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OCTOBER 7, 2016

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Who is this?

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FLU FIGHTER! NOTES FROM A PEDIATRIC RESIDENT

by Caroline Colden, M.D., Children’s Hospital of Georgia

lu season is upon us. The time to pester patients to get their annual flu vaccine is happening. It is annoying, we know. But why all the fuss about getting flu shots ? Especially when people say flu shots can sometimes cause the flu in some patients? The answer is because the flu—short for influenza—is a big deal. It has even been known to kill if serious enough.

And for the record, a flu shot does NOT cause the flu. It may sometimes cause a post-vaccination reaction, including body aches, low grade fevers, and pain in the injection site, but the actual flu it cannot cause. If you do get the flu, what are symptoms? Most people think of vomiting and diarrhea (the “stomach flu”), which happens more in kids than adults. More

common symptoms include runny nose, congestion, sore throat, chest pain, coughing, generalized body aches or weakness, and fatigue. It’s important to note that the flu may or may not be accompanied by fever, so a lack of fever does not mean lack of flu. Personally, I think the flu feels like an elephant sitting on my chest. Why do we care so much

his lady should be known as Miss October. No, Evelyn Hauser was never a pin-up model. In fact, unlike almost every other person who has been profiled in this long-running Medical Examiner series, she and her family spent their careers in business, not medicine. Even so, she was a force to be reckoned with in the field of medicine and medical research. Hauser was born into a bad situation: Her parents were Jewish, and the blessed event happened in 1936 in Vienna, Austria. At that location and in that year you know Hitler would surely enter the picture. Indeed, by 1938 the Nazis had occupied Austria, and the Hausers fled to Belgium, then to England, where they were confi ned in an internment camp on the Isle of Man. The family made it to New York City in 1940, and Evelyn Hauser always remembered being awakened by her mother to see the Statue of Liberty as they sailed into New York Harbor. Over the next few years the Hausers established themselves

Please see FLU page 10

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Remember the fi rst time you ever heard the word Botox? It was a little strange to discover that a drug is derived from a toxic substance — and not just any toxic substance, either. The botulinum toxin (known casually as botulism and formally as Clostridium botulinum) is the deadliest of all toxins. Just how lethal is it? In short, it has an LD50 as low as 1.3ng/kg. Allow us to explain. In the world of toxicology, LD50 is shorthand for “median lethal dose.” In other words, with the 50 added, it’s a measure of how much of a given substance would be a lethal dose (LD) to half (50 percent) of the members of a test population. In the case of botulinum, the amount is as low as 1.3 nanograms (ng) per kilogram (kg) of a person’s weight. A gram isn’t much to start with, but a nanogram is one billionth of a gram. That puts a nanogram right between the weight of one eyelash and the weight of a single grain of very fine sand. Let’s say we doubled the 1.3ng figure to 2.6 and rounded it up to an even 3ng/kg for simplicity. If we multiplied both numbers (3ng and 1kg) by 100 to get a test subject who weighs 100kg (220 lbs), it would take 300 billionths of a gram to reach 50 percent odds of killing that one test subject. That means, in turn, that 300 grams of botulism — only about one and a quarter cups — could kill a billion people. About half a gallon would be sufficient to wipe out everyone on the planet.

IS FOR BOTULISM And we willingly take this stuff into our bodies? Yes, we do. Of course, there is a huge difference between how much botulism a person would be exposed to from some improperly sterilized canned food and an injection from a doctor. As but one example, Botox is being used to treat strabismus, the condition where one or both eyes don’t properly align (for more information about strabismus, see the June 17, 2016 Medical Examiner, “The Advice Doctor,” p. 3, at www.issuu. com/medicalexaminer). In treating strabismus, doctors will inject a few picograms of botulinum toxin into eye muscles. A picogram is one trillionth of a gram. It’s no wonder that Allergan, the pharmaceutical company who markets the brand name Botox, said in 2011 that it could supply the entire worldwide demand for all of the two dozen and more approved medical uses of botulinum with less than a single gram of raw botulinum toxin. (To refresh your memory on how much a gram weighs, it takes more than 28 grams to equal one ounce.) The dozens of clinical

applications for this amazingly deadly substance include injections for abnormally and constantly twitching or blinking eyelids (known as blepharospasms); excessive sweating (a.k.a. hyperhydrosis); pediatric leg spasms in cerebral palsy patients; overactive bladder, including a strong frequent need to urinate accompanied by leakage, urgency and frequency; uncontrolled esophageal contractions; and migraine headaches. Botox’s migraine application was accidentally discovered as a side effect of one of its main uses: in cosmetic procedures. As far back as 2013, the American Society of Plastic Surgeons said botulinum toxin injections were the most common cosmetic operation at some 6.3 million procedures at that time. Botox injections work by weakening or paralyzing certain muscles or blocking certain nerves. The effects are usually temporary, lasting from a few months to a year, but in some cases a temporary fi x becomes permanent. Case in point: when used to treat strabismus, Botox can act like in injected eye patch. A literal eye patch over the “good” eye often helps permanently strengthen the weaker side eye muscle. Injecting Botox into the strong eye muscle can have the same effect, and by the time its effect wears off, the weak side eye muscle has stepped up its game and strabismus is cured. Like any drug, Botox has its list of risks and side effects and should only be administered by experienced practitioners. +

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— Slimming My Wallet Dear Slimming, Do I know anything about consumer affairs? I am an expert in consumer affairs! To directly address a point raised in your letter, I frequently speak to large groups about the dangers consumers face in various places, including the grocery store. Raw foods can be a wonderful thing, or they can be deadly. Raw fruits and vegetables are widely recognized as a beneficial dietary element in healthy diets, but that doesn’t mean every raw vegetable is safe. Eating raw red kidney beans is not a good idea. They contain a natural toxin called lectin that won’t be a problem if the beans are soaked in water (usually for about five hours) before cooking On the other hand, there are other foods that should never be eaten raw. Some people think a raw egg is the perfect addition to a power shake, but raw eggs can contain salmonella. Cooking kills the bacteria. The same potential is true of raw or undercooked seafood or shellfish. Raw oysters is a popular dish and the risk may be low, but it’s there. It’s a myth that hot sauce and/or alcohol kills bacteria. Proper food handling and preparation, and proper cooking means much lower risk. Investing a few dollars in a good food thermometer is a good idea too. + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in Examiner issues.

AUGUSTA

One family of providers.

Dear Advice Doctor, If you know anything about consumer affairs, I would appreciate your advice. I bought a treadmill that I saw in an online ad. I met the seller and paid cash. Turns out the treadmill didn’t work, but when I went back to the seller’s residence to talk about a refund, the house was vacant. What a raw deal for me! All I wanted to do was lose a few pounds, not a few hundred dollars. How can I fix this?

MEDICAL EXAMINER

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

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www.AugustaRx.com • E-mail: graphicadv@knology.net Opinions expressed by the writers herein are their own and/or their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., or its agents or employees take any responsibility for the accuracy of submitted information, which is presented for general informational purposes only. For specific medical advice, diagnosis and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2016 PEARSON GRAPHIC 365 INC.

WHO IS THIS?… from page 1 to the degree that her father was able to build a small chain (5 locations) of dress shops in Manhattan. Evelyn graduated from high school in 1954, then went on to attend Hunter College, part of CUNY, the City University of New York. It was there that she met her future husband, a man named Leonard Lauder. After the honeymoon, Evelyn worked for several years as a public school teacher in Harlem before quitting to go to work for her mother-in-law. Her name was Estée Lauder. As an executive in the family business (Evelyn was eventually the Senior Corporate Vice President of Estée Lauder), Evelyn created the Clinique brand name, developed its product line, and as Clinique’s training director was the first person to wear the brand signature white lab coat now worn by all Clinique sales people at cosmetic counters. So why is she being profi led in this feature of this newspaper? Lauder also happened to be on the board of New York’s Memorial Sloan-Kettering Cancer Center. She personally raised much of the $13.5 million that it took to establish the Evelyn H. Lauder Breast Center at Memorial Sloan-Kettering Cancer Center, which opened in October of 1992. She also helped raise another $5 million to create an endowment for funding breast cancer research there. The previous year (1991), Lauder and Alexandra Penny, then the editor of Self magazine, had a chat over lunch one April day about ways to focus attention on breast cancer research and raise money for research. That little chat resulted in two initiatives: the establishment of The Breast Cancer Research Foundation spearheaded by Lauder and Penny; and adoption of the pink ribbon as the symbol for breast cancer awareness. Colored ribbons as symbols of awareness connected to various health and societal causes took off when yellow ribbons were used to welcome back American diplomats held in the 444-day Iran hostage crisis which began in late 1979. Almost overnight, every cause had to have its ribbon and its color. Breast cancer patient and survivor Charlotte Hayley had introduced a peach-colored ribbon in a one-woman grassroots campaign to raise breast cancer awareness. Her campaign caught the attention of Alexandra Penney as she prepared Self magazine’s October 1992 special issue focusing on breast cancer, and Penney reached out to Hayley with ideas of collaboration in mind. Hayley rejected the overture, believing Self’s initiative with Estée Lauder was too commercial, according to pinkribbon.org. “Unable to use Hayley’s peach ribbon for legal reasons,” Self magazine “decided to go pink.” And the rest, as they say, is history. That history has Evelyn Lauder’s name all over it. Her husband personally bore the cost of registering The Breast Cancer Research Foundation as a legal entity in all 50 states. In 1993 Evelyn launched a new shade of lipstick called Pink Ribbon, and over the next two years alone, the Foundation and sales of Pink Ribbon lipstick combined to raise some $900,000 for breast cancer research. According to company figures, over the next 15 years the Estée Lauder Company raised $335 million toward breast cancer research and distributed some 80 million pink ribbons, including 1.5 million in connection with the 1992 Self breast cancer issue alone. The Susan G. Komen charity used the pink ribbon as a symbol of breast cancer awareness beginning in 1991, but the ribbon seemed to gain universal recognition only after the Estée Lauder/ Self magazine campaign. Evelyn Lauder died at her home in Manhattan at age 75 on November 12, 2011 from complications of ovarian cancer. Editor’s note: Charlotte Hayley was justified in trying to protect ribbon symbols from commercial profiteering. Because the pink ribbon is public domain in the U.S., not licensed by any organization, any company can put a pink ribbon on any product, and many do, even on products containing ingredients that can cause cancer. The practice, known generally as “cause marketing” and as “pinkwashing” in the case of breast cancer awareness (a mashup of “pink ribbon” and “whitewashing”), has been roundly criticized — and justifiably so. Especially this month, pink ribbons are everywhere, even on products from companies who have never donated a penny to breast cancer research. To help determine if the pink-ribbon-festooned product you’re considering buying actually contributes to breast cancer research, visit thinkbeforeyoupink.org and read the surprising article “4 Questions to Ask Before You Buy a Pink Ribbon Product.” +

OCTOBER 7, 2016

AUGUSTA MEDiCAL EXAMINER

OLD NEWS +

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

ABUSE OF CAREGIVERS

ave you heard the term “caregiver burnout”? The condition is very real. So much so that Medicare offers coverage for some caregiver respite. If you are caring for someone long-term and need a well-deserved break, you should look into this option. Diseases such as Alzheimer’s, Parkinson’s and other dementias can cause reactions like anger, threats and verbal and physical abuse by the patient toward the caregiver. If you have a situation where the patient is a large man and the caregiver a small woman, you have a recipe for potential disaster. Caregivers of combative loved ones have significantly higher rates of physical illness, depression and other health conditions. Even their mortality rates are higher compared with noncaregivers. The average person with early-stage Alzheimer’s disease, the most prevalent major neurocognitive disorder, is not diagnosed until one to two years after the onset of symptoms, according to AARP’s website. If you have concerns with behavioral changes in a loved

one it is important that a comprehensive evaluation including a neurological exam, a mental status exam and a brain scan be done. There are many other issues that can cause a change in cognition and behavior; it’s not always Alzheimer’s. A marked change can also be due to lack of sleep, stress and nervousness or depression. Even a urinary tract infection can manifest symptoms which mimic dementia, so it’s important to know the precise cause of any behavior change. Dealing with and caring for an abusive patient can be dangerous if the patient is becomes physical. Most caregivers are caring for a family member they love and don’t want to see them go to a nursing facility, but if physical abuse is involved, there may be no other

reasonable choice. You can’t sacrifice your safety and wellbeing to care for someone who may seriously injure you. Strong emotions may come into play in such cases, and the caregiver can suffer from a great deal of worry and guilt. If this is your reality, schedule an appointment with the patient’s doctor or a social worker for advice and information on how to admit a loved one into a facility. My own experiences with my mother who suffered from dementia was similar. She would wander off and go to any stranger who answered their door and ask for a ride to the airport - over 2 hours away. Of course they called the police, who returned her to me. This happened several times. One morning as I was getting ready to leave for work she threatened to stab me in my sleep that night. Since it was impossible to get her into a facility immediately, I left work early that day and brought home a locksmith who installed a deadbolt on my bedroom door. I took her threat seriously and had to do something to protect myself in the meantime. Would she have done such a thing? I don’t know. It’s an unpredictable disease at best and I wasn’t willing to take the + chance.

MYTH OF THE MONTH You can get the flu from a flu shot! The title of this series is Myth of the Month, which should be your first clue that getting the flu from a shot designed to prevent the flu doesn’t make much sense. But if we add just two words, we can make it a sentence that is not a myth: You can get the flu from not getting a flu shot. Flu shots work by exposing your immune system to the flu virus, causing the body to build up antibodies to fight the virus to protect you from getting the flu. “How can you say it prevents the flu when you just said it exposes us to the flu virus?” That is a good and logical question. The answer is that a flu shot contains dead viruses, not live and active ones. Even so, they trigger the

body’s defense mechanism. That doesn’t mean anything about flu shots is guaranteed: a person who doesn’t get a flu shot might not get the flu, and a person who does get a flu shot might get the flu anyway. Nothing is completely foolproof. Generally, however, a flu shot will result in a milder case if someone does wind up getting the flu. The nasal spray flu vaccine didn’t prove as effective as originally expected, so flu shots are the preferred delivery route. The flu vaccine is especially recommended for certain groups. Ask your doctor or pharmacist. + — by F. E. Gilliard, MD, Family Medicine 4244 Washington Road, Evans, GA 30809 706-760-7607

OCTOBER 7, 2016

AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW res? ABOUT DEATH-DEALING DONUTS

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t’s the political time of the year again. Thankfully, our politicians have all the answers. If you don’t beleieve me, just ask them. They will tell you what is best for you. It makes me think of what we need to do to improve our country, our society, our way of life. To reach the correct decision, one must look at reality. So let’s look at some numbers. Let’s look at who dies and why. The big push now is to remove all dangers to society. What can we easily do to save lives, to preserve quality of American life? These statistics are from the first half of 2016 in the US. Heart disease killed 282,325 people. It is a major problem. We spend billions on research to limit heart disease, but eventually we all die. The heart stops sooner or later, but we can change that. We can delay the inevitable day with eating right, exercise, and proper medications. Tobacco killed 160,680. Our government collects huge

taxes on tobacco. We have restrictions about where tobacco can be used. A step forward, no doubt. But people can smoke tobacco legally, deadly as it is. Obesity is blamed for killing another 140,939 people. We are the only society in the history of the world to have obesity as a major health risk, the only society where the poor are obese. We eat too much of the wrong things. So combined, smoking cigarettes and eating too much kills more people than heart disease. Our government is making efforts to limit both. Recently, our government officially named the misuse of opioids as a major problem. And justifiably so. And we have continuous campaigns against drinking and driving. Again, justifiably so. We limit where alcohol can be used and by whom: not while driving or by anyone under 18. But what are the numbers to justify this? Tobacco killed 160,680. Alcohol killed 45,908. Both

t s e B are horrible statistics. On the low end of statistics, prescription drug overdose killed 6,886. Murder by guns killed 5,276. Both gun deaths and overdoses are tragic, but tiny compared to the death toll from tobacco and alcohol. Clearly alcohol, tobacco, and over-eating are far worse than guns and opioids. (Point of full disclosure: A large portion of my practice is devoted to the use of Suboxone and counseling to help patients manage opioid use disorder.) In the 1920’s, we outlawed alcohol. It did not work. People wanted to drink alcohol so they drank alcohol, regardless of the deadly side effects. The problem was not the alcohol. The problem was

e n i c i d ME

with what people do with alcohol. Now we want to outlaw guns. That, too, will not work. People who want to have guns,will have guns. Guns are not the problem. The problem is with what people do with guns. Overeating kills 28 times as many people as guns and 20 times as many people as opioid overdose. So what is the real problem? Obviously, too much food. Do we outlaw food? Sugar? Soft drinks? Donuts? Of course not. That would be ridiculous. People want those things, so they will have them if they want them. Should we outlaw guns? Alter our Constitution? Or maybe we should amputate the trigger fingers of men

between 20 and 35, the age group responsible for most shootings. Neither option would be efficient or effective. We must be practical. We can’t destroy every evil. We don’t have enough money to do that. The bottom line is that each of us has a responsibility to limit the evils in own lifestyle. Symbolic acts will not suffice. Eat less. Don’t drink alcohol. Don’t take medications not prescribed by your doctor. And stay away from crazy people with guns. Remember: you are 28 times more likely to be killed by overeating than by a gun. Donuts are more deadly than guns. + Bad Billy Laveau is a formerlyretired MD who wields a pointed sense of humor - and now, tongue depressors too. He speaks and entertains at events for audiences not subject to cardiac arrest secondary to overwhelming laughter and glee. BadBilly@knology.net or 706306-9397. F REE T AKE-HO ME CO PY!

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An evil disease M

and her occasional mumbling. Back in July I was in another room one morning. Hearing her cry out, I rushed to her. She was breathing hard, her cheeks puffing in and out, her eyes were rolled back and she had a terrified look on her face. This episode lasted approximately three minutes. Her breathing gradually returned to normal, but she was ill the remainder of the day and slept quite a bit. Well, the next day she was back to her usual self, but she had a very large bruise on her right arm and another on the top of her right foot! The bruises were an ever-transforming mixture of red, blue, yellow, green, finally black. After one month they faded away, leaving a slight discoloration on those areas. We are mystified as to what caused the episode and the bruising. I am on a mission to find the answer. Alzheimer’s truly is an EVIL disease. +

y dear ninety year old mother-in-law, whom I affectionately refer to as our “houseguest,” has suffered with Alzheimer’s disease for roughly twenty years. The last six years she has been without recognition of any of us. Two years ago she became bedridden, incontinent and could not feed herself. Presently she is in a rigid fetal position. At times her arms move involuntarily, and she has a fairly strong grip. It is amazing that she still has a healthy appetite and can actually drink from a straw. Each day I watch her, wondering if she is still there on some level behind those empty eyes. Is there a purpose for her to linger in such a state? Does she comprehend? I pray that she cannot. She was always pretty and prissy, perfect makeup, high heels and dresses. She was a tough, independent, intelligent career woman, very respected and relied upon for her expertise. She would be mortified if she did know. There is no communication other than touch

It has been twenty years now.

— by an Examiner reader Augusta, Georgia

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

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

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OCTOBER 7, 2016

AUGUSTA MEDiCAL EXAMINER

Southern Girls Eat Clean Roasted Tomato and Shrimp Spaghetti Pasta This one-dish meal will send you into flavor heaven. With all the colors of Italy, this meal is as visually appealing as it is delicious. It is fresh, healthy and nutritious as well. The tomatoes gain a sweetness roasted in the oven and the fresh basil and parsley provide amazing flavors. Super quick and simple to prepare, you can have this dish on the table within 30 minutes. While I used gluten free pasta, you may use the spaghetti pasta of your choice. If you prefer, you can omit the shrimp and add a bit more Parmesan cheese. Enjoy! Ingredients: • 3 pt. of grape tomatoes • 1/4 tsp. crushed red pepper • 2 to 4 Tbsp. of extra virgin olive oil • 3 Tbsp. of fresh garlic, crushed • 1 box of spaghetti pasta (I used gluten free) • 1 lb. of fresh shrimp, peeled and deveined • 1 to 2 Tbsp. high quality balsamic vinegar • 2 Tbsp. fresh flat leaf parsley, chopped • 1 cup of loosely packed fresh basil, torn • Salt and pepper to taste • Parmesan cheese, fi nely grated, to garnish Instructions: Preheat oven to 350 degrees. Toss the grape tomatoes, crushed red pepper, 2 Tbsp. garlic, 1 tsp. of salt and 1 to 2 Tbsp. of olive oil together and place in a large baking dish. Bake in oven for

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Roasted Tomato and Shrimp Spaghetti Pasta approximately 30 minutes until tomatoes soften and juices run. Stir 1 or 2 times while baking. Remove from oven and set aside. This step can be done in advance and tomatoes will stand at room temperature until ready to use. Bring a pot of water to a boil and cook pasta according to package directions. Drain pasta and reserve 1 cup of the pasta water. In a large skillet, heat 1 to 2 Tbsp. olive oil over medium to high heat. Add 1 Tbsp. garlic and cook approximately 1 minute until softened, stir constantly. Add shrimp and a 1 to 2 Tbsp. of the reserved pasta water. Cook until shrimp are cooked through, approximately 2 minutes. Add the remainder of the

pasta water and balsamic vinegar. Reduce heat to medium-low. Continue cook for another 2-3 minutes, stirring occasionally. Stir in chopped parsley. Transfer spaghetti pasta to a large serving bowl, add shrimp mixture, tomatoes, basil, salt and pepper to taste. Toss gently and sprinkle with grated Parmesan cheese if desired. Serve immediately. + Alisa Rhinehart is half of the blog southerngirlseatclean. com She is a working wife and mother living in Evans, Georgia. Visit her blog for more recipes and information on clean eating.

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OCTOBER 7, 2016

AUGUSTA MEDiCAL EXAMINER

Pharma cy 4 11

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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.

EVERY COMPANY HAS ITS VERSION

t has always been the case with prescription medicines that each big drug manufacturer would put out their own version of the latest class of medicine. The difference from what was already available may be little if anything, but at least they were getting their market share. The latest new trend is more and more of this in the over-the-counter medicine market. In light of this trend I thought it was time to give everyone a warning about reading labels on non-prescription medicines. I don’t mean reading just the brand name but really reading the entire label. Make sure the active ingredients are what you are looking for, as well as what the medicine is used for and what class of medicine the active ingredients are. I can give you a few examples of this situation that you will find on the pharmacy shelves. The latest example I have seen in TV ads is the new Icy-Hot product. Icy-Hot was originally a muscle rub containing a salicylate-based product that provided heat to sore aching muscles. It was similar to Ben-Gay. Now there is Icy-Hot Lidocaine, another anesthetic rub that numbs the area of overworked nerves causing a reduction in pain. Lidocaine was already available as LMX cream, so this is not a new product, just a source of potential confusion for consumers. Don’t grab just for the name and think that the manufacturer must have changed the packaging a little bit. It gets even more confusing in other OTC drug categories. The over-the-counter class of cough and cold medicines is potentially the most confusing with all of its many options. Each brand of medicine may have a decongestant product, an expectorant product and an antihistamine product, all under a given trade name family. Labeling may involve just a single word difference in the naming. Mucinex has traditionally been an expectorant product used to treat chest congestion. Now they have a new Mucinex Sinus-Max, which is different from their Mucinex Maximum Strength product. The Sinus-Max formulation is a nasal decongestant and does not help with chest congestion at all.It does however have the potential to

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raise the blood pressure and heart rate, making it unsafe for patients with heart and blood pressure trouble. NyQuil has now brought to market a new product called ZzzQuil. NyQuil is a nighttime cough and cold medicine, while ZzzQuil is an antihistamine-only product used for sleep. If you walk down the aisle looking just for the big Quil on the label you might take home the wrong medicine and only get partial relief. The stomach and gastrointestinal medicines also have examples of adding new specialized products. These can be alike in their applications - and in labeling - so reading is even more important. For example, Dulcolax is a stimulant laxative used to produce a bowel movement. There is also a Dulcolax Stool Softener which has the same active ingredient as Colace. These medicines are stool softeners that make it easier to go to the bathroom, but do not actually cause a push along the GI tract like Dulcolax does. This may not sound like a big difference, but for a patient on pain medicines who is prescribed a stool softener to slow down their GI tract the original Dulcolax could be contraindicated in that specific patient. Or, the patient who needs a laxative but only gets a stool softener may not get relief and have their condition get worse, possibly to the point of hospital admission for relief of an impaction. But help is always nearby at your local pharmacy. Come in and talk to your pharmacist about which medication your doctor recommended as well as your symptoms and desired results. That way we can help you ensure that the product you get is the right one for you. Remember, we’re here to help, both with prescription medicines and over-the-counter medicines and supplements. +

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Questions about this article or suggestions for future columns can be sent to us at cjdlpdrph@bellsouth.net Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson (cjdlpdrph@bellsouth.net )

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OCTOBER 7, 2016

AUGUSTA MEDiCAL EXAMINER

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

AN APPLE A DAY by Lo Bannerman Fall is on its way and apples are ready for harvest! But how does this delicious fruit keep the doctor away? Let’s explore some amazing apple facts to find out. One medium apple contains about 80 calories, 4 grams of fiber, and over 10% of your daily recommended intake of Vitamin C. They are also packed full of antioxidants and phytonutrients that are linked to heart health and lowering cholesterol. They’re great breath fresheners too. Basic apple nutrition is consistent across varieties, so don’t hesitate to explore. A member of the rose family, apples have been grown around the world for centuries. Although Granny Smith or Red Delicious may be the fi rst to come to mind, an estimated 2,500 different apple varieties are grown in the United States alone. Start snacking on Fuji, Pink Lady, or Gala apples for a sweeter variety or try a Jonathan for that tart apple taste. If you want to bake, Golden Delicious apples freeze well and can often be used without peeling due to their thin skin. The skin is also where apples store most of their fiber, which

makes this a great choice for your dessert and your health. How can you find the best apples? Look for organic varieties at your local grocery store or grab a basket and head to a nearby orchard. Ellijay, Georgia is known for its many apple orchards and you-pick farms. Plan a road trip to this northwestern Georgia region and stop by Mercier Orchards, Hillcrest Orchards, or Red Apple Barn to name a few. In addition to apple picking, you may find yourself riding a tractor, drinking cider, or lost in a corn maze during your visit. If you can’t decide where to begin, attend the Ellijay Apple Festival on October 8, 9, 15, and 16 (visit www. georgiaapplefestival.org for more details). When you get them home, store your apples in a

cool, dry place for two to four weeks or place them in the refrigerator, when ripe, for one to two months. Try to give your apples open space (one bad apple truly does spoil the bunch) and keep them away from other fruits and vegetables, as they give off an ethylene gas that increases ripening and spoiling speeds. Here are some great apple snacking ideas. • Hold the Cracker: Thinly slice an apple and use in place of a cracker with your favorite cheeses. • Baked Apples: Halve and core an apple and place skin down on a baking sheet. Top with cinnamon, brown sugar, and butter and bake at 350 degrees for 30 minutes. • Lunchtime Crunch: Add thin apple slices to your turkey sandwich for a sweet and delicious crunch. • Sweet and Savory: Add a peeled and chunked apple to your next stew for a subtle sweetness that compliments fall flavors. Looking for an easy spin on a more traditional apple use? Try this in your slow cooker:

SLOW COOKER APPLESAUCE Ingredients • 3 lbs. (about 5-6) apples, any variety or a mix • 1/2 cup water or apple juice Directions Slice and core your apples. Place all ingredients into your slow cooker, cover, and cook on low for at least six hours. Use a potato masher or immersion blender to puree the applesauce until the desired consistency. Transfer to mason jars or other storage containers. Store applesauce in the refrigerator for about a week or freeze for up to six months.

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APPLES… from page 9 Applesauce Notes: • Try adding cinnamon or vanilla extract to your next batch for added flavor. • Leaving the skin on increases the fiber content and adds texture to your applesauce. If you aren’t a fan, feel free to peel your apples or test the thin skin of Golden Delicious apples. (You can peel before or after cooking. The skin falls right off after cooking but be careful: it will be very hot.) • Play around with different apple combinations to change up the sweetness and undertones of your applesauce. • Double or even triple the recipe until your slow cooker is full. Check in at six hours

and keep cooking if you want a smoother applesauce. Freeze any leftovers and savor the homemade taste yearround. What would you make with a bushel or a peck? A peck of apples weighs about 10 pounds whereas a bushel weighs about 42 pounds. The average person in Europe or the United States consumes about 46 pounds of apples each year. That’s equivalent to 8 gallons of applesauce! Enjoy! + Written by Lo Bannerman, Augusta GA MS Agricultural Education BS Nutrition The University of Arizona

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about the flu? The flu in a healthy, robust individual still has the capability of causing bad disease, and it’s unpredictable when a patient will take a turn for the worse and when they will recover without issue. However, it is the less healthy, less robust patients that we as pediatricians worry about to an even greater extent. Little babies or kids who have chronic illnesses such as asthma or other lung disease can become dangerously ill from the flu and even die. Other patients we worry about include those with weakened immune systems due to medications, cancer, or other illnesses. Those patients often cannot even receive the flu vaccine, and the only way to prevent them from getting sick is to minimize their exposure to the virus. So by vaccinating and containing the spread of the virus, we can accomplish many goals,

most notably: • 1) we keep kids healthier overall and decrease their risk of getting sick, and • 2) by vaccinating the healthy kids and preventing them from getting sick, we reduce the chances that they will in turn expose kids who cannot be vaccinated and protected directly. How is the flu spread? The same as other respiratory viruses, mainly via droplets in the air or on surfaces. Washing hands is a fantastic way to protect oneself against the flu, as is the flu vaccine itself. Everyone should discuss the risks and benefits of vaccination with their doctor on an individual basis of course, but overall, it is a great way to help kids stay healthy during flu season. +

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AUGUSTA MEDiCAL EXAMINER

The blog spot From the Bookshelf — posted by Claire McCarthy, MD on January 10, 2016 Edited for space

4 MISTAKES PARENTS MAKE IN THE PEDIATRICIAN’S OFFICE I love being a pediatrician; there’s nothing I would rather do. But sometimes I get frustrated by things that parents do — or don’t do. I’m not talking about things like being late (hey, I run late, it would be unfair to complain), or getting upset with the staff about waiting (what if it were your kid who needed more time?), or not holding their kid still while I examine him (I understand that some parents are better at that than others), or stuff like that. That comes with the territory. I’m talking about stuff that makes it harder for me to give good care. Here are four mistakes many parents make that I wish they wouldn’t: 1. They don’t come prepared. I love it when parents come to check-ups with their list of things to talk about, or when they come to sick visits knowing which medicines have been given, how many times the child has thrown up or exactly when the headaches started. You have no idea how helpful this is — and how much it helps me zero in on exactly what I need. Too often, parents just, well, show up with their kid and wing it. Which I get, actually. However, we aren’t mind readers, and we have a limited amount of time. So: keep a list somewhere of things you want to talk about at a check-up, and then bring it with you (lots of parents keep a list on their phone). If your child is sick, please be ready with all the details (especially important if someone else cares for your child while you work), including temperatures and medications (I love it when people bring medications with them). 2. They are less than honest. It’s embarrassing to tell the doctor that your kid eats vegetables once a week (or never), watches TV all day or is the bully of the classroom. It’s also no fun to admit that you often forget to give the asthma medicine or that you’ve waved the white flag in the tooth-brushing battle — or that you are guessing on the temperature because you lost your thermometer. But if I don’t know this stuff, I may miss not just an opportunity to help you in all these struggles, but I might make the wrong diagnosis. That could be bad. We aren’t here to judge; we have seen and heard worse, I promise. Tell the truth. I can’t take care of your child if you don’t. 3. They don’t say anything when the doctor screws up. If I don’t make sense, if I didn’t ask something important, if I’ve misunderstood something, if I’ve given an instruction that is unworkable or if I’ve made someone feel upset or bad in any way, I want to know. Pediatricians are human and can screw up like anyone else. But when we screw up, it can lead to the wrong diagnosis or treatment, to families not knowing what to do or not getting what they need. So speak up. Say, “I didn’t understand that.” Or, “He’s had a fever for five days, not one day.” Or, “You don’t understand, he’s never complained of a pain like this before.” Or, “I can’t give a medicine three times a day because of my job.” Or, “When you said that, it made me feel like you thought I was a bad mother.” I can’t guarantee that every doctor will take it well, but if your doctor can’t take some constructive criticism, get a new doctor. 4. They forget that they and the doctor are a team. I may be the doctor, the one with the medical training, but you are the parent — the one who knows and cares for the child. This one really sums up the others. The relationship with the pediatrician works best when parents and doctors work together to make the most of the visit. You are as important as the doctor. If you take an active role, things work out so much better. We want the same thing — your child to be healthy and happy. If you help me help you, we can make it happen. +

“We aren’t here to judge.”

Claire McCarthy is a pediatrician. She blogs at the Huffington Post, where this article originally appeared, and at Boston.com as MD Mama.

An excerpt of an Amazon.com review by reader Rob Hardy

We are proud of humanity’s progress in medicine. From Hippocrates down to the latest in gene therapy. doctors gradually but eagerly accepted new techniques and new science to get us where we are today. Except this did not happen. “For 2,400 years patients have believed that doctors were doing them good; for 2,300 years they were wrong.” [This] pessimistic view of the overwhelming failures of doctors is [the basis of] David Wootton’s book. The world has adopted the scientific method as the way of getting information and using it, but before the dawn of germ theory, there was only a firm hold on medical traditions, and the traditions were wrong. Even worse, in many cases medical treatment became more dangerous over time, as in the case of nineteenth century hospitals causing the deaths of mothers in childbirth far more effectively than independent midwives could do. This is a grim story, and there are reasons to think that doctors may still be addicted to doing the things they do because that’s what they have

always done. For a couple of thousand years, medicine was based on Hippocrates and his successors, especially Galen, whose theories dealt with balancing bodily fluids. There was no physiological benefit in such treatments, which could do nothing but make things worse. Yet such treatments were the staple of medical practice until the middle of the nineteenth century. One reason is that people generally tend to be healthy, and when they are sick they generally tend to get well; bodies are designed to do this even without help (or hindrance) from medical treatment. Another reason is the placebo effect, which only got to be understood in the nineteenth century. A final

and overwhelming obstacle was that having satisfied themselves that such treatments worked, and having formed a pattern of using it and taking fees for using it, [doctors] were much more prone, over many centuries, to preserve and transmit the tradition rather than to question or improve it. Wootton’s history is one of lost chances; medical science, he shows over and over, could have taken advantage of concepts known in biological science centuries beforehand, but did not do so. Doctors were, like any other group of people, set in their ways. They thought they had as good therapies as could be gotten, and so psychological and cultural factors kept medicine from advancing. It was not that there were gaps in equipment or pure science or intellectual resources, but bad arguments repeatedly drove out good and kept the status quo. It happened for centuries, and might happen in other ways in the future: a bit of skepticism on the parts of both doctors and patients could prove healthful. + Bad Medicine - Doctors Doing Harm Since Hippocrates, by David Wootton, 340 pages, published in 2007 by Oxford Press

Research News Hydration news Whenever we’re thirsty and drink to satisfy that thirst, we may assume that our thirst went away because we’re now rehydrated. Stop and think about that for a few seconds and it becomes obvious that we stop drinking fluids long before the body is rehydrated. It takes time for those fluids to reach the cellular level. In fact, because of the time lag between drinking and hydration, the signals the body uses to order up drinks and how it then says “when” are largely a mystery to science. Looking into the matter, researchers at Philadelphia’s Monell Chemical Senses Center have found that coldness and carbonation in fluids help reduce thirst. Adding menthol to chemically create the sensation of coolness also helped reduce thirst, demonstrating that temperature isn’t as critical as the perception of coolness.

The real-world application of the findings can help those at risk for dehydration — populations like athletes, the elderly, and soldiers — increase fluid intake: the research showed that people drink smaller quantities of cold, carbonated beverages, limiting their fluid intake. The choice is yours Researchers at Iowa State University released a study last month which examined why some exercise regimens fail while others succeed. It all came down to intrinsic rewards, combined with a regular prompt or cue. The most common example of a regular cue would be an alarm clock going off every morning. Another might be the end of the workday. For some people those are their regular cues to head to the gym or hit the front door for a walk or run through the neighborhood. But researchers found that

without a built-in reward, the alarm clock or other cue can be the signal to begin a debate: to get out of bed or not; to exercise today or not. But if exercise is intrinsically rewarding, people don’t have to convince themselves every time. Instead of viewing it as drudgery, they’ll want to exercise. Intrinsic rewards, said the Iowa State team, can vary from person to person. It could be chemical: serotonins and endorphins; it could be spending time with a friend who is a workout partner; it could be enhanced selfesteem. Weight loss, by contrast, is an extrinsic reward. Iowa researchers acknowledge that it can take time to develop intrinsic rewards from exercise, but that for the cue/reward system to work over time, the reward must come directly from the activity and not be extrinsic. +

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OCTOBER 7, 2016

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS +

by Dan Pearson

It’s true. I said I wanted to start running again I don’t and he told me to believe you. restrain myself.

No way. That muscle strain was so bad yesterday you could I’m just following doctor’s orders. barely walk.

You’re going running after work??? I’m just following doctor’s orders.

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

EXAMINER CROSSWORD

PUZZLE ACROSS 1. Floyd County (GA) seat 5. Fragrance 10. Slang for house, apartment 14. Test 15. Delete 16. Employ 17. Cover with gold leaf 18. Number after 24, sometimes 19. Capital of Western Samoa 20. Lg. area employer 21. Drudgery; hard work 22. Involuntary muscle 23. Most important 25. Allot 27. Antiquity (Literary) 28. Shivers, for example 32. Relating to waste matter 35. Middle East rug 36. Artists follower 37. Soon, in poems 38. Kidney adjective 39. Couch 40. Food label abbrev. 41. Boring? You might need this 42. Acts like a hot dog 43. Thick, dark brown syrup 45. Pale 46. AU head 47. Small sweet roll 51. Type of circus? 54. Its capital is Tehran 55. Feminine pronoun 56. Basic chemical element 57. Boredom 59. Grocery chain 60. Rebuff 61. Suit 62. Singles 63. Palm variety

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

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QUOTATION PUZZLE 29

I T S T G U

— Edmund Burke

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.

64. 1865 assassin 65. Decline DOWN 1. Cinemas starter 2. Rust 3. Its capital is Valletta 4. Ambulance wrkr. 5. ______ string 6. Recent area D.A. 7. Mr. Grey of tea fame 8. Ft. Gordon tenant 9. Offensive in Vietnam 10. Hill in North Carolina? 11. Former Philbin co-host 12. Eye part 13. Ray of light 21. Enterprise add-on 22. Brain ___ 24. Academic department head 25. Grinding tooth 26. Wicked 28. Dressed to the ______ 29. This task and the tool used

to do it are the same word 30. Some drinks are this 31. Brief it was 32. Team in baseball 33. Prefix for within 34. Carbonized fuel 35. Pelvic exercise 38. Deceptive ploy 39. Monte ______ Ave. 41. Out on the ocean 42. Physical or mental distress 44. Arms can be this 45. Apparition 47. Rumor; report 48. Red ________ 49. Summerville street 50. Uneven 51. Transit prefix 52. Sicilian volcano 53. Mr. Barnard 54. Knowledge, in short 57. Flow back 58. Natal intro 59. To yield Solution p. 14

X A M I N E R

1 5

4 5

6 4

U D O K U

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

Use the letters provided at bottom to create words to solve the puzzle above. All the listed letters following #1 are the first letters of the various words; the letters following #2 are the second letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.

I 1 2 3 4 5 6 7 1 2

B 1

S 1 2 3 4 5 6 5

1 2

L 1 2 3 4 5 6 7

1 2 3 4 1

— Author unknown

1.FANBAGTH 2.SEEESOOA 3.STEAIO 4.DLLNTH 5.STIEG 6.SNH 7.GY

SAMPLE:

1. ILB 2. SLO 3. VI 4. NE 5. D =

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

WORDS NUMBER

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

OCTOBER 7, 2016

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AUGUSTA MEDiCAL EXAMINER

THE BEST MEDICINE ha... ha...

the deputy starts beating him with his nightstick. After a few seconds he stops in mid-swing and asks the lawyer, “Do you want me to stop, or just slow down?” Moe: What’s the worst time to have a heart attack? Joe: When you’re playing charades.

hotshot big city lawyer runs a stop sign and gets pulled over by a county sheriff’s deputy. The lawyer thinks he is smarter than some deputy out here in the sticks. He decides to have some fun at the deputy’s expense. The deputy says, “License and registration, please.” “What for?” asks the lawyer. “You didn’t come to a complete stop at the stop sign back there.” “I slowed down, and no one was coming.” “You still didn’t come to a complete stop” says the deputy. “What’s the difference?” asks the lawyer. “The difference is you have to come to complete stop. That’s the law. License and registration, please!” the deputy repeats impatiently. “Tell you what,” the hotshot lawyer says. “If you can show me the legal difference between slow down and stop, I’ll give you my license and registration and you can give me a ticket. If not, you have to let me go with no ticket.” “Fair enough. Please exit your vehicle, sir,” the deputy says. As soon as the lawyer gets out of his car

Moe: Did you know humans eat more bananas than monkeys? Joe: That’s not surprising. I can’t even remember the last time I ate a monkey. Moe: What do you call poems about pigs? Is there a term for that? Joe: Sure. Pork rhymes. Moe: What do you give a sick bird? Joe: Tweatment, I guess. Moe: I really believe Hillary Clinton will be the fi rst f president. Joe: Huh? Moe: Oops. I meant female, but I guess the emale got deleted. Moe: Do you know how Barack proposed to Michelle? Joe: Sure don’t. How? Moe: He got down on one knee and sang, “Don’t wanna be ....Obaaaama self.” Moe: You know why the French like to eat snails? Joe: Escargot? Not really. Why? Moe: They don’t like fast food. +

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ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble wrote a long-time column in this paper entitled The Patient’s Perspective reincarnated in this new format. Feel free to contact her at marciaribble@hotmail.com Oatmeal for breakfast? Not a bad idea, but why not oatmeal, peanut butter, chocolate chip cookies? I know the recipes have tons of sugar; however, they can be made with non-sugar baking substitutes, and with a tall glass of milk make a pretty complete set of morning nutrients. That kind of thinking comes from the same mindset that exists in the claim that when I am 70 I will wear purple. There is a kind of interesting defiance implied in both. By the time we turn 70, many of us have grown tired of mindlessly following the dictates of society, especially when they apply to unreasonable requirements for females. Men can create their own lists. • Thou shalt not wear white after Labor Day. • Thou will always produce large meals for the whole family for all major holidays—with no help—and do the dishes afterward. • Thou must always think of others’ needs before your own. • Thou must always wear a bra in public. • Thou must wear dresses and high heel shoes to be fashionable. • Thou must grow your own fruits and vegetables and can or freeze them every year, even if you have serious health limitations. It takes some women many years to understand how ridiculous those rules are. For example, rules about wearing white should always include the additional proviso that “if you wear white, you will spill spaghetti sauce on your white clothes.” That goes with the rule that if you wear black, you’ll drip something greasy on your outfit. We’ve gotten away - thankfully - from the dictates of my parents and grandparents’ generations that required the wearing of corsets, girdles, garter belts and silk or nylon stockings. Unlike our moms and grandmas, we wore slips and bras and graduated to knee high stockings that held themselves up. Our slips and bras were never to be seen, not the straps, not the lower edges. Our toes must be hidden within our shoes. We had to wear hats in church, but they no longer came with veils attached. My mother canceled her subscription to Life Magazine when they published a photo with a mere suggestion of cleavage. Even the demands that we wear skirts to work fell by the wayside when I was a young woman. I went to work wearing dressy slacks at the bank on a Saturday, when the bank was closed and just the accounting folks were at work. My boss told me to go home and change my clothes. I told him it would take an hour for me to catch the bus, get home, and change my clothes, and another hour for me to catch a bus to get back to work, so it didn’t make much sense for him to lose my work for so long, and besides, my slacks would not prevent me from doing the work that needed to be done--auditing accounts. “Oh, well,“ he said, “You might as well stay.” After that time, wearing slacks started to be commonplace. Women like me started out breaking the rules, so it just makes sense that I would continue on that path into my seventies. +

THE MEDICAL EXAMINER IS PUBLISHED EVERY 1ST AND 3RD FRIDAY

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AUGUSTA MEDiCAL EXAMINER

THE MYSTERY SOLVED

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

...very cleverly hidden (in the bricks) in the p. 16 ad for AUBEN REALTY APARTMENTS However, we had no winner! Want to find your name here next issue? The new Mystery Word is on page 12. Start looking!

The Celebrated MYSTERY WORD CONTEST ...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package!

This is how many back issues of the Medical Examiner are available at issuu.com/medicalexaminer

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EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC. FOR RENT 1827 McDowell St., 1 mi to MCG. 2 bdrm, 1.5 bath, LR, DR, den, kitchen. Tile/hardwood floors. New roof. (706) 738-2331 MEDICAL OFFICE Large brick twophysician office for sale or lease. Newly renovated, convenient, very busy location in charming Aiken, South Carolina, just 15 miles from Augusta. Call Kay at (803) 270-1740 FOR SALE 3 bedroom/2 bath, single garage Townhouse in Martinez. Master/ bath down, 2 upstairs bedrooms share bath, large loft for office, playroom, den; wood-burning fireplace, covered back porch. Freshly painted with new flooring, lighting and ceiling fans. Easy access to Riverwatch Parkway, Washington Rd, I-20, Augusta. 1987 sq.ft. $147,900. 706-836-7001. ROOM FOR RENT 1 room, private bathroom, 2bdrm MH on private lot. Clean quiet neighborhood. Non-smoker. $600 monthly. Must be stable, verifiable references and income. Cable and Internet included. Warrenville, 5 min from Aiken, 20 min to Augusta. (803) 270-2658 POND VIEW! Evans all-brick 2-story with solar panels. Avg. electric bill $170 in Northwood, 3,400 sqft. Call 1-800401-0257, ext. 0043 24/7 for price and details. AUGUSTAGAHOMESEARCH.COM Foreclosures • MLS • Builders • Rentals (706) 564-5885

MISCELLANEOUS SUNSET MEMORIAL GARDENS Opening and closing at Sunset Mem. Gardens in Graniteville. Sale: $760 (Value: $1520+) Call 706-736-0596

ANTIQUE maple dinette set with buffet corner cabinet table with pull-out leaves. Four chairs with two captain’s chairs. Excellent condition. $300. Double bed early 1930s with mattress spring coverlet shams $150. Call (706) 860-2170 WANT TO BE HEALTHY? (Energy, weight loss, mental clarity) Go to gethealthyat.le-vel.com See video and Facebook. Sign free as customer. BEING PAID WHAT YOU ARE WORTH? Then make more money! Watch movie all out interview: ExtraMoneyInterview.net CEMETERY SPACES (2) Sunset Memorial Gardens, Graniteville SC adjacent to lighted military flagstaff, includes granite bench with urn space, installation and inscription. All $4700 ($8600 value). Spaces only: $2700. Call (803) 2953033

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QUOTATION QUOTATION PUZZLE SOLUTION: “To read without reflecting is like eating without digesting.” — Edmund Burke

FISHING CLUB wants more grey-haired members. Meet 2nd Thurs of month at Harbor Inn Restaurant, 12 noon. “Adventure Before Dementia” Info: (706) 736-8753

The Sudoku Solution 4

HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706-877-0421

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

SERVICES CELIA DUNN, DMD 584 Blue Ridge Drive, Evans GA 30809 (706) 650-9700

F. E. GILLIARD, MD FAMILY MEDICINE Acute & Chronic Illnesses Occupational Medicine PROMPT APPOINTMENTS (706) 760-7607

WORDS BY NUMBER “ Nothing tastes as good as being healthy feels.”

— Author unknown

OCTOBER 7, 2016

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AUGUSTA MEDiCAL EXAMINER

It’s a question of care Q: How do I keep my loved one safe and well cared for when they live in an assisted living or nursing home? 1. Visit at different times of the day and different days of the week. This will ensure that you are not anticipated by staff and therefore able to see the care of your loved one is consistent and hopefully at the highest level of quality. 2. Get to know the direct care staff, which are the certified nursing assistants and caregivers. Recognize that they have a difficult job to do for which they are not well paid, yet we assign such intimate work to them. When you are in the unit visiting your loved one, offer to help the direct care staff do simple chores or care for your loved one. Several examples include putting away their clean clothes, helping dress them and brushing their hair or teeth. These are all activities that the direct care staff often has to assist with, so by being willing to work alongside the staff, you show that you are invested in your loved one’s care. Getting to know the staff includes knowing

the direct care worker’s fi rst name when you communicate with him or her. This reinforces that you see them as a partner with you in caring for your loved one. 3. Get to know the administrator and the director of nursing. If a problem should arise, and you are unable to get it resolved after speaking politely to the direct care staff, you can then go to management and explain the situation. Since they know you, you will be more inclined to get assistance. 4. Post directives in your loved one’s room. Signs indicating laundry, food and television preferences can ensure consistency for your loved one’s care. Before posting, make sure to check and follow the facility’s guidelines in regards to how and where to hang signs, so that the directives remain posted and your directions are followed. 5. Be an advocate for your loved one while remaining considerate and polite with the staff. Sometimes complaints are necessary; it is how

you deliver them that is important. It is best to ask questions, like “How do you do things here?” rather than assigning blame before you’re familiar with the community’s operational procedures. It is a balancing act between your expectations, your loved one’s needs, and how you ask for all of those to be met. Avoid becoming known as the difficult family member. Instead, be the observant, helpful, determined family member who participates in their loved one’s care and will be purposeful about following through on requests and complaints. + — by Amy Hane. Amy Hane holds both bachelor’s and master’s degrees in social work from the University of South Carolina. She is a member of the National Association of Social Workers and is an Advanced Professional Member of the Aging Life Care Association. Amy is a licensed Master Social Worker in South Carolina and Georgia, an Aging Life Care Manager and is also a Certified Advanced Social Work Case Manager.

PROFESSIONAL DIRECTORY ALLERGY

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

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

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

DENTISTRY

DERMATOLOGY

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

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

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

FAMILY MEDICINE

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

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

PHARMACY

YOUR LISTING HERE

SENIOR LIVING

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

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

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

VEIN CARE

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

WEIGHT LOSS

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PSYCHIATRY

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OCTOBER 7, 2016