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SEPTEMBER 16, 2022
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WHERE DO WE
DRAW THE LINE? As you may have noticed, the pursuit of happiness — specifically healthy happiness — is a major concern for many people. It’s big business. Food labels are liberally festooned with health claims. Even if it’s a package of Jumbo Twinkies, the label will still announce that it’s non-GMO, or vegan, or “Now with Less Fat!” You know how products are being down-sized while keeping the price the same? We’re halfway expecting to see a 14 oz. package of salt that used to be 16 oz. announce, “Now With Reduced Salt!” It could happen. As we have said on these pages more than once, being a label reader is a good thing, especially the Nutrition Facts portion. Every one of us should give health all the attention it deserves. But are we taking it too far? A couple of years ago, Swedish researchers measured the health-conscious community against ten identifying characteristics of religions — things like a strong sense of community, a priesthood of some kind, sacred beliefs, places, and rituals viewed as uniquely superior and true, and a clear path to salvation, liberation, or deliverance — and discovered that by every single measure, health is indeed a religion. It’s got it all, including a plethora of both certified and self-appointed preachers; various interpretations of the one real set of truths; holy places where the faithful go to work out their salvation; and even its own set of backsliders and outcasts who gave it a try but fell by the wayside, some overwhelmed by shame and guilt and determined to return to the fold, others who will never be back. In the world of faith, there are people whose zeal moves them to actions that can only be described
as extreme. The September 11 attacks were perpetrated by religious zealots. More recently, faith has moved some to vandalize or bomb synagogues and abortion clinics, or murder those who operate them. They see no conflict between the ideals of their faith and their criminal actions. Their counterparts in the religion of healthcare might be typified by militant vegetarians who throw bags of fake (or real) blood on people who work in meat packing plants, or are simply carnivores. In less objectionable fashion, many proponents of this or that approach to health view everyone who doesn’t subscribe to their particular brand of healthy living with condescension. Can we all just get along? Most people realize that extreme approaches to health (or faith) are not usually sustainable over the long haul, and also tend to scare away potential converts. For a modest example, a determination to lose weight and get fit that involves going to the temple — strike that — gym — at 5 o’clock every morning would not survive long for many of us. It might be a little extreme. In fact, one journal quoted a doctor who was asked the question, which is generally more important, fitness or sleep? His answer: sleep. That doesn’t mean it’s extremist for someone to schedule pre-dawn running or fitness sessions, but it probably wouldn’t last very long for many. British cardiologist Rohin Francis has cautioned that some people actually get addicted to exercise, and The E Word definitely qualifies as a wonder drug. But as with any drug, there is an optimal dose. Not too little. Not too much. For E addicts, excessive exercise can cause sore knees, Achilles tendonitis, tennis elbow, and more. Of course, most of us needn’t fear getting too much exercise; 90% of us don’t get enough. The sad story there is, as mentioned above, exercise truly is a wonder drug. Dr. Francis isn’t anti-exercise. “It has such a multitude of benefits, not just on your heart, but for Please see DRAW THE LINE page 3
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SEPTEMBER 16, 2022
THE FIRST 40 YEARS ARE ALWAYS THE HARDEST
PARENTHOOD KNUCKLE-CRACKING by David W. Proefrock, PhD
Your 10 year-old son has been in therapy with a mental health professional for a few months since your divorce. Now his therapist is recommending that he be started on an anti-depressant medication. You aren’t sure you want him on medication. What do you do? A. The therapist is the professional and knows what is best. If you aren’t going to take their advice, why did you hire them in the first place? Agree to the medication. B. Get a second opinion before you agree to medication. C. If you are worried about the recommendation, stop the therapy or perhaps seek out a different therapist. D. Ask the therapist to explain to you in detail the recommendation. Make sure you know the reason for medication, the goals and the risks, any possible side effects, and an estimate of how long he will need to take the medicine. Agree only after you understand the recommendation in detail. If you answered: A. The therapist is the professional, but you are the parent and it is your responsibility to make an informed decision. B. You might decide that a second opinion is necessary, but first make sure you understand the recommendation in detail. C. You shouldn’t stop his therapy just because of the recommendation. Make sure you understand the recommendation completely and then make an informed decision. D. This is the best plan of action. You can only make an informed decision if you are appropriately informed.
AND ARTHRITIS Chances are pretty good that most of us know — despite our mothers’ warnings — there is no connection between cracking knuckles and getting arthritis. Speaking on a Merck Manual podcast about this very subject, one doctor said he would be more worried about people going blind from wiggling their ears than about getting arthritis from cracking their knuckles. A noted study on the issue was actually published in Arthritis & Rheumatology in 2004 based on 60 years of research by Dr. Donald L. Unger of Thousand Oaks, California. Dr. Unger recruited himself as the main participant for his study, which consisted of cracking the knuckles
on his left hand every day for six decades, but never once cracking those on his right hand. His conclusion was the same as the Merck doctor. In a speech accepting an award for his study (the Ig Nobel Prize, if you must know), Unger said, “Mother, I know you can hear me. Mother, you were wrong! And now that I have your attention, can I stop eating my broccoli, please?” Unfortunately, there happens to be a lot more about arthritis than just cracking knuckles that is the subject of medical mythology. Probably the most common is that arthritis is a disease affecting only old people.
The fact that your child is seeing a medical professional does not relieve you of the responsibility of making informed decisions about your child’s care. An informed decision means understanding the recommendation completely. +
That is false for several reasons. Even children can get arthritis, particularly the kind that results from inflammation, the kind a rheumatologist would treat. Older people can and do get that version (rheumatoid arthritis or RA), and also osteoarthritis, which in simple terms is a joint or mechanical issue more than one of inflammation. Have you ever heard the old wives’ tale that people with arthritis or other joint issues can predict the weather? Well guess what? It’s not an old wives’ tale. While temperature and humidity have no bearing on the matter, barometric pressure does. Research subjects have been isolated in rooms where the pressure could be raised and lowered, and they were able to accurately report those fluctuations based on how their joints felt. Some people think runners subject themselves to the risk of arthritis by punishing their joints with every jarring step. Not necessarily true. It can certainly elevate the risk, but with quality footwear and above all, good running mechanics, a person could enjoy pain-free running for decades. Some forms of arthritis have no known cure, but others, such as gout, can be managed very successfully and even cured by compliant patients. The key to treatment of any form starts with an accurate diagnosis and following treatment guidelines while avoiding fad diets and quack cures. Stay active, maintain healthy weight, avoid smoking, and feel free to crack your knuckles. +
Dr. Proefrock is a retired local clinical and forensic child psychologist. Headquarters for the well dressed man since 1963
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DRAW THE LINE… from page 1 mental wellbeing, diabetes, blood pressure, chronic pain, and cancer risk. These are all based on good evidence. The list goes on and on.” Getting what should be a daily dose of this wonder drug can be a challenge. Over the past 30 months, many people have transitioned to work-from-home jobs, and the majority of us sit for a living. But as Dr. Francis writes (at medpagetoday.com), “If you go from sedentary to building-in any form of regular exercise, you will reap incredible benefits because there is probably nothing else you can do in your life to improve your health more, aside from maybe giving up smoking.” Did you notice that he said any form of regular exercise? In other words, in the religion of fitness and health you don’t necessarily have to attend every Sunday and always go to the Wednesday night prayer meeting. For just about all of us, virtually anything we can add that involves movement or exercise is an improvement.
“I’m very healthy, an absolutely perfect physical specimen!” said Donald Trump last week.
The key word is balance. Perhaps you recall a past issue of the Medical Examiner where a question was raised about hot dog eating. Dr. Karp, in his aptly named column (No Nonsense Nutrition, which appears on page 8 in every other issue) gave it his blessing. The same would go for a donut, a corn dog, or one of those Twinkies we referred to earlier. If our health regimen is so fragile that it will collapse under the weight of an occasional donut or hot dog, we need to reevaluate and retool pronto.
Writing for the American Council on Science and Health, David Lightsey, MS, writes about the need for moderation and balance: “On the one hand we have the growing obesity acceptance movement, even though the health consequences [of obesity] are worse than smoking, drinking, or poverty. On the other hand, we have those who pursue physiques unattainable for most without cosmetic surgery, daily exercise regimes lasting hours in the gym, often requiring steroid use to obtain them, and a dietary protocol [with an] endless list of dos and don’ts.” It shouldn’t take a degree in medicine or nutritional science to live a salubrious life, nor should it require a life of constant deprivation and self-denial. We’ve got to draw the line somewhere. We can’t live on alfalfa sprouts and steroids, nor on cookies, cokes and couches. In sum, if salubrious living isn’t balanced and reasonable, it really isn’t salubrious. +
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QUESTIONS FROM READERS It’s a wonderful thing to hear from readers. Here are answers to some of the questions we often get. Who writes this thing? There are hardly any bylines. That is no accident. The publisher of the Medical Examiner, Dan Pearson, had the idea to create this publication decades ago. Back then he often saw an Atlanta-based health publication called Pulse. Although Pulse was an insert in the Atlanta Journal-Constitution, it was largely the work of a single person. Virtually every article was bylined, and they were all written by the same person. It was monotonous and seemed unnecessary and made the publication look like it seemed to be: a one-person operation. This paper is also essentially a one-man operation with the notable exception of our sterling collection of columnists. They all get the bylines they deserve. Anything that doesn’t have a byline — like this article — is written by Dan Pearson. Mystery solved. What happened to my Examiner newsstand? Print is dead. Well, a lot of it is. We just haven’t gotten the memo here at the Medical Examiner. Most cities have a newsstand problem, and Augusta is no exception. Publications like Buzz on Biz and Metro Spirit went out of business years ago and they abandoned their newsstands, which litter the landscape to this day. From time to time, various entities finally decide these eyesores need to be cleared away, and actively maintained Examiner boxes can get caught up in these sweeps. That happened recently to our newsstands at the Medical Collage of Georgia. We responded by resuming in-person delivery to all floors of the hospital, something we did years ago. Recently Eisenhower Hospital rescinded its permission for our box that had been in their lobby for years. Their reason: they said that Medical Examiner advertisers were in direct competition with healthcare providers on post who offer the same services. While such developments are disappointing, we have altered and adjusted our distribution to make sure the Medical Examiner is still available to everyone who wants to read it on paper (and of course, online is alway available). In fact, our press run and copies delivered has actually increased since the recent loss of the newsstand locations mentioned above. We don’t plan on going away anytime soon. +
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www.AugustaRx.com The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of salubrious news within every part of the Augusta medical community. Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397
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SEPTEMBER 16, 2022
#173 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 firstname.lastname@example.org by Marcia Ribble
tudents and practitioners of neurology no doubt recognize this man, considered the founder of modern neurology and one of the greatest teachers and clinicians in the history of medicine. Born in Paris in 1825, Jean-Martin Charcot (shar-KO) had such influence that he left behind more than a dozen medical eponyms (syndromes, conditions or diagnoses he discovered or that are named after him), including Charcot’s disease, Charcot-Bouchard aneurysm, Charcot’s triad, Charcot-Leyden crystals, and so on, plus Charcot-Marie-Tooth disease (CMT), which has nothing to do with teeth; it is a hereditary form of peripheral neuropathy named after Charcot, his resident Pierre Marie, and British neurologist Howard Henry Tooth. Charcot attracted students from all over the world, providing another major element of his legacy. His students included Sigmund Freud, Pierre Janet, Charles-Joseph Bouchard, Alfred Binet, and Joseph Babinski. Another student was Georges Gilles de la Tourette, discoverer of the syndrome named in his honor by Charcot. While only Tourette and Freud may be household names, each of the students above (and a number of others not listed) were and are noteworthy in their own right as they went to on to distinguished careers after being trained by Charcot. Upon Charcot’s death in 1893, Freud made a very perceptive observation about his teacher: “Of the many lessons lavished upon me in the past by the great Charcot, two left me with a deep impression: that one should never tire of considering the same phenomena again and again (or of submitting to their effects), and that one should not mind meeting with contradiction.” As would be expected of anyone who practiced any branch of medicine more than a century ago, some of Charcot’s findings and conclusions have been challenged or disproven over time. But his student Joseph Babinski managed that feat to his teacher’s face. A popular diagnosis in female patients in past decades was “hysteria.” Charcot thought he had discovered a new disease he dubbed “hystero-epilepsy,” a combination of hysteria and epilepsy. Babinski disagreed. In his view Charcot hadn’t discovered hystero-epilepsy; he had invented it. Babinski was eventually able to convince Charcot that afflicted patients were vulnerable to suggestion and were in essence performing the symptoms Charcot had predicted they would. Charcot’s acceptance of that assessment was a notable example of humility and the philosophy that truth is paramount. Charcot suffered from angina in his later years and died of heart failure in 1893. A bronze statue erected in his honor by his students in Paris was melted down for munitions by the Nazis during the World War II German occupation of France. +
Editor’s note: as regular readers of this column know, Marcia Ribble recently moved from Augusta back to Michigan where she was raised. The sun is shining and there’s a mild breeze making it fairly comfortable despite temperatures in the upper 80s and higher levels of humidity today. Tomorrow it will be skirting the 90s with high humidity and thunderstorms predicted. However by Tuesday, the humidity will drop into the pleasant range and the temperatures will be in the low seventies. For many years the weeks before and during Labor Day week were vacation days. That meant packing up the big old Chevy Beauville van and heading out to play in whatever location we’d chosen. Like in the South, Michigan offers an incredible wealth of choices. Over the years we took advantage of many of the possibilities available to us. Vacationing is one of many mental and physical health options we have, and our family took those options as a great way to spend two weeks. Camping was a family favorite. We camped in lower Michigan, upper Michigan, and in Canada, and wow, did we do a lot of fun things! One year we chose to focus on the Upper Peninsula. There we visited the Locks at Sault St. Marie. The huge freighters needed to move from Lake Superior to the lakes below, Michigan, Huron, Erie, and Ontario. Those routes allowed the ships to carry iron ore, lumber, grain, and other goods from port to port capturing all the growing and manufacturing from the entire region to gain access to other ports within the region and up the St. Lawrence Seaway. At the end of the seaway was access to the Atlantic Ocean and that took us from
regional trade to international trade. Many people don’t realize that the interior of our country carries on trade as important to our nation’s economy as ports like New York City. Soybeans grown in Michigan could be sold to foreign countries, as well as corn, wheat, rye, etc. In return, those emptied ships could bring in cargo important to the entire Midwest. The freighters are huge and in Bay City, where I live, they often move up and down the Saginaw River causing our bridges to open and close, stopping traffic from one side of the city to the other. It is fun to get out of the car while traffic is stopped for the bridge to go and wave to the sailors aboard, to guess about the contents, and to read the ships’ names. There are also places along the river where we can go to watch the freighters load and unload their cargo. Huge mountains of salt for winter are piled up from a freighter’s interior to keep our roads passable. At another site grain is lifted up from trucks and deposited in the ship’s cargo holds. Labor Day is nearly time for sugar beets to be carried on huge trucks. One thing my children enjoyed was watching those trucks go over bumps and seeing sugar beets fly off to the side of the road. On occasion we’d stop and pick one up. Raw sugar beets are just a little sweet because they must be processed to make sugar. They are not small like regular beets, but often weigh more than 10 pounds apiece. One vacation over two weeks provided our family with a year’s worth of educational experiences and connections, and the Locks took only one day to explore. The locks raise and lower the boats so the can move from one body of water to another, but that is not all there is to see there. I’ll have to tell you more about it next time. +
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SEPTEMBER 16, 2022
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THE PAST YEAR HAS TAUGHT ME A LOT
could have seen that. He had been waiting patiently for both of those to happen. I’ll just have to tell him all about it later I suppose. It is hard to believe that football season is back upon us again, and the baseball playoffs are just around the corner. Maybe lightning will strike twice. Who knows? So, what do we do with this information? We can’t change time, at least not unless we can find a DeLorean and a 1.2-gigawatt capacitor. All we can do is slow down when and where we’re able and enjoy the moment without spending our time anticipating some future moment. It is okay and even therapeutic to do a little of that, as it is nice to have special things to look forward to. We really should strive to be happy in our everyday life, not just on weekends. Not just on vacation. Not even just when we are healthy and feeling good. This year has taught me to do all that. I have a long way to go, but I’m still working on it, and I’m getting better at it. For starters, I’m going outside a lot more. I’m trying my best to walk in the woods every day, as often as our summer pop-up thunderstorms will let me. I also gave up a lot of hobbies that didn’t make me as happy as I thought they would, and I’ve narrowed down my pursuits to just a few that bring the most joy. I also spend a lot more quiet time without doing anything in particular except maybe listening to music, or even just listening to the wind and the birds singing as I sit on my porch with my beautiful wife and sip on a nice cold beverage. I hope that you too are adjusting to the new time scale that each year of your adventure into middle age brings you and finding something to be happy about every single day. +
It’s been a year now since my father died. As others have told me, you don’t ever get over it, but it gets a little easier. Of course, that is only if you average it across time, because sometimes, at least for a little while, it hurts just as bad as it did that day a year ago. This anniversary has caused me to pause and reflect some on all that has happened in this past year. Besides my father dying, I had three surgeries and almost one more. I was mostly dead for a brief time until a friend revived me with CPR. My entire immediate family and I got COVID-19. Just this past weekend, we found out that one of our dearest friends has leukemia. It never seems to end. As we age, illness or injuries befall us. Eventually, something gets us all. I’m pretty sure of that since I don’t know any folks that have gotten too far past 100 years on the earth. I never met Methuselah, but I’ll take the Bible’s word on his advanced age. That said, it doesn’t work that way anymore, for sure. Another affliction of growing older, if you can call it that, is that time passes by faster and faster. This past year was a blur. If someone told me as a young man that I had to wait a month for something, I’d be pretty anxious and impatient over it. Now, I’m still impatient, but I’ve noticed how my mind has adjusted to a different time scale. Just a little while back (it seems like yesterday but could have been last year...that’s another part of the affliction) my wife said we would need to wait a couple of years before we could make a certain large purchase I was wanting to make, and that seemed like a short wait to me. Of course, a lot of good stuff happened this past year too. My Georgia Bulldogs finally won another national championship after being so close so many times during the past 41 years. And on top of that, our Atlanta Braves won the World Series. I wish my dad
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A CENTURY OF PROGRESS
Most people celebrate their personal birthday about once a year. I say about once a year because those of the XY chromosome persuasion tend to be less that accurate about their exact number of birthdays. But I have the solution to their problems. After a woman turns 39, she can then celebrate the anniversary of her 39th birthday. I began celebrating the anniversary of my 49th birthday some years ago. I can’t rightly remember exactly how many. And for the record, I don’t care. Actually, I am not completely sure of my birthdate. I was very young at the time and have to take the word of others regarding that. To celebrate recent birth date anniversaries, I cooked on my Green Egg, ate too much, took a nap in my favorite chair, and finished off the rollicking date by watching depressing TV news. I could almost hear my arteries harden. I could have gone out to the Redneck Olympics and entered the belly flop contest. But I didn’t. I’m
BASED ON A TRUE STORY (most of the time) A series by Bad Billy Laveau
too old and ugly for that. Us old codgers should step aside and give young guys a chance to impress their girlfriends. Now that I am mostly awake, I think back about things that have changed in my lifetime, or more accurately, in the last hundred or so years. As usual, I made a list: 120 or so years ago The average life expectancy for men was 47 years. The average US hourly wage in 1910 was 22 cents per hour. The average US worker made $200 to $400 per year. Competent accountants made $2,000 per year. Dentists made $2,500 a year. Veterinarians made $1,500 to $4,000 per year.
Mechanical engineers made about $5,000 per year. The US had 8,000 cars and 144 miles of paved roads. The speed limit in most cities was 10 mph. Fuel for cars was sold in drug stores only. 14% of homes had a bathtub. 8% of homes had a telephone. It was believed that telephones would never be a commercial success because women and children would be too frightened to use them. 18% of households had at least one full-time servant or domestic help. The tallest manmade structure in the world was the Eiffel Tower (1,050 feet tall)! 95% of all births were home deliveries. 90% of doctors had no college education! Instead, they attended so-called medical schools, many of which were condemned in the press and by the government as “substandard.” Sugar was 4 cents a pound. Eggs were 14 cents a dozen.
SEPTEMBER 16, 2022 Coffee was 15 cents a pound. Women washed their hair once a month, and used Borax or egg yolks for shampoo. Canada passed a law that prohibited poor people from entering their country for any reason. The Five Leading Causes of Death were: 1. Pneumonia and influenza 2. Tuberculosis 3. Diarrhea 4. Heart disease 5. Stroke Penicillin and other antibiotics had not been invented. Pneumonia had a 90% death rate if the victim was overweight. Only 50% died if they were skinny. (With penicillin, pneumonia patients had a 95% survival rate.) Only a disgraceful man beat his wife any more than she needed, and never with a stick bigger than the circumference of his middle finger. (Skinny husbands with small hands were in demand.) The American flag had 45 stars. The population of Las Vegas, Nevada was 30. There were no show girls or flashing lights. No one had ever heard of silicone breast implants.
Tough football players played without helmets. Crossword puzzles, canned beer, and iced tea hadn’t been invented yet. There was no Mother’s Day or Father’s Day. 20% of adults couldn’t read or write. 6% all Americans were high school graduates. Marijuana, heroin, and morphine were sold over the counter at corner drugstores. Back then pharmacists said, “Heroin clears the complexion, gives buoyancy to the mind, regulates the stomach and bowels, and is a perfect guardian of health.” Coca Cola contained cocaine and was commonly called, “Dopes.” Women’s panties were frequently homemade from flour sacks. Bras had not been invented. There were about 230 reported murders per year in the entire U.S.A. A mouse was a four-legged rodent that made women scream and act crazy. If a kid got a spanking in school, he got a worse one when Please see CENTURY page 9
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TRYTHISDISH SEPTEMBER 16, 2022
by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb
CRUNCHY PUMPKIN SEED & ALMOND BRITTLE A tasty treat perfect for fall and winter holidays: Halloween, Thanksgiving and Christmas. Ingredients • Vegetable oil cooking spray • ½ cup water • 1½ cups sugar • 1½ cups slivered almonds, toasted • 1 cup pumpkin seeds • 2 tsp. margarine • 2 Tbsp. semi-sweet chocolate chunks, melted Instructions Cover surface of cutting board with parchement paper; lightly spray paper with cooking spray. Set aside. Heat water and sugar in a large heavy saucepan on high heat for 8-10 minutes or unitl the sugar turns a dark amber color, stirring frequently. Swirl pan and brush down sugar crystals on sides of pan with a wet pastry brush just until the sugar comes to a boil. Meanwhile, in a medium bowl, combine almonds and pumpkin seeds. Remove saucepan from heat; quickly stir
in almonds, pumpkin seeds and margarine. Immediately pour mixture onto parchment; spread evenly into a rectangle using a wooden spoon. While warm, cut into 24 pieces of candy. Let cool completely. Microwave chocolate in 15 second intervals stirring after each 15 seconds until it is melted. Transfer chocolate into a ziptop bag and move the chocolate to one corner. Snip the end off the corner and drizzle a thin layer of chocolate over the brittle. Yield: 24 servings (serving size 1 2-inch square) Nutrient breakdown: Calories 188, Fat 12g (6g monounsaturated, 2g saturated); Cholesterol .3mg, Sodium 2mg, Carbohydrate 12g, Fiber 2g, Protein 2g. Carbohydrate Choice: 1 Carbohydrate Diabetes Exchange Value: 1 Other Carbohydrate, 2 Fats (mostly good fat). +
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DON’T JUDGE A BOOK... by Ken Wilson Steppingstones to Recovery
...By its cover, right? I must admit, I’m a sucker for pretty book covers. They seem to jump out at me in a used bookstore, and they look better laying around my house! LOL! Publishers have a special department whose only job is to make their books stand out in a crowd to insure a better chance of purchase! I just finished reading a book about the fossil layers found in the Grand Canyon and sure enough, the ploy worked in my case. I’m sure I’ve passed up some good reading material in the past because of a plain cover. But we humans make
snap judgments sometimes and fail to consider that what’s inside is really what counts. Before I understood addiction and alcoholism, I did the quick-judge thing. Over the past 35 years that I’ve been in the rehab vocation, though, I’ve come to realize that what meets the eye isn’t necessarily the true presentation of the human document. For instance, I’ve lost count of the number of cases that have come through my door that go like this: Jane Doe is 35 - 40 years old and used to drink socially, like most Americans do, just a glass of wine at dinner... maybe two. But being the soccer-mom that she is,
working a full-time job plus carrying on full-time duties as a mother, sometimes she can’t sleep. She’s had problems sleeping since her teen years and now, over a period of 15-20 years, that one glass of wine has turned into a whole bottle after work because she learned that wine brings her sleep, blessed sleep. When she wakes up in the night she needs more wine to get back to sleep because her tolerance has increased. Inevitably she gets a DUI taking her kids to school. One DUI for her and another one added for each child in the car. It’s Georgia law! Picture in The Jail Report. Probation. DUI school. Increased insurance
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premiums. Lawyer fees, fines, community service. Total cost: about $10,000. Jane Doe agrees with the court that she needs treatment and obediently enrolls. Certainly the alcohol dependence needs to be addressed before other personal or mental needs can be addressed. But what is/was the real issue? We have to look inside the book covers of the human document. An observant licensed counselor realizes the original primary diagnosis: a sleep disorder! Sends Jane to a sleep disorder clinic and presto .. .in weeks she can now sleep without drinking wine! It does take weeks, sometimes months, but rarely much longer. Patience, patience. If only it had happened 15 years sooner. It’s what we call “under the iceberg” in treatment-ese. And the list goes on ... similar pattern, different story, different client. Abused as a teenager. Inherited chronic anxiety. Grief after the death of a loved one. Religious abuse. (Yes, you read correctly!). Unipolar Disorder. Bipolar Disorder. And for it all: alcohol to the rescue. A wise counselor opens the plain-Jane book cover, sees past the suffering alcoholic and addict and sees
SEPTEMBER 16, 2022
THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional
something beautiful inside, trite as it may sound. If I’ve seen it once I’ve seen it thousands of times. To note and to dispel a misconception: treatment may identify under-the-iceberg issues, but make no mistake, it is malpractice to open up some of these issues and think that during treatment these lifelong struggles can be resolved. Some, yes. All, no. Sometimes opening such a can of worms can lead to relapse very early in treatment, or make an alcoholic dive into a dark place and not come back up for air. It is incumbent on the therapist to identify and then seek to stabilize the suffering addict before addressing some serious muck. It takes time. I think I’m going home to dust off some ugly-cover books and look inside. They’re calling my name, begging me to have an unbiased glance after all these years. +
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SEPTEMBER 16, 2022
CENTURY… from page 6
he got home. 5th graders could actually do math, long division, and make change at the store. Every man and boy carried a pocket knife at all times, including at school and church. A pocket knife was a tool, not a weapon. By age 12, every self-respecting boy had a dog, a gun, and a knife. By age 12, girls could sew, crocket, iron, plus kill, dress, cut up, fry and serve fried chicken for Sunday dinner. (Dinner was at noon. Supper was at dark.) Girls were expected to remain a virgin until married. Boys? Well, that was a different question and subject to much lying, one way or the other. Virginity was a virtue. Pregnancy before marriage was a family disgrace and the girl was sent far way to have the baby, which was put up for adoption. “Baby Momma” was unheard of in family circles.
Single parent homes indicated the husband died in a war or in some other tragedy. Birth control was a mental exercise; now it is chemical or mechanical. Men smoked in public. Women did not. The same with voting. Soldiers were admired and respected. Only war veterans and criminal had tattoos. Being on welfare or getting a government check was a disgrace. Not paying one’s bills and filing for bankruptcy was unheard of. Every decent person went to church regularly. Presidents and presidential candidates always appeared in public wearing a coat and tie. Yes, much has changed since 1900. We have made much progress, medically and mechanically. But are we better off socially or morally? I think not. +
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EVERYBODY LOVES A GOOD STORY
More Americans have died on US roads since 2006 than in World Wars I & II combined
children also has fallen dramatically to 11.8 deaths per million children in 2020, a 61 percent reduction from 1975. Proper restraint use can help reduce deaths even more. Although the majority of children ride restrained, 212 children killed in crashes in 2020 were unrestrained, and others were improperly restrained.
hen it comes to crashes, children are much safer than they used to be. The rate of motor vehicle crash deaths per million children younger than 13 is less than a quarter of what it was in 1975. The rate at which children die as passenger vehicle occupants has decreased 56 percent, while the rate at which they are killed as pedestrians and bicyclists is less than one-tenth of 1975 rates. Proper restraint use can reduce crash deaths and injuries even more. Appropriate child safety seats provide significantly more protection in a crash than seat belts alone. Choose the right restraint for your child’s age and size, and always seat kids in the rear. All infants and toddlers should ride in the back seat in rear-facing seats until they reach the height or weight limit of their child restraints, which may not be until age 2 or older. Once they outgrow rear-facing restraints, children should ride in a harness-equipped forward-facing child restraint until they reach the height or weight limit of the child restraint. Top tethers should be used whenever a child restraint is installed forward-facing. When children outgrow child restraints, they should use belt-positioning booster seats until adult seat belts fit properly.
LET’S KEEP KIDS SAFE TOO
By the numbers Motor vehicle crashes remain a leading cause of death for children. A total of 845 children younger than 13 died in motor vehicle crashes in 2020; nearly three-quarters of these deaths were children riding in passenger vehicles. The number of child passenger deaths has declined by more than half since 1975. The rate of child passenger deaths per million
Transporting children safely Children are safest when they ride in the back seat in the right restraint for their age and size, until they are big enough for adult seat belts to fit properly. That means starting out in a rear-facing restraint before moving up to a forward-facing restraint and then a booster seat. Restraining children in rear seats instead of front seats reduces fatal injury risk by about three-quarters for children up to age 3, and almost half for children ages 4 to 8 (Durbin et al., 2015). In the front seat, children, particularly infants in rear-facing child restraints, may be at risk of injury or death from an inflating front airbag. Any restraint is better than none at all, but an appropriate child safety seat provides the best protection in a crash until children are large enough for adult seat belts to fit properly, usually when a child is about 4 feet 9 inches tall and 80 pounds. Appropriate child safety seats provide significantly more protection in a crash than seat belts alone. Harness-based child restraints reduce fatal injuries by 58-71 percent for infants (younger than 1) and by 54-59 percent for 1-4 year olds compared with no restraint (NHTSA, 2009). In comparison, adult seat belts reduce the risk of death in a crash among 1-4 year-olds by 36 percent. +
AND EVERYBODY HAS A STORY. WE’D LOVE TO HEAR YOURS. MEDICINE IN THE FIRST PERSON 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. Tell us if you want it “by you” or if it needs to be anonymous. Thanks!
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SEPTEMBER 16, 2022
the blog spot — posted by Ramses Perez, on April 2, 2018 (edited for space)
A SILENT MOMENT WITH A DYING PATIENT I used to work as a nurse in a medical-surgical floor a few years ago during the night shift. I met a patient who changed the way I look at and treat patients. She was in her 50s, and was just diagnosed with metastasized lung cancer that was likely terminal. She had just found out that same day, and she was flooded with a million emotions. I worked the night shift and came into the room to hand out that evening’s medications. Now that her family members left for the night and she was alone, she finally broke down in front of me and began to say everything that was on her mind. To be honest, it was emotionally difficult to be with her. Patients in the hospital often share these horrible life outcomes, and it was a true shock for me to learn about seemingly healthy individuals succumbing to rare diseases and having strokes and heart attacks at an unlikely age, many dying but many permanently disabled, a shell of who they used to be, prolonging the suffering of their family members. To survive, medical workers somehow need to be OK with these situations every single day yet feel like a normal, happy functioning person on the inside. The only way to do this is emotionally distancing yourself from patients. But this woman was different, and I will likely never forget her. She broke through all my defenses, and I found myself stopping everything I was doing in order to be in that moment with her. She reminded me of my mother; they were almost the same age. She told me about her children and how she didn’t know how they would cope with having their mother gone at such a young age. She talked about dying and how she was not afraid, that she wasn’t going to give up, and that she was going to continue fighting every day until the end. She would often laugh during her conversation, perhaps as a defense mechanism when she realized the despair was too great, and so the mind convinced her to do the opposite. She would describe the good times in her life but would suddenly be reminded of her likely fate and cry again. This happy, sad, angry cycle continued for about 30 minutes. I felt frozen. What could I possibly say to this woman that would help her? No amount of training could have prepared me to deal with this patient reaching out to me just inches away. Her sadness and complete despair radiated towards me like a heat wave on hot summer day, and I felt the deepest emptiness, like having a golf ball stuck in my stomach, unable pass through. Then, she stopped talking and looked at me, her eyes glassy and red. I suddenly became lucid and aware of everything that was going on around me. I looked around, and it was as if the room was gray. I could have sworn it had no colors. I heard my own breath deep in my ears. It was very shallow, yet low in pitch. I felt the weight of my own hands as gravity pulled down on them and my shoulders carried the weight. I heard the roughness of her breathing from her inflamed lungs and bronchus. I felt complete stillness. I couldn’t feel my heart. Was it beating? It was as if the world had suddenly stopped spinning and someone hit the pause button. The universe perfectly still. Nothing else mattered at that point. It was her and me in that room, connected by an invisible yet powerful bond between her mind and my own. The human connection. I knew then that I didn’t need to say anything. +
She had just gotten the news that day.
Ramses Perez is a medical student
From the Bookshelf This is the harrowing story, says Kirkus Reviews, of two brilliant immunologists, one Christian, one Jewish, who were separated during World War II yet found heroic ways to turn their typhus vaccine research against the Nazis. In a twist of irony not lost on the author (who also wrote, Ripe: The Search for the Perfect Tomato in 2010), the Nazis were deathly afraid of lice. The little insects were known to carry typhus, a dreadful contagious disease that could cause hallucinations, terrible headaches, raging fever, and often death. Typhus ravaged communities forced to live in subhuman conditions, including soldiers on the war front, as well as inmates in concentration camps and ghettos. It therefore became a wartime imperative to eradicate lice and the disease. In Poland, scientist Rudolf Weigl (1883-1957) and his assistant, Ludwig Fleck (1896-1961)—who would later write the seminal text The Genesis and Development of a
Scientific Fact—were both enlisted to develop a typhus vaccine: Weigl in the service of the German army and Fleck under SS guard at Buchenwald. Weigl, after all, had created the first typhus vaccine in th 1920s. The dual stories of Weigl and Fleck, beautifully told within the devastating tumult of Poland’s unfolding history, describe the war from a vivid perspective: that of the laboratory saboteur. Weigl secretly used his lab to smuggle vaccines to the Polish ghettos and recruited many intellectuals as lab workers, saving their lives. (Frequently, these respected
thinkers would be hired as louse-feeders, letting the creatures feed on their own blood—a surreal scene.) Meanwhile, Fleck’s lab was also a center of conspiracy, and his sabotage was even more dangerous and cunning: He produced a fake typhus vaccine for German troops and Nazi experimenters while sneaking real doses to desperate inmates. Both scientists risked terrible deaths to defend the idea of moral good despite the corruption, bloodshed and evil surrounding them. Allen is unflinching in his retelling of this monstrous era, but he manages to avoid writing a depressing narrative. Instead, Weigl, Fleck, and their vaccines illuminate the inherent social complexities of science and truth and reinforce the overriding good of man. An unforgettable book, concludes Kirkus. + The Fantastic Laboratory of Dr. Weigl, by Arthur Allen, 400 pages, published in 2014 by W.W. Norton & Company.
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SEPTEMBER 16, 2022
THE MYSTERY WORD
What are you reading?
by Dan Pearson
You and me both. She’s Cleaning lady? been “working from home” I didn’t know you for months now. have a cleaning lady.
It’s a note from my cleaning lady.
That’s crazy. So what does She sends me instructions on what to do. the note say?
The Mystery Word for this issue: CIEHTS
© 2022 Daniel Pearson All rights reserved.
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
ACROSS 1. Type of apple 6. Lincoln’s bucks? 10. Mountain range 14. Prince of India 15. Unlock 16. Hawaiian goose 17. Large wading bird 18. Breathe hard 19. Pre-Masters Week org. 20. Messenger 22. Large black beetle 23. Slippery fish 24. A small amount of somthing 26. Bird symbol in heraldry 28. Seasickness (French) 33. _____ scan 34. Willow genus 35. Artists’ ______ 37. Lowest pulse location 41. Tinged with a slight trace (abbrev.) 42. Might 43. Wear away 44. Tidal bore 45. Where the Wild Things ___ 46. Indian tent 47. A canon has two 49. Grating, harsh 51. Exercise regimen 55. _____ air 56. Lyric poems 57. SEC rival 59. Produces (in farming) 64. Wife of a 14-A 65. Former MCG head 67. Bay window 68. Lean 69. Hint 70. Pale green mossy lichen 71. Tune 72. Blood prefix 73. Sordid and disreputable
E X A M I N E R
We’ll announce the winner in our next issue!
4 3 8 6 8 7 4 7 1 9 7 5 6 2 9 9 8 5 4 2 6 3 1 by Daniel R. Pearson © 2022 All rights reserved.
DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.
by Daniel R. Pearson © 2022 All rights reserved.
DOWN 1. Rivalry lead-in 2. Challenge 3. Partly open 4. ________ from heaven (var. spelling) 5. Portable canvas refuge 6. Dandy 7. Apple product 8. Snake poison 9. Catch 10. Poorly or self-educated 11. Drive back 12. One could be acute or right 13. Smallest 21. Block up 25. Skin root 27. Monotonous; unvarying 28. Small particle 29. Huge continent 30. This is Life host on CNN 31. Becoming less 32. Lion sounds 36. Artist Andrew
S U 2 D 5O K U
38. Very good (in slang) 39. Capital of Yemen 40. Historical English court 48. Rescue partner 50. Mr. Rogers 51. Harbor towns 52. Northwest state 53. Russian revolutionary leader 54. One can be tipped 58. Pal 60. Scottish Gaelic 61. Type of dancing 62. Feat 63. Kill 66. Natal beginning
4 6 2 1 3 8 M P E 7O 5 T A E 96E 23 P H C 1N 9 T K 5 4 8 7 — Author unknown
U N A R H O P G E T A F L O N H T N L W N A E O T ’ A F P E H I D D H by Daniel R. Pearson © 2022 All rights reserved
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.
Solution p. 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.
O 2 3 1 1 2 3 O T 1 2 3 4 5 6 7 8 1
O 2 3
F 1 2 3 4 5
1 2 3 4
1 2 3 4 O 1 1 2 3
P 1 2 2
1 2 4
L 1 2 3 4
1 . U T T T S O O N A I W W F F G 2 . H H H H H E E E P S T A N N N 3 . R A V E E E E D O O L LT 4 . S L L O N E 5 . S N R 6 . G 7 . E 8 . R
1. ILB 2. SLO 3. VI 4. NE 5. D =
by Daniel R. Pearson © 2022 All rights reserved
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SEPTEMBER 16, 2022
THEBESTMEDICINE ha... ha...
man moved to a new town, so he found a new dentist and made an appointment. When the day came he noticed for the first time the dentist’s name from the diploma on the wall: Ferdinand Q. Slurzwinski, the very same name as a kid he went to high school with years before. “It’s got to be him,” he thought, “There can’t be two people with that name,” but when the dentist came in he changed his mind: the guy was way too old. But he asked the question anyway: “By any chance did you go to Springfield High?” “I sure did,” replied the dentist. The man was in disbelief that this geezer could have been his classmate, but despite his shock he said, “I think you were in my class.” “Really?” said the dentist. “What subject did you teach?” On the first day of school the teacher had all the children stand and introduce themselves. One boy said “My name is Abcdefghijkmnopqrstuvwxyz.” It was very hard to understand, so after asking the boy to repeat his name several times,
the teacher had him write it on the board. Abcdefghijkmnopqrstuvwxyz, he wrote. The teacher realized this was going to be an impossible situation for her and the children for the entire school year. “Do you have a nickname?” she finally asked. “Noel,” said the boy.
Moe: What do they call glass cookware in Jamaica? Joe: I give. What? Moe: Pyrex of the Caribbean. Moe: My wife and I laugh sometimes about how competitive we are. Joe: Oh yeah? Moe: Yeah. But I laugh more. Moe: My friend called me at work to tell me he’s changing his name to Spinal Column. Joe: That’s strange. What did you say? Moe: I was really busy. I told him I would call him back. Jokes that should be heard, not read: • How do you get a blind man to see? By boat. • How do you get a deaf man to hear? Just bring him over. • Why are Saturday and Sunday the best days to go to the gym? Because Monday, Tuesday, Wednesday, Thursday, and Friday are week days. • Moe: This is weird, but whenever I serve my kid alphabet soup he only eats the vowels. Joe: Why? Moe: Sometimes. +
Why subscribe to theMEDICALEXAMINER? Staring at my phone all day has certainly had no Effect on ME!
Because try as they might, no one can stare at their phone all day.
Dear Advice Doctor, I’ve always had a hard time saying no. It’s a skill I need to learn, but so far, it’s still mission impossible. Take a neighbor to a doctor appointment and wait with them for two hours when I’m already slammed? Sure. Provide snacks for the kids’ entire class? No problem. Do a co-worker’s job for them and then watch them take credit for it? Just ask. I know what I need to do. But I knew that five years ago and here I am still biting off more than I can chew almost every day. What’s the secret to making this change? — Too Agreeable Dear Too, You are certainly not the only person who grapples with this issue. We live in a fast-paced world, and many people eat on the run, in a rush, while driving, at their desk, etc. Anyone trying to eat in a hurry is at risk of biting off more than they can chew in the interests of speed. Another related problem in rush-rush eating is not chewing food adequately. Why are these matters of concern? The process of digestion is how our bodies access the nutrients in the food we eat. Shortchanging that process is like stealing from our own body and shortchanging our own health. It’s easy to forget that digestion is not something that starts after we swallow. There are chemicals and enzymes in our saliva that start the process of digesting food as we’re chewing it. What you describe is one of two ways people interrupt this important step in digestion. First, what you do: take bites that are too big. It’s almost impossible to properly chew a huge bite of food, which leads to the second issue: chewing too fast and too briefly. For many people, this is how they eat all the time, big bites or small. There are all kinds of ridiculous strategies offered as solutions, like counting how many times you chew each bite of food. Can you imagine? You can’t even have a conversation with friends or family because you’re counting your chews! A better answer is to focus on the enjoyment of eating. Slow down. Savor the flavor. Set your fork or your sandwich down after every bite. Take your time. Don’t talk on the phone or do work while eating that divides your attention. Your job for those few minutes is eating, and doing so mindfully (not mindlessly). Bon appetit! I hope this answers your question. + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.
SUBSCRIBE TO THE MEDICALEXAMINER +
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Why read the Medical Examiner: Reason #381 BEFORE READING
THE MYSTERY SOLVED The Mystery Word in our last issue was: OPTICAL ...cleverly hidden on the bench in the p. 1 ad for SCRUBS OF EVANS
THE WINNER: MALLORY STINSON! If that’s your name, congratulations! Send us your mailing address using the email address in the box on page 3. The new Mystery Word is on page 12. Start looking!
THE PUZZLE SOLVED A R C H
D A R E
A J A R
M A N A
M O T E
A S I A
L I N G
P O R T S
I D A H O
L E N I N
D E C R E A S I N G
S H E L T E R T E N T
D A M
S E A R C H
F I V E O P E N P A N T D O R D M A E R P R O W M A Y A R E S T R S H O C C Y A H N L U E E M O
R E P E T I T I O U S
U N L E T T E R E D
R E P E L
A N G L E
L E A S T
D O P E
A D E N
L E E T
E R S E
L I N E
D E E D
S L A Y
SEE PAGE 12
The Celebrated TheSUDOKUsolution MYSTERY WORD CONTEST 4 6 7 5 1 8 3 2 9
...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.
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QuotatioN QUOTATION PUZZLE SOLUTION Don’t let your fear of what could happen make nothing happen. — Author unknown
WORDS BY NUMBER The one who falls and gets up is stronger than the one who never fell. — Author unknown
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SEPTEMBER 16, 2022
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Dr. Eric Sherrell, DACM, LAC Augusta Acupuncture Clinic 4141 Columbia Road 706-888-0707 www.AcuClinicGA.com
CHIROPRACTIC Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A 706-860-4001 www.evanschiro.net
COUNSELING Resolution Counseling Professionals 3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866 www.visitrcp.com
DENTISTRY Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048
DEVELOPMENTAL PEDIATRICS Karen L. Carter, MD 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com
DRUG REHAB Steppingstones to Recovery 2610 Commons Blvd. Augusta 30909 706-733-1935
YOUR LISTING Floss ‘em or lose ‘em!
Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445
Augusta Area Healthcare Provider 4321 CSRA Boulevard Augusta 30901 706-555-1234 CALL 706.860.5455 TODAY!
EMF Safe Homes Sheila Reavill Certified Building Biology Specialist 209-625-8382 (landline) SURVEY•ASSESSMENT•REMEDIATION
IN-HOME CARE Everyday Elder Care LLC Certified Home Health/Caregiver 706-231-7001 everydayeldercare.com Zena Home Care Personal Care|Skilled Nursing|Companion 706-426-5967 www.zenahomecare.com
YOUR LISTING HERE Your Practice And up to four additional lines of your choosing and, if desired, your logo. Keep your contact information in this convenient place seen by thousands of patients every month. Call (706) 860-5455 for all the details!
LONG TERM CARE
WOODY MERRY www.woodymerry.com Long-Term Care Planning I CAN HELP! (706) 733-3190 • 733-5525 (fax)
PHARMACY Parks Pharmacy 437 Georgia Ave. ARKS N. Augusta 29841 HARMACY 803-279-7450 www.parkspharmacy.com
SLEEP MEDICINE Sleep Institute of Augusta Bashir Chaudhary, MD 3685 Wheeler Rd, Suite 101 Augusta 30909 706-868-8555
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SEPTEMBER 16, 2022
AIYAN DIABETES CENTER Diabetes Center
Diagnosed with Diabetes?
Aiyan Diabetes Center welcomes you to our comprehensive care team. Call for a same-day appointment! * ENDOCRINOLOGY * in many cases
Jamie Steinsapir, MD, PhD Endocrinology
Khalil Al Soutary, MD Endocrinology
OPHTHALMOLOGY Julian Nussbaum, MD Ophthalmology
PODIATRY, WOUND CARE Janaki Nadarajah, DPM Podiatry
LEG PAIN, VARICOSE VEINS, FIBROIDS Kaushal J. Shah, MD Vascular Surgery
Donald Brown, DO Vascular Surgery
P.A.D. Brandon Sur, MD Interventional Radiologist
462 FURYS FERRY RD • AUGUSTA 30907 (706) 868-0319 • AIYANDIABETES.COM FAX: (706) 868-3719