Medical Examiner 10-20-23

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OCTOBER 20, 2023

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

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ARE YOU A BEFORE? bonus blog spot OR AN AFTER? PINK RIBBONS AND MURDER BOOBS E — posted by Heather E. Schultz, MD, MPH, on October 5, 2021

verybody knows the old saying, smoke, drink excessively, or eat “an ounce of prevention is worth anything fried anymore, and they a pound of cure.” Maybe you even proselytize about healthy living to know the Groucho Marx version: “an anyone who will listen. ounce of prevention is worth a pound They’ve studied their affliction of bandages and adhesive tape.” like they’re cramming for med Although most of us no doubt school finals, exploring preventive agree with such wise words, it’s not measures they can still embrace, always easy to see the proof in our and various treatment options. everyday actions. Very often our As mentioned, many of us have lifestyles seem to suggest a third seen these radical transformations version: “an ounce of prevention isn’t — or maybe we were the transformnearly as fun as a pound of whatever er. Doctors see these kinds of 180s in the opposite of prevention is.” their patients all the time (although Sometimes we can get away with probably not nearly as often as they a less than salubrious lifestyle for would like). decades, but eventually all those It’s a good thing when we finally missed ounces of prevention catch up see the value of salubrious living with us, and some doctor gives us a and make important changes. It’s pound of bad news. sad when the changes come too late.

What then?

Even sadder, why can’t we do An amazing transformation often the right thing before our backs are takes place. Maybe you’ve seen this, against the wall, before years of or you were even the one who made unhealthy living have done their the change. damage, and before pounds of cure The before person gets almost no are required to undo what mere exercise, smokes, drinks too much, ounces of healthy habits could have is chronically sleep-deprived, and prevented? eats their weight in fried foods every In short, could week. more of us voluntariThe after version of the very same ly change from being person has left the dark side behind a before to an after — way behind — and without being forced almost overnight into it by dire medihas gotten hooked cal news?

That’s prevention on the left, on tofu and alfalfa If so, that would be a the cure on the right. sprouts. They don’t wonderful thing. +

I woke up this morning to a flood of ballerina pink emails for Breast Cancer Awareness Month. The irony was not lost on me as I rolled over in bed, protecting my body from the healing scars where my breasts used to be.

“I don’t even like pink,” I muttered to myself, while swallowing feelings of guilt. I shifted my mind to focus on gratitude … for awareness of breast cancer, encouragement of women to get screening mammograms, and fundraising for research. And yet, as a 41-year-old physician, I am often struck by how little I knew about breast cancer until my own boob tried to murder me.

Sure, I understood the importance of screening mammograms and breast self-exams. But I also knew that I, a Peloton-addicted vegetarian who had breastfed three children, must be immune from breast cancer. In medicine, we often think in terms of risk and family history, and there just weren’t boxes to check that would have prepared me for what was to come.

First, there was the unexplained nipple discharge a few days after I turned 41. I tried not to panic, but I also knew I needed answers quickly. Four days later, at my first mammogram, I was haunted by the cold machine that took images for hours. I still shiver thinking about how vulnerable and frightened I felt. My radiology report included a new term to me: “BI-RADS 5,” which a few Google searches revealed meant “definitely cancer.”

When I was diagnosed with breast cancer, it felt as though everything I knew was turned on its head. My perceived perception of perfect health vanished in an instant. After my biopsy, I stuffed an ice pack in my bra and went back to work, seeing patients. Maybe if I continued as if everything were the same, it would be. But alas, the cancer was all too real, and the old healthy me was seemingly gone in an instant.

I remember being so confused when friends called me a “warrior” and told me to “kick cancer’s ass.” I knew they loved me and were being

My own boob tried to murder me.

Please see PINK RIBBONS page 5

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AUGUSTAMEDICALEXAMiNER

OCTOBER 20, 2023

THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

MEDICAL MYTHOLOGY

PARENTHOOD

by David W. Proefrock, PhD

With three children, mealtimes are often chaotic at your house. The kids don’t all want to eat the same foods, or at the same times. You are concerned that they have nutritious meals, and that mealtimes are more enjoyable for everyone.

What do you do?

A. Left to their own, children will eventually select a balanced diet. There is no need to fight. Let them eat what they want and when they want. Stop worrying about it.

B. Keep preparing good meals, but don’t expect them to eat all that you prepare. If they don’t like what you serve, make it their responsibility to prepare their own meal.

C. Force them to clean their plates before they are allowed to leave the table. If that means they sit at the table until they go to bed, that is what will have to happen.

D. Serve small portions of foods that are good for them and that at least a couple of them like. Don’t allow snacks before dinner, and make snacks after dinner dependent upon eating most of their food.

If you answered: A. Children should not be allowed to choose their own meals on a regular basis. Occasionally it is fine, but it is not true that over time they will eat a balanced diet. It is better to prepare small portions of a variety of foods they like.

B. If you thought that mealtimes now are chaos, this would be far worse. Mealtimes should be an opportunity for families to share both food and companionship.

C. Almost every meal would end up pitched battle if you did this. Everyone, including you, would be miserable.

D. In most cases, this is the thing to do. It depends on what you are willing to tolerate. In general, small portions of good foods are a good idea, but it is never a good idea to force children to eat foods that you know they don’t like.

Mealtimes are a common area of conflict in families. They should be a time of togetherness. Plan a meal that works for the family with a minimum of punishments and conflicts. + Dr. Proefrock is a retired local clinical and forensic child psychologist.

FIST BUMPS ARE SAFER The COVID-19 pandemic gave everyone around the world a lesson in how disease is spread. Although not every suspicion ended up being verified by the facts, it was sometimes a little disconcerting to reflect on how close proximity to others — sometimes thousands of us in one place, all breathing the same air and using the same handrails — has the potential for spreading disease.

One of the first COVID casualties was the venerable handshake, a centuries-old gesture of friendship, goodwill and trust that overnight became synonymous with danger and disease. You don’t know where that hand has been!

Now that COVID has made the transition from marauding invader to over-staying houseguest, are handshakes still a bad idea?

That very question was recently tackled by the American Council on Science and Health ACSH), and they gave the subject a thorough examination.

The practice has an interesting history. Ancient Greeks used handshakes to check for concealed weapons, according to The Atlantic. Thomas Jefferson was an early proponent of handshaking as a more informal method of greeting that the arisocratic bows and curtsies of British high society.

More recently, says ACSH, the practice took a hit during the Spanish flu pandemic in 1918, but bounced back when the outbreak subsided.

Will the same thing happen after “our” pandemic? Many public health experts believe it will. Even during the pandemic,

the well-respected Cleveland Clinc stated in June of 2021 that handshakes were safe for those comfortable with the practice — but only if they had been vaccinated.

More recently, the fist bump has come into popularity as a safer alternativer to shaking hands: there is less skin contact, so logic seems to support that view.

Logic, however, isn’t always synonymous with fact. ACSH reports on a small clinical study in which the 50 participants donned sterile latex gloves that were then deliberately contaminated with bacteria (MRSA).

They then greeted researchers in one of 4 ways:

• a handshake • a handshake after using an alcohol-based hand sanitizing gel • a standard fist bump • a so-called “cruise tap,” which is a single-knuckle to single-knuckle bump Measurements were taken to determine the amount of bacterial transfer each method of greeting caused.

Although the handshake was the dubious winner, resulting in the largest transfer levels, fistbumps were not far behind.

The numbers were 16% for fistbumps and 22% for handshakes, a finding researchers described as insignificant. The cruise tap came next at 8%, and the safest greeting (6%) was a handshake after using hand sanitizer.

The study included a second component: participants used a virus-contaminated keyboard and mouse, then followed that up with either a cruise tap, fist bump, or handshake.

As before, the handshake transferred the highest amount of bacteria (the study defined it was 91%), but fist bumps were not a ton better at 59%.

Of course, COVID was and is a respiratory virus, meaning that the primary source of transmission is breathing in air that contains the virus courtesy of a nearby cougher or sneezer.

If the virus is on a surface, it still has to somehow make its way into the body’s respiratory system. “Although not impossible,” says ASCH, “it is more difficult for many viruses, including COVID-19, to spread in this manner [from surfaces].”

The bottom line? Since COVID is spread through the air, “a brief greeting such as a handshake is unlikely to transmit the disease,” says ACSH. Fist bumps transfer slightly fewer germs, but “the difference is marginal.”

The best advice: wash hands regularly and use hand sanitizer. +

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AUGUSTAMEDICALEXAMiNER

OCTOBER 20, 2023

o

Celebrate Creative Writing

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Augusta University Department of English and World Languages Creative Writing Program

THURSDAY, OCTOBER 19, 2:30 PM

WHY CAN’T I EAT BEFORE MY MEDICAL PROCEDURE?

Reese Library, Reese Room 2nd floor Poetry Reading Featuring Dr. Karen Head, Associate Provost for Faculty Affairs and Professor of English

WEDNESDAY, OCTOBER 25, 4:30 PM

University Hall 170 Creative Writing Faculty Reading from their Work Featuring Latria Graham, Daphne Maysonet, and Paul Sladky Refreshments will be served

SATURDAY, NOVEMBER 4, 6-9 PM Humanitree House (Downtown Augusta) Sand Hills New Issue Release Readings from the 47th Edition Open-mic Silent Auction Fundraiser

ALL EVENTS ARE FREE AND OPEN TO THE GENERAL PUBLIC

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WE’LL GUIDE YOU TO MAXIMUM MEDICARE BENEFITS

There are a number of reasons, but the top one might be that you want to survive the procedure. Yes, it’s that important.

Generally speaking, the “nothing by mouth” order comes into play when a patient will be sedated or under general anesthesia. In such conditions, it’s possible that stomach contents can be aspirated. What does that exactly mean?

Well, it isn’t a pretty picture. It means that while unconscious, a person may become nauseated and vomit.

That’s no fun even when we’re awake, but under anesthesia it can be an absolute nightmare. It’s possible, even likely, that some of the vomit can be inhaled (or aspirated) into the lungs. Even if that happens during surgery and doctors can immediately apply suction, there is a significant risk for lung damage and infection. Heartburn is a reminder of the caustic nature of stomach acids. Imagine the damage they can cause to delicate lung tissue. Partially digested foods have no business in the lungs, and a common result of aspiration is infections, and they can be very serious, even fatal.

There are countless cases in medical literature involving patients who lied to their doctor prior to surgery (“Nope, I haven’t eaten since last night”) who ended up paying a very high price: days or weeks on a ventilator, and sometimes death. Anyone playing that game is pulling a fast one on himself.

Granted, it’s possible that a person could sail through an operation with flying colors despite ignoring doctor’s orders on NPO (from the Latin, nil per os, literally “nothing by mouth”).

The instructions are a precaution, but they do add one more level of safety and remove one more source of potential risk.

Some people counter, accurately, that victims of car accidents, gunshots and stabbings, etc., are operated on without having to go NPO for 8 hours prior to surgery. Trauma surgeons are aware of this and take action accordingly.

The bottom line: not eating before a procedure helps doctors focus on the job at hand, not an unexpected complication of your doing. It helps you get well faster. +

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AUGUSTAMEDICALEXAMiNER

OCTOBER 20, 2023

Who is this? THECWORD

#199 IN A SERIES

W

atch Investigation Discovery channel much? Then this guy is practically your patron saint, even though you have no idea who he is.

But since you’re taking the time to read this column we’ll tell you: that’s Alec Jeffreys, a British geneticist who had what he calls a “eureka moment” in his laboratr’y back in 1984.

It was September 10, to be exact, an ordinary day — until using X-ray imaging Jeffreys noticed differences in the DNA of various members of his lab technician’s family. They had all volunteered samples in the interests of science at a time when DNA studies were in their infancy.

But on September 10, 1984, those studies went from infancy into teenagerhood, maybe beyond. Within a mere 30 minutes of noticing differences from one family member to another, Jeffreys’ eureka moment was realizing that virtually every person on earth had a unique DNA fingerprint.

The discovery was put to the test almost immediately, when just a few months later DNA was used to establish a young boy’s blood relationship to an immigrant family, settling a question that had no answer until Jeffreys came along. As the only lab in the world that performed DNA fingerprinting, Jeffreys stayed very busy with inquiries from across the globe.

He was very soon after in the center (or centre if you prefer) of a case that established DNA fingerprinting as we know it most often today.

Two teenage girls were raped and murdered near his lab, and a local teenager named Richard Buckland was suspected and brought in for questioning. Buckland made statements about the second of the two murders that police thought would only be known by the killer. Under more intense questioning, Buckland, described as having “learning difficulties,” confessed to the second murder.

Jeffreys was brought in by the prosecution to conclusively prove Buckland’s guilt by Colin Pitchfork comparing blood samples from him to semen samples taken from the victims. The results established that both girls were killed by the same man, but conclusively proved that man could not have been Buckland. The case was over, but only temporarily.

More than 5,500 men in and around the village of Leicestershire where the crimes took place were asked to provide blood or saliva samples. The 6-month project yielded zero matches.

But a year later, a bakery employee told a couple of his coworkers that he provided a sample for the investigation to police under the name of another bakery employee, Colin Pitchfork. One of those coworkers notified police, and Pitchfork was questioned and subsequently arrested. DNA evidence proved his guilt conclusively.

Jeffreys later said, “I have no doubt whatsoever that he [Buckland] would have been found guilty had it not been for DNA evidence.”

Aside from Jeffreys’ scientific papers, the breakthrough case of the correctly solved murders can be read in Joseph Wambaugh’s 1989 best-seller The Blooding: The True Story of the Narborough Village Murders.

The next time you hear of someone exonerated or convicted of a crime based on DNA evidence, think of Sir Alec Jeffreys. +

The American Cancer Society (ACS) estimates that 1 in 8 women will be diagnosed with breast cancer in their lifetime. For women in the U.S., breast cancer is the second most common cancer and the second most common cause of cancer death.1 Survival rates for breast cancer have been improving since the late 1980s, but since the early 2000s incidence rates (new cases) have also increased by 0.5% every year.1 There is no proven way to prevent breast cancer, but research shows you can take action to lower your risk.

harm.10 For people in active treatment, talk with your cancer care team before you start a new routine to find a plan that works for you.

The Bottom Line Physical activity can reduce your risk for developing breast cancer and can help survivors enjoy a higher quality of life both during and after treatment. Follow the HHS guidelines for physical activity to see the greatest health benefits. There are so many ways to be active.

What’s your move?

Lower Your Risk and Improve Survivorship with Physical Activity “The C Word” is a news brief of the Georgia Physical activity is one way you can lowCancer Center at Augusta University. For caner your risk for breast cancer.2,3 It’s not only cer information, visit: beneficial to people who have never had augusta.edu/cancer/community.To request cancer, however; it benefits survivors as well. exhibits or speaking engagements, contact Research shows when breast cancer survivors Maryclaire Regan at mregan@augusta.edu or are physically active during treatment, they 706-721-4539. Virtual arrangements can also be can experience reduced famade. tigue,4 depression,5 and anxSources: iety,5 and improved sleep.6 1. https://www.cancer.org/cancer/ The latest research on this types/breast-cancer/about/howtopic explores how physical common-is-breast-cancer.html activity before, during, and 2. Pizot C, Boniol M, Mullie P, et al. after treatment affects longPhysical activity, hormone replaceterm survivorship. A study ment therapy and breast cancer risk: A meta-analysis of prospective of high-risk breast cancer studies. European Journal of Canpatients found that those cer 2016; 52:138-154. who met the minimum 3. Hardefeldt PJ, Penninkilampi R, guidelines before diagnosis Edirimanne S, Eslick GD. Physical and after treatment had activity and weight loss reduce the lower rates of cancer recurrisk of breast cancer: A meta-analyaugusta.edu/cancer/community rence and improved rates of sis of 139 prospective and retrospective studies. Clinical Breast survival.7 Physical Activity Guidelines The same physical activity guidelines created by the U.S. Department of Health and Human Services (HHS) for the public are promoted by the ACS for all cancer survivors who can meet them.8,9 This graphic (left) suggests recommended practices. The HHS and ACS recommend dividing physical activity across the week.8,9 If you prefer moderate intensity activities, one option is to move your way for 30 minutes 5 days a week for a total of 150 minutes (2.5 hours). “Moderate intensity” activities include exercise like brisk walking (2.5-4mph), playing doubles tennis, and fast dancing, or chores like raking the yard.8 “Vigorous-intensity” activities include exercise like jogging, running, and joining a tough fitness class, or chores like carrying heavy loads up the stairs and shoveling snow.8 When breast cancer survivors cannot meet these guidelines, the HHS and ACS recommend being as active as you can.8,9 Cancer treatments can feel exhausting, but for most survivors the effort is worth the benefit, and evidence suggests there is a low risk for

Cancer 2018; 18(4):e601-e612.

4. Ehlers DK, DuBois K, Salerno EA. The effects of exercise on cancer-related fatigue in breast cancer patients during primary treatment: A meta-analysis and systematic review. Expert Review of Anticancer Therapy 2020; 20:865-877.

5. Singh B, Spence RR, Steele ML, et al. A systematic review and meta-analysis of the safety, feasibility, and effect of exercise in women with stage II+ breast cancer. Archives of Physical Medicine and Rehabilitation 2018; 99:2621-2636.

6. Kreutz C, Schmidt ME, Steindorf K. Effects of physical and mind-body exercise on sleep problems during and after breast cancer treatment: A systematic review and meta-analysis. Breast Cancer Research and Treatment 2019; 176:1-15.

7. Cannioto RA, Hutson A, Dighe S, et al. Physical Activity Before, During, and After Chemotherapy for High-Risk Breast Cancer: Relationships With Survival.

Journal of the National Cancer Institute 2021;113(1):54-63.

8. U.S. Department of Health and Human Services.

(2018). Physical Activity Guidelines for Americans, 2nd edition. Retrieved from https://health.gov/paguidelines/secondedition/ pdf/Physical_Activity_Guidelines_2nd_edition.pdf 9. https://www.cancer.org/cancer/types/breast-cancer/ risk-and-prevention/can-i-lower-my-risk.html 10. https://ascopubs.org/doi/full/10.1200/ JCO.22.00687 +

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OCTOBER 20, 2023

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age

BY J.B. COLLUM

into the equation, so I have learned to stifle myself when I notice something that could be improved. I now just tightly grip my jaw shut while I stare, count to 10 and then bring up another subject. That’s a good skill to learn when you will be around someone more than you are used to. Of course, we are only getting a preview because I do still spend most of my day away from her in my office down the hall, and she also works away from home two days a week. The challenge will be much more difficult when it becomes a 24/7/365 situation. Maybe I’ll take up fishing again.

Lorie and I do get along well though, and if you ask her, it is because she puts up with me and mostly ignores me. Simultaneously she says that I never listen to her, but I can’t help it that I have that male affliction that filters out the female portion of the sound spectrum. I learned it at a very impressionable age when I used to spend the night at my grandmother’s house and she, her sister, and their mother would constantly chatter while I tried to watch Saturday morning cartoons. My brain instinctually constructed a virtual notch filter that has stayed with me down to this day. Then it was reinforced when I listened to my mother fussing at my father and saw how it didn’t faze him. He didn’t get angry.

He didn’t even actually respond except to just say that he was sorry. Sometimes (rarely) mom would say something to him that didn’t call for an apology, so when he inevitably said he was sorry anyway, she then knew he wasn’t listening. So then he got to apologize again for not listening.

My father’s ability to let most anything slide off his back, like water off a duck, is something I have always admired and tried to imitate, though I usually fail. But I am certain that this is a skill that will help during retirement, so I am determined to do better. My wife is doing her part to help by giving me lots of opportunities to practice. On the off chance she reads this, I will say I am blessed to have her, as tolerant as she is of my unusual personality and deficiencies. She does complete me, like how an anchor completes a boat. I better clarify. I am the anchor. She is the boat.

Until next time, go take a look at how well you are set for retirement, health wise, financially, emotionally, and in regard to your relationships — both your spouse and the kid you may have to move in with. +

{

One aspect of middle age that I both look forward to and dread is retirement. We’ve done the math and figured out that we can both retire to a very comfortable lifestyle when I’m only 98. That didn’t seem accurate, so we ran the numbers again and came up with 99. Then we started lowering our expectations and determined that we can retire when I’m 67, as long as at least one of our kids is very successful and doesn’t mind taking us in and as long as we are healthy along the way to that age and as long as I keep getting raises and keep my job and if neither of us buys another car or any other major purchase.

So, no problem, right? I know. It doesn’t sound promising, but I’ll treat it like my honey-do list. If I ignore it, it won’t bother me until it has to. In the meantime, I will live in blissful ignorance. I’m pretty good at that.

Of course, finances aren’t the only thing we should be concerned with in planning retirement. I mentioned health earlier, and this is another major concern because you want to arrive at retirement day with the ability to enjoy your free time for as long as possible.

To do that, we need to start as early as possible because the earlier you start a healthy lifestyle, the less damage you will have to overcome and the easier it will be. Trust me on that. I know how hard it is. I have chronicled how NOT to do that in these articles for the past five years, though I am trying to do better now and have adjusted my diet and increased my exercise. Although I’ve seen some improvement, it has been difficult.

Another concern is mental health, as in whether you will get along with your spouse when you’re spending so much more time together than you are used to. Since I have been working from home now for over three years, I feel like we have a preview of how it will be, and I think it has gone swimmingly.

When I had to get up and go to work each day, I couldn’t be there to watch how my wife manages the processes she uses to clean the house and cook our food. Now that I have the time, I am helping out by pointing out the inefficiencies of her methods. My fulltime job revolves around finding better, more efficient ways to do things. So I have used that skill at home to help out. I watch her and take notes and then point out to her how she could move things around in the kitchen or change the order of things to save time and effort. I also look up and research labor-saving gadgets for the kitchen.

This next part may surprise you though.

It turns out that people don’t like someone with less experience than them in a given discipline coming in and telling them they are doing it wrong. Who knew? I was just trying to help, but apparently that doesn’t factor

{

AFTER CRUNCHING THE NUMBERS, I CAN RETIRE WHEN I’M 99.

J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. He may be reached at johnbcollum@gmail.co

PINK RIBBONS… from page 1 encouraging. But I was very scared and certainly had no clue how to become a warrior. I just felt immense pressure as my calendar was quickly filling up with medical appointments and heavy decisions. After my biopsy, there was genetic counseling, meetings with breast and plastic surgeons, and the decision to have a bilateral mastectomy followed by reconstruction. “Your new boobs will be even more amazing,” friends said. When they ask if I’m happy with the results, I’m not sure how to tell them that my numb chest now feels like someone else’s body.

Early detection absolutely saves lives. For me, it also led to a summer of chemotherapy (not fun), monthly injections to suppress my ovaries (hello, instant menopause), and daily medications to prevent the cancer from recurring (also not fun). I can’t wear a pink tutu and proudly announce that I beat cancer, because the truth is more complex and somewhat gritty. I will be fighting for years to come and hoping that the scary dark shadow of cancer recurrence isn’t lurking over my shoulder.

This month, I will celebrate the lives of breast cancer survivors like myself. But instead of tying up their narrative with a pink bow, I acknowledge the complex tapestry of ups and downs that accompany cancer treatment.

And if I must wear a tutu, please make mine black. + — Heather E. Schultz is a psychiatrist.

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AUGUSTAMEDICALEXAMiNER

OCTOBER 20, 2023

BUTCH, THE WILD CAT CHUNKER Butch had a good run at life, even if sometimes he was a half bubble off center.

He grew up in the flatwoods just off the Okefenokee Swamp at the end of deadend dirt road.

His uncle was a World War II veteran and later a US Congressman. His mother, Sarah, had a few loose wires. Fearing being forever stuck with tobacco tar on her hands and an overtanned neck secondary to too many hours in the field, Sarah took a trade school hair dressing course, bought a couple hair dryers, assorted chairs, and a few mirrors.

Nobody had ever heard of a beauty shop in a tobacco warehouse with unpainted walls, board floors, and no windows. Ventilation was provided by God whenever He made the wind blow at the right angle. No appointments necessary. Saturdays only. Cash on the barrel

BASED ON A TRUE STORY (most of the time) A series by Bad Billy Laveau

head. No cussin’ allowed.

Butch’s father, Frank, shook his head and said, “Sarah, since I married you, life certainly has not been dull.”

The shop kept Sarah out of the fields for years.

When Butch was 4 years old, Sarah and Frank brought him to meet me and my brother. By coincidence, a strange cat had just taken up residence at our home.

My father warned Butch and his parents that the cat wasn’t fully tamed and might scratch if touched.

Momentarily, Butch grabbed the cat by the tail and swung the cat around his

head like a circus merry-goround. The cat went flying 20 feet through the air, hit the ground in high gear, and shot into the woods. The cat wasn’t seen again for half a week. Even then, the cat was not in a happy mood.

When in the first grade, Butch began pinching girl’s boobs on the bus. Then for some weird reason, Butch got at the back of the bus and licked a clean streak down the aisle all the way to the front steps. Girls recoiled in disgust. Boys laughed and pointed in amazement. The bus driver was perplexed when he saw Butch’s dirtblack tongue, but he wisely decided to not report the incident to Sarah. No telling what she might do. Butch did not die and is probably immune to thousands of unknown germs.

Butch’s future could have been in question. He could have joined Clyde Beatty as

a lion tamer in old Hollywood movies, but he didn’t.

Same thing with Sigfried and Roy in Las Vegas. Or an alligator wrestler in an old roadside zoo in Florida.

When Frank and Sarah died, Butch did nothing bad or totally crazy. He took over the family chicken farm operation. It was a 7-day-per week job required skill and knowledge. Picking up dead chickens and incinerated them according to Government regulation was not his strong suit.

About once a month, Butch deemed it time for recreation and escape.

Butch went to the County Line Beer Joint, is a mild-mannered local gunand-knife club. You were patted down for a gun or knife, and if you did not have one, they gave you one so you would have a fair chance when THE FIGHT broke out. (Not really, but

you get the idea.) Butch drank beer and argued until someone beat his butt in good fashion and sent him home to heal. Butch never seemed to win, but it did not hinder his monthly adventures.

A rough and ready woman finally took up with Butch and they had a couple kids. His sons took on chicken farming, but not fisticuffs. Barroom fights don’t inflate your bank account.

Eventually, Father Time tracked down Butch and burdened him with heart disease. He had never smoked or done drugs.

Recently he lost the heart disease battle much as he lost fights at the County Line Beer Joint.

I shall miss Butch. One never knows when one might need a wild cat chunker. Or a chicken farmer consultant. +

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not interrupt the habitual, compulsive intake of vodka and wine. She had completed multiple treatment and detox programs, but didn’t want to stay in the hospital. Her medical doctor was evidently not acquainted with the ASAM tool, and as a result gave her a prescription for 30 Librium tablets to take as instructed over a period of a week and sent her home.

Now, for just a moment, think like an alcoholic. These pills were benzodiazepines that go straight to the GABA (gamma-aminobutyric acid, if you must know) receptors in the brain. Benzos and alcohol are basically the same thing to the brain, which can make benzodiazepines a good fit for withdrawals if — a very big if — monitored medically. Some people, usually with support at home, can be compliant with such a routine, but not this woman who had suffered the ravages of alcoholism for a lifetime.

She didn’t show up to work or AA meetings for two days, and when officers made a wellness check at her home she was found dead on the kitchen floor, having taken the whole bottle of pills within two days and had consumed vodka on top of the pills! I know, I know…had the doctor only known about the ASAM Criteria...

When an addiction professional, underscore professional, makes an informed recommendation, he or she is really not kidding. For your own good, it’s what you really need. +

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treatment. 450 pages is a lot, I know, so I have a challenge to present this material to you in simple and abbreviated terms.

Why bother? Because daily I hear, “Treatment Center X won’t take me!” or “They kicked me out of the hospital just when I was beginning to get better.” You should know and understand how this all works. It will decrease your anxiety and frustration when you’re up against the Big Bad Wolf of Insurance Re-Imbursement, at least. And at best, it will help you find and accept treatment/counseling for addictive disorders.

The first “ASAM Dimension,” or criteria for admission addresses your Intoxication/Withdrawal Potential.

I’ve referred a number of people to hospital-based inpatient treatment, and after a brief assessment in the emergency room they were sent home and told to enroll in an intensive outpatient treatment program. Why? Because they didn’t meet the criteria for admission to inpatient detox!

Meaning, it had been 3-4 days since their last drink and they were “out of the woods” as far as needing medical detox – no DTs (look that up!) for them! Or they tried to get inpatient detox for opiate use.

Not! I know of no insurance company who will authorize inpatient admission for opiate withdrawals only. Why not?

It’s not life threatening. You won’t die from opiate withdrawals…you’ll only want to, but only for a minute!

Story time. Years ago I know of a female in her 40s who sought outpatient ambulatory detox at home.

This woman needed inpatient detox since she could

n Joi

SO...

COMB HAIR OFTEN?

I’m often amused by guys needing treatment who come to see me with their own pre-planned outcome in mind and who want me to sign on to their plan instead of hearing my recommendation because they just don’t want to hear it.

Recently I’ve heard: • “I want help to stop drinking, but I’m gonna keep smoking weed.”

• “I won’t go to inpatient treatment but I’ll come to your outpatient program.”

• “You just want to make money off me, so I’m not gonna do treatment.”

• “I refuse to go to a halfway house, but I’ll do treatment again.”

Sometimes I think people think that we addiction counselors make recommendations on a pull-a-planout-of-a-hat approach, or we choose a plan because we personally like or dislike them. Much to the contrary, there is a patient placement “bible” that licensed/certified counselors use to make such recommendations. It’s called the American Society of Addiction Medicine Patient Placement Criteria (ASAM for short), and it’s a 450-page book guide to admission, continued stay, and discharge criteria for all levels of addiction counseling and

OCTOBER 20, 2023

SHORTSTORIES

AS A NURSE, HAS A PATIENT EVER TOTALLY DISGUSTED YOU? As a nurse, you always try to remain neutral to difficult people, choosing to treat them compassionately, maybe listen to their story if you have time, and try to get them back on their feet. But despite my training and temperament there is one guy I particularly remember from my ER trauma nursing days who made my blood boil.

I was working a late shift on a Friday night and a guy was brought in by ambulance who had been involved in a serious car crash. He was driving home from work after a long day when a drunk driver lost control of his vehicle, cut across a traffic lane and slammed into the side of his van, tipping it over on its side, where it skidded until it hit a guardrail. The poor guy was trapped in the van for 40 minutes, and when he was finally brought in he had arm and chest trauma and a suspected broken neck. He was strapped to a backboard and was literally fighting for his life.

Then a second patient was wheeled in with a shoulder injury and a facial abrasion. Not being in any imminent danger, he was brought into the minor injuries area where I happened to be working. He was rude, aggressive, and under the influence of drugs and alcohol, complaining that he wasn’t being dealt with quickly enough. In fact, he was the drunk who had caused the terrible accident through which another man was now fighting for his life and facing a life of paralysis, possibly even death.

The drunk guy was getting louder and louder, shouting and swearing to be tended to. Sitting opposite him was an older man with demetia who had taken a fall and was waiting to be checked over too, but all the doctors were busy attending to the traffic victim in majors, who they now found was bleeding inside his chest.

The aggressive drunk continued his barrage of abuse and on seeing me attend to the old man opposite, screamed out, “Just put a pillow over his face, it’s disgusting!”

Boy, that pissed me off. It was the last straw and I couldn’t stop myself. I walked over to him, bent down and spoke quietly into his ear: “Sir, I’ll tell you what is disgusting. You drove tonight knowing you were drunk and under the influence of drugs and you have destroyed another man’s life, a man who had done a hard days work and just wanted to go home to his family and is now in the next room fighting for his life…Sir, you are disgusting!” +

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CRASH

COURSE

More Americans have died on US roads since 2006 than in World Wars I & II combined

P

bills. You too may be out of work for awhile.

You’re going to have to pay an attorney, and your auto insurance is going to skyrocket — and it won’t be coming down anytime soon.

One other possibility that unfortunately can’t be ruled out: what happens if the collision caused by your tailgating results in a fatality? Maybe multiple fatalities? Take everything already mentioned and add the word “prison” to it.

Admittedly, this peek into the world of tailgating portrays a worst-case scenario. But even this very dire picture is not even slightly unrealistic. These kinds of worst-case situations happen every day of the week.

Considering the specific parameters of this series — driving habits that people hate — it’s no stretch to think that someone being tailgated would react angrily, perhaps slamming on their brakes.

Are you going to run up on the bumper of a complete stranger and trust that they won’t do something that starts a terrible chain reaction of events?

If you answered no, we’ve done our job.

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TEN THINGS I HATE ABOUT YOU Part 3

5. How many total strangers do you trust?

(See the Sept. 15 and Oct. 6 Medical Examiners for numbers 1 through 4) We don’t mean just trust a little. We mean what complete stranger would you trust with your life, your family’s life, and all the money in your pocket and in your bank account and maybe all the money that you’ll make in the next year?

You say you don’t even trust your closest lifelong friends that much?

Well then wait a minute. Wasn’t that you driving down the highway the other day going probably 75 mph not 6 feet from another car’s back bumper? Onlookers probably thought you were being towed by the first car.

The crazy thing about it was there were no vehicles in the right lane. As the front car kept speeding up — probably to try to get away from you — you kept speeding up too, staying on his bumper when you could have easily gone around.

Whatever the reason for tailgating was, it wasn’t good enough. Any car tailgating that closely had better have a blue light going and a siren blaring.

Since that didn’t apply to your car — or 98% of the other vehicles on the road in the act of tailgating — the only assumption a bystander can make is that you are one of those ultra-decent people who believes the best about everyone. After all, the lead car only needs to stop quickly for any real or alleged reason, and you’re toast, legally and financially.

You will be on the hook for the repairs to the other guy’s vehicle and all of his medical and rehab expenses. If he ends up being out of work for awhile, his lawyer will be suing you for his lost wages (which might be temporary or might be permanent), plus whatever else he can throw in, from pain and suffering to the kitchen sink.

By the way, don’t forget to add the costs to repair your vehicle if a collision results from your tailgating. You also may have extensive medical

6. The road is not your personal property Do you ever notice how many drivers are literally unyielding? And in case we haven’t noticed, that very word —YIELD — is emblazoned on many a traffic sign, and they’re all yellow, signifying that they are cautionary alerts.

Of course, yielding works both ways. Yielding is for everyone.

To illustrate, someone coming down the ramp off Walton Way Ext. onto eastbound I-20 is supposed to merge politely (that’s the best word for it) into the flow of interstate traffic. One doesn’t come barreling down the ramp expecting other cars to get out of the way. Safe driving means merging in a way that doesn’t cut off or endanger other drivers.

The other side of that same coin, however, is reserved for vehicles on the main road. Have you ever attempted to merge and there’s a car that’s directly in your way? You’re going to have to either floor it or brake hard to complete your merge. If we use our Walton Way Ext ramp as an example again, after you manage to merge you notice 4 lanes to the other driver’s left without a single car nearby. They could have easily moved over to - politely - allow you to merge. Are they daydreaming? On their phone? Just rude?

Who knows! But getting bent out of shape + over it, tempting though it may be, is a waste.

In part 4: More sources of highway hatred.

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erhaps you missed the first two installments of this series. If so, our general premise is that bad driving annoys other drivers, and annoyed drivers become bad drivers. We are not here to excuse the reactionary drivers and lay all of the blame on the triggering drivers. No, they are both to blame, the first for their initial offense and the second for being too immature to just be an adult and drive on.

Even so, the fact remains that doing something that makes other drivers’ blood boil (rightly or wrongly) has to count for something bad. Those actions should be avoided. For instance:

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the blog spot — posted by Roxanne B. Sukol, MD on Oct. 13, 2023 (edited for space)

FRUIT & SUGAR: DEBUNKING THE MYTHS Many patients have asked me if it’s OK to eat fruit.

They’re worried about eating foods high in sugar. Is fruit in that category? No, it is not. Does anyone really believe that fruit is what’s causing the paired epidemics of diabetes and obesity? This scourge is not being caused by fruit.

Let’s think about this. As long as the sugar in the food you choose to eat is encased within a fiber matrix (as is the case with fruit), you can feel free to eat it. As long as your doctor hasn’t diagnosed you with a significant blood sugar problem (like uncontrolled diabetes), fruit is, generally speaking, a good choice. Even if you are diabetic, there are only a few whole fruits — mainly tropical fruits like mango and pineapple — that are likely to spike your blood sugar.

I’d like to share a personal story that dates all the way back to 2002, the year I decided that the time had come to stop eating commercially produced baked goods. This huge category in the American diet includes most of the bread, crackers, bagels, muffins, waffles, pancakes, breakfast cereals, biscuits, cakes, and cookies in supermarkets, restaurants, hotel breakfast bars, and corner grocery stores.

Virtually all of these products are made with corn syrup, sugar, and stripped carbs like white flour. Stripped carbs are nutritionally bankrupt, and the widespread malnutrition they cause had everything to do with why the government passed legislation requiring that white flour be enriched.

Whole-grain wheat does not require enrichment because it has not been stripped of its nutrients in the first place.

Before 2002 I ate gobs of white flour and other stripped carbs. When I stopped, I was pretty hungry. That’s because at first I didn’t know what to substitute. I looked in my cabinets and found something that might work: dried fruit.

Raisins, apricots, prunes, dried apples. There were plenty to choose from. I brought some to work for a mid-afternoon snack. The dried fruit was pretty good, satisfying and filling, and it did the trick. The afternoon went by more easily, and I no longer arrived home famished and exhausted.

Sometimes, usually because I had run out of dried fruit, I ran across the street to an ice cream shop across from my office for a vanilla milkshake. That’s because I still really had no idea what to eat.

Here is an important take-home message: Even though my intake of dried fruit increased markedly, and despite an occasional milkshake, the weight fell off me, and the inches disappeared. Within just a few weeks, my clothes fit a lot better. That weight never came back; of course, you can believe me when I say I never missed it.

All these years later, now I might eat apple slices, sometimes with a spoonful of peanut butter; cucumber slices dipped in hummus with olive oil; oatmeal with raisins; or a handful of nuts. But in those days, I wasn’t sure what to choose if not those “cheezy crackers” or “sunny chipz” that beckoned from the vending machine down the hall.

This experience opened my eyes big time: We were, and still are, all operating under a number of significant and fundamental misconceptions. Here I was eating dried fruit, which I had learned to avoid due to its supposedly high sugar content, and the weight was falling off. I stopped advising my patients to avoid dried fruit.

So yes, you should feel free to eat fruit. Fresh, frozen, or dried with, if you’re wondering, little or no added sugar. +

POUNDS DISAPPEARED I DID NOT MISS THEM

Roxanne Sukol is an internal medicine physician

11 +

AUGUSTAMEDICALEXAMiNER

The

Money Doctor ESTATE PLANNING: IS YOUR PLAN COMPREHENSIVE? Estate planning or planning for death is not something that people like to think about.

It is understandable why 55% of adults do not have a last will and testament in place.

Along with the psychological barrier of the topic, estate planning can be confusing and hard to understand which is why talking to an attorney that practices estate law in your state can help you navigate the process. Your financial advisor can also help coordinate with your estate planning attorney to ensure many of the moving pieces are put in place.

In general, spending a little extra money with a competent attorney is well worth the cost to help you avoid major mistakes or family conflicts down the road.

Many people do not realize that a significant number of your assets may not pass through your will. You may hear the terms “probate assets”, meaning they pass through your will, and the term “non-probate assets”, meaning they pass to your beneficiaries by other means. A few examples are retirement accounts and life insurance proceeds that have beneficiary designations. One of the best ways to make sure all your property or assets pass to your loved ones the way you desire is to have your estate planning attorney and financial planner create a funding checklist. The list should include all the assets from your financial statement along with your life insurance policies. Next to each item should be instructions on what steps should be taken to ensure the asset or property passes according to your estate plan.

Here are a few examples of the different assets you may want to ask your estate planning attorney to provide guidance on.

Primary Residence or Real Estate - If you own property jointly with someone else the titling of that property may dictate who gets it when you pass. A common form of ownership is Joint Tenancy With Rights of Survivorship (JTWROS) which means the person you own the property with will receive the property. JTWROS assets do not pass through your will.

FUNFACT: This issue contains more than

Checking, Savings, or Brokerage Accounts – Most people have these, but many people do not know that they can designate instructions for beneficiary designations which will direct who will receive the funds after your death. Your bank or financial institution calls this a paid on death or transfer on death request. Be very careful with adding family members as joint owners on these accounts.

You will want to understand the impact that has on the accounts at your death and the risks associated with those directions. Ask your estate planning attorney about this, often times it may make sense to let these accounts pass through your estate based on your will.

Life Insurance Policies - The funds from life insurance pass to your loved ones based on the beneficiary designations you provide the life insurance company. A common pitfall when major life events happen is not updating your life insurance beneficiary designations.

People who have recently gotten married may still have their parents or siblings listed instead of their spouse. We have even found ex-spouses listed many years after a divorce.

Retirement plans - These accounts are also controlled by your beneficiary designations.

A mistake here could cost your beneficiaries a significant amount in taxes. By naming individual beneficiaries you give your beneficiaries the opportunity to extend the required distributions over a longer period of time which allows them to take advantage of further tax-deferred growth.

We have found that clients sleep better at night after putting an estate plan in place.

Although the subject is hard to talk and think about, everyone will benefit from having a comprehensive plan in place. The key is making sure your plan covers all your assets including those that may pass outside your will.

by Clayton Quamme, CFP® a financial planner with AP Wealth Management, LLC (HYPERLINK “http://www.apwealth.com”www. apwealth.com). AP Wealth is a financial planning and investment advisory firm with offices in Augusta, GA and Columbia, SC. +

25 different letters!

+ 12

AUGUSTAMEDICALEXAMiNER

The Examiners

OCTOBER 20, 2023

+

Well, it’s almost Halloween

Finally.

by Dan Pearson

Oh, I can top that.

I saw a display in July that said Be Thankful.

They had Halloween stuff on display two Tell me about it. or three months ago!

Being thankful in July?? What are people thinking???

The Mystery Word for this issue: DRYHITO

© 2023 Daniel Pearson All rights reserved.

EXAMINER CROSSWORD

PUZZLE

1

2

3

4

5

6

7

8

15

16

17

18

19 ACROSS 1. Drain, as a waterlogged or 21 22 23 24 25 26 flooded area 29 30 8. Matured 35 36 37 15. An ophthalmologists’s job 16. Make eggs naturally 40 41 42 43 17. Mosquito protection 45 46 18. Architectural column in 49 50 51 the form of a man 19. A golf ball’s resting place 54 55 20. Used up 58 59 60 21. Yard invaders 25. Curtain calls 63 64 65 29. Glass ornament 71 30. A puff, especially from 73 a joint 31. Ovum

by Daniel R. Pearson © 2023 All rights reserved.

35. Nerve involved in 15-A 37. Speech defect DOWN 39. Austrian mountain 1. What an extra bedroom 40. Long-tailed rodent could be 41. Abundantly supplied 2. 15-A interest 44. Contend 3. Like rainy weather 45. Entirely 4. Behave 46. School founded in 1701 5. Follow closely 47. Commerce 6. Banks of Chicago 49. Deceptions 7. University governor 51. Garment of 57-A 8. Decay 53. Old 9. Got A Secret beginning 54. Like some hairdos 10. Beat 57. Notorius Roman emperor 11. Pass by 58. Medical prefix 12. Title 61. Non-medical doc 13. English public school 63. Of the eye 14. Body blemish 66. Weirdest; creepiest 21. Away from the mouth (Zool.)

71. Place for docking a boat 22. Someone from Kathmandu 72. Severe intellectual 23. ______-tale disability 24. Military “Star Wars” abbrev.

73. Went in 26. First word of the city that’s 74. Reigning home to Texas A&M 27. Character in a Steinbeck classic

BY

10

11

12

13

14

31

32

33

34

69

70

28

38

39 44

47 52

48 53

56

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61

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68

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, OCT. 29, 2023

We’ll announce the winner in our next issue!

7 4 E 1 2 S 5 7 X 6 8 U A 5 4 7 6 2 1 D M6 8 I 2 9 8 5 7 O N 2 6 5 K 7 E 2 6 3 2 1 U R

20 27

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

by Daniel R. Pearson © 2023 All rights reserved.

72 74

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

28. Repose 32. Forced feeding (esp to an animal) 33. Unpowered aircraft 34. Tight & brief swimsuit 36. Shed tears 38. Favorite, as a theory 42. Consumes 43. Deere implement 48. Operated 50. Stitch 52. Become visible 55. Freezing cold 56. Type of park 58. Nursing add-on 59. Symbol 60. ____-free 62. Wine sediment (usu. plural) 64. It often goes with ice 65. Blood is this 67. Traveler’s stop 68. Bush Field abbrev.

69. Wrongdoing 70. Make lace

L N Z T T G O W E W S T C E O E S H A R E N C R O A I I W I E A A I E A M E T T O A A V R I H

1 2 4 3 7 6 N 8 T5 6 9 S 3 I1 D 9 S7 V2 8 5 4

— Biologist E. O. Wilson

by Daniel R. Pearson © 2023 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.

C 2 3

4

5

6

7

1 2 3

’

1 2 3 4

1

1 2 3 4

1 2 3

SAMPLE:

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

H ’ 1 2 3 4 5 6 7 8

9 5 8 4 7 2 3 1 6

’ 1 2 3 4 5 6

D 1 2 3 4 5

1 2 3 4

— Alcohol

1 2 3 4 5

1.BDDDMYYCJS 2.AAAEEOOOUH 3.AUSCUNNNEO 4.SCCAUNTT 5.UNLEE 6.DTS 7.NE 8.T

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 © 2023 All rights reserved

WORDS NUMBER

9

THE MYSTERY WORD

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OCTOBER 20, 2023

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AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

J

ack and Jim were not the brightest bulbs, but they managed to get a job digging ditches. One day as Jack threw a load of dirt over his shoulder, he accidentally hit Jim on the side of his head and cut off his ear.

“Help me find it in all this mud!” cried Jim. “If we find it they can sew it back on!”

After a few frantic minutes, Jack called out, “Here it is!” and handed the ear to Jim. “That’s not mine,” said Jim, throwing the ear back in the mud after inspecting it. “Mine had a pencil behind it.”

When you stop and think about it, a gym is full of little people trying to get bigger and big people trying to get smaller.

Moe: Never lie to your radiologist.

Joe: Why not?

Moe: They can see right through you.

Joe: The last time I had to see a radiologist was when I had a reaction after eating sausage.

Moe: So what happened?

Joe: Radiologists see the wurst in people.

The

Advice Doctor

Moe: Didn’t you tell me that you signed up for a mail-order bride? Some site from Eastern Europe or somewhere?

Joe: I sure did. Finally took the plunge.

Moe: You ordered a bride???

Joe: Yup. About a month ago.

Moe: Well, can I meet her?

Joe: Not yet. My Czech is still in the mail.

©

Moe: I used to walk up to the bar and the bartender knew my name and what to get me before I even opened my mouth.

Joe: What about now?

Moe: Same, but now it’s my pharmacist.

Moe: You know what one Karen is called?

Joe: Just a Karen I guess.

Moe: Correct. Do you know what a group of Karens is called?

Joe: No, tell me.

Moe: A homeowners association.

Student: If my main parachute malfunctions, how much time do I have to deploy the emergency chute?

Instructor: The rest of your life.

A yankee moved to Georgia, the peach state, and decided to go to the store and buy some.

He asked an employee where he could find canned peaches.

“I’ll see,” said the employee, then walked away and never came back.

He asked a second employee who said the same thing before walking off.

The man finally gave up and found them himself on Aisle C. +

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.

SUBSCRIBE TO THE MEDICALEXAMINER +

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By popular demand we’re making at-cost subscriptions available for the convenience of our readers.

If you live beyond the Aiken-Augusta area, or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house!

Dear Advice Doctor, I love my wife, but she has a habit that drives me up the wall. She has a very contentious relationship with her mother, yet for some unknown reason they talk on the phone every day. Correction: they argue every day. Then the same thing happens after every call: she’s mad at the world, but she vents her spleen by yelling at me. I’m 100% innocent, but I’m the most convenient target. How can we break this cycle?

The Cycle is Vicious Dear The Cycle, You definitely raise an interesting point, one that I think many people ponder from time to time.

After all, I would say that nearly everyone has heard of the spleen, but how many people know what its function is, or even where it’s located in the body? My guess: very, very few.

So let’s see if we can rectify that situation.

The spleen has three main roles. #1: it cleanses blood.

It contains cells called phagocytes which devour viruses, bacteria and other microorganisms. The phagocytes or macrophages also devour old red blood cells and red blood cells that are misshapen. The components of those cells are stored and recycled by the spleen. That’s pretty amazing all by itself, isn’t it? #2: your spleen is one of the places where B-cells and T-cells are produced. These lymphocytes produce antigens that attack infecting organisms as key elements of the immune system. #3: the spleen stores one-third of the platelets in our body. Platelets are responsible for clotting blood and thereby controlling bleeding.

The spleen is adjacent to the stomach on the upper left side of the body and is its location near the surface makes it vulnerable to injury. A ruptured spleen can cause serious life-threatening internal bleeding and is a life-threatening emergency. An injured spleen may rupture immediately after an injury, or in some cases, days or weeks after an injury. As vital as its various roles are, it is possible to live without a spleen, although someone who has had their spleen removed (a splenectomy) is vulnerable to infections.

I hope this answers your question. Thanks for writing! + 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.

Why read the Medical Examiner: Reason #8

NAME ADDRESS CITY STATE ZIP Choose six months for $22 ____ or one year for $40 ____. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

BEFORE READING

AFTER READING

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

...cleverly hidden on the lady’s gray sweater in the p. 3 ad for SCOTT INSURANCE GROUP

THE WINNER: JOHN TAYLOR! 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!

OCTOBER 20, 2023

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED D E W A T E R R I P E N E D E Y E C A R E O V U L A T E N E T T I N G T E L A M O N L I E S P E N T A N T S E N C O R E S B E A D T O K E E G G S O P T I C L I S P A L P R A T R E P L E T E V I E A L L Y A L E T R A D E L I E S T O G A A G E D U P S W E P T N E R O H I S T O P H D O C C U L A R E E R I E S T M O O R A G E A M E N T I A E N T E R E D R E G N A N T

SEE PAGE 12

The Celebrated TheSUDOKUsolution MYSTERY WORD CONTEST 1 2 9 8 3 7 4 6 5

...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 We have created a Star Wars civilization with Stone Age emotions.

— Biologist E. O. Wilson

WORDS BY NUMBER Just because you can’t dance doesn’t mean you shouldn’t dance.

— Alcohol

7 3 2 8 6 4 9 1

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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

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.

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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!

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Thank you for supporting our advertisers! advertisers!

SHORTSTORIES WHY IS IT ACCEPTABLE FOR A DOCTOR TO SEE YOU 30 OR 60 MINUTES PAST YOUR APPOINTMENT TIME, BUT A PATIENT’S APPOINTMENT WOULD BE CANCELLED IF THEY SHOWED UP THAT LATE? Many years ago I had a severe injury that needed a hand surgeon immediately.

The doctor arrived 15 minutes after the ambulance delivered me to the ER and I was rushed into surgery within 30 minutes in the hope that they could save my hand.

The surgery lasted more than 6 hours, and while I lost a couple of fingers, the rest of the hand was saved.

The following week I went to his office for a follow-up and walked into a waiting room JAMMED with patients. I began speaking with the lady who sat next to me and asked her how long the wait usually is to see the doctor, and she told me that it could be 10 minutes or it could be hours.

I asked why and she told me that her appointment was originally supposed to be the week before, but the doctor had left for an “emergency,” and when saying that word she use air quotes.

I knew that I was that emergency, and every single person that day was rescheduled because of it. He was the only hand specialist within 200 miles and when someone like me shows up in the ER, he was the only doctor who could respond.

This is not common for most doctors, of course, but to this day, whenever my doctor is late, I just sit back and think about that hand specialist and understand that not every day is going to go as planned, for me or the doctor.

I just might have to wait for someone who is worse off than I am. I’m okay with that. +

JEWELRY SURGEON

the

15 +

AUGUSTAMEDICALEXAMiNER

OCTOBER 20, 2023

+ I

THE DASH A poem by Linda Ellis

I read of a man who stood to speak At the funeral of a friend.

He referred to the dates on her tombstone From the beginning to the end.

He noted first came the date of her birth And spoke of the following date with tears, But he said what mattered most of all Was the dash between those years.

For that dash represents all the time That she spent alive on earth And now only those who loved her Know what that little line is worth.

For it matters not how much we own The cars...the house...the cash.

What matters is how we live and love And how we spend our dash.

So think about this long and hard; Are there things you’d like to change?

You never know how much time is left That can still be rearranged.

If we could just slow down enough To consider what’s true and real, And always try to understand The way other people feel.

And be less quick to anger And show appreciation more And love the people in our lives Like we’ve never loved before.

If we treat each other with respect And more often wear a smile...

Remembering that this special dash Might only last a little while.

So when your eulogy is read With your life’s action to rehash, Will you be proud of the things they say About how you spent your dash? +

M.E. THEMEDICALEXAMiNER •

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CALL AHEAD: (706) 284-0190 To view my work visit scscja.org. Click on resources, then merchandise.

Click on the ring photo, then the PDF link.

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FIBROIDS? AUGUSTAMEDICALEXAMiNER

OCTOBER 20, 2023

WE CAN HELP

Have you been diagnosed with uterine fibroids and are experiencing heavy, painful periods?

Uterine fibroid embolization is a minimally-invasive non-surgical option for eliminating fibroids and their side effects.

CALL FOR AN APPOINTMENT TODAY!

AUGUSTA VASCULAR CENTER 630 13th St., Suite #250 • Augusta 30901

PHONE 706-724-2500

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PHONE 706-854-9932

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