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AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006
SEPTEMBER 20, 2013
The antidote to childhood obesity: shown above
B
ut wait. There’s more. The Centers for Disease Control (CDC) says, “There is no single or simple solution to childhood obesity.” Having said that, the CDC goes on to advise parents to pursue a relatively simple formula:
• Limit media time for kids to no more than 1 to 2 hours of quality programming per day. • Serve your family water instead of drinks with added sugars. • Visit your child’s daycare center to see if they serve healthier foods and drinks.
Give them a “go/no go” menu list of permitted foods and drinks for your child. • Do the same thing at your child’s school. Ask if they have a salad bar in the lunchroom. Encourage them to pursue that option if they do not. • Have plenty of fresh fruits and
vegetables in your family’s diet at home, and limit meals high in fat and sugars. • Finally, as illustrated, make sure your kids get plenty of active play time every day. An hour or more every day is the goal. It’s not a workout; it’s play. It’s not that complicated, is it? +
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SEPTEMBER 20, 2013
AUGUSTA MEDiCAL EXAMINER
DON’T LICK THE BEATERS Useful food facts from dietetic interns with University Hospital’s Augusta Area Dietetic Internship Program
Thinking about detox? Think again. by Katelyn Metz, Augusta Area Dietetic Internship/University Hospital dietetic intern Detox diets have jumped to the forefront of fad diets for those trying to lose a few pounds. It is not uncommon to see someone drinking cucumber-infused water or sipping a swamp-colored smoothie while walking down the street. Why are people drinking such bizarre concoctions, and what health benefit does it offer? Detoxes claim to improve sleep, energy, weight management, and gastrointestinal health while ridding the body of toxins that can build up from the environment and from consuming excessive amounts of processed foods. Some of the common detox diets include, but are not limited to: • The 28-day Raw Detox: a diet that is based on a raw vegan diet and assures weight loss. • The Master Cleanse or Lemonade Diet: a diet focused on consuming a lot of water along with lemonade and maple syrup (Rated among dietitians as one of the worst fad diets). • The Raw Food Diet: consumption consists only of uncooked, clean, green, or lean food, with promises to eliminate the toxins that promote weight gain. • The Juice Cleanse Diet: a 3- to 8-day diet of organic juice smoothies which claim to detoxify the liver and blood, balance pH levels, and provide more energy. So, where does science stand on claims such as these? 1. The gastrointestinal tract is not “dirty” in the sense that it requires cleansing. The gastrointestinal tract is home to numerous species of healthy bacteria, but when such bacteria are disturbed by a type of “detox,” the healthy bacteria may be wiped out and replaced with bad bacteria. 2. The placebo effect is a very strong phenomenon. Claims made by various detox diets can lead people to believe the statements, in turn providing a very strong emotional motivator, so people will believe they are doing something good for their body. However, there is no scientific evidence that proves health benefits from detox diets, as much of the data has been self-reported (and is therefore biased and unreliable in the eyes of scientific research) and intensive studies have not yet been completed because this fad diet is so new. 3. Detox diets have the potential to create a weight yo-yo effect. Like any other fad diet, people may find it unrealistic and hard to maintain. Detox diets can lead to fluctuation of sugar levels, irritability, dizziness, and may actually facilitate weight gain upon cessation. Heart and blood sugar problems have also been identified as adverse side effects in various studies regarding yo-yo dieting. 4. More intense studies must be conducted to verify the claims and investigate long-term effects of detox diets. Since this is the most recent fad diet, more studies must be conducted for science to determine the overall safety of such diets. 5. The best way to “detox” is to eat sensibly. There is no shortcut or quick-fix; eliminating toxins from the body is a continuous process. Eating balanced meals and consuming 4-5 servings of fruits and vegetables, 5-7 servings of protein, 6-8 servings of grains (with at least half being whole grain), 3 servings of low-fat dairy, and limiting the intake of salt, sugar and oils on a daily basis is the best way to eliminate toxins from the body. +
Editor’s note: Healthcare is a whole new ballgame with the passage of the Patient Protection and Affordable Care Act (PPACA). How will healthcare providers be affected? What about patients? And how about employers who provide health coverage as an employee benefit? How will Medicare and Medicaid recipients be affected? Look to this column for the answers.
HEALTHCARE REFORM & YOUR BUSINESS by Russell T. Head, CBC, CSA
THE WAITING IS OVER. THEY’RE HERE.
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s of the issue date of this Examiner, it will be just 10 days until the marketplaces/exchanges will be open for business. Some in this industry hoped that it would all go away. We have been studying, adapting and watching since March of 2010. The waiting is over. In the past 8 months, I have discussed many aspects of the Affordable Care Act (ACA) in this column. Some at length, and some in summary. Russell Head As the exchanges open, I would like to provide an overview of the tax credits and plans that are available in the marketplace. Insurance Affordability Programs • Advance Premium Tax Credits – These tax credits will reduce insurance premium amounts for people enrolled in a Qualified Health Plan (QHP). The credits are designed to assist people who meet certain financial criteria in obtaining the required coverage. Tax credits can be paid in advance to assist in paying premiums but will be reconciled and recovered with the individual’s annual tax return. • Cost Sharing Reductions (CSR) – This is a new federal program that will help QHP enrollees reduce the amount of their out of pocket expenses such as deductibles, co-payments and co-insurance affiliated with the plan they are enrolled in. The payments are made directly to the insurance company that issues the plan an individual is enrolled in. • Medicaid – States have the option to expand access to more low income adults. Georgia and South Carolina have opted not to expand their Medicaid programs.
• Children’s Health Insurance Plan – This is an existing federal program for low and moderate income children that provides health care benefits with affordable out of pocket costs. Qualifi ed Health Plans The Marketplace will be offering 4 QHPs that are known as “Metal Levels.” Each QHP will vary by the amount of costs they will be covering such as the percentage the plan will pay, the amount of the deductible or office visit co-payment. • Platinum Plans – This level will provide coverage at 90%. It is the most expensive QHP with the highest premium and the lowest out of pocket expenses. • Gold Plans – This level will provide coverage at 80%. • Silver Plans – This level will provide coverage at 70% • Bronze Plans – This level will provide coverage at 60%. It is the least expensive QHP with the lowest premiums but the highest out of pocket expenses. Note: Catastrophic plans will in offered in the marketplace but will not be eligible for the Advance Premium Tax Credits and the plans are available with or without financial assistance. Next Issue: More on the Marketplace. For further explanations of the ACA/ PPACA provisions outlined in this article, please refer to the following resources: www.hhs.gov www.irs.gov www.healthcare.gov www.cms.gov Russell T. Head is a Partner and Chief Visionary Architect with Group & Benefits Consultants, Inc., Augusta’s largest, privately held employee benefits consulting firm. He can be reached at 706-733-3459 or rthead@gandbc.com. Visit Group & Benefits Consultants at www.groupandbenefits.com. +
Looking for medical service providers of all kinds? Consult our Professional Directory on page 15 +
PROFESSIONAL DIRECTORY
SEPTEMBER 20, 2013
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AUGUSTA MEDiCAL EXAMINER
An editorial about an editorial licenses. Now every time I see suicidal hotheads darting in and out of lanes, riding my bumper at 65 mph, or speeding up to keep other drivers from merging, I imagine my inexperienced offspring navigating through the chaos. And I feel a knot of real fear. People of a certain age have been bemoaning “the end of civility” for centuries, so all such proclamations should be taken with a grain of salt. That said, I don’t think the growing “screw you” ethos on the roads is an isolated phenomenon. The last dozen years have taken a toll on most Americans’ confidence, and the cocky optimism that was once a bedrock of our national character has given way to a sour self-absorption. Everything of value feels finite and precarious — jobs, wealth, status, even our right to occupy space in a more crowded world. In this zero-sum reality, you’re either a winner or a loser; people think they can’t afford to give a damn about anyone else. So they don’t. On the road and in life, being a jerk is contagious. +
The excellent weekly news review magazine The Week makes its living quoting excerpts from newspapers, magazines, blogs and websites around the world to provide thought-provoking content for its readers about the news and issues of the day. We’d like to return the favor. Last week’s The Week (Sept. 13, 2013) contained this commentary from Editor-in-chief William Falk. It bears repeating: It isn’t your imagination: There really are more idiots on the roads. In a new Washington Post survey, 12 percent of drivers admit to frequent feelings of “uncontrollable anger” toward other drivers — double the percentage of self-admitted road ragers in a 2005 poll. The psychologist who conducted the survey, road-rage specialist Leon James, thinks that if everyone were being honest, about 30 percent of drivers would be classified as chronically angry and dangerously aggressive. These morons didn’t used to bother me much, since I’ve got about 1 million miles on my personal odometer and know how to stay away from trouble. Then, over the summer, my two daughters got their driver’s
SEE PAGE SIX
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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What: Representatives from companies who provide mobility devices such as scooters and wheelchairs will provide information and product demonstrations.
Contact: Eva Erwin (706) 364-1662 Note: This event is free and open to the public. +
When: Tuesday, September 24, 2013 at 6:00pm
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The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of news within every part of the Augusta medical community. Submit editorial content to graphicadv@knology.net Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com Augusta Medical Examiner photography: H + D Photography www.handdphoto.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397
(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net Opinions expressed by the writers herein are their own and their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., or its agents or employees take any responsibility for the accuracy of submitted information, which is presented for informational purposes only. For specific medical advice, diagnosis and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2013 PEARSON GRAPHIC 365 INC.
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SEPTEMBER 20, 2013
AUGUSTA MEDiCAL EXAMINER
Hope IS Possible
Is fear holding you back?
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ur doubts are traitors, And make us lose the good we oft might win, By fearing to attempt.” — William Shakespeare Shakespeare was an amazing man. He had such a tremendous grasp and perspective on people and what goes on their minds. He said doubts are traitors. Usually when we hear the word traitor we think of politics or maybe the military. But as it relates to fear? Hmmm. Shakespeare says doubts are traitors since they prevent us from even attempting to do things. Is that you? Has that been you in the past? Fear is universal. In Britain, they have a health awareness week designed to raise awareness about the impact fear and anxiety can have on our lives. Wow! According to the Mental
Agateophobia- Fear of insanity Allodoxaphobia- Fear of opinions Anthrophobia or AnthophobiaFear of flowers Arachibutyrophobia- Fear of peanut butter sticking to the roof of the mouth Bibliophobia- Fear of books Bromidrosiphobia or Bromidrophobia- Fear of body smells Clinophobia- Fear of going to bed Dementophobia- Fear of insanity Dikephobia- Fear of justice Ergophobia- Fear of work Febriphobia or Fibriphobia or
Fibriophobia- Fear of fever Gnosiophobia- Fear of knowledge Hygrophobia- Fear of liquids, dampness, or moisture Ideophobia- Fear of ideas Japanophobia- Fear of Japanese Kopophobia- Fear of fatigue Lachanophobia- Fear of vegetables Melophobia- Fear or hatred of music Neophobia- Fear of anything new Ophthalmophobia- Fear of being stared at Paralipophobia- Fear of neglecting duty or responsibility
Polyphobia- Fear of many things (There are no Q fears) Rhytiphobia- Fear of getting wrinkles Selenophobia- Fear of the moon Tremophobia- Fear of trembling Uranophobia or OuranophobiaFear of heaven Venustraphobia- Fear of beautiful women Wiccaphobia: Fear of witches and witchcraft Xenoglossophobia- Fear of foreign languages (There are none in the Ys) Zelophobia- Fear of jealousy +
for some types of fear. Usually it has to do with the thought of a threat of something going wrong in the future rather than right now. Anxiety and fear can hold you back from doing things you want to do or need to do, thus affecting your health. Health problems that are directly based on fear include phobias, panic attacks and anxiety disorders, including obsessive-compulsive disorder. These are serious concerns and if you’re experiencing any of these, you should discuss it with your doctor. You can also visit www.mentalhealth. org and obtain much more information as well. Some common questions about fear and anxiety include why do I feel like this when I’m not in any real danger? Why won’t my fear go away
and leave me feeling normal again? What makes me afraid? What makes me anxious? What do fear and anxiety feel like? What is a panic attack? What is a phobia? And how do I know I need help? Have you ever taken a moment to stop and think about what you fear most in life? Some people will automatically assume the top answer is death. Death is a very common fear, for who is actually ready to die? Many people are terrified of death. However, there is one fear that rings even more powerfully in most people: public speaking. For some reason, people in general are horrified by the thought of speaking to a large audience. Regardless of the topic, people hate talking in front of groups of other people. Have you ever heard of
a phobia list? Well, it exists. There’s a website (www. phobialist.com) that lists hundreds and hundreds of different reasons and things that people fear. The list begins with A and ends with Z. I have to admit I have never heard of many of them. Here are some (above) that I found most interesting. Have you ever heard of any of them? There’s one for nearly every letter of the alphabet. That’s a lot of fear. That’s too much fear. If fear is intruding in your life, resolve today to seek help. + Helen Blocker-Adams is Executive Director of the Southeast Enterprise Institute; mental health advocate; and youth advocate. You can reach her at hba@hbagroup-intl. com or visit her website at www. helenblockeradams.com
Stay at home alternatives from the professionals at Right at Home “Right at Home” owners Celeste Hoffman and Kathy Crist introduce therapy dog Snickers to Mrs. Margaret Lista. Photo by Todd Lista.
For more information and a free in-home assessment, call
803-278-0250
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Trust is like an eraser; it gets smaller and smaller with every mistake.
“
Helen Blocker-Adams
Health Foundation, fear and anxiety are part of the body’s natural response to threats or thoughts that something bad might happen. Usually fear or anxiety lasts for just a short time and then passes. But sometimes they last longer and a person can get stuck with them. Fear and anxiety can take over your life, affecting your ability to sleep, eat, concentrate, travel, enjoy life, and even leave the house or go to work or school. Sometimes it’s hard to break the cycle, but it’s possible. And thanks to the world wide web, the Mental Health Foundation is available so that you don’t have to suffer alone and without help. Mental Health Action Week started in the 1950s. This is a time used to raise awareness of important mental health issues, focusing on a different issue each year. Fear and anxiety were the focus in a recent year, and with good reason, as we have discussed. What is fear and anxiety? Fear is one of the most powerful emotions. It has a strong effect on both the mind and body. It provides strength and focus through adrenaline in immediate emergencies like a fire, or when being attacked by a dog. On the other hand, it can also resonate when you’re faced with non-dangerous situations like taking exams, starting a new job, going on a date or even to a party. Anxiety is a word we use
SEPTEMBER 20, 2013
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AUGUSTA MEDiCAL EXAMINER
WHAT EVERYBODY OUGHT TO KNOW ABOUT BEHAVIOR MODIFICATION, COUNTRY STYLE
C
arl Ladson was 6 years old, limp, dehydrated, and flirting with death when his mother rushed him into my office. Grief overwhelmed her and sapped her soul. I grabbed Carl in my arms and literally ran through my crowded waiting room and across the street to the hospital. EMTs would have taken too long. Carl’s shock was secondary to systemic salmonella contracted from an injured turtle he found on the roadside. Makes one remember that no good deed goes unpunished for long. Carl responded to antibiotics, IV fluids, and the constant care of the nurses and his mother. He went home to a wooden shack in the backwoods for a normal life of country upbringing. A couple days later, Carl’s father, Charles, showed up in my office without an appointment. “I want to see the Doc. It’s personal. I’ll wait all day if need be.” Although I had never met Charles, my receptionist, Robbi, knew Charles to be a heavyduty man of honor and action. “Come back to his private office. The doctor will see you right away.” Robbi herded me in to see Charles. He stood immediately and shook my hand with intensity. “Thank you, Doctor. I owe you. Carl is my boy. I was out of town and my wife didn’t know how sick he was. She said my boy would have died if not for you. Here’s some money.” He stuck some folded $100 bills in my surprised hand. “It’s not enough, but it’s all I
have right now.” The amount was far more than I charged, but Charles refused to take it back. The set of his jaw, the emotion in his eye said don’t argue with Charles. His departure was immediate and without another word. A week or so later, Charles came back to see me. “Doctor, I don’t have any more money for you.” “You don’t owe me any more. You have paid more than enough.” “You’re wrong, Doctor. Carl is worth more than I can ever pay you. If you ever need anything, if anybody ever bothers you, you call me. I’ll take care of whatever troubles you. Believe what I say, I can and will take care of anything for you. Anything.” My eyes dilated as belief in Charles permeated my soul. I called my Dad for some background. He enlightened me. Charles was a war veteran with steely nerves and a true eye who believed in fidelity. Once the Sheriff had trouble with petty break-ins in an outlying community. The county could not afford regular patrols, so the Sheriff gave Charles a gun, a star, a uniform, and a mission: stop the low-lifes any way you see fit. Charles took him at his word. Maybe Charles was the prototype Charles Bronson used for his character in his Death Wish movies. It took Charles about two days to identify and then locate some young hoods on their way to make things worse. He encountered them in the dead
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Best of night, gave them a lecture about man, stewardship, God, and law. Being young and bulletproof, they laughed in his face. Who was this old man to tell three young bucks what to do and not do? Charles kneed one in the groin, back-handed the second into the middle of next week, and with his left hand grabbed the third by the throat and gave him a heavy right punch to the gut. “Want some more? Or do you want to go home to your mother in one piece?” Struggling to breathe, he finally croaked, “Go home right now. Sir.” “Good. Take your friends with you. They will live, for now. I catch you messing up again, there will be hell to pay. Believe what I say.” Henceforth, my Dad said, peace reigned supreme thereabouts. Sometime later, a diabetic patient, Taylor, complained to me in passing that somebody was stealing tires and rims from his trailer moving business. I told him to hire Charles to stop the thefts, no questions asked. The next visit, Taylor was the happiest he had been in years. The tire thefts had ceased
e n i c i d ME
and his girlfriend was as nice as she had ever been. She no longer nagged him about money or his occasional beer or watching football all the time. She had come to understand that football was a man thing, but she wanted to learn more about it. He said it all happened after he hired Charles, so he put Charles on the payroll permanently. Charles’ title was VP in Charge of Everything. The tire part I expected. I had no explanation for the girlfriend part. I called Charles. “What happened?” “His girlfriend was sleeping on the side with a young stud who’s too sorry to work,” he told me. “He was stealing the tires. I waited until they were in bed together, broke down the door, and beat that sorry SOB with a billy club. I took Polaroids of him and her. Then, I kicked him out the door naked in the middle of the day. I kept his keys and wallet. “Then I told her to get dressed and to shut up with the crying and begging. “I told her that she was now a new born Christian and would be the world’s best girlfriend, mistress, wife, whatever Taylor preferred. If I
heard even a rumor about her being anything different, I’d blister her butt ‘til it glowed in the dark, then I’d give Taylor the Polaroids. She’d be out in the street. Believe what I say.” Sweet Thing took Charles’ combination of Christianity and behavior modification therapy to heart. Her conversion was instant and thorough. Billy Graham can’t hold a candle to Charles. Neither could Dr. Phil or Dr. Laura for that matter. So what are things you ought to know about all this? 1. When your word has weight, people respect that 2. Political correctness is good in debates. It’s worthless in the real world 3. Behavioral modification works 4. Behavioral modification does not always require a psychotherapist 5. People tend to do what they are rewarded for doing 6. People tend to not do what they are punished for doing That being said, can anyone explain to me why the government takes money away (punishment) from people who work and gives money (reward) to people who will not work? + 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
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It started with a bulls eye
M
SEPTEMBER 20, 2013
AUGUSTA MEDiCAL EXAMINER
y medical odyssey started innocently enough in July 2012 when I noticed a dark “bulls eye” image in my left eye. It was discovered that I had a torn retina. The doctor questioned me about any accidents that might have caused the damage. I told the doctor I had no idea. The cause is a mystery to this day, but the solution was surgery at Trinity Hospital. Before surgery the anesthesiologist told me not to worry about pain because the doctor would put a needle in my eye to deaden it. This was more information than I needed at the time. Recovery required that I be face down 23 hours per day
s
“I had to lie face-down 23 hours a day.” for twelve days. This, as you would imagine, was not easy. There are ways to make it a little easier, such as a mirror to allow you to watch TV (as long as you don’t mind watching TV backwards). During surgery the eye is filled with a gas which puts pressure on the retina and allows it heal. If you don’t keep your head down it’s all for nothing. Twelve days is a long time to walk, eat and sleep with you head down but it was worth the aggravation to keep my eyesight. My right
eye makes up for the impaired left eye and I actually see pretty well. The worst part is at night, because while you are asleep you want to turn over. No one gave me a clue how to solve this problem until I realized that lying on the couch kept me in place. Keeping my head down on the couch required one arm and a pillow to hold my head in the right position. It worked out okay. Just a month later, in August of last year, in pain and discomfort I went to the emergency room at University Hospital. After some testing my gall bladder was removed. I will never forget waking up as I was wheeled out of surgery. There were two sensations at once: bright
lights and a pain that made me exclaim that my stomach was on fire. They must have given me more anesthesia as the pain went away in seconds. My wife and I thought we were home free until December through January, when the stomach problems returned to the extent that we thought I was having a heart attack. We went back to University, and after several days of testing it was found that there was a blockage in a duct and this was removed with an endoscopic procedure. With a sigh of relief I scheduled a routine colonoscopy in March of this year. After the procedure the doctor told us the results were good except for the discovery of a nodule on my prostate. A biopsy of the prostate was required. The eleven-needle biopsy to determine if the nodule was cancerous was quite an experience. Just imagine eleven bee stings one after another when the
needles are inserted into the prostate. Cancer was confirmed and a second procedure was performed to place three gold markers into the prostate. I will leave it to your imagination as to where the needles are positioned to enter the prostate. Only three “bee stings” this time. I’ve been going through 44 radiation treatments from GRU, which end this month. I must say all of the medical facilities, doctors and technicians are the very best. God bless them all. + — Submitted by Mac Johnson Augusta, Georgia What’s your story? 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 309030397. (The Medical Examiner reserves the right to accept, reject, or edit any submission at its sole discretion.) Your story can be “by Anonymous” if you wish.
WE’RE BEGGING YOU We’re never too proud to beg. What we’re begging for is Medicine in the First Person stories. With your help, we’d like to make this a feature in every issue of the Medical Examiner. After all, everybody has a story of something health or medicine-related, and lots of people have many stories. Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx.com. Thanks!
“The cause was a mystery for a long time.” “And that’s when I fell.” nearest hospital “He doesn’t remember a thing.” “The was 30 miles away.” “I was a battlefield medic.” “He was just two when he died.”
“OUCH!”
“It was a terrible tragedy.” “She saved “I sure learned my lesson.” “I retired from medicine my life.” “It seemed like a miracle.” seven years ago.” “We had triplets.” “It was my first year “I thought, ‘Well, this is it’.” NOTHING SEEMED of medical school.” “They took me to the hospital by helicopter.” TO HELP, UNTIL. . “It took 48 stitches.”
ambulance crashed.” “Now THAT hurt!” “The “My leg was broken “I’m not supposed to be alive.”
“This was on my third day in Afghanistan.” in three places.” “I lost 23 pounds.” “Turned out it was just indigestion.” “At first I thought it was something I ate.” “The smoke detector woke me up.”
Everybody has a story. Tell us yours. Here’s our “No Rules Rules.” We’ll publish your name and city, or keep you anonymous. Your choice. Length? Up to you. Subject? It can be a monumental medical event or just a stubbed toe. It can make us laugh or make us cry. One thing we’re not interested in, however: please, no tirades against a certain doctor or hospital. Ain’t nobody got time for that.
SEPTEMBER 20, 2013
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AUGUSTA MEDiCAL EXAMINER
Southern Girl Eats Clean
Are you a beet lover? If you are, then you already know how delicious they can be, and how much nutrition they provide. If you have not previously been a fan of beets, then I’m hoping these pickles might help persuade you to give beets a second chance. Red Beets are very familiar to me, but it wasn’t until last year that I was introduced to golden beets. I didn’t even know that beets could be anything but red. I found some golden beets at the grocery store and decided to try them. When I came home I did a Google search on “golden beets” so I could learn more about them. Turns out, golden beets are pretty much the same as the red variety minus the pink juice that stains everything (huge plus). Golden beets are a bit milder than red ones and when roasted, they are a so wonderfully sweet. They are just as nutritious as red beets too. Golden beets are now my beet of choice! Interesting beet fact: Beets were used by ancient Romans as an aphrodisiac. Yep, that’s right. Science has proven that beets contain high amounts of boron, which is directly related to the production of human sex hormones. That’s a good enough reason to give them a try right there. (Source: http://www. fullcircle.com/goodfoodlife/2012/05/10/6-health-benefits-of-eating-beets/)
Pickled Beets
• 4 to 5 medium to large organic golden beets • 2 small organic Vidalia onions, cut in half and sliced very thin • 1 Tbsp. of Real Salt or sea salt • 3/4 cup of apple cider vinegar • 3/4 cup of white wine vinegar • 1/4 cup of organic pure cane sugar • 4 cloves of garlic, crushed • 1 tsp. of mustard seed • 1 tsp. of dill weed • 1/2 tsp. of crushed red pepper • 3 or 4 pint size mason or Ball jars Remove greens from beets and
wash well. Wrap each beet in a piece of foil. Peel and slice onion and place slices into a bowl. Sprinkle salt over onion and toss to coat all pieces. Put salted onion slices into a colander and place colander over a bowl. Cover and refrigerate. After 3 to 4 hours, remove and rinse salt from onion slices and let drain. Set aside. Place foil wrapped beets into a shallow baking dish and roast in the oven for 1 hour at 425°F. Check with a fork to make sure
beets are completely done. Once done, remove tin foil from beets and let cool. When beets have cooled enough, use a small paring knife to peel the tough skins away. Cut beets into 1-2 inch pieces. Layer the onions and beets into the jars. (I used 3 jars, but you may need 4 depending on the size of your beets) In a small sauce pan add the vinegars, sugar, garlic, mustard seed, dill and red pepper. Heat over medium heat and stir to dissolve sugar, bring to a boil, reduce heat and simmer for approximately 5-8 minutes. Pour vinegar mixture into the jars over the beets and onions. Seal and let cool completely before placing in the refrigerator. Pickled beets may be stored in the refrigerator for up to a month. + Alisa Rhinehart writes the blog www. southerngirleatsclean.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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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 • Eisenhower Hospital, Main Lobby, 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
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USEFUL EFFECT — OR TROUBLESOME SIDE EFFECT?
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here are many drugs in common use today that started out as prescribed treatment for something else entirely. A drug would be approved and released, only to find that a particular unexpected side effect was especially prevalent, and that side effect could become useful as an indication all its own. In this issue we are going to look as a few of these instances and the advances we have enjoyed as a result. Probably the most famous side effect that resulted in a new medicine was from the blood pressure medicine Loniten. You’ve never heard of Loniten? You have heard of the medicine that resulted from it. It all began when it was discovered that people who took Loniten had a propensity to grow hair. No sensse wasting a good formulation, so Loniten was reinvented as a topical solution to be applied to the scalp. And it was renamed: Rogaine. A similarly “hair-raising” side effect was discovered with the prostate medication Proscar, so the dose was adjusted and rebranded as Propecia. Lately a new class of blood pressure medicines has proved useful in treating
another disease. As a result it is now being used in more patients for the “side effect” benefit than for the drug’s originally intended use. These medicines are known as angiotensin blockers and consist of two classes of medicines that work in the kidneys to lower blood pressure. But it was subsequently discovered that these medicines protect the kidneys in diabetics. So doctors now prescribe a low dose angiotensin blocker to diabetics as preventative medicine, since kidney damage is a major complication in diabetes. Other side effects have been used to patient’s advantage over the years. Many drugs were used as a treatment for depression, only to find that the drowsiness they caused was too great at the dosages required to be effective against depression. As a result they were then used in low to moderate doses as a sleep aid. Trazodone and amitriptyline are two examples of this class. Antidepressants have been useful in other “side effect” areas besides sleep aids. Amitriptyline has been used to reduce the incidence of migraines in some people, and has also been useful in treating nerve pain.
Propranolol is a beta blocker that works to lower blood pressure as well as regulate heart rate and rhythm. In addition to its blood pressure effects, it too has been used for its ability to reduce incidence of migraines just like amitriptyline. It has also helped reduce the occurrence of stage fright in some patients. Secondary use of the antipsychotic drug chlorpromazine is somewhat rare, but not unheard of. In addition to its use in mental disorders, it can be used in hepatic porphyria cases to prevent the
debilitating stomach pain that accompanies this disease. Many people with seizures being treated with gabapentin and Topamax who discovered that nerve pain in their backs was decreased, led to the use of these and other seizure medicines as nerve pain solutions. After this use was validated, it was increased to include diabetic neuropathy in extremities and this pain was also relieved. To minimize side effects of these multi-use medications research was done and Lyrica was developed. Lyrica is a medicine specifically targeting nerve pain and diabetic neuropathy. This last example emphasizes the research that may result from side effects. In addition to using the old medications in a new role, companies may choose to bring out new medicines reformulated to more specifically target the desired effect. + Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson (cjdlpdrph@bellsouth.net If you have any questions, comments or article suggestions please email us at cjdlpdrph@bellsouth.net
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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.
DISE AS
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SEPTEMBER 20, 2013
AUGUSTA MEDiCAL EXAMINER
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SEPTEMBER 20, 2013
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AUGUSTA MEDiCAL EXAMINER
by Ross Everett
I HAVE SEEN THE ENEMY...
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nd we are him. It’s a common paraphrase for the old, often-butchered quote from the Pogo comic strip. Yet, after just two and half months in the trenches of our hospitals and clinics in these United States, I can confidently say it holds true for our healthcare system. There are many things within healthcare outside of our control as both doctors and patients. However, I have already seen several commonly cited problems for which we are all to blame. Macro-healthcare, or healthcare at the community, state or national level, is a complex system. There are the major players: the insurers, drug companies, major health networks, legislators, etc. Then there are the smaller factors, vast amounts of little microhealthcare systems, consisting of individual doctors and their patients. Each has its impact on every single part of healthcare, particularly focusing on the doctors and patients. Consider this a call to be conscious of your “carbon footprint� in healthcare, your “tiny ripple,� your effect. Numerous examples run rampant in the clinics and hospital floors. But I’ll start with a favorite: the high costs of ordering tests. This is a commonly-cited source for escalating healthcare costs in the U.S., particularly since other countries seem to avoid spending similar amounts. Doctors are certainly have their share of the blame, and the disorganization and lack of unity between different medical record systems is also to blame (see my Feb. 2013 article). I’ve already exhausted all of my fingers and toes trying to count the times we’ve ordered another MRI because we didn’t have a copy of the patient’s last one, done in the last few months. The test costs a couple thousand dollars each time. Yet, patients usually have no qualms with tests. In fact, they welcome them. I won’t fault anyone for trying to explore his condition. However, a recent conversation illustrates an excellent point. A middle-aged woman
presented with a rare autoimmune disease, for which there is a diagnostic blood test. The test is very specific, and would never be ordered without a high suspicion of the illness. Yet, as the patient’s father put it, “It seems like if it were just a simple blood test, then everyone should have it.� While his intentions were noble, it just goes to show the gross oversight the majority of individuals have for healthcare. I attempted to explain to him that there were “simple blood tests� for hundreds and hundreds of diseases, and that each of these individual tests could cost a great deal alone, much less combined. Now let me present a very different example. Friends and family members constantly ask me why on earth people have to wait so long at the doctor’s office. Why are these doctors riding their God-complex so high that they think they can make patients wait for over an hour? Well, again, the blame is shared. In my experience, most doctors do not allot enough time per visit. While it’s probably a good thing they’re exceeding the 15 or so minutes that’s on the schedule, it doesn’t take long for those extra five minutes to add up quickly. Yet, some blame falls on the patients too. I remember one morning, sitting in my attending’s office from 8:00 to 9:00 am, essentially twiddling our thumbs, as our first three patients were no-shows. From 9:00 to 10:00, the schedule went as it should and things were fine. In the following hour, the next three patients that were expected to show up did. However, two of the three no-shows from earlier that morning also arrived. I know it’s easy to be an outsider looking in and say that it’s too bad—they missed their chance. But consider one was a wheelchair bound, impoverished patient who relied on a transport service to get to their appointment. If the service was late picking them up, is it really their fault? Can you really turn this person, who probably needs care more than many of the others, away Please see THE ENEMY page 10
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1 Available only in AL, AR, DE, FL, GA, MD, MS, NC, SC, TN, VA, WV, DC and select counties in NJ and PA to Residents, Interns, Fellows, Doctors of Osteopathy (DO) or licensed medical physicians that have completed their residency within the last 10 years. 2 Borrowers should note that 100% mortgage financing will result in no property equity until such time as the loan principal is paid down through regular mortgage payments and/or the property value appreciates. Additionally, if property values decline you could owe more than your property’s value. 3 A down payment may be required if the property is located in a declining market. 4 Adjustable Rate Mortgage (ARM) products have interest rates that may increase after consummation. The information contained herein is intended as informational material for the sole and exclusive use of the business entities to which it was distributed and is subject to change without written notice. Equal Housing Lender. SunTrust Mortgage, Inc., 901 Semmes Avenue, Richmond, VA 23224, NMLS # 2915, is licensed by the Department of Corporations under the California Residential Mortgage Lending Act; is an Illinois Residential Mortgage Licensee; is a Lender in Massachusetts having Mortgage Lender license #s ML1216, ML0133, ML1432, ML1914, ML1913, ML1815, ML2411, ML1214, ML2442, ML2491, and ML2538; is licensed by the New Hampshire Banking Department; is licensed by the New Jersey Department of Banking and Insurance, toll free 1-800-330-4684; is a licensed lender in Rhode Island; and is doing business in Arizona as Crestar Mortgage, 7250 N. 16th Street, Ste. 100, Phoenix, AZ 85020. Š2012 SunTrust Banks, Inc. SunTrust and SunTrust Mortgage are federally registered service marks of SunTrust Banks, Inc. REV082712HJ-R STMR1068
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SEPTEMBER 20, 2013
AUGUSTA MEDiCAL EXAMINER
MEDICARE MATTERS +
by Trisha Whisenhunt
MEDICARE SUPPLEMENTAL INSURANCE
M
edicare Supplemental Insurance (Medigap) Policies are sold through private insurance companies. These policies help pay some of the costs Medicare does not cover. You have a one-time, six-month window which begins the day your Medicare becomes effective to purchase this coverage without any of
your pre-existing conditions being considered in the calculation of your premium. After the six-month initial enrollment period, you may still be able to purchase a supplemental policy but the cost may increase. Supplemental policies must follow federal and state laws designed to protect
the consumer. They must be identified as Medicare Supplemental Insurance and must be standardized policies identified in most states by the letters A-N. Plans E, H, I and J are no longer offered, but if you already have one, you may keep it. Some supplemental policies offer coverage which Medicare does not offer. This applies medical care if you travel outside of the United States. With a supplemental policy, Medicare will pay their share of approved, covered health care costs and your supplemental policy pays its share. You will have to pay the premiums for your supplemental policy. Federal law does not require insurance companies to sell supplemental policies to people under age 65. If you are under age 65, you might not be able to buy the supplemental policy you want or any supplemental coverage until you turn 65. However, some states require
supplemental insurance companies to sell these policies to those people under the age of 65. The State of Georgia does offer supplemental policies to those persons under the age of 65 and receiving Medicare. Please be aware that different insurance companies may charge different premiums for the same policy. In some states, a policy may require you to use a specific hospital, doctor or other health care provider. It is important to do your homework. To be eligible for a supplemental policy, you must have both Medicare part A and B. A supplemental policy covers only one person. Married couples will each need to purchase their own policies. You cannot have both a supplemental policy and be enrolled in a Medicare Advantage Plan. If having supplemental coverage is important to you and you are currently enrolled in
an Advantage Plan, you will have to disenroll from the Medicare Advantage Plan and switch to a Part D prescription plan during the next open enrollment period. If you have a supplemental policy and decide to drop it to enroll in an Advantage Plan and later change your mind, you will be unable to get your previous supplemental coverage back. As with any contract, be sure to read it before your sign so you can be certain what you are purchasing is the appropriate coverage for your individual needs and situation. For more information on supplemental insurance coverage (Medigap) or to find policies in your area, visit www.medicare. gov/medigap or call Medicare direct at 800-633-4227. Written by Trisha Whisenhunt, CSRA Area Agency on Aging / Medicare Counselor Source: Medicare & You +
THE ENEMY… from page 9 is now
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for being late? How about the other patient, who apologized extensively for being late, citing a tire blowout on the way that morning? Regardless of the reasons, you can see just how quickly the day’s structure comes undone. Reading over this article, there isn’t any research put into it. There aren’t any profound “ah-ha” moments that come from wise proclamations. Here were merely examples that have been thrown at me time and time again in just the past two months. Still, I urge you to remember that healthcare is, in its simplest of forms, a two-way street between you and your caregiver. Remember that the decisions you make and the impacts you have are multiplied several million times over. I’m not asking you to avoid care, or to go with the flow, regardless of where it takes you. I simply ask that we all consider our own footprint in the system and do our part to make it better. Ross Everett is a 3rd year medical student at the Medical College of Georgia. He grew up in Buford, Georgia and graduated from the University of Georgia in 2011. In addition to his coursework, he is interested in health policy, health systems and health management. Please contact him at wideeyedwhitecoat@gmail.com and Like him on Facebook at Wide-Eyed White Coat. +
SEPTEMBER 20, 2013
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AUGUSTA MEDiCAL EXAMINER
From THE Bookshelf
The blog spot — Posted at www.gruntdoc.com
A WORD TO THE WISE: WHEN YOU LAND IN THE ER... ...please consider the following: • Your Doctor is your Doctor, not your waiter. “Will you be waiting on me” is the wrong question. • The Doc doesn’t care where you parked or that it’s paid parking. Deal with it. • Have a clue as to why you came, and be able to express it in three or fewer sentences. “You’re the doctor, you figure it out” will not cause the doc to laugh. We’ve heard it all. Ditto for “an ambulance.”
“Have a clue as to why you came.”
• The gown goes on with the split in the back. And not over three layers of clothing. • Practice being able to answer a direct question: “Yes” and “No” are perfectly reasonable answers. • We really don’t care that your neighbor is the chairman of the hospital board. Unless he comes in with you and holds your hand, you’re a patient. If he does come in holding your hand, you’re a painful patient, and we’re not going to enjoy taking care of you. • We care about you, really. Don’t make us regret it by asking for two weeks off for your sore throat, or by asking for us to fill out your disability forms. Or by calling your nurse names. Big mistake.
This book came out in 2008? How did I miss that? I want this book! I hereby freely confess I have not read this book; I just found out about it five minutes before starting this “review.” But I am sold already. Here’s the deal. I don’t know how many rooms are in our house (do you count bathrooms, for example?), but my wife is in charge of all of them except one. That one room is my office. Coincidentally, every room in the house is spotless except for one: my office. It’s the room with the sign over the doorway reading, “Abandon hope, all ye who enter.” I subscribe to the philosophy that every horizontal surface should be covered by books, folders, mail — pretty much anything you can get your hands on. It’s just not proper for horizontal surfaces like tables, shelves, desks, even floors in some cases, to be naked and exposed. Naturally, this is a source of great shame for those of us afflicted with this condition. But someone apparently asked author Eric Abrahamson if he suffered from disorganization
• If you take an ambulance to the hospital for your paper cut, expect to wait in the waiting room.
• We understand you don’t plan for emergencies. Behaving badly doesn’t reflect well upon you, and doesn’t make us care more. • Your litany of complaints about all your prior doctors does not endear you to your current doctor. • The louder you get the less we want to deal with you. • If you take a medication, go write it down, now, and put it into your wallet/purse/whatever. “It’s a small white pill” narrows it down to about 2 billion medicines. • “You have it in my records” is not a usable dodge for the above. This stuff is your responsibility to keep track of, not ours. • Yes, I know your doctor told you “...and have them call me when you get there.” Even money says when I call your doc they’re going to tell me you’re a P.I.T.A. and to do what I want. • Never, ever lie to your ER nurse. Their BS detectors are excellent, and you lose credibility when you lie. Same for the docs, but we have fewer direct ways to show displeasure. There’s more, but if I give it all to you now, will you keep reading? Speaking of blogs, the Medical Examiner’s blog is found at www.AugustaRx.com/news
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A Perfect Mess by Eric Abrahamson and David Freedman, 352 pages, published in January 2008 by Back Bay Books
the
• Yes, we know you get medicaid if you are pregnant. Go to the Health Department and get a test. Don’t fake “abdominal pain” to get a test.
• We do not call the waiting room the penalty box, but there’s a committee considering it.
and he evidently replied, “No, I enjoy it very much.” Hence the genesis of this book, which neatly — if I can use that word — accomplishes two sublime goals. One: reassuring and comforting those of us whose neat-freak inner-self has never seen the light of day; and two: attacking the Neat Police who flaunt their organizational skills, who are never late for appointments, who have a place for everything and have everything is in its place. And I must say, Abrahamson has the chops to do it: He is a professor of management at Columbia University School of Business. That’s impressive. His
co-author, Mr. Freedman, is a business and science journalist who has written for The Atlantic Monthly, Newsweek, and Wired, among other publications. One reviewers said the book is “surprisingly well-ordered.” How insensitive. How callous. That’s like saying you’d be surprised that a fat person could create a low calorie dish. That, friends and neighbors, is hate speech. Publisher’s notes say A Perfect Mess offers “an astounding array of anecdotes and case studies of the useful role mess can play in business, parenting, cooking, the war on terrorism, hardware stores, and even the career of Arnold Schwarzenegger.” Take note: messy places are part of the arsenal of democracy. Half an hour ago I was about to clean my office. Not now. I’m not going to let the terrorists win. Instead, I think I’ll see if I can order a copy of this book. Or maybe I already have one here somewhere... +
Anti-bullying programs get results — bad results A study conducted by the University of Texas at Arlington has uncovered a startling fact: students at schools with antibullying programs are more likely to be victims of bullying than children at schools without such programs. The findings were culled from data provided by the Health Behavior in SchoolAged Children (HBSC) study taken every four years by the World Health Organization. The sample analyzed for the Texas study consisted of some 7,000 students aged 12 to 18 from nearly 200 schools. UT researchers cautioned that there may be no actual disparity in bullying rates between schools with and without antibullying programs. “Students who are victimizing their peers,” said the study author in a ScienceBlog.com article, “have learned the language from these antibullying campaigns.” In other words, they have learned from
Clipping File
the programs themselves the kind of conduct they should deny if questioned by parents and teachers. The UT Arlington team found that boys are more likely to be the victims of physical bullying, while girls are usually dishing out or being victimized by emotional bullying.
Be like Humpty Dumpty How? By having a great fall. One excellent way to do that is by staying healthy this fall. A flu shot might be just the ticket. An article in The Wall Street Journal last week reviewed what’s new. The experts say this year’s flu shots offer protection from a wider variety of flu strains. The trick is when to take the plunge: it takes about two weeks after a vaccination to be fully protected, so it’s not good to wait ‘til the last minute. If you’re allergic to eggs, typically used in vaccine production, there are egg-free options for you. Allergic to needles? Ask your doctor or pharmacist about micro-needles
that do the trick with barely a prick of the skin. And if even that is too much, take your flu vaccine via nasal spray. Bottom line: if you want to follow the advice of most public health officials and be immunized against the flu, you have few, if any, excuses. When should you brush? Should you brush immediately after a meal or after drinking a sugary beverage? Probably not. Jeffrey Cole, former president of the Academy of General Dentistry said in The Wall Street Journal that drinking a soda can lower oral pH to about 2.5 (ideal pH is 7), about the same as drinking vinegar. At this level of acidity, tooth enamel is temporarily softened and weakened. Brushing immediately applies abrasives to the teeth at their weakest moment. Waiting an hour or so allows saliva to restore proper pH, making brushing safer. Best bet right after eating: vigorously rinse with water. +
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SEPTEMBER 20, 2013
AUGUSTA MEDiCAL EXAMINER
THE EXAMiNERS +
by Dan Pearson
I should have said a man Instead I said he was was shot “point-blank Uh oh. I see where shot “point-blank What words? in the peritoneum.” in the perineum.” this is going.
Terrible. I got one word How was your mixed up with another. anatomy essay test?
THE EXAMiNERS
THE MYSTERY WORD The Mystery Word for this issue: SEEIDEAS
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PUZZLE
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© 2013 Daniel Pearson All rights reserved.
EXAMINER CROSSWORD
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Click on “Reader Contests”
QUOTATION PUZZLE
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20 21 22 ACROSS 1. Mr. Aaron 23 24 25 26 5. Run away with a lover 27 28 29 30 31 10. Augusta’s Moses 14. Lotion ingredient 32 33 34 35 36 15. One of several at 37 38 39 Highland & Wrightsboro 16. Great lake 40 41 42 17. Pull up by the roots 43 44 45 19. A.M. order 46 47 48 49 50 20. Pen prefix 21. Garland 51 52 53 54 55 56 22. Job 57 58 59 23. Smash 25. Bewitched Barbara 60 61 62 27. Sleep ltrs. 63 64 65 28. Spanish miss 32. Baby score (abbrev.) by Daniel R. Pearson © 2013 All rights reserved. Built in part with software from www.crauswords.com 35. Mediterranean island 36. ___ and the Art of 32. Old, ripened DOWN Motorcycle Maintenance 33. Around prefix 1. Hell 37. Bug 34. Pasture 2. First letter of the Hebrew 38. Mass, as of chewed food 35. Tiny particle alphabet 39. Throb 38. Waist 3. Water wheel 40. Period of history 39. Best of Augusta _____ 4. New Zealand parrot 41. The ______ position 41. DOJ agency, estab. 1908 5. 8 Mile star 42. San Diego player 42. Someone who acts so as 6. Pertaining to the moon 43. Handicapped to impress others 7. Toward the mouth 45. Distress signal 44. Many computers 8. Meat paste 46. Expectorate 45. Like many crackers 9. The weather 47. Raw fish dish 47. Because 10. Harris follower 51. ______ Fiction 48. Louvre pyramid architect 11. Orderly 53. Likely to change 49. Damp 12. Likes (in slang) 56. Witty remark 50. Scratchy 13. Job category 57. By mouth 51. Game played in Aiken 58. Having equal or constant 18. Provide food 52. Russian river 24. Streetcar entropy 54. General location of 52-D 26. Already dead before getting 60. Lois or Kiffin 55. World’s #1 alcoholic to the ER 61. Daughter of one’s brother beverage (by consumption) 28. Dish of cold raw vegetables or sister 59. Tolkien goblin 29. 12th month of the Jewish 62. Twenty letters after 2-D calendar 63. Auto line from 1897-2004 30. Gas type 64. Dog-______ 31. Poker stake 65. Augusta is one Solution p. 14
BY
,
N E F T H T U T N A W I E L A S A E Y Y B N I S E S F R W M Y N M O H G D G S I L M I E I U by Daniel R. Pearson © 2013 All rights reserved
— Benjamin Franklin
DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once. Black squares indicate spaces between words, and words may extend onto a second line. Solution on page 14.
E
4 7
3 9
X A M I N E R
8 5
2 7
S
9 6 7 8
2
3
1
9
4 8
3 5
5 1
6 4 4
8
2 5
by Daniel R. Pearson © 2013 All rights reserved. Built with software from www.crauswords.com
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 or numbers with minimal choices listed. A sample is shown. Solution on page 14.
1
2
3
1 2 3 4
1 2 3 4 5 1
1
L 1 2 3 4
2 -
H 4 5
3 1
2
3
A A 1 2 3 4 5 6
1 2 4
5
6
B 1 2 3 4 5 6 — Ann Landers
1 2 3
7
1 . B A D T T T W I N L A 2 . R R H H A S I L E E 3 . W E E E L KA U T 4 . A S N E T T L 5 . DY E S H 6 . R S E 7 . D
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
by Daniel R. Pearson © 2013 All rights reserved
WORDS NUMBER
All Mystery Word finders will be eligible to win by random drawing. We’ll announce the winner in our next issue!
13
16
18
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
SEPTEMBER 20, 2013
THE BEST MEDICINE ha... ha...
A
n old preacher was dying. He sent a message for his IRS agent and his lawyer (both church members), to come to his home. When they arrived, they were ushered up to his bedroom. As they entered the room, the preacher held out his hands and motioned for them to sit on each side of his bed. The preacher grasped their hands, sighed contentedly, smiled and stared at the ceiling. For a time, no one said anything. Both the IRS agent and lawyer were touched and flattered that the old preacher would ask them to be with him during his final moment. They were also puzzled because the preacher had never given any indication that he particularly liked either one of them. Finally, the lawyer asked, “Preacher, why did you ask the two of us to come?” The old preacher mustered up some strength, then said weakly, “Jesus died between two thieves, and that’s how I want to go, too.” Sid: The doctor told me to drink carrot juice after a hot bath. Sam: Did it work? Sid: I don’t know. I can never finish drinking the hot bath.
Mother: I need to speak to the doctor. It’s an emergency. My infant has a temperature of 103. Doctor to Nurse: Find out how she’s taking that temperature. Nurse: How are you taking it? Mother: Oh, I’m holding up OK I guess. A man was in the hospital recovering from surgery when a nurse came in to ask him how he’s feeling. “I’m OK, but I didn’t like the four-letterword the doctor used in surgery,” he answered. “What did he say?” asked the nurse. “Oops.” Why did the boy tiptoe past the medicine cabinet? He didn’t want to wake the sleeping pills. Why did the chicken cross the Mobius strip? To get to the same side. Why did the one-handed man cross the road? To get to the second-hand shop. A Sunday school teacher asked her class, “What was Jesus’ mother’s name?” One child answered, “Mary.” The teacher then asked, “Who knows what Jesus’ father’s name was?” A little kid said, “His name was Verge.” Confused, the teacher asked, “Where did you hear that?” The kid said, “You know, people are always talking about Verge ’n Mary.” +
Why subscribe to the Medical Examiner? Because no one should have to make a trip to the doctor or the hospital just to read Augusta’s Most Salubrious Newspaper.
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SUBSCRIBE TO THE MEDICAL EXAMINER By popular demand we’re making at-cost subscriptions available for the convenience of our readers. If you live beyond the Aiken-Augusta area or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house! NAME ADDRESS CITY
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AUGUSTA MEDiCAL EXAMINER
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Choose ____ six months for $16; or ____ one year for $32. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397
The Patient’s Perspective by Marcia Ribble
T
oday almost everything in my communications network is down. That includes my internet, home phone, and TV. Then, when I tried to report all Comcast systems down, they responded to my call by rejecting my call because it came from another system on my cell phone. And it is happening on a really busy day when I am trying to get ready to leave on a trip up to visit my family and friends in Michigan. Boy, do I ever feel not listened to! These are the kids of problems that can occur when Comcast makes the assumption that if there’s a problem with my internet or my TV reception, I will use my landline which is part of their network to communicate with them, except that it’s not working either. If I tore out my hair in this kind of situation, I’d not only be an old lady, but an old bald lady by now. And I’m much cuter with my white curly hair. At least that’s how I see it! All communications are fraught with this general problem, some kind of interference between the sender and the receiver. Both patience and persistence are needed to overcome the interference so communication can occur. It’s not my fault that all my Comcast systems are down. And it’s likely that it’s not Comcast’s fault either, and that somewhere, electrical engineers are pulling out their hair in frustration, too. Today, at my orthopedic surgeon’s office, I was told that I am healing very well and won’t need to come back for two years. I solidly agreed with him. We didn’t need to quibble about my still using the walker for balance issues caused, not by my knee, but by my disintegrating spine, about which nothing can be done.
Talk is cheap. Not talking can be deadly.
He was happy because I’m smiling with the Bell’s Palsy mostly healed now, because my knees no longer hurt, because, at the age of 69, and soon to be 70, I’ve gone back to work, and because I’m about to take off on a long drive up to Michigan to visit family and friends up there. We’re both feeling great satisfaction about a surgery with very positive outcomes. Although there can be problems with communicating, we’ve had few of them. This has allowed us to feel good about how well our communication has worked for both of us. In the office today I listened to a man new to the practice and needing to have both hips replaced. He was, as many are, very wary about surrendering his already hurting hips to the doctor. I hope that he will have the same kind of good experience that I did, feeling free to talk with the doctor about any issues, including his fears of the pain, so he can get the explanations I received, the support of the physical therapy folks, and be able to truly enjoy his later years. That’s where I am. Woo-Hoo! + Marcia Ribble received her PhD in English at Michigan State and retired from the University of Cincinnati. She taught writing at the college level and loves giving voice to people who have been silenced. She is now teaching again at Virginia College in Augusta. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.
DOING RESEARCH? The Medical Examiner website has a zillion links to useful and informative sites of all kinds. Visit www.AugustaRx.com/StudyHall.html
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SEPTEMBER 20, 2013
AUGUSTA MEDiCAL EXAMINER
THE MYSTERY SOLVED The Mystery Word in our last issue was: OPERATION
...cleverly hidden (in the picture of J. Perkins Brewster) in the p. 10 ad for DRUG OF CHOICE COFFEE Congratulations to KELLY McDANIEL, 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, a $40 Scrubs of Evans gift card, and if she’s a coffee drinker, 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, 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
SENDING US A CLASSIFIED?
EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC.
perfect getaway from the urban rat race, to raise kids, or retire. 706-798-4359 or 706-831-9015
ROOMMATE WANTED! 3 bdrm, 2.5 bath house with pool, 2 minutes from colleges. Perfect for medical or grad students. $425+share utils. 706.993.6082
WEST AUGUSTA House for rent. 3 bdrm, 2 bath, 1500 sqft, 1-car garage, 3024 Sterling Road, located off Stevens Creek at Riverwatch Pkwy. $850/mo. Call 678467-7187.
FOR SALE: 3 BR house + 1 BR apartment (private entrance) + 2 full basements. Apt ideal for aging parent, or home office, or rental (now rented; income to offset mortgage). 310sqft basemt perfect for office or playroom. 2nd basemt (240sqft, large windows) great for workshop or studio. House & apt (2042sqft), hardwd floors, new baths. Lush back yard. Tanglewood area, near Augusta Mall. $93,500 OBO. 617-6292915. FOR RENT: Perfect location 1 mi. from MCG 1827 McDowell St. house for rent. Two bedrooms, 1-1⁄2 baths, living room, dining room, den, kitchen. Recently refurbished, tile and hardwood floors, ceiling fans, w/d hook-up, new fridge, cable, storage house. Renter pays utilities. $750 plus deposit. 706.738.2331 LAND Unique thirteen acres. Bold, beautiful rocky creek running through
FOR SALE: GORGEOUS, immaculate, never occupied townhome located mins from Medical District. 2 bed, 2 bath, master en suite, walk-in closets, office. 1450 sq ft. hardwood floors throughout, fabulous upgrades, custom kitchen and baths. Floor to ceiling windows, fenced yard. Partially furnished! 120k OBO. 803-507-6621. Augustagahomesearch.com Foreclosures • Rentals • MLS Roman Realty 706-564-5885
SERVICES CAREGIVER looking for work. Will do light housework too. (706) 738-2366 WILLS, TRUSTS & POWERS OF ATTORNEY - We can fulfill your legal and estate planning needs through preparation of simple wills, complex trust agreements,
advance directives for healthcare, and/or durable powers of attorney. For more information call John R.B. Long, Attorney at Law, 411 Telfair St. Augusta GA 30901 (706) 868-8011. Mention this ad for a no-charge consultation. BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673) FULL-SERVICE MOVER Anthony’s Professional Moving, 28 years serving the CSRA moving hospital equipment, offices, homes, apartments, etc. Estimates are FREE. Call 706.860.3726 or 706.814.8141 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.
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WHAT’S YOUR DRUG OF CHOICE?
H A D E S A G E D
P E R I
Augusta Medical Examiner Classifieds
(OURS IS COFFEE)
P O L O
U R A L
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.75
1.00
1.25
1.50
1.75
2.00
2.25
2.50
2.75
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3.25
3.50
3.75
4.00
4.25
4.50
4.75
5.00
5.25
5.50
5.75
6.00
6.25
6.50
6.75
7.00
7.25
7.50
7.75
8.00
8.25
8.50
8.75
9.00
(Copy this form or continue on additional sheet if more space needed.)
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P A T E
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D E S K A N T E I T C H Y
QUOTATION QUOTATION PUZZLE SOLUTION: Page 12: “If you desire many things, many things will seem but a few.” — Ben Franklin
AD COPY (one word per line; phone numbers MUST include the area code): .50
E M I N E M
SEE PAGE 12
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.25
K E A C A T T R E A R M F A B P I P L E S
The Sudoku Solution
COFFEE IS GOOD MEDICINE VISIT DRUGOFCHOICECOFFEE.COM BUY AT INNER BEAN CAFE
6 3 8 4 7 9 2 5 1
4 2 5 1 3 8 7 6 9
7 1 9 5 6 2 8 3 4
8 9 6 7 5 4 1 2 3
3 4 2 6 9 1 5 7 8
5 7 1 8 2 3 9 4 6
1 5 7 9 4 6 3 8 2
2 8 4 3 1 7 6 9 5
9 6 3 2 8 5 4 1 7
WORDS BY NUMBER “The naked truth is always better than a well-dressed lie.” — Ann Landers
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SEPTEMBER 20, 2013
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AUGUSTA MEDiCAL EXAMINER
Preventing dementia patients from wandering by Kathy Crist Finding a confused and disoriented person wandering about is frightful for both the individual and for loved ones. The Alzheimer’s Association reports that as many as 60 percent of Kathy Crist people with dementia will wander and may get lost. “Dementia” is a broad term for a decline in memory or other mental or language abilities that significantly limits the activities of daily living. If you or someone you know is a caregiver for a dementia
patient, it’s important to recognize the warning signs of wandering. Here are specific wandering signs to watch for in those dealing with decreased cognitive ability: • Restlessness, pacing or repetitive movement. • Difficulty with locating familiar places like a bedroom or bathroom. • A desire to “go home” even when already at home. • Attempting to go to work or to fulfill former obligations. • Returning late from a regular walk or drive. • Inquiring about the whereabouts of past or current family and friends. Even with the most diligent of caregivers, wandering by a dementia patient can still happen. If you have outside nursing assistance, they should perform a safety assessment
of your home and educate you and your family members to include personal safety and monitoring of those with dementia. One of the keys is to continually adapt safeguards as a patient’s needs change. We recommends a number of steps to help prevent wandering: • Assess the time(s) of day when a person is most prone to wander. Plan extra activities or exercise during these periods to decrease the restlessness and anxiety of wanting to leave. • Address the underlying cause of wandering. Is your aging loved one wandering at night because of waking up hungry or thirsty • Secure your home with hardto-access door and window locks (place locks high or low on exterior doors or add slide bolts). Hanging bells on
doorknobs is a simple and costeffective deterrent, too. • Install an outside fence with secured gates. This allows the loved one to still get some fresh air without ambling off. • Use monitoring devices such as jewelry or bracelets with radio transmitters. Local law enforcement and organizations like Project Lifesaver can be of additional assistance. • Practice restful sleep habits. Reducing daytime napping and caffeinated drinks can help lessen the urge to wander instead of sleep. • Involve neighbors. Introduce your aging loved one to neighbors and give them a phone number to call in case they see your loved one about in the neighborhood. • Provide adequate supervision. Never leave a person with dementia and
possible wandering issues alone at home or in a car. • If wandering occurs, immediately call 911 and file a missing person report before searching the immediate area yourself. Phone the Alzheimer’s Association Safe Return® program at 1-800625-3780. Registering with this nationwide program for Alzheimer’s or related dementia can provide an additional resource for caregivers of dementia patients. Right at Home is a provider of in-home care and assistance. We are dedicated to providing peace of mind for families. Right at Home can provide assistance for as little as a few hours per visit to around the clock care if needed. To learn more call 803-278-0250 or visit then on the web at www.csra. rightathome.net. +
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PROFESSIONAL DIRECTORY ALLERGY
DERMATOLOGY
Tesneem K. Chaudhary, MD Allergy & Asthma Center 3685 Wheeler Road, Suite 101 Augusta 30909 706-868-8555
CHIROPRACTIC Poppell Chiropractic Clinic 1106-A Furys Lane Martinez 30907 706-210-2875 Most insurance plans accepted
Steppingstones to Recovery 2610 Commons Blvd. Augusta 30909 706-733-1935
Group & Benefits Consultants Inc. 3515 Wheeler Rd, Bldg. C Augusta 30909 Floss ‘em or lose ‘em! 706-733-3459 www.groupandbenefits.com
Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048 Dental Partners of South Augusta W. Palmer Westmoreland, DMD 2504 Peach Orchard Rd Augusta 30906 706-798-8300 Evans Dental Group 4250-2 Washington Rd Evans 30809 706-860-3200 www.evansdentalgroup.com
DRUG REHAB
EMPLOYEE BENEFITS
DENTISTRY Dr. Judson S. Hickey Periodontist 2315-B Central Ave Augusta 30904 706-739-0071
Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Augusta 30904 706-733-3373 www.GaDerm.com
FAMILY MEDICINE Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Thomson: 706-595-7825 Primary Care Rates
HOSPICE Alliance Hospice 3685 Old Petersburg Rd. Suite 145 Augusta 30907 706-447-2461
LASER SERVICES Ideal Image 339 Fury’s Ferry Rd Martinez 30907 1-800-BE-IDEAL • www.idealimage.com Schedule a FREE Consultation
OPHTHALMOLOGY Roger M. Smith, M.D. 820 St. Sebastian Way Suite 5-A Augusta 30901 706-724-3339
OPTICIAN
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
VEIN CARE
Murphy & Robinson O Phil Harris 1571 Walton Way Augusta 30904 706-737-2020
P T I C I A N S
PHARMACY Medical Center West Pharmacy 465 North Belair Road Evans 30809 706-854-2424 medicalcenterwestpharmacy.com Parks Pharmacy 437 Georgia Ave. N. Augusta 29841 803-279-7450 www.parkspharmacy.com
Vein Specialists of Augusta G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 501 Blackburn Dr, Martinez 30907 706-854-8340 www.VeinsAugusta.com
YOUR LISTING HERE Augusta Area Healthcare Provider 4321 CSRA Boulevard Augusta 30901 706-555-1234 DIRECTORY RATES A simple black & white listing is only $95 for six months or $175 for the whole year. Add your logo and the price is just $119 for six months or $219 for the entire year. CALL 706.860.5455 TODAY!
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AUGUSTA MEDiCAL EXAMINER
SEPTEMBER 20, 2013