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BREAST CANCER

ON SYMPTOMS WHAT ARE THE SYMPTOMS OF BREAST CANCER? When breast cancer starts out, it is too small to feel and does not cause signs and symptoms. As it grows, however, breast cancer can cause changes in how the breast looks or feels. Symptoms may include— • New lump in the breast or underarm (armpit). • Thickening or swelling of part of the breast. • Irritation or dimpling of breast skin. • Redness or flaky skin in the nipple area or the breast. • Pulling in of the nipple or pain in the nipple area. • Nipple discharge other than breast milk, including blood. • Any change in the size or the shape of the breast. • Breast pain of any kind. WHAT IS A MAMMOGRAM? A mammogram is an X-ray of the breast. Doctors use a mammogram to look for early signs of breast cancer. Having regular mammograms can lower the risk of dying from breast cancer. If you are age 50 to 74 years, be sure to have a screening mammogram every two years. If you are age 40–49 years, talk to your doctor about when and how often you should have a screening mammogram. + More at AugustaRx.com/news

ver the years here at the Medical Examiner, I admit to some degree of reluctance to get on the annual October breast cancer bandwagon. But as you can see from the headline above, I’m finally ready to jump on. For the record, I support any effort against any type of cancer. I’ve had it twice myself. My dad died of cancer, and so did my mother and my mother in law. I hate cancer and what it has done to me, to my family, and to millions of other people and their families. But sometimes I think October is a little overboard, especially when you look at the big picture. Measured by mortality statistics, breast cancer is the third-most deadly cancer. Numbers one and two are lung cancer and colon cancer. Combined, those two kill something like five times as many people as breast cancer. But I ask you now: during what month do we observe

lung cancer awareness month? What month is colon cancer awareness month? Look at the accompanying list of the top ten cancer killers, and if you know the month when any of them celebrates cancer awareness — other than breast cancer — you get a gold star. Do the people with those nine other cancers think we don’t care about them? And what about other conditions? Take the number of women who are diagnosed with breast cancer, double it, and you’ll have roughly the number of women who suffer domestic violence, according to CDC figures. What month is designated for domestic violence awareness? (For the record, lung cancer awareness is observed during November; colon cancer awareness during March; and domestic violence awareness month is October.) Getting on board But I’m finally ready to jump on the breast bandwagon. So what if other cancers or issues aren’t publicized as well as they should be? That is not the fault of those that are. It’s no reason to penalize them or downplay their significance. The issue shouldn’t be to ignore Breast Cancer Awareness Month; it should be to become more aware of the other cancers and how more people can support the fight against them. And believe me, those other cancers need our support. They all do. To illustrate, look at the dollar figures for National Cancer Institute clinical research funding for the top cancers (right). There seems to be little if any connection between how dangerous a

OCTOBER 5, 2012

Worst Ten Cancers Deaths caused by the ten most deadly cancers in the five years between 2003-2007, according to the National Cancer Institute:

U.S. CANCER DEATHS

1. Lung and bronchial cancer: 792,495 lives 2. Colon and rectal cancer: 268,783 lives 3. Breast cancer: 206,983 lives Breast cancer is the second most common cancer in women in the United States, after skin cancer, according to the Mayo Clinic. It can also occur in men — there were nearly 2,000 male cases between 2003 and 2008. The cancer usually forms in the ducts that carry milk to the nipple or the glands that produce the milk in women. Nearly 40,000 people are expected to die from breast cancer in 2010, according to the NCI. 4. Pancreatic cancer: 162,878 lives 5. Prostate cancer: 144,926 lives 6. Leukemia: 108,740 lives 7. Non-Hodgkin’s lymphoma: 104,407 lives 8. Liver and intrahepatic bile duct cancer: 79,773 lives 9. Ovarian cancer: 73,638 lives 10. Esophageal cancer: 66,659 lives TOTAL: 2,009,282 or 401,856 per year

Research dollars The National Cancer Institute is the main federal agency for cancer research, and NCI research funding is a bellwether for dollars spent on cancer research everywhere. It’s interesting to compare the figures from the list above with rankings of NCI research funding for fiscal year 2009: 1. Breast: $599.5 million (39,840) 2. Prostate: $293.3 million (32,050) 3. Colorectal $264.1 million (51,370) 4. Lung $246.9 million (157,300) 5. Leukemia $220.5 million (21,840) 6. Non-Hodgkin’s Lymphoma $130.8 million (20,210) 7. Ovarian $110.1 million (13,850) 8. Pancreatic $ 89.7 million (36,800) 9. Liver $ 70.3 million (18,910) 10. Bladder $ 25.8 million (14,680) Note: the right-hand column of numbers in parentheses represent NCI projections of 2010 deaths for each listed cancer. +

Please see BREAST page 16

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AUGUSTA MEDiCAL EXAMINER

The Short White Coat

“My meaning simply is, that whatever I have tried to do in life, I have tried with all my heart to do well; that whatever I have devoted myself to, I have devoted myself to completely; that in great aims and in small, I have always been thoroughly in earnest.” – David Copperfield by Charles Dickens

y name is Caroline Colden, and I am a second year medical student at the Medical College of Georgia. I undertake The Short White Coat to share with you some of my thoughts and experiences in my daily life as a medical student. What I share may seem mundane or irrelevant to some people, but it will be what I deem to be significant and most representative of what actually transpires in my life. I have read previous Short White Coat columns, and though I realize I have rather large shoes to fill, I hope I will be accepted as an adequate successor to Dr. Hevil Shah. Let me begin by explaining my reasons for opening with a quote from David Copperfield, for it is very likely that future articles for The Short White Coat will be peppered here and there with references to the book. Dickens’ David Copperfield is my absolute favorite book. It is a source of inspiration, a sense of calm, and a standard of virtues, beliefs, and approaches to life after which I try to model myself. My favorite quote from the book is actually not the one above, but the very first sentence on the very first page: “Whether or not I shall turn out to be the hero of my own life, or whether that station will be held by anybody else, these pages must show.” David Copperfield begins his narrative by introducing himself to his readers, much as I endeavor to do here. He discloses immediately that he has not determined conclusively who the hero of his life is or will be, and that he may never find out. He goes on to assert,

however, that even if a hero for the story of his life never appears, its pages must still be shown. Perhaps the story’s readers (if not Copperfield himself) can determine who held that station. Personally, I find it hard to believe that anyone could actually be the hero of his or her life. I feel inclined to explore the possibility that perhaps the point of living is the opposite: not to be one’s own hero, but to be a hero to someone else. I think that is where the true value of life lies. The real privilege rests not in the ability to better one’s own life, but to use one’s life to help others. What better achievement exists in this world? Perhaps that was the point Copperfield wanted to make at the very start of his narrative, before any other impressions were generated. He does not know whether he is the hero of his own life or whether that station will be held by another, just that his story must be told so that he could share the stories of all those who touched and influenced him; to celebrate those people who helped him feel true love, who aided him during his struggles, and who cried with him during the troughs of his life, but also raised him to its peaks. The pages of his story were shown so that David Copperfield, and perhaps Charles Dickens through his character, could show his readers the true lessons and beauty of life. He wanted his readers to meet his heroes. While it seems that I am writing a book report about David

Copperfield at this point, I hope that readers bear with me. For me, his is an example I want to follow; I seek to examine his motives in life in an effort to understand my own. My quote above also reflects my own sentiments enormously. David expresses to his readers that regardless of what he has done or will ever do in his life, it will have been in earnest. What a powerful maxim by which to live! Whether we win or lose all of the struggles we face in life – and there will indeed be struggles – we should always be in earnest! I know of no one who does not wish and work for success… why would anyone not? But seeking success is not necessarily enough. It is the method by which success is sought – with integrity, dignity, and, most of all, sincerity – that confers value to the cause. Sincerity is paramount to every honorable pursuit. Sincerity implies true dedication. Sincerity implies respect. No cause was ever properly pursued or respected without sincerity. I apply these beliefs to my pursuits in the field of medicine. It will be a privilege and an honor to practice medicine someday, and I will approach no cause with greater responsibility or respect than the cause of protecting human life. No people are more deserving of respect and sincerity than a doctor’s patients, and I will absolutely strive every day of my life to uphold these values that are so necessary and immutable. These may be merely opinions

“I do not want to be the hero of my life.”

A med student’s notebook only. But they are the opinions and beliefs that I hold close to my heart. So now, as did our dear friend David Copperfield, let me introduce myself to you. I am 23 years old, and I am in my second year of medical school. My hopes of pursuing a career in medicine are central to who I am, as are the people who help me along the way. I am not — and do not want to be — the hero of my own life. I hope instead to be an impact upon someone else’s life. Perhaps I will someday accomplish this as a physician, or perhaps I will accomplish it in a nonmedical setting. Or perhaps I will not make a difference at all. No matter what, I will at least have tried, and will have tried sincerely. I will share my stories not so much so that people can read about me and my daily life but so that they can become acquainted with some of the people whom I consider to be role models and heroes in my life. While I cannot guarantee that you will like my stories and opinions, I can at least assure you that they will be sincere. I accept this position as writer for The Short White Coat column in this paper with honor and pleasure, and I will do my utmost to continue the tradition of providing insight into the lives of the people who don “the short white coat.” Like our friend David Copperfield, I will be “thoroughly in earnest,” and I will let these pages show that. + — by Caroline Colden

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AUGUSTA MEDiCAL EXAMINER

ore than a decade ago my mother (now 90 years old) went to a Wendy’s restaurant in Kansas City with her grandchildren. Carrying the order back to the car, she stumbled due to a pothole in the Wendy’s parking lot. She fractured her hip and experienced a good deal of pain. The Wendy’s personnel were very helpful and called an ambulance. Mother underwent a hip replacement and at her age needed to spend several weeks in rehabilitation. Clearly, she could have sued Wendy’s because the pothole was quite dangerous. But Mother was brought up during an age before the enthusiasm

. .personal integrity intact. for lawsuits. She wouldn’t hear of suing the fast food chain. We did at least encourage her to get in touch with Wendy’s advertising department and maybe make one of Dave Thomas’ notable commercials to state that although she fractured her hip in the incident, she did not drop her Wendy’s order for the children’s hamburgers and drinks. Mother enjoyed the commercials for

Wendy’s and would chuckle at the memory of her fractured hip, although of course it was a very trying time for her. Mobility was very imporant for her as she often shared time with her nine extremely active grandchildren. Dave Thomas passed away years after mother’s accident, and she never did sue the restaurant chain or make a commercial. Instead, she wrote dozens of Thank You cards to thank all personnel involved in the treatment of her fractured hip. She truly appreciated those in the medical profession. + — submitted by Nell Osterman Augusta, Georgia

You can drop us a line too. We’d love to hear your story.

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

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Why would anyone pay for a subscription to a free newspaper? That’s certainly a legitimate question. The answer: as a major regional medical center, patients come to Augusta hospitals and physicians from all over the Southeast. The MCGHealth Medical Center alone sees patients from every single county in Georgia, not to mention South Carolina, Florida, and beyond. Add to that the regional reach of Eisenhower Army Medical Center and both Veterans Administration hospitals, the Joseph M. Still Burn Center at Doctors Hospital, MCGHealth Children’s Medical Center, Walton Rehab and University Hospital, and it’s clear that many people seeking treatment in Augusta are not local residents. Furthermore, some of our most loyal readers are in town only occasionally. Or their treatments and visits to Augusta are only temporary. Even local residents may find it more convenient to walk to their mailbox than visit one of our many newsstands. Subscriber copies are mailed the day prior to the issue date so they will be received by most readers no later than the publication date printed on the paper. Copies are sent by First Class mail in a sealed envelope so they’ll arrive promptly and in crisp condition. Rates are $16 for a 6-month subscription (12 issues), $32 for a full year (24 issues). Complete the form below and drop it in the mail with your payment. Thank you! +

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Hope IS Possible

Let’s have awareness of this too

Helen Blocker-Adams want to dedicate this week’s column to an important week coming up in October. Much press and emphasis is made to Breast Cancer Awareness Month during October, and rightly so. You will see the color pink in the downtown Augusta and medical complex area throughout the month and many events are held in recognition of that special month. But I don’t want another special observance to go

unnoticed: Mental Illness Awareness Week, October 7-13. With the unemployment rate here in the CSRA still above the national average, childhood obesity at an all time high, and many other social ills plaguing our communities, mental illness and mental health are affecting people and our communities in a huge way. I want to recognize Mental Illness Awareness Week, share what it is about and also some ways you can engage in your community to help make a difference. The National Day of Prayer, another important event held this month, will be held Tuesday, October 9th and there will be events held in cities everywhere. For more information, you can visit www.nami.org to get information on NAMI Augusta and other NAMI chapters across the U.S. The information following was obtained from the NAMI website:

Mental illness is a medical illness — it does not discriminate. One in four adults experiences a mental health problem in any given year. One in 17 adults lives with a serious mental illness. In this election year, it’s worth remembering that mental illness affects Republicans, Democrats and independent voters alike. It’s not a partisan issue, but it does involve every issue from the economy and, budget priorities. Since 2012, states have cut mental health services by $1.6 billon, at the same time that need has increased. Unemployed people have been four times more likely to report symptoms of severe mental illness than others. Americans who experienced involuntary changes in employment status, such as pay cuts or reduced hours, were twice as likely. The need also is increasing as our troops return home from Iraq and Afghanistan, some with “hidden wounds.” They must not be forgotten in the years ahead. Treatment works, but only if a person can get it. Early

identification of symptoms and treatment results in better outcomes During MIAW, let’s all talk with friends and neighbors about mental illness and recovery. It’s an opportunity to learn facts and end myths to help break the stigma— and silence— that too often surrounds the topic. By changing attitudes about mental illness, we can change lives. In 1990, the U.S. Congress established the first full week of October as Mental Illness Awareness Week (MIAW) in recognition of NAMI’s efforts to raise mental illness awareness. Since 1990, mental health advocates across the

country have joined together during the first full week of October in sponsoring many kinds of activities. MIAW has become a NAMI tradition. It presents an opportunity to all NAMI state organizations and affiliates across the country to work together in their communities to achieve the NAMI mission through outreach, education and advocacy. The National Day of Prayer for Mental Illness Recovery and Understanding is Tuesday, Oct. 9, 2012. MIAW’s theme this year is “Changing Attitudes, Changing Lives.” + Helen Blocker Adams is President/ CEO of The HBA Group, Intl and Executive Director of the Southeast Enterprise Institute, Inc. Visit her website at www.helenblockeradams. com. If you like politics, visit her blog at www.projectlogicga.com. You can reach her via email at hba@hbagroup-intl.com Helen’s new book, Unlikely Allies: 8 Steps to Bridging Divides that Impact Leadership can be purchased by visiting www.hbagroup-intl.com or www.authorhouse.com

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WHAT EVERYBODY OUGHT TO KNOW ABOUT MISDIRECTED EMOTIONS by Bad Billy Laveau At a recent cookout, a certain “gentleman” became one with a pint of Black Label Jack Daniels. As might be expected, he became 10 feet tall and bulletproof. Alcohol takes away two layers of civilization. Apparently he had only three layers of civilization to begin with. At some point in the festivities I happened to make a strong statement against violence toward or otherwise any mistreatment or disrespect of women. He took exception to that. He ineloquently announced that “women need a belt on their butts now and then to let them know their place.” He got in my face and “called me out,” as they say in the Old West. A hush fell over the room. Attention centered on the perpetrator and me. I neither blinked nor bothered to look at him. I continued my meal as if he did not exist. He ranted on for a couple of minutes, questioning my manhood, spouting irrelevant profanities, until it became apparent to him and everyone else that not only would I not respond to him, I cared not that he even existed. Slowly, he retracted into

loneliness beneath the glare of mass disapproval of his inappropriateness. For the remainer of the evening, he was shunned and ignored. Eventually, he sulked away and was swallowed up by the night. The following day, I received several calls complimenting my restraint and steady manner. To each, I noted, “Neither my mother nor Sun Tzu would have approved of me lowering myself to that level of idiocy. The best battle won is the battle never fought.” Thankfully, the crude inebriate failed to show his face for the next cookouts. All of that brings me to things you should remember when a disagreeable situation confronts you. Here are a few:

Best Beauty is skin deep. Ugly goes clean to the bone.

Personal threats signify deceit and weakness.

One act of goodness outweighs 1,000 apologies.

Diplomacy should be handled with these thoughts in mind. Daily life should be handled

All evil is rooted in lies.

Do not mistake good manners for acceptance. Past tolerances do not guarantee future tolerances.

Goodness is rooted in truth.

If an act fails, more of the same guarantees more failure.

If you blame your failure on others, then you have failed twice.

If you fail to plan, then you plan to fail.

Bad Billy Laveau is a retired MD with a pointed sense of humor. Bad Billy speaks and entertains at public and private events for audiences not subject to cardiac seizure secondary to overwhelming laughter and glee BadBilly@knology.net or 706306-9397

Forgiveness requires earnest confession and apology. An insincere apology is a lie.

Do not mistake silence for ignorance — or weakness.

e n i c i d ME

the same way. We would have fewer wars. Fewer Saturday night shootings. Fewer domestic dysharmonies. Fewer court cases. Fewer ER visits. Fewer divorces. +

Failure comes from within, ot from those around you.

GOT A STORY? Seriously, who doesn’t?

A loud voice signifies weakness.

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AUGUSTA MEDiCAL EXAMINER

Health 101 by Sandy Turner, RN, EdD, Family Nurse Practitioner, and Assistant Dean for Administration in the GHSU College of Nursing WHAT IS THAT SPOT? ost of us don’t really pay much attention to spots on our skin. As we age we tend to get more and more. And while most of them are harmless we do need to look at them every so often. Damage that we do to our skin often doesn’t cause a problem until many years later. We usually start by having a sunburn or even sun poisoning, a rash, or blistering from the sun. Our skin can take the damage a few times but the more drying and burning that it takes the more damage is done to our tissue. We may know that we need to apply SPF (at least 45) sun lotion to our skin every 2 hours, but often we forget. Hats and long sleeves help also but don’t forget areas like ears, nose, lips and hands. Sun-exposed areas are the most vulnerable to damage so those are the areas that we generally focus on. But other parts of our body need inspection too. For example it isn’t normal to get a mole on the bottom of your foot, so they need to be evaluated if they are found. We use the mnemonic ABCDE when we evaluate a mole. This stands for:

• Asymmetry or not perfectly round • Border or ragged edges • Color or mottled appearance of browns and black, • Diameter or bigger than an eraser head and • Elevation, raised above the skin surface, or • Evolution meaning an area in the process of change. These indicators give us a rough estimation of a problem but the true test is to cut it out and look at the tissue under a microscope. Most of us have moles and skin tags on our bodies that never change. Some are red

and some are brown. There would be a concern if they start to change, get larger or change color. Viruses can cause bumps or rashes but they go away in time. If they itch they are caused by something external and will go away in time also. Some flat lesions caused by sun damage are called actinic keratosis. They are dry flat patches that usually are on the back of hands and arms or even on the face from over exposure to the sun. They can be scratched off or even frozen to get new healthy skin to grow in place. They are called pre-cancerous because they can change but in themselves are harmless. Another lesion that causes a lot of concern is one called seborrhea keratosis. Keratosis actually means a callous like patch of skin. These patches appear to be ‘stuck on’ to the skin and are usually on the trunk rather than on sun exposed areas. They may even be a bit greasy and crumbly. They can even be scratched off of the skin but will usually grow back over time. These, while may not be particularly pretty, are also harmless. You need to look at your body every so often or have someone else look at the areas you can’t see. If something new pops up or starts to look different have it evaluated. If you are concerned the best thing is to have it taken off. +

HEALTH 101 – Information to help you make positive changes in your life to improve your health by Sandy Turner, RN, EdD, Family Nurse Practitioner, Director of the Good Samaritan House, A Free Community Health Center Open Mondays 15 pm. 213 N Main St., Dearing, GA 706-556-9080.

Editor’s note: Exceptional Living appears exclusively in the Medical Examiner each month, addressing issues that all of us can benefit from involving people with special — let’s call them exceptional — needs.

Exceptional Living

A mile in his shoes by Naomi D. Williams, MPH, CHES, CIC®

The last few months I’ve noticed that I become frustrated and at times a bit irritated when doing daily living activities with my son. For instance, over the weekend while I was feeding him it felt as if time was standing still and it was taking an eternity for him to eat. To top it off he was making a mess by blowing raspberries with food still in his mouth, letting the milk flow with a steady stream out of the side of his mouth. The culmination was when he hit my hand causing the spoon and the food on it to fly over his head, creating a fresh new spot in my already food spotted rug. Needless to say, this was not one of our better eating sessions. It’s moments like these that throw me into having a reality check that at times verges on a pity party. I’ll think of what other three year olds are able to do, the autonomy that they have and the freedom that their parents have. I recount the things that people say and sometimes the things that they do and say to myself “If they only knew what my life was really like…” I started to go there after the incident with Noah this past weekend and I received a quick gut check. Right in the middle of my “woe is me,” my “ah ha moment” was “What about Noah?” What would it be like to walk a mile in his shoes? That thought changed my attitude and perspective greatly. I began to think of what my attitude would be if I was completely, one hundred percent, dependent on someone else for all of my needs. In addition to that sole dependence, not having the ability to say what I want or need, or even to express myself with any type of basic language would be extremely frustrating. Being visually impaired is the sour icing to a halfbaked* cake (in my opinion). So, not only do I have to wait on others to do everything for me because I can’t control my muscles, I can’t articulate what I want or how I feel, and I can’t see what’s coming or about to happen to me. I have to depend on people to tell me what they are going to do and when, which most of the time doesn’t happen, because people are used to living in their “typical” world and forget to adjust their mindset and attitude to my differently-abled world. When I broke down the steps of what a day in the life of Noah would be like, my eyes swelled with tears. Not because I feel sorry for him, but for the admiration that I have for him in how he handles everything. He has the sweetest disposition and the best attitude ever. There are days that he doesn’t want to be bothered, he has his favorite people and then those that he merely tolerates, just like the rest of us. At the end of the day we actually have more similarities than differences. I can honestly say I don’t think I would be as happy, tolerant or graceful as Noah is if I had to walk more than a mile in his shoes. *So as not to have the “half-baked” comment misconstrued here are my thoughts concerning that choice of words. A halfbaked cake may be done on the outside and still soft and not quite done in the middle. When considering Noah’s challenges inclusive of desires, trials and triumphs, they remind of a half-baked cake. There are things that he wants to do and can partially do, but because the brain damage he isn’t able to fully complete. For example he will grab and hold a cup or spoon, but it takes three or more tries before getting it to his mouth; he tries to sit up but hasn’t figured out that his hands have to go down on the ground which will push him up. +

THE MEDICAL EXAMINER BLOG CAN BE FOUND AT WWW.AUGUSTARX.COM/NEWS WHATEVER YOU DO, DO NOT DENY YOURSELF THE SINGULAR PLEASURE OF VISITING REGULARLY.

Naomi Williams is a health educator by training, an entrepreneur by nature, mom, and advocate of the best kid ever, Noah Samuel.

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OCTOBER 5, 2012

AUGUSTA MEDiCAL EXAMINER

Adventures Sparkle in Administration

ister Mary Louise Hermann was destined for health care leadership. She had special gifts that made her an extraordinary manager. For the Archdiocese of Savannah she created and built St. Joseph Hospital (now Trinity) from its inception. For 19 years she led St. Joseph as a premier center for health in the Southeast. In January 1971 Sister died, in office. A search committee for her replacement, chaired by Jimmy Williams, then president of First National Bank, chose me to fill Sister’s position. I started in early April 1971. My family stayed in Missouri until the school year was over. I lived at the hospital in the “Bishop’s quarters.” It was customary for a hospital’s Chief of Medical Staff to be involved in all significant hospital activities, and therefore Dr. Ira Goldberg as Chief at that time was on the search committee. Ira was a highly regarded Obstetrician. He was also a very kind and personable individual. As one historian put it, “He was a hell of a nice guy.” I find it memorable that Ira and I became good friends and worked well with one another. During the wait for my family I was often privileged to have dinner with the Goldbergs. The dinner was usually capped off with Ira and I lying in backyard hammocks, looking at the stars and having intriguing discussions about who knows what. They were pleasant evenings. Almost to the day that I took office at the hospital, a tragedy struck. It involved a patient, one of Ira’s, who came to St. Joseph to deliver a baby. Put very simply, blood flows from the heart to the human body’s extremities with the vessels getting smaller and smaller, and then returns for oxygen replenishment through vessels that are getting progressively larger. In other words, when the blood is furthest from the heart its contents are the most concentrated. Apparently this patient’s medication was placed in a vessel that was getting smaller, causing trauma to the small capillaries of the patient’s hand. The consequences were not good. My family eventually arrived and my visits with Ira were diluted and more official. Then one day in maybe July, 1971 Ira came by in a casual fashion. His reason: he wanted to ask me to have the hospital serve as a co-defendent in the lawsuit by the patient with the dramatized hand. He pleaded that St. Joseph was rightly involved and that its participation would increase the chances of winning the case. He had been sued another time and deeply feared that this second suit with him standing alone would be disastrous. I had to tell Ira that to implicate St. Joseph in this way was not within the realm of my authority. It was a devastating blow for him. As much as I might have wanted to help Ira, I just could not implicate the hospital. Later that summer Ira Goldberg had his last and most devastating tragedy. Sailing on Clark Hill Lake with another family and with the water level high, the mast of the sailboat hung up on a live power line. As the mast teetered to and fro off the line, sending pulsating electrical charges through the boat, Ira — vintage Ira — helped to save all of the passengers’ lives except one: his own. He was a great man, one of the finest that I have ever know. At the next St. Joseph board meeting I was asked to write a eulogy for Ira, which I did. Presumably it continues to rest in the archives of St. Joseph. I feel honored to have known him, and for what I wrote some 40 years ago to be part of Ira Goldberg’s tragedy-driven life. + Editor’s note: This series is by Bill Atkinson, former CEO of Trinity Hospital (then St. Joseph Hospital), and the author of the comprehensive 2009 Medical Examiner series on the founding of the Augusta area’s major healthcare providers.

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

Around town: • Barney’s Pharmacy, 2604 Peach Orchard Rd. • Birth Control Source, 1944 Walton Way • ASU 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 • Southside Family Y, Tobacco Road, Augusta • Surrey Center, Surrey Center Pharmacy, Highland Avenue, Augusta • Top-Notch Car Wash, 512 N. Belair Road, Evans • Wild Wing Cafe, 3035 Washington Road, Augusta

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

OCTOBER 5, 2012

AUGUSTA MEDiCAL EXAMINER

P harmacy 411 EDITOR’S NOTE: 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.

FIRST DIABETES. NOW HEART DISEASE? Think back to your childhood days of playing games. You push over the first domino and the next would fall, right? It’s the same way with diabetes and heart disease. First you develop diabetes due to the inability to control your blood sugar levels, and then the higher levels of sugar in your bloodstream cause damage to your veins and your heart. One is a risk factor for the other, just like a line of dominos affect each other. So let’s talk a little bit about how this occurs. Let’s picture sugar molecules flowing through our blood vessels. Due to diabetes there are more of these little crystals than normal. Think about the shape of a crystal and its sharp points. As these crystals flow through the bloodstream they nick the inside of the vessels causing damage which, in turn, gradually causes the vessels to become harder and stiffer than normal. Cholesterol plaque gets stuck to these sites, which narrows the vessel. When pieces of plaque break off, clots form which can stop the blood from flowing at all. When that happens the result is a heart attack or stroke, depending on where the clot forms. If a clot forms in arteries supplying the heart, blood flow will be reduced, causing a lack of oxygen to heart tissue and damage to the heart muscle. That, in turn, leads to heart failure. These events occur over a long period of time, so a diabetes diagnosis does not mean you are due for a heart attack tomorrow. However, today is the time to start preventing the damage, and that means getting control of your blood sugar, blood pressure and cholesterol. For all you diabetics — and your numbers are growing — here are some sobering statistics. Diabetics have a two- to four-time higher risk of developing heart disease. More diabetics die from heart disease than from any other single diabetic complication. Diabetics will develop heart disease at a younger age, and be harder to treat than a non-diabetic patient. People with diabetes also have a greater chance of not showing outward symptoms of their heart disease. But it’s not all bad news. Here are some risk factors for heart

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disease that are controllable. A healthy diet can work in several ways to reduce your heart risk. Lower weight lowers the risk, which is helped along by the healthy diet. Increasing your activity level, with your doctor’s consent, and lowering your stress level will decrease your blood pressure as well as decreasing your overall heart risk. Since this is a pharmacy article I should also mention that taking your medications every day as prescribed goes a long way toward preventing bad outcomes. I have diabetics that come to the pharmacy that are so compliant with their therapy that eye doctors cannot find any signs of eye damage due to diabetes. The eyes are normally one of the first areas where collateral damage from diabetes appears. So what does a diabetic need to do to be safe when it comes to the risks associated with diabetes and heart disease? Think of the first three letters of the alphabet. For A, a diabetic should always know their A1C level (pronounced “A-one-C”). This a blood test done by the doctor that gives you a picture of your average blood sugar reading over the past two to three months. A good A1C is less than seven percent according to the American Diabetes Association, and less than six and a half percent according to clinical endocrinologists. Your doctor will discuss your personal goal in this and other tests. So A is for A1C. B is your blood pressure. A healthy blood pressure will help prevent heart disease. An average acceptable blood pressure is less than 120 over 80. Again, get your personal goal from your doctor. Finally, C is for cholesterol. Remember that cholesterol plays a role in heart disease also so the lower your bad cholesterol and the higher your good cholesterol, the better. By keeping all three of these numbers front and center in your mind and managing them carefully you can prevent a large percentage of the complications from diabetes and heart disease. Also keep in contact with your doctor and pharmacist to allow them to encourage and help you along the way. + Questions, article suggestions or comments on this article email us at cjdlpdrph@bellsouth.net Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson (cjdlpdrph@bellsouth.net )

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OCTOBER 5, 2012

AUGUSTA MEDiCAL EXAMINER

Ask a Dietitian

t’s difficult to celebrate Halloween without thinking of The Wizard of Oz and the infamous Wicked Witch of the West. If only everything evil could be dispatched with a bucket of water over the head, we could all live happily ever after. Unfortunately, real life isn’t quite that simple. In addition to Halloween, October highlights another threat to life and liberty — and not just in Kansas, either. That threat is breast cancer. I’ve heard women complain after past Octobers that a full month of unrelenting reminders of this dreadful disease makes them want to hop a broom and fly off to undisclosed destinations far, far away. While on some level I understand the sentiment, it’s probably more practical to stay put and educate ourselves on our best defense. So, if a bucket of water won’t eradicate cancer, what nutritional tricks might help? For starters, maintaining optimal body weight is of great importance and is facilitated by following the other recommendations: • Limit empty calorie choices. We all know what falls into this category: candy corn, chocolate bars, cupcakes, cookies, etc. All the Halloween favorites. There should be no wailing like a banshee over this recommendation because it contains the important word, “limit.” By definition this means “to set boundaries or apply control.” It does not

mean you cannot partake of a small indulgence here and there. It simply means that candy corn should not become the go-to food of October (followed by pie in November and cookies in December … you get the idea). Why not start the youngsters off on the right track by offering non-candy “treats” this Halloween (toy trinkets, coloring books, dried fruit, etc.)? And for the rest of us (adults, that is) here are some other words to live by between now and December that will reduce the risk of breast cancer: • Eat Vegetables, Fruit, Whole Grains, and Legumes. This should sound familiar by now as it has also been a recommendation of the new My Plate over the past year. Cancer prevention tips from the Academy of Nutrition and Dietetics (AND) suggest filling at least two thirds of your plate with vegetables, fruits, whole grains and beans. Be careful in the preparation of these items so that you don’t minimize the benefit by adding undesirable elements in the cooking process (such as caramel to apples, fatback to vegetables, etc). • Limit Intake of Red Meats and Processed Meats. There’s that word limit again. In this instance the AND recommendation is no more than 18 ounces (cooked weight) of red meat like beef, pork, lamb per week. Some quick math is in order here to put

this in perspective. There are 16 ounces in a pound so if you select a quarter-pounder hamburger, you have eaten 4 ounces of meat. Replace the red meat with fish, poultry and beans. • Consume less sodium. This too should sound familiar because it is part of the 2010 Dietary Guidelines and has been in the news quite a bit lately. Too much sodium increases the risk of stomach cancer. Most of our sodium intake comes from consuming processed foods (including bread) and not from what we add through the salt shaker (which you should banish from your table). Therefore, you absolutely must read food labels in order to control your intake. I guarantee you will be surprised with what you find. The DG suggest limiting intake to less than 2,300 mgs per day with further limitation of 1,500 mgs per day for those 51 years or older, any age of African American, and those with hypertension, diabetes or chronic kidney disease. • Limit Alcohol. Evidence suggests that alcohol consumption may increase the risk of a number of cancers, including breast cancer. Try quenching your thirst in other ways such as sparkling water,

iced tea, etc. (So, the bucket of water came in handy after all). If consumed at all, limit alcoholic drinks to 1 to 2 per day for women and 2 to 3 per day for men. Again, a little perspective goes a long way. The American Cancer Society defines one alcoholic drink as the equivalent of 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits. Not a nutritional recommendation but of equal importance is regular intentional activity. Walking door to door with your children on Halloween night, while

intentional, only covers one day of the year. Regular exercise needs to be more frequent. Park the broom and use a pedometer to challenge yourself to more steps each day until you reach your fitness goals. Good nutrition and daily exercise are your best defense, even better than a bucket of water. + Author Cindy Elia, M.S., R.D., C.D.E. is the Nutrition Specialist for the CSRA Area Agency on Aging, your gateway to aging resources. Got a question? Drop us a line: info@AugustaRx.com.

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20 JOE 9.21 - TOKYO

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You’ll be glad you did. There’s always interesting and informative information posted at the Medical Examiner blog:

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OCTOBER 5, 2012

AUGUSTA MEDiCAL EXAMINER

Got mosquitos? by Rebecca Head Early fall is the best time to be outdoors. For mosquitos, it is a time to feast. Mosquitos can quickly take over an area, making it impossible to be outside. They can reproduce if they have access to just a tablespoon of water. This means that hollow trees, bird baths, clogged gutters, or even children’s toys left in the yard can become a breeding ground for these pesky insects. Mosquitos go through four life stages: egg, larva, pupa, and adult. The first three stages are aquatic and last anywhere from

day time. Once a yard has been sprayed, it also helps to keep standing water away from the house by making sure to put away toys, clean out clogged gutters, and use mosquito repellent in bird baths. With their diapause ability and the high rate at which they can reproduce, mosquitos can make the outdoors unbearable. If managed properly, the mosquito population can stay in check and families can go back outside without having to light citronella candles or slather on bug repellent. +

5 to 14 days. Once the pupa has developed, it breaks out of its shell, dries its wings, and takes flight. If something interrupts their lifecycle, the mosquito will go into diapause. This means that when the mosquito is immersed in water again, it will finish its lifecycle and become an adult. The diapause stage can last for up to two years. This means, for example, when the birdbath is full of mosquito larvae, dumping the birdbath is not a solution to a mosquito problem. The larvae will wait in diapause for the next big rain to complete their lifecycle. Mosquitos feed on nectar when they hatch, and males

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See also the Medical Examiner blog: www.AugustaRx.com/news continue to feed on nectar throughout their adult life. When the females are ready to mate, they need the protein in blood in order to reproduce. When a mosquito bites, it draws blood while injecting a poison under the skin of humans or animals. Mosquitos spend most of the day hiding under leaves and in trees to avoid the heat, and they come out around dawn and dusk. With 72 odor receptors located on their antennae, mosquitos are well adapted to find a blood source. They use these receptors to detect carbon dioxide and octenol which humans and other animals produce. Certain humans are bitten more frequently than others. Some studies show that blondes are bitten more frequently than brunettes and that people who are more active are bitten 50% more by mosquitos. Not only can these insects cause discomfort when

they bite, but some mosquitos carry diseases including yellow fever, many forms of encephalitis, malaria, and West Nile virus. The best way to treat for mosquitos is spraying. A pest control technician will spray leaves and brush to eliminate mosquitos hiding during the

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11 +

AUGUSTA MEDiCAL EXAMINER

The blog spot — Posted May 5, 2010 at http://drwes.blogspot.com. The author is an internist, cardiologist and cardiac electrophysiologist and is a clinical associate professor of medicine at University of Chicago’s Pritzker School of Medicine.

TOP TEN REASONS TO BE A DOCTOR With all the negative press, the pay cuts, the uncertainty of health care reform, I am approached by people who secretly whisper in my ear, “Would you have your child go in to medicine?” On first blush, I am tempted to answer “Heck no!” given the administrative hassles, the changes in the public’s perception of our profession, the front-load of education and the long hours involved. But those observations are at best superficial. With more careful analysis, I asked myself what makes medicine special. Here’s my list:

“

Medicine is never boring.

10. Independence - No matter what happens on the larger public policy scale, when it comes to decisions regarding a patient’s care, it will always be the one-on-one interaction between the patient and the doctor that will ultimately decide the best approach for care. 9. Respect - The title “Doctor of Medicine” still carries weight in our society. With that respect, however, comes significant moral imperatives to maintain that respect. 8. Flexibility - For those not adept at one-to-one interactions with people (the clinical side of medicine), there are a myriad of opportunities opened with the MD or DO degree in public policy, research, science, journalism, consulting, business, etc. This flexibility of options open to doctors ensures job security.

From THE Bookshelf Now here is a book with admittedly limited appeal. The only people who would conceivably buy this book are people who have bad habits they’d like to change. That narrows the market of potential buyers and readers down to somewhere in the neighborhood of about 7 billion people. Yes, if you didn’t already pick up on it, there was a hint of sarcasm in the previous two paragraphs. There is anything but a shortage of potential readers for a book like this: we all have bad or unhealthy or simply annoying habits — and probably all three (and more). Of course, organizations are made of people, which means that corporations, clubs, congregations, cities, and pretty much any other collection of people also probably have bad habits. The question isn’t who makes repeated mistakes; we all do. The real issue is what can we do about it? Author Charles Duhigg tackles that question and along the way explains a great deal about the science behind it all. Habits are rather fascinating, to say the least, especially bad ones. After all, why would

Clipping File

6. Influence - Physicians matter. People know it. But you’d better be ready to be cornered at cocktail parties.

4. Trust - Like Smith Barney says, you have to “earn it,” but once you have a patient’s trust and confidence, it’s the tie that binds. By virtue of your title, you are invited into the most secret parts of patients’ lives to share their deepest concerns - a truly remarkable privilege. Corporate meetings never leave me with that feeling. 3. Humility - Medicine will always keep you humble since there will never be a time when you can know it all or cure it all - ever. The blessing and the curse of our profession: learning never ends. 2. Fascination - Every day we work with the most amazing technology imaginable. The wonder of it all never ends. Even something as simple as cutting the skin of the belly with a scalpel while listening to the patient chat idly about their grandkids thanks to remarkable local anesthetics, you are reminded of the amazing wonders of modern medicine every day. 1. Teamwork - Medicine is, by definition, a team sport. No physician can do what we do in isolation. Our “Club Med” has challenging pre-requisites, but once in, it is a vocation where we share collectively in the trials and tribulations of patient care. We win and we lose together. Whether we are doctors, nurses, technicians, administrators, clerical staff, safety personnel or maintenance workers, each of us are constantly working for a common goal: the health and well-being of our patients. When it works, nothing, I mean nothing, is as cool as that. +

The Power of Habit by Charles Duhigg, 400 pages, published in 2012 by Random House

the

7. Variety - I have been doing medicine a long time and have yet to see two days’ activities or two patients that are the same. Ever. Bottom line: medicine is never boring.

5. Reward - I cannot not think of anything superior to helping a fellow man or woman at a time when they are most vulnerable or in the greatest need. It also occassionally provides upgrades to first class when you help treat a syncopal patient on an airplane.

we do something to which we fundamentally object? Or that we know annoys or troubles our friends or marriage mate? Or that threatens our job security? Or our very life? And not just once, habitually? A person might hate using bad language and yet find himself doing so often; another is annoyed by a habit of procrastination; the next person is always late for everything: work, appointments, meetings; still another smokes or constantly overeats even though he despises the habits and wants to quit. It’s odd to think we would do something we consider

objectionable, and then repeat it so often that it becomes a habit, yet we all do it. And so do organizations made up of thousands of people. Duhigg explores several corporate examples of breaking away from the old, “because that’s the way we’ve always done it in the past” thinking that had dramatic results. Much like someone who grabs a bag of Skittles or Cheetos, sits down in front of the boob tube and polishes off the whole bag without even realizing it, individuals and large groups of people often do things on auto-pilot. It’s called habit, and as Duhigg’s title suggests, habits are powerful. The nice thing about habits is that they’re all powerful. Good habits are as powerfully entrenched as bad habits, so when we successfully replace a bad habit with a good one, we have a strong ally. By helping readers to explore why they do what they do - in business and in life - Duhigg provides the analytic tools and reward systems that just might help us to get busy “breaking bad.” +

Getting a head start? Smoking doesn’t traditionally get the spotlight until next month, when the annual Great American SmokeOut occurs. But since there is never a bad time to quit smoking, here’s a helpful tip backed up by the results of a recent clinical study: exercise decreases nicotine cravings. In fact, University of Exeter researchers say that based on their research, exercise is “strongly recommended” as an ally for anyone trying to quit smoking. While there is more pharmaceutical support for quitters available than ever (nicotine patches, Chantix, etc), exercise is free, carries with it few if any negative side effects, and is always available, unlike a cessation product that you might run out of at the moment of your worst cravings. It never hurts to doublecheck with your doctor before beginning an exercise program, but researchers say anything — running, walking the dog,

riding a bike, hopping on the treadmill — can help diminish sudden cravings for nicotine and help you get past a temporary crisis. Andy Williams’ disease We admit, there’s no disease named after the Moon River singer who died last week. If there was, it would probably be bladder cancer, which was the official cause of death for the 84year-old Arkansas resident. While there are various causes for bladder cancer (some of them yet to be discovered), the top risk factor — implicated in as many as half of all cases — is smoking. Other than quitting smoking, see your doctor right away if you have pain when urinating, blood in the urine, or are having to go more than usual. Like many other cancers, bladder cancer is deadlier and harder to treat the longer it goes undiagnosed. Better brains built by breakfast A U.K. study released last week discovered that skipping

breakfast significantly reduces students’ speed and accuracy on cognitive and memory tests compared to those who ate breakfast. Although the study did not identify what students had for breakfast, those who skipped a morning meal had a 7% lower measure of what the study called “power of attention,” the ability to focus and avoid distraction. Skippers detected 7% fewer targets in target-detection tasks, and 9% fewer pictures in a picture-recognition test, at a 9% slower rate than students who had breakfast. Also, variability in response time, “an indication of focusing consistency,” was 10% more erratic in those who missed breakfast. Of the 1,386 students aged 6 to 16 who participated in the study, girls who skipped breakfast were “significantly more disrupted in their ability to focus” than boys who didn’t have breakfast. Girls were also more likely to be skippers: 7.6% compared to 5.6% of boys. +

+ 12

OCTOBER 5, 2012

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS +

by Dan Pearson

I fell. During Fall Prevention Month.

Ironically, September was What’s ironic Fall Prevention Month. about that?

I blame it on these new shoes.

That is pretty funny.

Well, they are slip-ons.

The Mystery Word for this issue: BELOCAP

EXAMINER CROSSWORD

PUZZLE

ACROSS 1. Sanford penalty indicator 5. A Doll’s House playwright 10. Utters 14. Trevi Fountain location 15. Tree with a pancake connection? 16. Like some Bush Field jets 17. ___-ready, as in some convenience foods 18. Braid (archaic) 19. Pre-euro Italian bread 20. Selective mass extermination 22. Muffle 24. A lot, informally 25. ___ for Life 27. Without weapons 31. Ships 35. Capital of Yemen 36. Excrete 38. “That’s your best...” 39. Bomb type 40. CTs, for one 41. Mr. Ballesteros 42. ___ about; go here and there for fun 43. “Thou ____” 44. Wood destroyer 45. Voted in 47. Improve in appearance 49. Drive back 51. Mythical sea monster 52. Plot 55. A little cupid 60. Stool type 61. Newborn score 63. Past president of MCG 64. Bacterial beginning? 65. ASU library 66. Send forth 67. Exam 68. Board game 69. Nevada city

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

VISIT WWW.AUGUSTARX.COM TO ENTER! 1

24 27

‘

38 41 44 47

49 53

Click on “Reader Contests”

QUOTATION PUZZLE 32

H A C D T F H D E S H I S L T I I D A O C A D N M E A A A T E F I H A K I G Y E W S Y N E M I

48 51

— Robert Ingersoll

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above. Once any letter is used, cross it out

Solution p. 14

DOWN 1. _____ Hollow 2. Word sometimes before life or sick 3. Augusta corner 4. Family tree 5. Drink 6. Poet 7. Albert of Nazi infamy 8. Antiquity 9. Unnecessary 10. Spreads out 11. Parched 12. Of long ago 13. C21. Prolonged unconsciousness 23. Boundary beginning 26. Bell bookings 27. Customary practice 28. Neo follower 29. Battery terminal 30. The Roaring Twenties was one 32. Film critic Roger

33. Riverwalk is on one 34. Strict; severe 37. Guy’s opposite 40. ______ Blood, as it’s commonly called 41. Magician 43. Brain ____ 44. Epstein’s partner 46. One of the Cs in HCCU 48. Belonging to actress Julianne 50. Beer variety 52. Quick!!! 53. Word often paired with traffic or head 54. Homburg and panama 56. Pole 57. Domesticated 58. Weak, as in proof 59. Upon; to 62. Green shade

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.

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

X A M I N E R

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. All the listed letters following 1 are the 1st letters of each word; the letters following 2 are 2nd letters of each word, and so on. Try solving words with letter clues and entering unique and minimal choice numbers (such as 5 thru 8 in this puzzle). A sample is shown. Solution on page 14.

1 2 3 4 5 6 7 8

R 1 2 3 4 5

1 2

I 1 2

T 1 2 3

1 2 3 4 5 6

— Author unknown

1.WOGHATI 2.FRRASH 3.EAAN 4.PGT 5.HOE 6.SV 7.E 8.R

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 5, 2012

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AUGUSTA MEDiCAL EXAMINER

THE BEST MEDICINE ha... ha...

Ten Famous Medical Quotes 1. My doctor is wonderful. Once when I couldn’t afford an operation, he touched up the X-rays for me. - Joey Bishop 2. After a year in therapy my psychiatrist said to me, “You know, life isn’t for everyone.” - Larry Brown 3. She got her looks from her father: He’s a plastic surgeon. - Groucho Marx 4. I’m not feeling well. I need a doctor

immediately. Call the nearest golf course. - Groucho Marx 5. The art of medicine is in amusing a patient while nature affects the cure. Voltaire 6. A woman went to a plastic surgeon and asked him to make her like Bo Derek. He gave her a lobotomy. - Joan Rivers 7. Whiskey is by far the most popular of all remedies that won’t cure a cold. - Jerry Vale 8. Anyone who goes to a psychiatrist should have his head examined. - Samuel Goldwyn 9. Never go to a doctor whose office plants have died. - Erma Bombeck 10. I’m always amazed to hear of air crash victims so badly mutilated that they have to be identified by their dental records. What I can’t understand is, if they don’t know who you are, how do they know who your dentist is? - Paul Merton +

Opening Doors to a Cure SEEKING STUDY PARTICIPANTS TO COMPARE CURRENT & NEW CANCER TREATMENTS: Breast Lung Prostate/Genitourinary Gastrointestinal

Hematological Malignancies Skin Cancer Prevention

We are a Minority-Based Community Clinical Oncology Program

For More Information Please Call 706-721-6875 Or visit http://www.mcg.edu/cancer/ for a list of all trials

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The Patient’s Perspective by Marcia Ribble

little more on the issue of weight-loss surgery. In my journey through research land, I learned an awful lot, not just about the various surgeries and their differences, but also about the aftermath in terms of all kinds of issues: nutrition, satiety of food, individual psychology, and the likelihood that after going through all that, we can gradually eat too much and expand the stomach again. Most important to me in the decisionmaking process was discovering that my psyche and the required diet after surgery, beginning with liquids only, then baby food, and finally little bits of real food, like two tablespoons of vegetables, don’t seem like a good match. I recall previous surgeries I’ve had and their resulting liquid diets, and begging the doctors for real food. They all told me I’d be just fine, that the liquids had enough calories to keep me OK, but I have never believed them, not for a second. My brain is convinced that I’m being deliberately starved and that I’ve lost control over whether I will live or die. I feel terrified and helpless. The same thing is true when I have an IV in and am not allowed to drink anything. When my mouth and throat are dry, there is nothing that can convince me that I’m not in immediate danger of death. Logic does not apply in that situation, nor does medical expertise. I am in my body and I know how I feel and to have doctors act as though I’m just being obstinate is of no help whatsoever. Somehow or another, doctors need to discover that scientific knowledge and medical reality never trump gut feelings and psychic reality in their patients. So I ruled myself out as a candidate for all kinds of weight loss surgery, realizing that the only thing which has a possibility of working for me is good old-fashioned hard work. I acknowledged to myself that I will simply have to change my eating habits and my often

Talk is cheap. Not talking can be deadly.

sedentary ways of living, even though I now eat much less than I did in my thirties. So it’s not as much a matter of overconsumption most of the time as it is of poor choices. For example — and you can laugh at me here if you’d like — I heard that adding cinnamon to foods would stabilize my blood sugar. So I decided that the luscious cinnamon rolls at my grocery store, the good ones like Dad made in our bakery with sweet roll dough and thick white icing, were perfectly acceptable with a couple of hard boiled eggs for breakfast. Not five rolls, nor three of them, nor even two. Just one. Then yesterday at the grocery store I noticed that one of them was not a serving at an acceptable 290 calories, but that a serving was one-half of a roll. So I had been scarfing down 600 calories. OMG! What was I doing to myself? Following the advice to “Eat This, Not That,” I chose Pepperidge Farm’s Cinnamon Raisin Swirl bread, which has the cinnamon, added raisins, and only 80 calories a slice. I encourage you to do the same kind of thinking and let’s see what we can accomplish with using our brain and willpower instead of surgery. I’ll let you know how well I’m doing from time to time. I wish us all well in the process. + Marcia Ribble received her PhD in English at Michigan State and recently retired from the University of Cincinnati where she taught composition. She taught writing at the college level and loves giving voice to people who have been silenced. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.

GRAPHIC ADVERTISING

Publisher of the Medical Examiner Proudly celebrating our 24th year in Augusta publishing, 1988 — 2012

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AUGUSTA MEDiCAL EXAMINER

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

...carefully hidden (on the signpost) in the page 9 ad for WILD WING CAFE Congratulations to Cheryl Owens, who scores a $20 Wild Wing Cafe gift certificate, two free movie passes courtesy of Health Center Credit Union, a free Top Notch Car Wash gift card, and a jar of Drug of Choice gourmet coffee. Win this stuff! The new Mystery Word is on p. 12. Start looking!

The Celebrated MYSTERY WORD CONTEST ...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then be the first to find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries you’ll score our goodie package: gift certificates from Wild Wing Cafe, Top Notch Car Wash, Cheddar’s, and movie passes from Health Center Credit Union! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (WInners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher.

The new scrambled Mystery Word is found on page 12

EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC. FOR SALE Brand new contemporary townhome/end unit in The Vista on Hwy 1, minutes from MCG. 1450 sqft. Two bdrm, two baths, office. Walk-in closets, lots of upgrades. Hardwood throughout, custom tiled kitchen/bathrooms. Floor to ceiling windows, pristine condition. Ready today. $125K - OBO. 803-5078991. WEST AUGUSTA Two bedroom townhome, quiet & clean units close to ASU, GHSU and hospitals. $645/mo. Call 706951-3598. 11112

FSBO SPRINGLAKES One story brick home built in 1981 Bonus Rm upstairs; 2,792 SF finished downstairs; MBR with two closets (one walk-in); 3 addl BRs; 2 Full Baths and 2wo Half Baths; Formal LR and Dining Rm w/hardwood floors; Large Breakfast area with hardwood floors; Walk-in Pantry; Kitchen redesigned with Stainless Appliances & Granite tops (7 years old); Nice Laundry Room; Large Den with built-ins & fireplace with gas logs; Double Garage. 127 Reed Creek Rd Martinez, GA $229,900 Lot: .7 Acre with sprinkler system front and rear. Google this address and look for it on Zillow.com Phone: 706/863-0886

TOWNHOME large furnished room (dresser, bed, night stand, linens) for rent with private bathroom in convenient and very nice neighborhood near Doctors Hosp. $445 a month includes utilities and Internet service. Please contact 706589-0238 ask for May. TOWNHOME Great location, everything new, 2 master suites, sunroom, all appliances. $98,000 (706) 504-4023 WEST AUGUSTA Luxury 3 BR / 2 BA Townhouse, 1-car attached garage located off Pleasant Home Road $725 /mo 706-228-4655 TOWNHOME 3 bedroom, 3 full bath townhome. 2 master suites, like new, end unit with extra parking, single garage, covered patio, $125,000. 706-799-0394

MISCELLANEOUS MATTRESS We have a Queen Pillowtop Set that is new and still in the wrapping $150 Call or Text 762-444-7615.

SERVICES CNA IN-HOME CARE I assist with daily activities, prepare meals, light housekeeping, grocery shopping, doctor’s appts. I will meet you to discuss your specific needs. Call 706-833-9787

USE THE FORM BELOW AND MAIL IT IN, OR GO TO WWW.AUGUSTARX.COM AND PLACE & PAY CONVENIENTLY AND SAFELY ONLINE. THANKS!

(OURS IS COFFEE)

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(Copy this form or continue on additional sheet if more space needed.)

Send this form with payment to:

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

OVERWEIGHT PEOPLE WANTED! Try our bold new formula for weight loss, mood enhancement and energy. 100% natural, pharmacist-tested and recommended. Visit www.weightlossbyfrank.com to request FREE 2-day trial. Serious inquiries only. (706) 373-8867 after 5 pm. or e-mail f.wadford@comcast.net 9212

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QUOTATION PUZZLE SOLUTION: Page 12: “If I had my way I’d make health catching instead of disease.” — Robert Ingersoll

AD COPY (one word per line; phone numbers MUST include the area code): .50

LAWN SERVICE Commercial, residential. Call Vince: (704) 490-1005

QUOTATION

In case we need to contact you. These numbers will not appear in the ad.

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NOTICE! ATTENTION! If any current or past employer has failed to pay you min. wage or time and a half overtime pay, you may be entitled to an order from US Federal Court awarding you twice the amount of your unpaid wages plus atty. fees. For info, call Arthur H. Shealy, Attorney at Law, 803-278-5149, 1010 Plantation Rd, North Augusta SC 29841. You may be entitled to a similar award for unpaid wages if your employer required you to perform duties during your lunch hour, before clocking in, or after clocking out.

SEE PAGE 12

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

SPARKLING CLEAN Looking for offices to clean. No contract req. Husband & wife team have years experience and give FREE on-request estimates. Call 706.831.8552 or 706.831.8553

THE PUZZLE SOLVED

SENDING US A CLASSIFIED? WHAT’S YOUR DRUG OF CHOICE? Augusta Medical Examiner Classifieds

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

The Sudoku Solution

COFFEE IS GOOD MEDICINE VISIT DRUGOFCHOICECOFFEE.COM FOR YOUR REFILLS TODAY

WORDS BY NUMBER “A hangover is the wrath of grapes.” — Author unknown

Multiply by number of times ad to run: x Total submitted: $

The Augusta Medical Examiner publishes on the 1st and 3rd Friday of every month. Your ad should reach us no later than 5 days prior to our publication date.

Thanks for reading!

www.AugustaRx.com

OCTOBER 5, 2012

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AUGUSTA MEDiCAL EXAMINER

HELP… from page 16 As a co-owner of Right at Home for the last seven years, I have met with thousands of family members who are unsure of what to do next. Being able to help these folks in their time of need is why I do what I do. Receiving a thank you letter from a grateful family member saying the care provided to their loved one really made a difference for them and their family member is very gratifying. The CSRA has many resources available to help with the growing needs of caring for an aging parent, grandparent, or spouse. I have recently become involved with CSRA Senior Resource Advisors. We are an organization on a mission to help not only the aging parent, but also the caregiver in charge of providing care. CSRA Senior Resource Advisors has teamed up with The Senior Citizens Council to present some of the resources available, identify what the resources do, and how to contact the resources. This vital and much asked for information will be discussed in an upcoming workshop, entitled... “Mom Needs Help and So Do I!!!”

This event is free and open to the public. “Mom Needs Help and So Do I!!!” will be held on Thursday, October 18th from 8:30 a.m. to 2:30 p.m. at the Aldersgate United Methodist Church, 3185 Wheeler Road, Augusta, Georgia. To register or to get more information, call The Senior Citizens Council at 706-868-0120. We hope that you will join us as we address ways to make care giving a positive experience for everyone. +

OCTOBER

THURSDAY

Kathy Crist, co-owner of Right at Home of the CSRA is available to discuss your family care giving needs. Right at Home is dedicated to helping seniors by providing private-duty care giving services. Right at Home serves Augusta/Richmond County/Columbia County, North Augusta, Aiken and surrounding areas in SC. If you need help with caring for a loved one, please contact them at 803-278-0250 or on the web at www.rightathome.net/csra.

BALD

TO SUPPORT MEDICAL EXAMINER ADVERTISERS

IF YOU’RE

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During October, the Medical Examiner would like to celebrate skin with a gallery of hairless heads. If you have lost your hair courtesy of cancer treatment or some other medical condition like alopecia, we want to hear from you — soon.

MEDICAL EXAMINER Please call 706.860.5455 or e-mail Dan@AugustaRx.com

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AUGUSTA MEDiCAL EXAMINER

OCTOBER 5, 2012

BREAST… from page 1 cancer is and how much research funding it receives. For example, pancreatic cancer kills more people than ovarian cancer and non-Hodgkins lymphoma (NHL) combined, yet funding for pancreatic cancer research lags behind either of them by tens of millions of dollars. Leukemia and NHL are roughly equal in terms of mortality rates, yet leukemia gets about $90 million more in funding each year than NHL. Lung cancer is the big killer on the Worst list, causing almost four times as many deaths as breast cancer, yet research funding is nearly two and a half times greater for breast cancer: nearly $600 million per year versus less than $247 million for lung cancer.

More information at the Examiner blog: www.AugustaRx.com/news

Share the love When it comes to breast cancer, once upon a time it wasn’t discussed at all, at least in public. Then it gradually became okay to bring it up in very delicate terms. Now, it’s “I <heart> Boobies.” As one blogger noted, “You can ‘heart’ boobies as a man or a woman. Children ‘heart’ them. As a universal method of infant

sustenance, they appeal to people of all ages. Surely, there aren’t many people who do not ‘heart’ boobies.” Well said, well said indeed. Half the world has them and the other half likes them. Somehow it’s easier to get behind the cause of breast cancer than, say, the pancreas. And that’s not to take anything away from the cause of fighting any and all cancers. They’re all deserving of the death sentence. And who’s to say that a breakthrough in fighting breast cancer won’t have applications in fighting all other cancers? So I, for one, am finally on board. I support this effort. — Dan Pearson Publisher

“Mom needs help and so do I!” by Kathy Crist Right at Home of the CSRA Approximately 43.5 million adult children over the age of 50 – America’s baby boomer generation – are caring for aging loved ones while working and raising their own children and facing their own life challenges. The best time to plan for the care needs of parents and other loved ones is before the person’s health or living situation reaches a crisis mode. Finding yourself in the role of being caregiver for an aging parent or spouse can be an overwhelming situation. At some point in our

Every Thursday evening:

Wine & Tapas

lives we all need a little help. In today’s world, most of us work outside the home, are raising our own children and now we are faced with the fact that our parents are having health-related issues and need our help. • Do you know where to go or who to ask for help? • Do you know what resources are available? • Are you aware of all of the options that are available? • Do you know how to get the help you need now or will need later down the road? Please see HELP page 15

La Maison ON TELFAIR

Three tapas dishes displaying Chef Heinz’ unique culinary skills and four specially paired wines. A unique experience every week. $ 25 per person

OCTOBER WINE DINNER

Friday evenings:

NOVEMBER WINE DINNER

Specialty Martinis Half price

Sunday, October 14, 5:30 pm BUENA VISTA WINERY DINNER To get more information and to make reservations, visit our website

Sunday, November 4, 5:30 pm WILLAMETTE WINERY DINNER To get more information and to make reservations, visit our website

WE LOOK FORWARD TO SERVING YOU SOON Celebrating Chef Heinz’ 20 years at La Maison

Chef Heinz welcomes you

706.722.4805 • 404 Telfair Street • New Hours: Tue - Sat: 5:00 pm until • www.LaMaisonTelfair.com

TopNotchExpressCarwash.com 4 area locations • 706/868-1450

SHOE 25% OFF! ANY ONE REGULARLY PRICED PAIR OF SHOES WITH THIS AD.

Not valid with any other offers or discounts. Not valid on sale or clearance merchandise. One coupon per customer per day. Expires Oct. 18, 2012. MUST PRESENT THIS AD.

ESTABLISHED 1930 - SERVING AUGUSTA FOR 5 GENERATIONS

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