. Realize that in time you will most likely experience a change of heart. 2. While you’re waiting, call the National Suicide Prevention Lifeline at 800-2738255 (800-273-TALK) or visit suicidepreventionlifeline.org for Live Chat and more information. Help is available all day and all night 365 days a year, and they offer help especially targeted to veterans, LGBTQ, youth, native Americans, disaster survivors, and survivors of previous suicide attempts. They’re also glad to provide advice if you’re calling about someone else. +

ARE DOCTORS USED TO DEATH?

Doctors are human beings, not robots. The subject of physician grief over the death of patients has not been extensively studied, but the National Institutes of Health collected what data it could find about doctors, interns and medical students coping with death, and the results show grief is a very common emotion in the healthcare field. In one study reported in JAMA, 73.1 percent of medical students reported crying and 16.5 reported “near crying” over the death of a patient and/or the family’s resulting distress. An Australian study found that crying in hospitals was reported by 76 percent of nurses and 57 percent of physicians. An Austrian study of 275 medical personnel found that crying on the job was “prevalent.” B. Siegel, writing in JAMA, admonished, “Please, fellow physicians, don’t cry in empty rooms, in stairwells, or in locker rooms—cry in public and let the patients and staff heal you and see you are human.” Overall, the NIH says “a significant proportion” of physicians and medical students have cried over patient deaths. +

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WHAT TO DO WHEN SOMEONE DIES It is undeniably one of life’s worst moments. A family member has died. It really does not matter if the death was sudden and unexpected or a long time coming. It is still a terrible and bewildering moment that hardly anyone is really prepared to face, whether the death occurs in a hospital or at home. What should you do at that moment? Thankfully the answer is not complicated. If it happens at home, call 9-1-1. Emergency personnel will arrive quickly and provide the assistance and direction you need. If the family member’s death occurs at a hospital or other healthcare facility, one of your first calls should be to the funeral home of your choice. They deal with these difficult situations each and every day and know exactly how to navigate the many details that need to be addressed. +

WHY WERE DEATH MASKS POPULAR? In the days before photography, a death mask was the best way to accurately portray someone’s appearance. They were often used as the basis of busts and statues in memory of the Napoleon’s mask person who died. In “John Doe” missing persons or murder cases, death masks were also used by police to facilitate positive identification by relatives long after the unidentified person was buried. +

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Food for thought: Because of successful vaccination efforts with the 2-dose series of the measles-mumps-rubella vaccine (known as MMR), measles was effectively declared as eradicated in 2000 as an endemic infection in the US (i.e., it was no longer naturally found here, and new cases since then have been the result of reintroduction by travelers from abroad, as in the case of the Disneyland outbreak) However, the number of people vaccinated in the US must reach 95% to achieve widespread “herd immunity” (safety in a group simply because there are not enough people susceptible to a given disease) and keep the measles virus from becoming endemic in this country again. Lower percentages of people vaccinated means the measles virus could reclaim the US as its home once

again. And it would further mean that unvaccinated individuals can no longer rely on the artificial protection conferred by herdimmunity because too many people could get infected and subsequently spread the virus. Further food for thought: the measles virus is incredibly contagious. The CDC estimates that for every initial case of measles, 12 to 16 people will become infected secondarily. That is just how very infectious the measles virus is. It is spread by respiratory droplets or secretions, and people with measles are contagious from 4 days before to 4 days after onset of rash. Now picture this: kids running around a daycare, playground, birthday party. Someone there is coughing and sneezing (no rash yet) and thinks he or she just has a cold. Kids do what

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OCTOBER 19, 2018 kids do best: share germs. Perhaps there is a newborn or infant siblings at home, or an older brother receiving chemotherapy....do you see how easy it is for this virus to spread? For the sake of justifying why I want everyone to care about vaccines and about achieving the desired thresholds to maintain community safety as a whole, let’s review measles real fast. It starts off like a basic cold, with cough, congestion, sneezy runny nose, red eyes, malaise, high fevers. Then the classic rash (red, fine bumps) starts about 3-5 days later, usually on the face fi rst and then spreading downward. So what’s the big deal? Measles doesn’t always stop at just cold symptoms and rash. Complications of measles include ear infections (which can be severe enough to lead to permanent deafness), pneumonia, and infections of the brain (called encephalitis). The complications alone can be devastating. Furthermore, there is a rare chance that a child infected by measles can develop a form of encephalitis years later that can leave them with permanent neurological damage and dementia. So it’s really not just the rash that we need to care about! We classically give it as a 2-dose series at 12-15 months and 4 years of age. A vaccine against the measles virus exists and it works. And it’s safe. The measles-mumps-rubella vaccine works and is safe and it keeps our kids safe. That’s a trifecta! The MMR virus protects those who cannot yet protect themselves. They’re counting on us. Parents, let’s not disappoint them. +

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OCTOBER 19, 2018

WINTHISPOSTER!

The challenge was simple, yet daunting: spell as many words as possible using only the letters in “medical” and “examiner.” Whoever sent us the longest list wins this useful human anatomy poster. How many word possibilities are there? We have no idea, but it is a lot. The winner sent us 142 words! And we only disallowed 2 of them, for a grand total of 140 words. Think that’s a lot? It doesn’t even scratch the surface. Here is a list of a few words we came up with that were not on the winner’s list: 1. meal 2. air 3. crane 4. cram 5. Mexican 6. Mexicali 7. excel 8. dear 9. diner 10. menial 11. medial 12. card 13. rad 14. cad 15. cairn 16. miler 17. rani 18. mama 19. maam 20. nard 21. mina 22. mace 23. den 24. men 25. dace 26. Dane 27. dale 28. dare 29. dine 30. dire 31. dim 32. rim 33. dame 34. deal 35. rear

36. dialer 37. dice 38. reminder 39. rid 40. leer 41. reel 42. mire 43. liar 44. lend 45. mend 46. rend 47. rind 48. narc 49. me 50. lee 51. lea 52. cam 53. lire 54. lira 55. nicer 56. came 57. drama 58. lice 59. rice 60. mile 61. rile 62. deem 63. rex 64. ire 65. idea 66. raid 67. carmine 68. rime 69. dime 70. relax

ARE PEOPLE STILL CONSCIOUS AFTER BEING BEHEADED?

71. remix 72. remail 73. rename 74. remain 75. remind 76. reclaim 77. remade 78. nerd 79. din 80. rein 81. dam 82. damn 83. riled 84. exam 85. nix 86. clime 87. crime 88. declare 89. declaim 90. claim 91. demi 92. mime 93. max 94. Nile 95. maximal

Clearly there were many options to choose from. And the entries were fast and furious. People like anatomy professors, surgeons, and preschool teachers want and need this poster. Alas, only one person could win this fabulous grand prize. And that one person is a Medical Examiner mail subscriber:

BETTY HERRING of Martinez, Georgia

Congratulations, Betty! +

Read her full word list at the Medical Examiner Facebook page: Facebook.com/AugustaRX +

The bad news is that it would appear that they are, although briefly. The good news is that decapitation as an official means of execution is illegal all over the world, with the exception of four countries in the Middle East. No one knows the answer to the question with absolute certainty, obviously, but there is some clinical and anecdotal evidence to suggest that consciousness does not instantly end with decapitation. A 2011 study in the Netherlands tried to establish if the practice of euthanizing lab rats by decapitation was humane. The rats were connected to an electroencephalograph (EEG) to measure their brain activity prior to the dirty deed. After being separated from the body, the rats’ brains continued to show measurable electrical activity in the range and frequency associated with consciousness and thought for about four seconds. The guillotine is often associated with France, which adopted it as the state’s official means of execution in 1792 and then went on to remove as many as 30,000 heads per year, chopping off the last one in 1977. In one case, the 1793 execution of Charlotte Corday for the assassination of revolutionary leader Jean-Paul Marat, the executioner held her severed head aloft and smacked its cheeks. The gathered throngs were astonished to see the expression on her face clearly register indignation. In another case, a doctor attending the 1905 execution of a man named Henri Languille recorded that he spoke to the severed head, calling out “Languille!” The eyes opened and focused on his, then closed. He called again and the eyes opened at looked at him a second time, but not a third time. The doctor described the episode as lasting 25 to 30 seconds. Both King Charles I and Queen Anne Boleyn are reported as appearing as though they were attempting to speak following their decapitations. And in 1989, an Army veteran was in a car accident with a friend who was decapitated, yet looked down at his separated body and, according to the friend, displayed expressions of shock and confusion, then terror and grief before assuming the distant, absent look of death. +

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#77 IN A SERIES

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

by Marcia Ribble

f you had to pick one person in the medical field during the past century who made death the focus of their entire practice, it would have to be Elisabeth KüblerRoss. It was she who developed the well-known “five stages of grief,” also known as “the Kübler-Ross model,” which charts loss through denial, anger, bargaining, depression, and finally acceptance. What people often miss is that the five stages as KüblerRoss originally identified them are not about our grief over someone else’s death. They are instead the stages we travel through when faced with our own impending death: Denial - There must be some mistake. Not me! Anger - After all the good I’ve tried to do, this? Why me? Bargaining - “Lord, please let me at least live long enough to see my grandchild born.” “Dear God, if you let me live, I promise I’ll quit drinking for good.” Depression - There’s no hope. It’s over. Why bother with anything? Acceptance - If I can’t fight it, I might as well accept the inevitable and prepare for it. Over the years since the five stages were fi rst enumerated by Kübler-Ross in 1969, many people have applied them to grieving survivors too. Dr. Kübler-Ross, originally intending to pursue a career in pediatrics, instead went into psychiatry and at the time (the late 1950s) was appalled by the treatment of terminal patients. To illustrate, one of her contemporaries, British nurse Cicely Saunders, the woman known for creating the modern hospice movement in the 1960s, had worked at a hospital called St. Luke’s Home for the Dying Poor. The name itself exudes despair and hopelessness. Kübler-Ross, Saunders and others championed the hospice movement as a means of providing improved and more appropriate care. The philosophy had been to almost ignore terminal cases; there was nothing medical science could do for these people except wait for them to die. The hospice movement got these individuals out of hospitals and their we-must-fi x-it mentality and into hospice facilities that focused on palliative care (from a Latin root word meaning “to cloak”), an approach that focuses on making a disease or its symptoms less severe or painful without dealing with the underlying (and often incurable) cause. Dr. Kübler-Ross made her philosophies well-known through her 1969 book, On Death and Dying, inspired by her work with terminally ill patients. She also was on the faculty of the University of Chicago’s Pritzker School of Medicine, and by her own estimation had taught some 125,000 students important lessons in death and dying, a subject often ignored in medical school curricula. Born in 1926 in Switzerland, Kübler-Ross immigrated to the U.S. in 1958. She and her husband had two children. She died in Scottsdale, Arizona, at age 78 in 2004. +

As last week demonstrated, one important way in which we can improve our opportunities for healthy living is to be prepared for storms. Reading about hurricane preparedness alerted me to the fact that bad weather and dangerous conditions can happen any time of the year. That means we always need to be prepared to care for our needs. But when I think about preparedness, I see a lot of hoping and wishing and less common sense. Looking at the recommended preparedness lists I can see that I am not prepared for catastrophic emergencies. I do not have many of the required and essential components for food, water, and shelter. My documents are not neatly organized to quickly grab and go. My medications are stored in different places in the house and I don’t always have several weeks’ worth on hand. There are a lot of holes in my planning and procedures to ensure I will be OK until help can arrive. If I look at the fate of the people of Mexico Beach following Hurricane Michael, it quickly becomes apparent that my situation after such a disaster would be dire. As a diabetic I am concerned about some of my medications which must be refrigerated. How would I keep them cold if the electricity was out for a year as it has been in Puerto Rico? Even those meds that don’t need refrigeration could be destroyed if conditions were too wet or too cold, or if my house was demolished with little warning to bring them with me. My pharmacy could be inoperable. My doctors could be unavailable to refi ll prescriptions. What would I do? I’m not sure.

Then there are the multiple gallons of water needed per person and per animal. I am so dependent on being able to open the tap and get water immediately. I live in a small home without a lot of storage space for gallons of clean water, and even if I have them, there is no guarantee that they and my home would survive the disaster. I do have quite a bit of canned food, but not necessarily the right kind of canned food. And I do have a manual can opener that works well. But again, that food relies on my home remaining intact. It also assumes that I am still in my home after a catastrophe and not in a shelter, or many miles away from home seeking shelter in an area not affected by the disaster. I have a grill, but no charcoal, no fire starter, and no axe to cut down wood to make a fire. I do have woods behind my home with some old dry wood that would work if I could get to it, cut the wood, and carry it back to my house and through the house to my backyard. I could burn my books, I suppose, but in an emergency, I might not even consider that they could serve that function. I might be too distraught to think well. All in all, it seems really challenging to consider all the possibilities of disaster, let alone all the ways to be prepared for survival in case of a disaster. Perhaps I need a disaster plan for my preparedness plan: 1) Try to keep my phone charged. 2) Remind myself that I am resilient in the face of challenges. 3) If I must leave, take my dog KC with me. 4) Watch Diners, Drive-ins, and Dives for places out of town to eat. 5) Stay connected to people I love so I know they’re OK. 6) When all else fails take a nap. +

OVULATION PRODUCES NEW EGGS EACH MONTH WHICH WILL IT BE? This is a common belief: according to a Yale University study, almost 40 percent of women would agree with the statement in this article’s title. But that statement is false, fake, fiction, a fabrication. In truth, baby girls are born with their lifetime supply on day one, an estimated 1 million eggs.

According to the American College of Obstetricians and Gynecologists, as many as 700,000 of them are already gone by the time puberty arrives. Beginning then, each month the body selects a couple dozen eggs (think of it as two cartons) from the remaining 300,000 still viable at puberty — a number that continues to steadily and regularly decrease for the next twenty or thirty years — and prepares them for possible ovulation.

The key word (sorry you 20 or so monthly also-rans) is possible, since only one egg will survive the selection process and await the possible arrival of only one equally victorious sperm cell. Their joyous union is a fairly rare event, sometimes happening a mere once, twice, or three times during all a woman’s reproductive years. Knowing the truth makes it easier to understand why making babies later in life with eggs nearing their expiration date carries higher risks. +

OCTOBER 19, 2018

Musings of a Distractible Mind

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

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OCTOBER 19, 2018

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he drug test came back abnormal. There was THC present. I walked back to Mrs. Johnson (not her real name) and raised my eyebrows. “What’s wrong?” she asked, not used to whatever kind of look I was giving her. “Uh, you forgot to mention to me that you smoke weed.” She blushed and then smirked. “Well, yes, I guess I forgot to put that down on the sheet. I don’t do it often, but sometimes it takes mind off of things. I get anxious about my kids, my husband...and my heart problems. I only smoke one or two a night” She’s not your typical pothead. She’s in her sixties, has coronary heart disease, irritable bowel, hypertension, is on Medicaid, and is the essential caricature of the the poor white folk who live in the deep south. And she smokes weed. I was doing drug testing on her as part of my office policy since Mrs. Johnson gets 30 Percocet per month. I had to test her. And now I caught her in a lie, trying to cover up her use of illegal drugs. While I find value in regular drug testing of patients using controlled drugs, the way in which it is often enforced in some practices is one more factor in the decay of trust on both sides. The central dilemma of our current system makes doctors choose between the business and the patient. The ideal business scenario for doctors is to have very sick patients who require multiple procedures, yet spend as little time with each patient as possible. This, of course, is the absolute worst thing for patients, who want to be healthy, avoid unnecessary or excessive care, and have

doctors who spend time with them. Doctors are forced to either give up income to do what is right for patients and for society, or to stuff their consciences securely in the overhead compartment and run the business well. Some doctors seem to comfortably lock their consciences away, but most find a compromise on the spectrum between high income/bad medicine and low income/good medicine. It’s the main thing that drives doctors to burn out.

What’s best for doctors is the exact opposite for patients So the patient is left wondering if the reason “the doctor can only handle one problem at each visit” is because it makes more money. The patient wonders if the doctor won’t talk to them on the phone because they only make money when patients come to the office. Care is abbreviated even more by the onerous demands of coding, defensive documentation, and data submission for “quality measures.” How can good care occur when what little time the doctor spends with the patient is dominated by the doctor-computer relationship? Those of us who are bothered by such things are the ones who go home feeling terrible about the poor care we are giving. One of the main reasons I don’t charge a copay for office visits is that I wanted nothing to undermine my patients’ trust. Charging a copay would do little to increase my income, but a patient could question my motivation for requiring an office visit. Some doctors

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expect patients to take advantage of this and want to be seen all the time. Why would someone want to go to the doctor all the time? It simply doesn’t happen. My patients seem more apologetic about coming in and “bothering me.” My business model works best when the people I treat are healthy and happy. My business success coincides with what they want for themselves (and what works best for the healthcare system), and they like it. I have every motivation to keep them happy and healthy. Once they realize this, they seem to relish our relationship, not wanting to jeopardize it by being “too demanding.” I think it’s remarkable to both sides: I am amazed that my patients want me to be wildly successful in my business, and my patients are amazed that I want them to be incredibly healthy, off of medications, and only needing me infrequently. So when Mrs. Johnson’s drug test came back, I wasn’t inclined to kick her out of my practice or even lecture her about telling the complete truth. After all, isn’t smoking a little weed better than taking daily Valium or Xanax? Isn’t it better than drinking moonshine, or asking me for more Percocet to “calm her nerves?” Instead, I laughed. The craziness of this “country bumpkin” doing her best Cheech and Chong imitation just seemed funny. “Just don’t smoke too much, Mrs. Johnson,” I said. “And be careful getting that stuff. I don’t treat people who are in jail!” She laughed, and gave me a hug before she left. On her blouse I noted a faint but familiar smell from my high school days. + Yes, the test was right.

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OCTOBER 19, 2018

THE MONEY DOCTOR

USING DEBT WISELY One of the key factors in determining how fast you build wealth is your use of debt. We help our clients focus on becoming debt free by retirement which makes monthly cash flow in retirement much less stressful. Before reaching retirement, using debt wisely is prudent to help you reach your goals. What does it mean to use debt wisely? For every family, the answer will be a little different, however there are

some basic principles you should consider to help you make good decisions with debt. From a long-term perspective, we believe it is helpful to think about debt as future consumption that you have pulled forward. As an example, if you take out a $25,000 auto loan today to purchase a car, what just happened? The lender has given you money today in exchange for future payments that will equal more than the $25,000 original loan amount. For most people, this means they will use “future earnings” also referred to as “future consumption” to pay the loan payments. This allows you to drive the car while earning money to pay for it instead of the alternative strategy which is saving for the large purchase and paying for it all at one time. So the crucial question is when should families use future consumption or incur debt, and when should

families save for a large purchase? Two very important factors are the amount of the purchase and if the item you purchase will appreciate or depreciate over time. For large purchases such as a home that if well cared for will likely hold its value or even appreciate over time, the use of debt can be a healthy way to purchase the home. For smaller purchases such as a couch that even when well cared for will lose value over time, the use of debt can be unhealthy. It is best to save for those smaller depreciating purchases. Another major factor is the length of time you plan to use the item you are purchasing. The upfront costs of homeownership makes it hard to justify buying a home if you are moving every 1-3 years. Cars are another good example. If you buy a new car every 1-3 years, using debt to make the purchase each time can be a significant

headwind to building wealth. The fi rst years of a financed car’s life will have the highest depreciation and largest interest payments. There is a growing trend of extending the number of years on an auto loan to lower the monthly payments. Where 36 months was once considered a long term of payment, now 60 or 72 months is not uncommon. Doing that will increase the amount of interest you pay and increase the risk of becoming “upside down,” which means the amount owed on the car is higher than the car’s value. It is best to reverse this cycle. How is that done? Once a car is paid off, we recommend you immediately start saving for the next vehicle purchase while still driving the current car to reduce or eliminate the auto loan on your next purchase. Just take the amount of your former car payment and continue paying it, now into your savings account.

For all families, high levels of credit cards, student loans, car loans, or other personal debt can put you in an unhealthy financial position. If you find yourself in a situation with high levels of unhealthy debt we recommend you make a list of all your debts. Organize it from the highest interest rate to the lowest interest rate to prioritize the payments. Before fi xing the problem (paying highest interest rate debt fi rst), reflect on how it started. Understand that getting out of debt requires you to give up something today in order to get something tomorrow. +

by Clayton Quamme, a Certified Financial Planner (CFP®) with Calvary Wealth, LLC ( HYPERLINK “http:// www.calvarywealth.com” www.calvarywealth.com). Calvary Wealth is a feeonly financial planning and investment advisory firm with offices in Augusta, GA and Columbia, SC.

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.

OCTOBER 19, 2018

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My husband is a diabetic, and he struggles with cravings for sweets and high carbs. I believe people without diabetes cannot understand their daily challenges. I try to help him by having alternatives to high carb and high sugar snacks around the house. I created this Coconut Cranberry Vegan cookie recipe so he could have a healthy alternative and yet feel he is having a satisfying snack. I use almond flour in this recipe because foods made with refi ned wheat are high in carbs but low in fat and fiber. This can spike blood sugar levels and followed by a rapid drop, which can leave a person feeling tired and hungry, craving foods high in sugar. However, almond flour is low in carbs and high in healthy fats and fiber. For this reason, almond flour’s properties give it a low glycemic index, meaning it releases sugar slowly into the bloodstream to provide sustainable energy. Also, it is important to note that people with diabetes may tend to be deficient in magnesium, especially if they have uncontrolled high blood sugars, because their body may be clearing it out along with excess sugars in the urine. It is estimated that 25% to nearly 40% of people with type-2 diabetes have a magnesium deficiency, and correcting it through diet or supplements may significantly reduce blood sugar and improve insulin function. Since almond ingredients well. flour is packed with magnesium, its ability In a small bowl put flax mill and water. to improve insulin function may also apply Stir well and let set on counter for 3 minutes. to people without type-2 diabetes who have Melt coconut oil in the microwave, about either low magnesium levels or normal 15 seconds in a small microwave-safe bowl. magnesium levels, but are overweight. Combine in the bowl with flax and water, and add vanilla. Stir well. COCONUT CRANBERRY VEGAN COOKIES Add liquid ingredients to the dry and mix INGREDIENTS until a soft dough is formed. Place in freezer • 1-1/4 cups almond flour for 10 minutes to chill, then roll dough into • 1/4 small dried cranberries balls and flatten them to 1/4 inch thick. Place • 1/2 cup unsweetened coconut flakes on parchment lined cookie sheet. • 1/2 teaspoon baking powder Bake 12 minutes or just until the edges • 1/2 teaspoon salt start to brown. Remove from oven and allow • 1 tablespoon maple sugar to cool to room temperature before removing • 1 tablespoon flax milled from pan. + • 2 tablespoons water • 3 tablespoons butter flavored coconut oil by Gina Dickson, Augusta wife, • 1/2 teaspoon vanilla extract mom and grandmother, colon INSTRUCTIONS Preheat oven to 350 degrees In a large bowl combine almond flour, cranberries, coconut flakes, baking powder, maple sugar, and salt. Stir to mix all

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OCTOBER 19, 2018

WHAT IS DETOX? by Ken Wilson Executive Director, Steppingstones to Recovery

• Balanced meals • Assistance with medications • Transportation to physician appointments • Weekly outings • Courteous caregivers on staff 24/7 • Currently accepting residents and referrals • Only 30 minutes from downtown Augusta We have been in operation for over 20 years and make our residents feel like family. Contact us for more information: (706) 799-2647 or (706) 360-1185

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Last month we discussed “The Myth of Detox.” This time: what detox really is. This column is sparked by the myriad of calls I get daily from people who think their insurance is going to cover this journey on an inpatient basis. When I explain that they are unlikely to get approval from their insurance carrier for such a luxury they often hang up on me and call the next number on their list. Sometimes I’m the tenth call and they finally come out of denial and accept that “it ain’t gonna happen.” Withdrawal from alcohol or drugs, you see, is a fight against the body’s attempt to maintain homeostasis, the balanced chemistry that it has experienced for some time even though it has been injurious to the body. In general, withdrawal effects are opposite of the effects of the drug of choice: – alcohol is a calming “downer,” but the withdrawal effects have characteristics of anxiety; cocaine and meth are “uppers,” but the withdrawal effects are manifested with the need to sleep and often symptoms of “long face” or situational depression. This is the body’s way of getting you to give it what it’s demanding. When experiencing these symptoms, it is natural to want the easy way out and just take more of your drug-

THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional of-choice to avoid the opposite mood-swing that is being felt. However, if this practice is followed for some length of time you will experience an “increased tolerance” to your chemical-of-choice and have to keep taking more and more of it, to the point of ruining your health and possibly overdosing without even realizing it, going to sleep at night and never waking up. So you’re between the proverbial “devil and the deep blue sea.” What a struggle! Nobody wants to feel this badly. Everybody in this dilemma wants an easy way out of the pain, and most think the magic elixir is inpatient detox! Back to the myth again: there is no such thing as painless detox and withdrawal. There will always be some. So who will win? The drug, or your resolve to be free from its slavery? When faced with

this decision, the best ploy is to seek professional medical help by a trained professional who deals with addiction and recovery on a regular basis. Instead, many turn to the internet with all its confusing and confl icting ideas. Not the medical doctor who might even tell you “I’m not used to this and not sure what to do in your case.” Not the 1-800 numbers that plaster web searches. Not somebody else who went through a similar circumstance. They are not you. Not your best friends who are armchair medical professionals. Not pacing pharmacy aisles for naturopathic miracle solutions. If you genuinely want to withdraw from alcohol or benzodiazepines, please seek competent medical assistance or you could possibly have a seizure and die. Please see DETOX page 15

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9 +

DON’T LICK THE BEATERS

prevent their contact with cells. Lycopene also impacts the cardiovascular system by reducing LDL cholesterol and blood pressure. Beets are nutritious top to bottom. Their leaves are a rich source of fiber, vitamin K, vitamin A, vitamin C, iron, calcium, and potassium, while the root of the plant is full of nutrients such as fiber, iron, potassium, vitamin C, folate, and manganese. Iron is needed to help with the transportation of oxygen throughout the body. Vitamin C is a powerful antioxidant and aids in the absorption of iron. Potassium may help lower blood pressure. One cup of uncooked beet contains 13 grams of carbohydrates with about 4 grams coming from fiber. When you are at your local Farmers market, look for this nutrient-packed vegetable! Beets found as two varieties; Detroit Dark Red, with a bold red coloring, or the Golden variety which is yellow-orange in color. The red color is indicative of the presence of lycopene and the yellow color indicates anthocyanin. Other more uncommon varieties are the Chioggia (red and white striped in color), Formanova (more cylindrical shaped like a carrot), and the Lutz Green Leaf (red and larger in size). +

OCTOBER 19, 2018

Useful food facts from dietetic interns with the Augusta University MS-Dietetic Internship Program

BEET IT! by Nicole Herring, MS, Dietetic Intern Summer is finally starting to wind down. Soon cold weather vegetables will be at the peak of their maturity and will be readily available at your local farmers markets and grocery stores. Be on the lookout for beets. While the tap root is usually the most used part of the plant, the green leafy top can be eaten as well. In years past, beets were mainly grown to harvest the green leaves; the root was considered coarse and hard to eat. Eventually, this beautiful, sweet root vegetable was not only discovered to be delicious, but contains many essential nutrients and important compounds that can decrease risk of chronic disease. Beets are high in fiber and antioxidants. Both the leaves and beetroots contain soluble and insoluble fiber needed to help maintain a healthy digestive tract, reduce cholesterol, control blood glucose and lower cancer formation risk. Fiber adds bulk to the stool and may aid in the quick elimination of waste from the body, which

may lower the risk of cancer. In addition to fiber, beets contain antioxidants. Lycopene (a carotenoid) and anthocyanin (a flavonoid) are both found in beetroots and may help to prevent and protect our cells from damage. Our cells can be damaged by free radicals, but antioxidants help prevent that damage and aid in the repair of damaged cells, reducing the risk of cancer. Several studies have provided evidence that lycopene helps to reduce the production of excessive cell growth of human gastric and

prostate cancer cells. Antioxidants work with the immune system to destroy free radicals and

There are other ways our diet may help to prevent and manage chronic diseases. For more information consult a Registered Dietitian Nutritionist or visit the Academy of Nutrition and Dietetics website, www.eatright.org. Registered Dietitian Nutritionist are trained and credentialed professionals who provide nutrition and health

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AUGUSTAMEDICALEXAMiNER

WHAT ABOUT FUNERAL PRE-PLANNING?

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Call us today! 803-279-2770 www.superiornursingsolutions.com We are locally owned and operated, with more than 50 years combined experience working at the Savannah River Site

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Lower extremity Working now? Not necessarily Take-Out Available? Yes, from shoes and socks? Good for: Walking, dancing, kicking things.

Arthur D. Thomson, GA

H H H H H 10/8/2018 I recently reviewed my nose. I said it smells. Literally. It wasn’t supposed to be a joke. The thing is, my feet smell too. How is that possible? +

Kyle K. Ft Gordon, GA

H H H H H 10/8/2018 People don’t believe me when I tell them this, but I am a foot soldier. +

Eddie J. Aiken, SC

H H H H H 10/9/2018 Can anyone tell me what a square foot is? I first heard this term years ago and I’ve been checking out people’s feet ever since, and I’ve never seen a single foot even close to square in shape! +

Eddie J. Aiken, SC

H H H H H 10/9/2018 Also, the term foot rest confuses me. I don’t understand how just one part of the body can rest. But if my foot is resting, isn’t the rest of my body too? I mean, unless I’m walking on my hands. +

Janet A. Modoc, SC

H H H H H 10/10/2018 I’m an artist, and I sell foot prints from my online gallery. They’re suitable for framing. +

Aaron K . Martinez, GA

H H H H H 10/11/2018 I read Kyle K’s review on 10/8...the foot soldier at Ft. Gordon. I’m not a soldier, but despite that I go on foot patrols 5 days a week. I’m a podiatrist, you see. +

Bert L Augusta, GA

Most people don’t take this avenue to save money, but some do. The avenue we have in mind is body donation. David Adams, Director of Anatomical Services at Augusta University, says that most donors are people who have been generous supporters of their favorite causes throughout their lives. It’s only natural that upon their death they donate their body to science. Using the real thing to train medical students has a history that goes back to ancient times. One of its attractions is that almost everyone qualifies to be a donor (assuming they are no longer among the living, that is). In other words, the body of someone who is skinny is as effective a teaching tool as the body of someone who is overweight. Long-time smokers and lifelong alcoholics can help students see the effects of such habits better than any textbook could ever do. There are a few strings attached, such as bodies can’t be accepted that have been autopsied or already embalmed or severely injured in a traumatic accident. There are a few other deal-breakers, like deaths from highly contagious diseases. Of course, no one is paid for a donated body. It is a donation, after all. But perhaps the #1 string is that a person has to make the arrangement to donate their body before death. There is much more information at Augusta University’s website (visit augusta.edu/mcg/cba/bodydonation or visit augusta.edu and click the “A-Z Index” at the bottom of the main page and go to “B” for Body Donations) including how to become a registered donor and how all the arrangements work. Alternately, they may be reached at (706) 721-3731. +

THE THRILL IS GONE Ready to get your life back?

H H H H H 10/13/2018 I heard about someone taking a foot bath. That’s just not right. What about washing the rest of the body??? +

Michael P. Beech Island, SC

H H H H H 10/14/2018 I was always taught to put my best foot forward — and I try to. But wearing shoes and socks every day makes it kind of pointless, you know? +

Merle F. Jackson, SC

H H H H H 10/15/2018 I think it’s cool how much a person can communicate just with their feet. Like if I say I’m going to put my feet up, I’m going on break. Resting. But if I put my foot down, I’m taking charge. I’m in control. All that with just my feet. +

Carrie W. Martinez, GA

THE ZERO-COST FUNERAL

H H H H H 10/16/2018 I just got a job at a shoe store at the mall! I’m so excited. I’m going to be selling flats, sandals, boots, oxfords, and pumps. Which reminds me, isn’t the term “footpump” redundant? That’s like saying you’e going to buy a headhat. What other kind of hat is there? Ditto for pumps. I mean, no one wears pumps on their hands. +

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There are people who think funeral pre-planning is some sort of gimmick cooked up by the funeral industry to drum up business, and in your specific case it might be. Every situation is different. For example, if you believe you will never die, then pre-planning would be a complete waste of time. Why plan for something that’s never going to happen? There are others among us who have analyzed the odds and have noted that virtually every person who has ever walked the face of the earth in all recorded human history prior to the last 100 years or so has died. These people don’t exactly want to die, they aren’t looking forward to dying, and they want to delay it as long as possible. In other words, they aren’t morbid or pessimistic about things. They aren’t fatalistically expecting every day will be their last. But they are realistic enough to know that the inevitable is going to happen eventually. When that day comes, they don’t want their loved ones burdened with all kinds of important decisions at an already terrible time. Taking care of things ahead of time is a load off everybody, and it makes for much easier decisions. Realistically, practically everyone should do it. Except, of course, people who plan to live forever. +

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OCTOBER 19, 2018

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AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf — posted by Linda Girgia, MD, on May 29, 2017 (edited for space)

DELIVERING THE WORST NEWS Mr. A was a young man just into his twenties with advanced AIDS in an era when we did not know so much about this killer disease. All of us saw him in the hospital many times, and we all feared to be his doctors because he was just mean. Walking into his room was like stepping into the junkyard and that scraggly dog just running at its leash to sink his fangs into your flesh. No one knew what caused him to be so nasty; perhaps it was his diseases or the time he spent in jail or his drug habit. There were fights over who would go round on this patient when he appeared on our roster. My team usually lost. And I was the lowest intern, the scut monkey of the team in that year. He was admitted this time by the team on-call the previous night with the complaint of headaches and trouble swallowing. We all went in together to exam him with our attending because he had some interesting neurological deficits. Probably not so much interesting to the patient and, in fact, anything found “interesting” by a group of doctors in training was probably very bad news for the patient. Indeed, the MRI of his head and neck revealed an AIDSrelated central nervous system lymphoma which essentially was a death sentence for him. We sat in the cafeteria discussing the case. Our attending said that someone would need to go tell the patient the results. She looked toward the second year resident who was currently my senior and told him to do it. He looked at me and without any hesitation told me to do it. Before I could even consider any excuse, he walked briskly away, and I knew it was now my job. I had never given a patient bad news before and really did not know what I should say. He was on the fifth floor, and I remember this because I was too scared to take the elevator. Deciding to climb the stairs instead to slow down this death march, my heart sank lower and lower with each single stair until finally, I arrived on the fifth floor. I knew no one else was going to help me; I was on my own. Fear seized me, but not because I was afraid of this man any longer but because I empathized with him. He was about my age, and he was going to die. And I was the one who would have to tell him. Entering his room, he turned his head to look at me with fury in his eyes. Every fiber in my body strained to prevent me from turning around and running out of his presence. I opened his chart to the dreaded report. I read the results to him much like a judge reads a prisoner the charges against him. I explained what a lymphoma actually was and that in this case there was no treatment. “Am I going to die?” he asked with fear in his eyes, but looking into them I realized he already knew the answer. “Yes,” I answered quietly as tears began their slow descent down my cheeks. “When?” he asked again. “I don’t know,” I replied. “Soon.” “Thank you,” he said with genuine appreciation in his voice. At that moment I no longer considered him the mean patient; I loved him as a human being. I left the room before the tears became a river on my face. On my escape, I ran straight into his mother and sister entering the room. They saw me and both immediately started crying, but I continued to leave. I could not say another word because I knew I would break down in grief. I did not learn how to tell a patient that he was going to die that day; instead, I learned that it is easy to pass judgment and much harder to pass empathy. +

The task was passed down the line to me.

Linda Girgis is a family physician who blogs at Dr. Linda.

If you were alive 100 years ago today, you would consider yourself very fortunate. In 1918 the world was in the death grip of two insatiable killers. World War I had spilled rivers of blood across the globe, eventually killing an estimated 16 million soldiers and civilians and leaving some 37 million people injured. That sounds horrific until the grim stats from the second killer are added up. In 1918 the Spanish flu epidemic infected around 500 million people — one-third of the world’s population — eventually killing somewhere as many as 100 million people. Some sources put the U.S. death toll at 675,000. Others say “only” 550,000 Americans died, but even if the lower figure is more accurate, that amounts to five times higher than the U.S. military death toll. Despite regular scares in our time from Ebola, swine flu, bird flu, HIV, SARS and more, it’s difficult to comprehend an epidemic so virulent that it could sweep around the entire globe,

striking down hundreds of millions of people. We could more easily wrap our heads around it if it had happened in ancient times, or even the Medieval era, like the socalled Black Death plague of the 1340s. But a mere 100 years ago? How could a plague go unchecked, killing not just frail newborns or those of advanced years or those already weakened by other illnesses? This disease struck down people in the prime of life who had been strong and healthy just days before. Arnold’s account shows how pervasive the Spanish

flu’s effects were: it struck Groucho Mars, novelist John Steinbeck, Walt Disney, Franklin Roosevelt, Mahatma Gandhi, and British Prime Minister David Lloyd George among its millions of victims. The appeal of this book lies in its ability to remove us from numbers so starggeringly high as to be incomprehensible — can any of us get an accurate mental picture of what 500 million peop0le looks like? — and introduce us to the individuals and the families who were struck down by the flu. Another aspect of the book is the investigations into how this disease managed to evade capture and control until it eventually burned itself out. Those investigations are still happening today. In short, it’s a gripping account that will no doubt appeal to anyone interested in history, especially medical history. + Pandemic 1918: Eyewitness Accounts from the Greatest Medical Holocaust in Modern History by Catharine Arnold, 368 pages, published in August 2018 by St. Martin’s Press

Research News Cause of death: loss of hope That might sound a bit far-fetched, but a new study published by researchers at England’s University of Portsmouth says it’s not as implausible as it might seem. Known medically as psychogenic death, a complete and utter loss of hope is a dangerous condition, indeed. Some might say, that’s exactly what depression is, but researchers say this is a different animal altogether, often the result of severe trauma. Doctors believe the condition is caused by a trauma-triggered malfunctions in the brain’s anterior cingulate circuit. The result is complete apathy and a total absence of emotion and lack of will to live, even when it comes to the most basic activities like eating or using the bathroom. At its worst, the condition can result in a total shutdown to outside stimuli, including severe pain.

Intervention can be as basic and simple as getting the person involved in physical activity or as complex as intense psychological intervention. Hearing restoration news One of the ways we register sound is by the impact of sound waves on tiny cilia - hairs - found in the cochlea, part of the inner ear. Earlier this week scientists at the University of Rochester Medical Center announced they have found a way to regrow these hair cells as a means of restoring hearing. The research was prompted by observations of mice, birds, frogs and fish, who have been proven in previous research to have the ability to regenerate lost sensory hair cells. In fact, humans are believed to be the only vertebrates who can’t do it. Focusing on an epidermal growth

factor (EGF) they identified, scientists were able to use the EGF to stimulate new growth (study authors used the word “proliferation”) of sensory cells. Routine application of the discovery is probably a long way off, but it’s a promising lead. Postpartum D’s cause Postpartum depression has been linked to the level of pain experienced by the mother, but new information presented this part weekend at the Anesthesiology 2018 annual meeting suggests the true indicator is not pain experienced during labor and delivery but instead recovery pain after the blessed event. The research suggests that doctors need to do a better job of helping patients manage pain after the baby is born — and that new mothers need to do a better job of communicating their pain levels to their doctors. +

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AUGUSTAMEDICALEXAMiNER

THE EXAMiNERS

OCTOBER 19, 2018

Did you hear about Joe?

Joe who?

by Dan Pearson

Your grief counselor? That’s terrible. I’m so sorry for your loss.

My friend Joe. He died.

Well, he was so good at what he did Then I think maybe I almost don’t care. he was too good.

The Mystery Word for this issue: REMUNST

EXAMINER CROSSWORD

PUZZLE

ACROSS 1. Gulf War missle 5. Unwanted cholesterol 8. One can come before labor 12. Beginner 13. Inhibitor intro 14. Shakespeare title word 15. Theater award begun in 1956 16. Surgery is sometimes this 18. Inking device 19. Lyric poem 20. Title of a knight 21. Attach by stitches 22. Nine Inch Nails frontman 24. Campground chain 26. It is a rival of 30-D 27. Type of foam 30. It can precede land and sea 33. Pale 34. It’s next to Vietnam 36. Slippery tree 37. Turkish governor 38. Partner of 50-D 39. Ty of baseball 41. Talks of note 42. Sleep disorder 44. Home of local note 46. Doctor of rapology 47. Gear tooth 48. Fast day after Ramadan 51. Student govt 54. Gist 56. To free; relieve 57. Biopsy destination 59. Relating to hundredths 62. Fortune’s partner 63. Aggravate 64. Corpse 65. Among 66. Pulsate; throb 67. Type of band 68. Lower digits

50 58

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

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

DOWN 1. Very common sign 2. Big word in Augusta 3. Kidney output 4. Name of anonymity 5. Disgraced Today host 6. Part of all URLs 7. They can be cyanotic 8. 21st letter of the Greek alphabet 9. Greek god of war 10. Hawaiian goose 11. Butterfly film (in brief) 13. Nearby town named for Indians indigenous to Northern California 14. Lindsey’s predecessor 17. Fourth-largest county in South Carolina (by acres) 19. The first word of many stories 23. Stun, as with a tazer 25. Popular ISP 27. Park in Augusta 28. Florence brought plenty

Click on “READER CONTESTS”

47 52

VISIT WWW.AUGUSTARX.COM

QUOTATIONPUZZLE

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

21 24

26 30

8 14

19 22

! 3 E G A P E E S ! K A E R B N O

Simply unscramble the letters, then begin exploring our ads. When you find the correctly spelled word hidden in one of our ads — enter at AugustaRx.com

29. Symbol of slavery 30. It is a rival of 26-A 31. Blood blockage 32. Intro for lance 33. Unite 35. Ocean 37. Hogan or Crenshaw 40. London broadcaster (abbrev) 41. Longest river in Spain 42. Parched 43. For each 45. It talks, supposedly 46. Bread we pray for 48. Slow heartbeat prefix 49. San Antonio mission 50. Partner of 38-A 51. Fresh wound reminder 52. Heredity carrier 53. Faris of the big screen 55. Macon county 58. Hospital size yardstick 60. Small child 61. Sound of a cow 62. Obese Solution p. 14

— David Geffen

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

E X A M I N E R

3 4 7 4 3 8 6 5 1 8

1 2 4 6

2 1 9 4

7 1 9 3 7 2

S 2 U 1 D 8 O K 3 U

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

Use keypad letters to convert numbers into words suggested by the definitions provided. Sample: 742 (body part) = RIB. Solution on page 14. 1. 3223 (body part) ____

6. 24378 (body part) _____

2. 5477 (body part) ____

7. 84862 (body part) _____

3. 23559 (body part) _____

8. 35269 (body part) _____

4. 4247 (body part) ____

9. 74685337 (body part) ________

5. 5347 (body part) ____

10. 2236636 (body part) ________

All the words used in this week’s TEXT ME are taken from the anatomy poster in our reader contest.

TEXT

THE MYSTERY WORD

OCTOBER 19, 2018

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AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE

The

Advice Doctor

Joe: I guess it would have to be Mrs. Fire.

ha... ha...

Moe: What do you get when you divide the circumference of a pumpkin by its diameter? Joe: Pumpkin pi?

Moe: Where does your new girlfriend work? Joe: At Riverbanks Zoo. Moe: Wow. Sounds like she’s a keeper.

This guy bumped into an old school friend here once was a family so poor that the mother would sometimes send her children and started showing off, bragging about his high-paying job and his expensive sports to the neighbors with a button and ask the car. Then he pulled out his phone and neighbor if she would sew a shirt onto it. showed the old friend a picture of his wife and said, “She’s beautiful, isn’t she?” Moe: When I die I want to leave my body to The friend replied, “If you think she’s science. beautiful, you should see my girlfriend.” Joe: Oh yeah? “Why,” the bragger asked, “Is she a Moe: Yeah. Specifically, to a scientist who’s stunner?” working on bringing the dead back to life. “No,” the friend said. “She’s an optician.” Moe: What do you call a hippie’s wife? Moe: If they gave out trophies for being Joe: Mississippi. humble... Joe: If you are about to say what I think Moe: What does a clock do when it’s hungry? you are, you’d better stop now. Joe: I give. What? Moe: ...I would give mine to whoever won Moe: It goes back four seconds. second. Moe: What was the name of the dinosaurs Moe: Hey, I got a joke for you! Why did the that were pure glass? doctor take his nose apart? Joe: Those were called Py-Rex. Joe: So he could see what made it run? Moe: You know how dog catchers are paid? Moe: I had my fi rst date last night and it Joe: By the pound I suppose. went really well. Joe: That’s good. Moe: What is your favorite Robin Williams Moe: What an underrated fruit! + movie — without any doubt?

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

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

Dear Advice Doctor, One of my co-workers is always asking me for advice about all her problems. I don’t want to come across as critical, so I would try to gently suggest possible solutions instead of telling her she’s doing this or that wrong. Well, apparently I somehow touched a raw nerve because last week she suddenly clammed up completely. She barely acknowledged my presence all week. Should I ask her what I said wrong, or just be glad I’m not her amateur psychiatrist anymore? — Enjoying the silence - but it’s eerie Dear Enjoying, I understand how uncomfortable this is for you, but it might ease your pain a little to know that nationwide more than 3 million people suffer from just one aspect of raw nerves, the one known as peripheral neuropathy. The not-so-comforting aspect, though, is that this can be a chronic condition. Sometimes it manifests as sharp pain, sometimes as a burning sensation or a pins-and-needles feeling, and sometimes (thankfully, some sufferers say) as numbness. Many cases of tingling nerves are idiopathic, meaning the cause is unknown, but the most common known trigger is diabetes. High levels of blood sugar can damage nerves, which is why it is so important for diabetics to regularly and frequently check their blood sugar and do the best job they can to manage and control their diabetes. Testing once a day can be just asking for trouble. Sometimes neuropathy can be caused by poor diet (sometimes paired with alcoholism), injury, as a side effect of medications — especially chemotherapy drugs — or from diseases other than diabetes, like shingles, HIV, hepatitis C, rheumatoid arthritis, and lupus. While it might be tempting to self-medicate or consult “Doctor Google,” anyone with peripheral neuropathy really needs to consult a physician to see if the cause can be identified. That offers the best chance of getting relief. You and your doctor can hopefully manage or even stop the underlying condition causing the neuropathy, and in the meantime offer pain-relieving medications and lifestyle advice that may help keep things from getting worse. I hope this answers your question. + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.

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

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+ 14

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

! 3 E G A P E E RE A K ! S

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

ON B

THE WINNER: ANDREW FELAK Want to find your name here next time? If it is, we’ll send you some cool swag from our goodie bag. The new Mystery Word is on page 12. Start looking!

THE PUZZLE SOLVED S T O P

C Y B E R

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M O O D Z N O A C C A P E M B B T U B M A C O G A N U N T E S N O Y A T

L D L P A O I S H U T P A T I E S I R R K O A M E M O W A N L B E Y E D A P N D R E B A I R B R I D I M A L F B O D Y A B O Y T

SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher.

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SEE PAGE 12

The Celebrated TEXT ME ! 3 E G A P E E MYSTERY WORD CONTEST S ! K BRE A

...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!

OCTOBER 19, 2018

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OCTOBER 19, 2018

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DETOX… from page 8 For every upside, there is a downside. Getting through initial withdrawal effects is no proverbial Sunday picnic. I admire everyone who decides to make this fi rst step, knowing the discomfort they will face the first few days. Helpful hints: If you or someone you know decides to begin their journey to sobriety by abstaining from alcohol or drugs more or less abruptly, do help them with this helpful hints: • Be present – you don’t have to talk, just be with them. Help with water, reading, talking as they lead the conversation, and don’t leave them alone. • Put your friend in contact with others who have gone on before them – they are credible friends at this time. It helps to know “I’m not the only one...” • Stay in contact with a medical professional in case things don’t go as planned. • Help by assisting your friend in whatever pleasure is appropriate – good food, at home movies, and let them drive the agenda as they may not want company. • Continually point out that “in a few days this will be over” and your life will be better...much better. Without drugs, life always gets better. And that’s no myth! +

HOW DOES ORGAN DONATION WORK? When someone dies in a hospital or other healthcare facility, there are established procedures about what happens next. But what happens when a person loses their life outside a medical facility in a car accident or a shooting? They are typically transported directly to the morgue. In both cases, the law mandates that people are contacted who can arrange for tissue donation, even if the person had not made arrangements to be an organ donor before their death. Carl Eubanks, the director of Tissue Donor Services for the Medical College of Georgia at Augusta University, says the law provides the opportunity for families to create at least something positive out of a tragic event. “We simply ask the family what their preferences are,” he says. “And there are no wrong answers. We just want to give them the choice.” Most of us have little appreciation for the constant need that exists in a large medical community like + Augusta’s. For example, nothing artificial works as well as human skin in treating burn victims, and Augusta certainly sees plenty of those at the Joseph M. Still Burn Center at Doctors Hospital. The Georgia Eye Bank transplants corneas; heart valves are indispensable, with numerous advantages over mechanical or pig valves; veins are used for bypass surgeries; bones are used in many ways, including grafts; Ft. Gordon treats many wounded soldiers Please see ORGAN DONATION page 16

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ORGAN DONATION… from page 15 with tissues from generous Augusta families. It is often a matter of great comfort for a family to know that someone they’ve lost in death was able to contribute to the quality of life, if not the very survival of others. And it is definitely others — plural. Tissue from a single donor can help as many as 70 or 80 people. So each time a family says yes, the impact is significant. Something else that makes a difference in Augusta’s program is its reach and scope. It isn’t big. While some tissue procurement programs will provide anything they have to anyone anywhere, Augusta’s primary focus for its donated tissue is, well, Augusta. That makes it unique. That too can be comforting for families, knowing the help they so generously offered stays in the community. The program uses what Eubanks

calls “the donor circle,” which means “we help you because you help us.” Hospitals across the region who participate in keeping the tissue bank stocked are rewarded with preferred access to that stock. No one has been turned away in Eubanks’ 30 years, but the primary focus is on the hospitals in the donor circle. More information is available by calling the tissue donor office at any time 24/7: (706) 721-3411. Major organ donations for transplantation from people who are alive but without brain activity— lungs, kidneys, livers, hearts, bones, etc — are contracted to LifeLink of Georgia, serving 182 hospitals across the state - and two in South Carolina. All such generous donations have helped thousands of local patients and their families, and give hope to the thousands of people in Georgia alone who are on waiting lists for various tissue transplants. +

OCTOBER 19, 2018

THE DEATH-PREVENTION CHECKLIST No one is making it out of here alive, as they say. But that doesn’t mean any sane person wants to hasten the process. So what is the secret to keeping the grim reaper at bay? It’s not terribly complicated. Here are a few tips, starting with the standard Tip #1. Might as well get it out of the way: • For heaven’s sake, don’t smoke, and if you do, quit as soon as possible. • Get regular exercise. It doesn’t have to be running marathons, but just be an active person as much and as often as possible. • Keep your weight in recommended ranges for your height. See page 8 our previous issue for BMI guidelines (you can read it online at issuu. com/medicalexaminer). • Eat healthful and salubrious foods like fruits and vegetables every day. You don’t have to be a food Nazi; you can drink Cokes and eat donuts. But they shouldn’t be regular staples of your diet. All things in moderation — except the healthy stuff; eat as much of them as you want. • Regularly read the Medical Examiner to keep healthful reminders in front of you on a regular basis.

PROFESSIONAL DIRECTORY +

ALLERGY

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

AMBULANCE SERVICE

AMBULANCE • STRETCHER • WHEELCHAIR

706-863-9800

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

COUNSELING

LONG TERM CARE

DENTISTRY

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

WOODY MERRY www.woodymerry.com Long-Term Care Planning I CAN HELP! Floss ‘em (706) 733-3190 • 733-5525 (fax) or lose ‘em!

Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048 Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

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

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

DEVELOPMENTAL PEDIATRICS

YOUR LISTING HERE

DRUG REHAB

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

SENIOR LIVING

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

YOUR LISTING HERE

Augusta Gardens Senior Living Community 3725 Wheeler Road Augusta 30909 Augusta Area Healthcare Provider SENIOR LIVING COMMUNITY 706-868-6500 Prices from less than $100 for six months www.augustagardenscommunity.com CALL 706.860.5455 TODAY!

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