Medical Examiner 7-2-21

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

JULY 2, 2021

M E D I C I N E

I N

T H E

F I R S T

Dog bites woman

On Friday, April 2, I got off work like any normal Friday when our office closes at noon.

I always look forward to Fridays because it’s our short day. Fridays are always my “Get things done day.” I bought a new set of tires for my car, made it home and started to clean my car out in my driveway.

My dog Blaze was Blaze

P E R S O N

sitting in the driveway watching me. While I was cleaning out my car. I heard a dog growling and screaming at the same time.

I looked up and did not see Blaze. I ran around my car to find a humongous male dog attacking my little red pit terrier. My first reaction was to grab Blaze because the other dog’s jaws were

around my dog’s neck. Blaze was screeching with pain and blood was all over my driveway.

When I grabbed Blaze the stray dog lunged at me, biting the middle finger on my left hand. My finger immediately turned blue from the bite to the tip. Blood was everywhere by this point. I was so afraid because my children weren’t home, my dog was hurt, and I was hurt.

My finger instantly became tight and swollen. I kept moving my finger like you do when you jam it. My heart was pounding. I could literally feel my heartbeat in my swollen finger. I was petrified! I screamed, hoping my neighbors would hear me and help. I grabbed anything I could to get this dog Please see DOG BITES page 10

Inpatient mental health care matters

by Danielle Wong Moores

When a patient arrives at her hospital in excruciating physical and mental pain from a severe burn or a traumatic accident, psychiatrist Dr. Maria Rivell manages the mental trauma caused by these kinds of severe physical injuries.

“How do you turn that around?” asked Rivell, who is the trauma psychiatrist for the Burn and Trauma Center and the consultation liaison psychiatrist, both at Doctors Hospital in Augusta. “You need someone in mental health to help with that part of the healing of the patient because it really impacts everything else.”

Even so, her role is one that not many hospital have — even ICUs and trauma centers. Yet it continues to be a real need, one that’s been amplified in the general acute care setting due to COVID-19.

A web search for “psychiatry in acute care” pulls up only a handful of anecdotal results — a practice here, or a program there — that is actually delivering mental health care to acute care patients in hospitals.

There has been a push to integrate behavioral health and medical care. “Policymakers and providers alike recognize the need to not only allocate more resources to behavioral health and substance abuse prevention,” Please see MENTAL HEALTH page 2

AUGUSTARX.COM

LISTEN TO

YOGI It was Yogi Berra who coined “It ain’t over 'til it’s over,” a fractured phrase that is full of meaning and significance right now.

It’s safe to say that most of us feel like COVID-19 is heading for the exits. But make no mistake: it’s still in the house. If Yogi was still around he would definitely say it ain’t over ‘til it’s over, and it’s definitely not over: the virus has already killed more people around the world this year than it did in all of 2020.

The fact that COVID-19 is still raging in other countries is of little concern to some people. That’s just human nature. But right here at home, consider what is of great concern — or at least should be: all the COVID-19 deaths still happening in the US are among people who are not vaccinated.

Of the more than 19,000 US COVID-19 deaths during May, an Associated Press analysis found that only 150 of those who died — that would be 0.7% — were fully vaccinated people. In other words, 99.3% of COVID deaths in the US are currently afflicting the unvaccinated. The AP also said that according to government data, COVID infections in fully vaccinated people during May accounted for fewer than 1,200 hospitalizations out of a total of more than 853,000 COVID-related hospital admissions. That’s about 0.1%.

CDC Director Dr. Rochelle Walensky said last week that nearly every US COVID death at this point is “entirely preventable” and because of that, “particularly tragic.”

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AUGUSTAMEDICALEXAMiNER

THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD

by David W. Proefrock, PhD

Your 5 year-old son got angry recently and let out a string of curse words. You had no idea he knew words like that and have no idea where he heard them. What do you do?

A. Find out where he heard those words and make sure he doesn’t spend time there or with that person anymore.

B. Tell him not to say those words because they are not nice.

C. Put him in time out for a few minutes. Then tell him in no uncertain terms that those words are not acceptable.

Make sure he understands.

D. Wash his mouth out with soap.

If you answered: A. You might never find out where he heard the curse words and even if you do, it might be someplace you can’t keep him away from. You can’t separate him from all other kids.

B. You need to be a bit more definite in your response. Saying “that’s not nice” probably won’t be taken very seriously.

C. This is the best response. Make sure he knows it is wrong to curse. You may have to do this more than once, but it is still the best response.

D. This might be what your mother or grandmother would have done, but it’s not the best way to teach a young child not to curse.

Children hear inappropriate language all around them, on television, in school, in the neighborhood, and from grownups. There is no way to keep them away from it. The proper course is to teach them not to curse rather than try to make sure they don’t hear other people cursing. + Dr. Proefrock is a retired clinical and forensic child psychologist.

JULY 2, 2021

MENTAL HEALTH… from page 1

said a special report entitled “Behavioral Even when nurses or physicians ask a Health: Fixing a System in Crisis” in Modern patient how they’re doing, if a patient says Healthcare, “but also to redesign care models he or she is fine, the conversation often ends to treat the whole patient.” there. For example, consider a patient with The report also cites the fact that, according diabetes and a badly infected foot that now to the U.S. Centers for Disease Control and needs to be amputated. “My main question Prevention, 29% of adults with a medical con- would be, ‘Why is he so lackadaisical about dition also have some type of mental health losing a leg?” asked Hertza. “Why don’t we disorder, and close to 70% of behavioral investigate the relationship between emotion health patients have a medical co-morbidity. and poor medical compliance? What’s going “Both conditions often act as a driver for one on so we can address the behavior to keep another, heightening the risk that a patient the patient from being admitted again, or with a chronic disease will develop a meneven losing the other leg? But this is a patient tal health disorder and vice versa,” said the that would typically never get an assessment report. for mental health because they’re not crying The pandemic only served to highlight or angry.” flaws in the current mental health system, Hertza launched IPS within the past year said Rivell. Even before COVID, mental health to help meet these needs. Through a team care tended to focus on those in mental health of 15 mental health therapists, IPS now crisis—not the patient with diabetes on the serves Doctors Hospital and Select Specialmedical floor who keeps getting readmitted ty Hospital in Augusta, along with several because depression has kept her from managother hospitals across the Southeast. He also ing her disease. Or the patient admitted for a partners with a practice management group cardiac issue who is also bipolar but has been in Chicago. self-medicating by drinking alcohol or using In Hertza’s integrative model, anyone drugs. admitted as an inpatient receives a visit from COVID-19 itself was isolating for patients, a member of his team; each visit typically said Dr. Jeremy Hertza, an Augusta neutakes between 20 and 50 minutes. Providers ro- psychologist and founder and medical also note if they believe any specific services director of Inpatient Psych Solutions (IPS), or neurocognitive testing might be needed. which provides inpatient mental health care Patients who would benefit from help receive in acute care settings across the U.S. “Early on it within the first 24 to 48 hours of being in COVID, family members were not allowed admitted, instead of days later, and as a to visit relatives [in the hospital], and it was a result may require less medication: “Because very lonely, scary and isolating experience for now the patient has someone to talk to and a lot of people,” he said. doesn’t need an antidepressant,” said Hertza.

Because acute care settings don’t often have Providers can then focus on providing mental health therapists medical care, since the or testing to help underadded burden of navistand the average patient’s WHAT IS ACUTE CARE? gating a patient’s mental mental state, COVID or state is now handled by a not, “One, you end up not Acute care is a branch of health care therapist. serving the patient to the where a patient receives active but “Patients have been best of your ability;” said short-term treatment for a severe in- thrilled,” added Hertza.

Hertza, “two, patients end jury or episode of illness, an urgent “It helps them feel more up staying in the hospital medical condition, or as part of re- comfortable in a hospital longer; and three, they covery from surgery. Care for acute setting to have someone leave without any cophealth conditions, commonly in an to talk to and process ing skills for the medical inpatient setting, is the opposite of and deal with things they issues they have after they chronic care or longer term care. never would otherwise be leave the hospital.” helped with.” +

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AUGUSTAMEDICALEXAMiNER

JULY 2, 2021

PART B OF A 26-PART SERIES

B is for Barotrauma

Not many among us have ever heard of barotrauma, but nearly all of us have experienced it. And with travel starting to open back up, more of us have barotrauma in our future than at any time since 2019.

As you might surmise from the word itself, barotrauma involves pressure in some way (as in barometer). Further evidence comes from our decorative B, which is blasting off.

In plain English, if your ears have popped while ascending or descending in an airplane, you have experienced barotrauma. The same thing can

happen when driving in the mountains or riding an elevator in a very tall building.

Normally air pressure in the middle ear is the same as it is in the outside world. The eustachian tube allows air to flow freely from the middle ear to the back of the nose and throat, and that keeps the pressure equal.

Problems arise when there is a difference between internal and external air pressure and the eustachian tube is blocked by a cold or an ear infection.

In children this doesn’t take much, since all their equipment is miniaturized to begin

with. That’s why takeoffs and landings are prime time for crying babies on flights.

To make matters worse, you can’t tell a baby to do the things older kids and adults do to alleviate the pain and pressure: chew gum, suck on hard candy, yawn, or swallow frequently.

Because of those facts, pediatricians will sometimes advise parents of a small child with a severe cold or ear infection to delay air travel until better health returns. On the other hand, if a trip is coming up that involves flying, get that sick child to the doctor well in advance of the departure date so that colds and infections can be brought under control.

Sucking on a bottle or a pacifier helps — we’re still talking babies here, by the way — and it’s best to have kids awake before descent, since swallowing is more frequent when we’re awake than asleep.

Barotrauma generally causes no permanent damage to ears or long-term hearing loss, but if any issues persist for more than a day or two, check with your doctor. +

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Let’s not get ahead of ourselves, boys and girls. We could be celebrating prematurely. Nobody wants to be Chicken Little and cry “The sky is falling! The sky is falling!” when no such thing is happening. On the other hand, if someone knew the sky was falling (or very likely could) and didn’t say anything, that would be irresponsible negligence.

As the COVID situation currently stands, great progress has been made. Things are trending in the right direction.

However, warnings are being sounded by multiple agencies about a couple of troubling situations.

One is the emerging threat presented by a different strain of the original virus known as the Delta variant (or as we call it here at Medical Examiner world headquarters, “COVID-21”).

It is much more easily transmissible than the original, and it makes those infected by it much sicker than the original.

It is already creating new hot spots in places in the US and around the world where they thought they had already turned the corner and were well on the way to “normal.” It’s very concerning to public health experts. One university’s computer model projects a possible return to 1,000 deaths a day in the US (by comparison, the COVID death toll reported on Monday of this week was less than a tenth of that).

The other area of huge concern is the slowdown in vaccinations. Call it vaccine hesitancy, vaccine apathy or something else, it’s comparable to passengers on the Titanic ignoring lifejackets that were freely and readily available because they believed the ship to be unsinkable — some no doubt even after it struck the iceberg. How many of those passengers would wear a lifejacket the second time if they were granted a do-over? Answer: at least 100% of them.

As cited in the Yogi article on page one, somewhere north of 99% of all COVID deaths still happening are striking people who are not vaccinated. So the title of this article is asking the wrong question. It should be “What can be done to ensure there are no unused vaccine doses?” Unvaccinated people, it’s time! Get your shots! (Also, see the ad on page 2.) +

MEDICALEXAMINER

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AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

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JULY 2, 2021

AUGUSTAMEDICALEXAMiNER

#142 IN A SERIES

Who is this?

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

by Marcia Ribble

I

n our last episode, as you may recall, we profiled a man who is remembered by medical historians as one of the two founding fathers of gynecology. That man, Lawson Tait, did the founding on the other side of the Atlantic. This man, J. Marion Sims of Lancaster County, SC, handled things over here. And my goodness did he handle them.

It’s always a bit unfair to judge people who lived and worked in decades long past (in this case the mid-1800s) by the standards of the 21st century.

But let’s go ahead and do it anyway.

Born in 1813, Sims attended USC in Columbia for two years beginning in 1832 before taking a 3-month course in medicine at the Medical College of Charleston (today’s Medical University of South Carolina [MUSC]), followed by enrollment in Philadelphia’s Jefferson Medical College, where he graduated in 1835.

Sims returned to Lancaster to practice medicine, but after his first two patients died, he promptly abandoned the Palmetto State and moved to Alabama (still in 1835), where he became a plantation doctor, treating the slaves of wealthy white landowners.

Such doctors had two primary roles: to ensure that male slaves could produce and female slaves could reproduce. The latter category is where Sims made his mark on medicine.

And he didn’t do it without help. Lots of it. And nearly all of it was provided by unwilling assistants.

Sims invented several new methods of surgery that have benefited untold numbers of women in the century and a half since he practiced. But he developed these techniques not only by trial and error but without anesthesia. One slave underwent 30 separate experimental surgeries at Sims’ hands in his quest to develop a means to repair vaginal fistulas.

In at least one case Sims simply purchased a female slave expressly for his experimental convenience. He built a backyard hospital for himself in Montgomery, Alabama that housed subjects for his surgical trials. As he noted in his autobiography, The Story of My Life, “There was never a time that I could not, at any day, have had a subject for operation.”

In fairness it should be noted that none of these practices raised so much as an eyebrow at the time. In fact, an 1830 prospectus for what is now MUSC boasted that “No place in the United States offers as great opportunities for the acquisition of anatomical knowledge. Subjects being obtained from among the colored population in sufficient number for every purpose, and proper dissections carried on without offending any individuals in the community.”

This far along in this biographical sketch, anyone still reading is well justified in wondering how this man could be viewed as “the father of modern gynecology.”

We should explain the good things he did. Alas, that will have to wait until our next issue. +

Despite, or perhaps because of, the heat (which hasn’t been bad compared to some years), we have arrived at the most auspicious culinary period of the year. The foods available now have earned a well-deserved reputation for being among the healthiest we can choose. My neighbor brought over a bag of the freshest, tastiest strawberries I have eaten in a long time. Farm to table! My table! there were none of those strawberries that have all the flavor of cardboard, and no drippy juice whatsoever! I felt like I had died and gone to that big farm market with all those exquisite fresh fruits and vegetables that came straight from a farmer who loves the land and its produce.

Today’s groceries came with two fresh ears of corn, fresh asparagus, cuties oranges, bananas, and other luscious offerings. If anything could convince me to become a vegetarian, these beautiful fruits and vegetables could do it. All the lovely colors and fresh flavors remind me of when I was a child and so many healthy fruits and vegetables were only available when they were in season.

In those days we would all pack into the car and buy two dozen ears of corn at our favorite farm market. Dinner would be corn, fresh and sweet and delicious. Tonight I am going to relive that experience, including remembering watching kids with missing front teeth, whose cobs had rows of uneaten corn that made us all laugh.

Green beans were another veggie we could

make a whole meal of. After months when the only beans came out of a can, these were a completely different critter. I would happily sit and snap beans to make eating them possible.

There were a few disputes about whether both ends should be removed, and I always sided with leaving the pointy end on the beans.

When I got old enough to have a garden I planted green beans, but I also planted wax beans which are delicious, and eating them, raw but hot from the days heat was a treat almost as good as the tomatoes I also grew.

That was back in the days when tomatoes tasted like tomatoes.

Choosing the seeds, I always selected older varieties that hadn’t lost any of their bright, slightly tart feeling on my tongue, tart enough that dad put sugar on them. Mom only used salt and a smidge of pepper on hers. I tried both and like salt and pepper best. Even better was tomatoes sliced thick and put in bacon, lettuce and tomato sandwiches on real bread. You know, real bread that doesn’t turn into mush in a sandwich. Some bread today has to be toasted before you can even make a sandwich with it. Not ever my preferred selection. Real bread has four ingredients, flour, salt, yeast and water, nothing else, unless you’re making a sweet bread like raisin bread, and then all that’s added are sugar, raisins, butter, and cinnamon. What a blessing good bread is!

I learned how to make rhubarb sauce from my Mom. We ate it on bread with peanut butter. And all this food talk is making me hungry, so I’d better cook some of my veggies.

Happy summer to you! +

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JULY 2, 2021

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age

BY J.B. COLLUM

THE

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I don’t know how I managed to avoid getting pected, excellent side-effects. Just last night, I some help for my sleep apnea all these years. actually slept through the entire night without Wait, yes, I do. I am cheap. At least when it getting up even once to go to the bathroom. comes to healthcare. Why is it that we will pay The first few days with it I went from the old $1000 for a phone and $8 for a cup of coffee standard of waking up three to five times per but get upset when a prescription that can night to go to the bathroom down to just one. I make us feel so much better costs $100 for an was happy with that, but to go through the enentire month? That is certainly something to tire night without waking up once was unthinkponder. able just a week ago. I could get used to that.

That said, there has been a shift in my think- I had a lot of outdated ideas about CPAP ing in the last few years. As my health issues, machines that I will try to clear up here, in case some of which I have suffered with for many you are on the fence about pursuing help with years, get harder and harder to bear with age, sleep apnea. First of all, I had heard that they I am reaching out for help. I am dry your sinuses out, but mine getting so many things checked has a built-in humidifier and it is out and fixed. I recently visited even heated, and I have experian orthopedic surgeon and am The side effects enced none of the dryness that scheduling long overdue carpal people had warned me about. were excellent. tunnel surgery for later this Second, I’ve seen indentations on year. I might as well since I have the faces of CPAP machine users almost reached my health insurand I thought that was unavoidance out-of-pocket maximum. able. I have since learned that That is both depressing and most people don’t use the whole liberating at the same time. Boo, I have spent face masks anymore that are the real culprit a lot of money so far this year on doctors and here and that the “nasal pillows” they now use prescriptions. Yay, I soon won’t be paying out in most cases leave no mark and neither do the any more money for healthcare the rest of this straps that hold them on. Lastly, I was worried year. I’m not sure how to feel about that. about the cost of the unit, but my insurance But back to sleep apnea. My physician has company took care of most of it, and I will only tried to get me to undergo a sleep study for be paying about $20 each month for just a few years, but I was always quoted figures north months until my annual out of pocket figure is of two or three thousand dollars and it had reached. to be done in some clinic instead of my own I’ve only had it a week, so I have a lot more bedroom, so I refused. I mean, how could I to learn, but if this trend continues, as I expect even fall asleep knowing that the night’s sleep it to, I suspect that I will be wishing that I would be costing me more than a week’s did this a long time ago. So, learn from my rental at a luxury oceanfront penthouse condo experience. If you feel sleepy most of the day, in Myrtle Beach? Now that I think about it, especially in the late afternoon, or if your partmaybe I could cry myself to sleep with that ner complains about your snoring, or you’ve thought, but that’s no fun. awakened with him or her pressing a pillow Everything changed a couple of months ago over your face, please get some help before it is when I found out that the cost is now down too late. There really is no excuse anymore. You in the low hundreds, and you can do the sleep will not regret it. There are more benefits that study in your own bed. So I did it. Just last were detailed to me by my doctor that I won’t week after waiting for the results, following up go into here, but essentially, he said that if I with my doctor and then waiting for it all to go took care of my sleep apnea and lost weight, through my insurance company, I finally got most of my issues would likely go away. my CPAP machine and have now used it for a Well, one out of two ain’t bad, I suppose. + full week. I already see the benefits. Just last night, I sat in my recliner past 10 in the evening J.B. Collum is a local novelist, humorist and and didn’t fall asleep even once! I can’t rememcolumnist who wants to be Mark ber the last time this happened. It isn’t perfect Twain when he grows up. He may be and I was told that it will take some time to get reached at used to it and to get the full benefits, but I feel johnbcollum@gmail.com better already and there have been some unex-

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AUGUSTAMEDICALEXAMiNER

WHAT CARS LOOKED LIKE

by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb

ORZO WITH TOMATOES & ZUCCHINI The rich flavor of this recipe makes it a wonderful accompaniment to any grilled meat or you can just add beans for a main course.

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Ingredients • ½ cup dry whole wheat orzo • 1 cup reduced sodium chicken broth • 1 tablespoon extra-virgin olive oil; divided • 2 garlic cloves, minced • 1 large zucchini, chopped (1½ cup) • 2 yellow squash, chopped (1½ cup) • 3 tomatoes, chopped (about 1 pound) • 2 tablespoons basil minced

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begin to break down. Toss in basil at the very end of cooking or top with basil to serve. Serve vegetables over orzo and enjoy.

Kim’s note: If the pan with the zucchini gets a little dry before you add the tomatoes you can take some of the liquid from the orzo and add to that pan. This is a technique used for cooking with less oil.

Of course, olive oil is healthy but it is high in calories; some is good but more is not always better. +

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Yield: 4 servings (serving size: 1 cup) Nutrition Breakdown: Calories 120, Fat 4.5g (0.5g saturated fat), Cholesterol 0mg, Carbohydrate 17g, Fiber 3g, Protein 4g, Potassium 466mg, Phosphorus 23g.

Percent Daily Value: 20% Vitamin A, 45% Vitamin C,

6% Iron, 2% Calcium Diabetes Exchange Values: 1 Vegetable, 1 Starch, 1 Fat

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Instructions Add 1 ½ teaspoon olive oil to a medium sauce pan and place over medium heat, add orzo and sauté until lightly toasted. Add chicken stock, bring to a boil, reduce heat and simmer 6-8 minutes until al dente.

Meanwhile, place a nonstick skillet over medium heat and add remaining olive oil. Once hot add zucchini, and squash, cook for about 6 to 7 minutes until just beginning to brown. Add in the tomatoes and garlic, cook until tomatoes are fragrant and

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ASK DR. KARP

NO NONSENSE

NUTRITION Mariah, a Facebook friend from Wisconsin asks: “What is your input on white rice? Isn’t it a whole grain? I like mixing it with vegetables or eating it as a side dish, yet I have heard that eating white rice is the same as eating a bowl of sugar.”

Focusing on specific foods and thinking they are either “good” or “bad” is most often the work of advertisers and marketers, not nutrition scientists. Concentrating on your overall eating pattern,

the variety of foods you eat and how you combine them at meals, well, that’s healthy.

Demonizing white rice makes as much sense as demonizing white potatoes, two foods that have definitely been targeted as “unhealthy” in today’s culture. Although it is true that brown rice is a much better source of fiber, vitamins and minerals, white rice, especially the white rice you buy in the supermarket (enriched with thiamine, niacin and iron), fits into a healthy diet.

It is an important source of calories, complex carbohydrates and other nutrients, such as manganese.

Historically, when white rice replaced brown rice in the diets of Asian peoples, it caused an epidemic of beriberi, a thiamine-deficiency disease. Today, in most countries, white rice is enriched with thiamine.

In addition, when you add other foods to white rice, such as mixing the rice with veggies or beans, it makes the rice a more complete food by increasing the fiber, vitamin and mineral content of the rice. I cooked some white rice as part of our dinner last night to go with the baked chicken and tossed salad. After the water boiled, I added a mixture of white rice and red, black and white lentils. Rice and lentils have the same cooking time and need the same amount of water to cook, so it is very easy to combine them in one

Beware of online pharmacies!

pot. Also, lentils are one of the only beans that do not have to be pre-soaked to soften them. Besides making the rice more nutritious, it adds color, interest and texture to the white rice.

White rice also has big advantages when it comes to long-term storage. During the COVID pandemic, when people were isolated and wondering which foods have longer shelf lives, white rice was right up there near the top of the list. Because white rice is what is left after the rice husk, bran, and germ are removed and has almost no fat, it has a very long shelf life, up to 25-30 years! It can’t turn rancid, a problem with higher fat foods such as brown rice. Brown rice generally has a shelf life of only

JULY 2, 2021

about 6 months.

White rice is not a whole grain rice because the husk, bran and germ has been removed. However, white rice is an important source of calories for most people in the world. Thinking that eating white rice is the same as eating a bowl of sugar is simply not correct. It is true that, in a pure laboratory testing situation, white rice raises your blood sugar faster than brown rice. This is most likely due to the fiber in the brown rice, which tends to retard sugar absorption into your blood. However, when you add beans and/ or veggies to the white rice, the fiber in those foods can slow down blood sugar rise and serve the same function. Also, unlike a purified

laboratory diet, when you eat simple, white rice in the real world, it is most likely part of a meal containing a variety of other foods, which also affects the amount and duration of your blood sugar rise.

When I think of rice, here are what I consider to be the important considerations: 1) Don’t fry the rice. When you fry rice, either white or brown rice, you are turning a low-fat food into a high fat, high calorie food. You certainly don’t end up with “healthier” rice because you fried brown rice instead of white rice.

2) Pay much more attention to what you put on the rice. When you go out to eat, do you order “Buddha Veggie Delight” or “Sweet and Sour (fried) Chicken with fried rice?

3) Look at the cost too.

Brown rice is about twice the cost of white rice. Remember that you do not have to spend more money to have good nutrition.

What is the “No-Nonsense Nutrition” advice for today? Can white rice fit into a healthy diet and lifestyle?

Absolutely! +

Dr. Karp

Have a question about food, diet or nutrition? Post or private message your question on Facebook (www.Facebook.com/AskDrKarp) or email your question to askdrkarp@gmail.com If your question is chosen for a column, your name will be changed to ensure your privacy. Warren B. Karp, Ph.D., D.M.D., is Professor Emeritus at Augusta University. He has served as Director of the Nutrition Consult Service at the Dental College of Georgia and is past Vice Chair of the Columbia County Board of Health. You can find out more about Dr. Karp and the download site for the public domain eBook, Nutrition for Smarties, at www.wbkarp.com Dr. Karp obtains no funding for writing his columns, articles, or books, and has no financial or other interests in any food, book, nutrition product or company. His interest is only in providing freely available, evidenced-based, scientific nutrition knowledge and education. The information is for educational use only; it is not meant to be used to diagnose, manage or treat any patient or client. Although Dr. Karp is a Professor Emeritus at Augusta University, the views and opinions expressed here are his and his alone and do not reflect the views and opinions of Augusta University or anyone else.

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Ask a Dietitian

AUGUSTAMEDICALEXAMiNER

DON’T TAKE A VACATION FROM HEALTH

by Kim Beavers, MS, RDN, CDCES Diabetes Educator, Rural Health Services, Kbeavers@ruralhs.org

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Sometimes on vacation vegetables are not quite as easy to find so think “where will the veggies be today?” Make sure to load up on them when they are available.

Overdoing sugar and fat while on vacation can make the digestive tract unhappy and likewise make you (or your travel companions) unhappy too. Full enjoyment is most likely to be had when we balance splurges with the foods that contribute to health. Another health related strategy is to plan active adventures. What non-food adventure can you add to your vacation? Hiking, biking, walking, swimming are a few ideas to get your started.

The last leg of the trip is the “return home” segment and is often the most difficult. First off, most people are not as flush with cash which makes that reusable water bottle important again. The foods to keep on hand are typically the same as the “getting there” segment with perhaps less fresh offerings.

Wherever you go, whatever you do I wish you loads of healthy summer fun and adventure. As always “Eat well, live well!” — Kim +

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panies who already suppor tens of com t us !

This is where balance comes in. It is important to enjoy what the world is providing you while honoring what your body needs for wellness. This is very similar to looking at a holiday buffet, where you check out the offerings and decide what is really worth having.

There are two strategies to remember in this case 1. There are no “forbidden” foods. 2.

Just because something is offered does not mean you are obligated to eat it). Below are some things to think about as you navigate food offerings on vacation: • What can you not get anywhere else?

• What have you really been looking forward to trying or having?

• Can you share this with your travel companions or do you want this to be a splurge just for you?

• While deciding what you want to splurge on, also take note of what you want to include to support your health goals and your body? For example if the splurge will be later in the day, can you eat a breakfast that is health supportive?

• What about vegetables?

the Join

Ah, vacation! How I have missed you! Not only are we preparing for vacation but we are preparing to go AWAY on vacation to beautiful Hawaii.

When I think of vacations far away (i.e. not the beach house with a kitchen) I think of food. All the different food options and cuisines that hold something unique, local and special. But as a dietitian I think of the health aspect too.

How can we marry together the allure of foods’ cultural adventure and our health goals?

It is actually easier than you might think!

First, recognize that food is an important part of travel.

Food brings us intimately closer to the culture we are experiencing at the time. Traditional foods are passed down from one generation to another - a true connection to both culture and ancestry. For this reason it must be enjoyed, by locals and travelers alike. So, how do we handle the health aspect of going on vacation?

To be savvy with food and health goals while traveling it is best to break travel into segments. Let’s call stept one the “getting there” segment. This is the easiest leg of the trip to manage. Leave home with plenty of granola type bars (I like low sugar KIND bars, RxBars, and Nature Valley Protein bars). Other packable items are dried fruits, nuts, seeds, jerky, or a simple PB on whole wheat (no J for travel because it gets too squishy in my bag). If travel is within the country, then my favorite produce to pack are apples and celery sticks. They keep well and do not end up getting squishy. Of course always carry a reusable water bottle; it helps with cost and decreases plastic use, a win-win.

During the “we have arrived” segment of travel the real food adventure begins!

EAT WINGS!

9 +

+ 10

AUGUSTAMEDICALEXAMiNER

CRASH

COURSE

More Americans have died on US roads since 2000 than in World Wars I & II combined

A

bangs against the inside of the skull, and so on.

Seat belts prevent all of that. Cars are designed with so-called crumple zones that absorb and cushion the impact of a crash, in effect slowing down the jolt from sixty to zero. Even without deliberately-created crumple zones, the laws of physics are unavoidably in play as fenders and other structural components collapse in sequence, soaking up kinetic energy and imperceptibly slowing down the crash. And as we established earlier, seat belts further help to cushion the blows. In effect, a belted occupant is part of the structure of the vehicle, not a loose pinball ricocheting around a violent and chaotic scene.

One of the variables in the mix on this topic occurs when some people in a vehicle are belted in and others aren’t. One of the relevant statistics on that scenario: in a frontal crash, an unbelted back seat passenger sitting behind a belted driver raises the risk of death for the driver by 137 percent (as compared to both wearing seat belts).

Seat belts are one of the true success stories in the quest to make driving safer and collisions more survivable. In 1983, roadside studies of observed seat belt use showed a mere 14 percent of front seat occupants used their belts. In 2019 that number was 91 percent.

The Insurance Institute for Highway Safety, the source of the statistics we’ve just been quoting, conducted a national telephone survey in 2012 to determine the top reasons why people don’t wear seat belts. For people who said they use belts some but not all of the time, the top reasons were driving only a short distance, forgetfulness, and discomfort. Among respondents who said they never use seat belts, the top reasons were discomfort, the belief that they aren’t necessary, and a dislike of being told what to do.

Next issue: more interesting information about seat belts. +

{

s everyone knows, Seat Belts Matter. But they matter much more than most of us realize.

Sure, back in the earliest days of seat belts they were little more than straps. In recent years seat belts have gotten far more sophisticated than early automotive engineers could have ever imagined.

Belts in newer vehicles are engineered to work in coordination with airbags to manage and control the forces at play during a collision. Although seat belts permit free movement in normal driving conditions, within nanoseconds of the start of an impending crash — that’s right, even before the crash, triggered by hard braking — embedded devices called crash tensioners lock down, keeping occupants securely in place. But those tensioners are tempered and cushioned by other devices called force limiters. They permit some belt webbing to spool out (with micro-seconds) to help soften the impact and prevent, in particular, chest injuries.

Despite the technological advances and refinements, seat belts are still doing the same basic job they were originally designed to do: make occupants part of the wreckage. As crazy as that sounds, it’s true.

Without seat belts, people in a crashing vehicle suffer multiple collisions with potentially deadly results.

Let’s say a car leaves the road at 60 mph and hits a tree. Car versus tree is collision #1. The car may come to a sudden and violent stop, but the unbelted passenger(s) continue traveling forward at 60 mph for a split second more until collision #2 occurs as they slam into the steering wheel, the dashboard, the windshield, or perhaps they leave the vehicle and hit the same tree the car did. Then collision #3 occurs when internal organs inside the body that have been along for the same 60 mph ride slam forward.

The heart plows into the sternum; the brain

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JULY 2, 2021

DOG BITES… from page 1

off of mine. I even grabbed my kitchen trash can to help get this stray dog off mine.

Once I got my dog and myself into the house I called my son and daughter for help. My finger was throbbing and I was grabbing anything I could find to try to stop the bleeding. When I finally slowed down the bleeding I just knew I would probably need stitches, but I keep icing my finger and moving it the whole next day, thinking that my finger would be fine if I just kept doing what I was doing.

Saturday late afternoon, I bought some medicine — well, a bottle of Jack Daniel’s to tell you the truth — because the pain was throbbing so bad that I could not sleep.

My old college roommate came from Columbia, SC to look at my finger and check on me. She too is in healthcare.

She brought some supplies to clean the area good and wrap it up in gauze. I didn’t know how I was going to do my job because I am a scheduler, and 90% of my job is typing.

The pain was so bad that on Sunday morning my college roommate took me to University Hospital Prompt Care.

The PA immediately sent me to the Right afterward University Hospital ER. A whole series of physicians who looked at my hand were amazed that I could move my finger. I was admitted and told I would probably need surgery on my middle finger first thing the next morning. I had a total of 35 shots around my wrist and inside the bites in my middle finger, including a tetanus shot and two other shots in my shoulder and hip. It was the most painful experience I have ever felt, worse than childbirth. There was no need to scream because what good what it have done? It was excruciating pain!

I was then sent up to a room. I could not believe I had to stay in the hospital on Easter morning. Because of COVID-19, no visitors.

My two children at home worried and my ex-husband was in shock because I’m in the hospital as a patient and not as an employee.

My finger was so painful. However, I received the best love, support and professionalism while I was a patient at University Hospital. I did not realize the severity of my injury. They said I might lose my finger in the process. I prayed and cried that first night, but the love that I received got me through this horrible experience.

Every day I prayed that I could go home to be with my children and get back to my normal life.

I saw Dr. Kilgore, an infectious disease The current situation physician and he was amazing! I was blessed to have him because during this scary experience he taught me so much important information. I was on pain medication and several antibiotics and was finally released from University Hospital.

I was happy to finally be released however, my finger was still extremely painful and kept getting infected. I started to think my finger would never be the same. I lost all feeling in parts of my finger, but still felt sharp pains. After several physician appointments with Dr. Abell (orthopedics), Dr. Kilgore (infectious disease), and Dr. Price (my primary care) I finally got released from orthopedics after two failed attempts to try to go back to work on June 7.

So this injury has given me two months of pure pain. Today, I still struggle with my finger some. The infection pretty much gone.

I will have a bad scar. My pain level went from a 1,000 to now about a 3. I finally have feeling in most of my finger, I can move it, and I am able to do my job that I love and helping my patients.

Thank the lord I’m an employee that always comes to work because I had 380 hours of FMLA to use to help my kids out financially with bills and food.

I am truly blessed and I thank God every day since that day for not letting me lose my finger and helping me through this horrible situation. My red pit terrier Blaze is fine. She had to be treated at the vet for puncture wounds and get medicine for infection. She and I were a pair to see because we were both moving extremely slow throughout those first two weeks especially. +

— Sent in by Kristine Ivey Grovetown, Georgia

JULY 2, 2021

11 +

AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf — posted by Gerald P. Corcoran MD, on June 24, 2021 (edited for space)

WHY I BECAME A DOCTOR The landscape of medical practice has changed dramatically over the many decades I have been in practice.

I wrote the following essay some years ago, but I find my feelings are even stronger today.

To be a doctor I guess I always wanted to be a doctor. Persistently and unequivocally, my dream was to become a doctor — but not just any kind of doctor, a family doctor.

While my medical school classmates were seduced by the glamor, prestige, decisiveness, and ego of the various specialties, I never changed my goal.

[My] professors (all specialists) tried to beat (browbeat) it out of me with derogatory comments about “LMDs” (Local Medical Doctors). There were many comments about the lifestyles of various GPs and what it said about them.

These professors extolled the advantages of wealth and how easy it was to make money in the specialties. But their arguments fell on deaf ears. Even the vanity appeals of “you’re too smart to be a GP” and “you’ve got great hands for surgery” didn’t sway me. I ended up becoming the only FP in my medical school class. I guess I heard a different drummer.

I have thought many times about what attracted me to medicine. I believe the real attraction was because of one seminal event, electrifying in its impact.

I was about 10 or 12 and was sick, lying on the daybed in the den. The atmosphere in the house was tense. My mother and father were beside themselves — I guess from worrying about me, their youngest. My mother was wringing her hands and talking incessantly. My father was grimly silent. The doorbell rang, and Dr. Gutman came in.

He was a GP from up the street. He had an office in his house but made house calls. He was not particularly pleasant, but he was our family doctor — our only doctor.

The most amazing thing happened when he entered the house: all of the angst disappeared! Mind you, it was not because of science or knowledge. It was not after the exam and the pronouncement of diagnosis and prognosis but when he simply entered the house! His very presence enveloped all in the house in feelings of reassurance, competence, compassion and caring. That’s what I wanted to do. That was who I wanted to be.

I hope I have achieved that level of providing comfort and reassurance simply by being a competent, caring, compassionate doctor.

Patients will turn to me on leaving and say, “I always feel better after being here with you.” I find that a great compliment and an affirmation that I have succeeded at my job.

Many of the patients I am now seeing have been with me for over 40 years. Some were delivered into my hands. Some I have breathed life into, some I have snatched from the jaws of death. All have touched my life and shaped my career. I am profoundly grateful for their trust, faith and presence.

I have cared about them all. I have sacrificed my time and leisure, many of my family’s needs and my individual interests for their well-being.

I don’t regret the personal sacrifice, but I apologize to my family and those around me for their involuntary sacrifice. I have been rewarded with money and prestige, perhaps not as great as many of my colleagues, but enough.

The expressed feelings of my patients are truly priceless.

Trying to convey this to the medical students that come to my office is difficult. I tell them that I come to the office not to work but to see a bunch of old friends — and I get paid for it! It is more than any person deserves, and I remain honored, grateful, and don’t ever want it to stop. +

I heard a different drummer.

Gerald P. Corcoran is a family physician

What sets this book apart from many like it — books about how this disease or that one was vanquished — is that most are written by researchers and historians; this one was written by the man who actually did the deed.

D.A. Henderson, MD directed a ten-year worldwide effort that officially eradicated what had been a centuriesold plague (literally) on the human race, claiming half a billion lives in the 20th century alone.

The thing is, no one involved really believed the effort could succeed.

As noted medical writer Richard Preston recounts in the Foreword, respected scientists like René Dubos believed that even if the eradication of smallpox was theoretically possible, from a practical and economic standpoint it was chasing after the wind. It would require an in-person presence in a million tiny and remote thirdworld villages in places like Somalia, India, Bangladesh, Pakistan, and Nigeria; and an equally impressive presence in teeming metropolises all over the world. It was an immensely daunting task.

Recording the story of the demise of smallpox — the first time in human history a major pestilential disease had been eradicated — was another monumental task Henderson was eminently qualified to tackle.

Very few people are alive today who have first-hand knowledge of smallpox, or any exposure to it that didn’t come from the internet or a book. A 2021 fantasy we can all related to is to contemplate what it means to vanquish a hideous and devastating scourge. We can experience the fantasy vicariously through this book.

It is informative from the front cover to its final page.

For instance, a special two-pronged needle — called a bifurcated needle, shown on the book’s cover — was invented specifically for administering the smallpox vaccine. It was so vital to the effort that when “Target Zero” was reached, those responsible were inducted into an elite group of Henderson’s creation, The Order of the Bifurcated Needle.

This highly recommended book takes readers from the medieval history of smallpox, through the international 20th century effort to erase it from the face of the earth, and into the future and the thorny 21st century ethical questions about the use of smallpox as a biological weapon and its possible use by terrorists (the CDC and a Russian research facility still maintain viable samples of the smallpox virus despite international calls for the destruction of the samples).

Henderson died in 2016 at age 87 due to complications from a fall. + Smallpox - The Death of a Disease

by D.A Henderson, M.D., 334 pages, published in June 2009 by Prometheus Books

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+ 12

AUGUSTAMEDICALEXAMiNER

The Examiners +

Do you and your husband work at the same place?

Whatever gave you that idea?

by Dan Pearson

I said no such thing.

I thought you told My husband is lazy and me you’re both in unemployed. healthcare.

What I told you was that Are you sure? I I’m a caregiver and my could have sworn... husband is a caretaker. © 2021 Daniel Pearson All rights reserved.

EXAMINER CROSSWORD

PUZZLE

1

2

3

4

5

12

13

16

17

8

9

10

THE MYSTERY WORD The Mystery Word for this issue: LUNARTA

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

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, JULY 12, 2021

We’ll announce the winner in our next issue!

EXAMINER SUDOKU

11

15

6

18 21

22

24 28

29

40

36 41

45 49

9 1 2

30

35

46

52 58

59

5

6 8

50

57

3 2

60

70

7 8

7 6

3 5 4

2

7

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67

7

8 9

64

8

1 3

9

by Daniel R. Pearson © 2021 All rights reserved.

36. Grand add-on 38. Registered 40. Removal 43. Pacific diet staple 45. Component 48. Gilbert Islands atoll (and capital of Kiribati) 50. Crown adjective 53. Cut to required size 54. Helper 55. Bulldog’s school 56. Prepare a gun for firing 57. Diving bird 58. First name of a Tulsa university 59. Type of star 60. Variety of dive 63. Disfigure

Solution p. 14

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

QUOTATIONPUZZLE H O Y O Y O R A N A V E T A T N O I H S V E I N D D E U T U I H O W Y S P G L

by Daniel R. Pearson © 2021 All rights reserved

6 8 O B9 H A2 W5 1 T3 — Epicurus 4 7

7 5 1 4 3 6 8 9 2

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.

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

1

2

T 3

I 5

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

6

7 1

U S 1 2 1 2 3 1 2 3 4 1 2 3 4 W U 1 2 3 4 5 6 1 2 3 4 5 6 7 8 9

K 1 2 3 4

1 2

1.LOSSAWWWINGY 2.OOOOATUEFSH 3.CNNMRTTAU 4.OKTTTED 5.KITE 6.REIN 7.FMG 8.EU 9.LS

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 © 2021 All rights reserved

BY

7

14

19 20 ACROSS 1. Aircraft intro, sometimes 23 5. Drop prefix?

25 26 27 8. Duration 31 32 33 34 12. Dregs 13. Swelling 37 38 39 15. Medical district avenue 42 43 44 16. Ancient false god 47 48 17. Soviet forced-labor camp 18. Great Lake 51 19. Put in order 53 54 55 56 21. Flower secretion 23. Bethesda agcy.

61 62 63 24. Medical prefix 65 66 25. Loiter 68 69 28. Eradicates (with “out”) 31. Obamacare acronym

by Daniel R. Pearson © 2021 All rights reserved.

32. Bird description?

35. Oozes DOWN 37. Silent 1. Sin City star 39. Prepare a jet for winter 2. At one’s elbow takeoff 3. Duct type 41. Metal fastener 4. Beech follower 42. Tubular support for a vein 5. Castrate 44. First prime minister of 6. Kill Bill star India 7. Type of school 46. Healthcare wrkr.

8. Sample for testing 47. List of mistakes 9. Savannah is one 49. Blue Cross brand 10. Capital of Western Samoa 51. Type of hygiene 11. Never (in poems) 52. Title of a knight 13. Brainiac 53. Augusta’s famous Dub 14. Owing 56. Warns 20. It goes through Sudan 61. Monetary unit of Iran 22. Epochs 62. Secret love affair 24. ______ ward 64. Bow 25. Hoover and others 65. Doing nothing 26. Severe/sudden 66. Low-grade sandstone 27. Held by 25-Ds 67. Molten rock 29. Orchard starter 68. Reward (archaic) 30. Chilling intro 69. Noah’s craft 33. Kidney-related 70. Dash; flair 34. Recline

WORDS NUMBER

6

JULY 2, 2021

3 4 2 9 8 7 1 6 5

2 6 5 3 1 8 9 7 4

4 1 3 7 2 9 6 5 8

JULY 2, 2021

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

The

13 +

Advice Doctor

Moe: What’s the difference between Donald Trump and a sparrow?

Joe: The sparrow can still tweet.

©

Moe: Rudy Guliani and I have something in common.

Joe: Me too: neither of us can practice law in the State of New York.

A

man visits a fortune teller who greets customers from her home. He goes to her house and knocks on the door.

“Who is it?” she calls out.

Disappointed, the man walks away.

Police want to interview a suspect in a series of home invasions wearing nothing but socks and a top hat.

The Chief of Police, however, insists that the police wear their usual uniforms.

Two flies are sitting on a pile of dog poop when one of the flies breaks wind.

“Do you mind?” says the other fly. “I’m trying to eat over here.”

Moe: Seems like calendars are becoming obsolete.

Joe: Yeah, their days are definitely numbered.

Moe: Why was the 9V battery kicked out of the church’s community room?

Joe: I bet they were having an AA meeting.

Moe: What’s the difference between a hill and a pill?

Joe: One is hard to get up, the other is hard to get down.

Moe: What’s the difference between an idiot and a pizza?

Moe: One is easy to cheat, the other is cheesy to eat.

Moe: What’s the difference between a cat and a frog?

Joe: A cat has nine lives, but a frog croaks every night.

Moe: What’s the difference between a bowl of moldy lettuce and a depressing song?

Joe: Please! Last one!

Moe: One is a bad salad, and the other is a sad ballad.

Moe: There’s one thing I hate about ordering duck at a Chinese restaurant.

Joe: What’s that?

Moe: The bill.

Moe: I’m thinking about starting a business to breed racing deer.

Joe: What for? + Moe: I think I can make a quick buck.

Why subscribe to theMEDICALEXAMINER? What do you mean?

Staring at my phone all day has had no Effect on ME!

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

Dear Advice Doctor, I read this column every issue and I’m amazed by how many people ask you questions about stuff that isn’t related to medicine.

You are a doctor, right? So my question IS about medicine, thank you very much. My doctor is great but his staff is horrible. Every appointment someone different gets under my skin. I think they take turns. Do you think I should find a new doctor, or just ignore his rude and incompetent staff?

— Sad and Sore Dear S&S, This is a subject that I think many of us can sympathize with. I know personally, when something gets under my skin, especially this time of year, the culprit is often a mosquito. They are annoying, no question about it.

The question is, what can we do about it?

You can do an internet search and discover dozens of allegedly sure-fire recipes for homemade natural mosquito repellents. They have an undeniable popular appeal because, after all, who wants chemicals sprayed all over their body?

The honest answer to that question is: people who don’t like mosquitoes. The experts say that people who don’t like mosquitoes should think twice about candles, bracelets, and expensive ultrasonic devices that claim to keep mosquitoes away. Researchers at New Mexico State University (and plenty of other institutions) have studied what works and what doesn’t, and they say those chemical sprays do the trick.

As distasteful as that might sound to some, the active ingredient in many sprays (DEET), has been widely used for decades, and studies show it is safe and effective against mosquitoes and ticks carrying malaria, West Nile virus, Zika virus, and Lyme disease, according to the EPA. Before anyone condemns chemical sprays, consider this chemical: p-menthane-3,8-diol, or PMD. Natural repellant fans would probably automatically avoid it, but p-menthane-3,8-diol is nothing more than the official name for oil of lemon eucalyptus extract. Yes, some chemicals come from plants. Who knew?

And to the point of our discussion, oil of lemon eucalyptus extract (aka PMD) is the only DEET-free spray that New Mexico researchers found to be effective and long-lasting.

Thanks for writing, and I hope I answered your question. + Do you have a question for The Advice Doctor about health, life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.

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JULY 2, 2021 Often, as we find ourselves being caregivers for elderly loved ones in our life, we long for a vacation. However, we often consider whether to take our loved one with us. If you decide to invite your elderly loved one on your family vacation, think of the front porch as the window for the loved one to participate as fully as possible.

Consider this: You might have your 90-year-old mother or grandmother join you at the beach house. She can enjoy many facets of the beach vacation by sitting in the rocking chair on the front porch. She can hopefully see the ocean as the tides lap gently at the shore, perhaps her hearing is still good enough that she can listen to the surf, and maybe even see or hear her grandkids or great-grandkids playing and splashing in the water. She could certainly enjoy watching them come back from the beach, all dirty with sand but with smiles on their faces. She can sit on the porch and enjoy conversation with you and the rest of her family and sip sweet tea, lemonade or maybe a glass of wine. Perhaps she can watch the sunrise or the sunset. Maybe she enjoys playing cards, and you can invite her to join in a family game of cards as you sit at the picnic table on the front porch. Maybe she likes to read, and she can rock and read, even if she can’t walk on the beach like everyone else.

There are ways to incorporate your family member who is not as capable physically or cognitively as he or she used to be. Just be creative, and he or she will be so glad that you included them. +

IT’S A QUESTION OF CARE What activities can my aging loved one participate in while we’re on vacation together?

by Amy Hane, a licensed Master Social Worker in South Carolina and Georgia, an Advanced Professional Aging Life Care Manager and also a Certified Advanced Social Work Case Manager.

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