Medical Examiner 11-4-22 by Daniel Pearson

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HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS

NOVEMBER 4, 2022

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THEHEARTOFTHEMATTER I’VEHADIT WITH LIFE

As regular readers (thanks!) of this publication know, our previous issue featured a cover story about cheating cancer. It highlighted that medical researchers estimate almost half of all cancers are preventable. Considering what a scourge cancer is, that is fabtastic news. But as bad as cancer might be, it’s not the worst thing we have to deal with. That dubious distinction belongs to heart disease; it’s the leading cause of death among both men and women. The good news is that we could have entitled this article, “Be A Cheater, Part II,” because heart disease, like many cancers, is also eminently preventable. And it isn’t even particularly complicated. In fact, it could be distilled down to four basics, the ABCs of heart disease prevention. Here you go, free of charge: A IS FOR ASPIRIN Talk to your doctor about taking aspirin to prevent or lower the risk of heart attacks and strokes. It isn’t ideal for everyone, but for many people aspirin is a simple, inexpensive, and effective strategy. B IS FOR BLOOD PRESSURE High blood pressure increases the risk of stroke or heart attack more than any other factor. Knowing your bp is the first step toward controlling it (if it’s high - and it probably is). C IS FOR CHOLESTEROL There’s good cholesterol and there’s bad cholesterol. And there’s having enough of this necessary substance and there’s having too much. Knowledge of your numbers can help make them better numbers. S IS FOR SMOKING Smoking increases the risk of having a heart attack or stroke by raising blood pressure. Quitting offers both immediate and long-term benefits in a number of ways. Your doctor and pharmacist can help.

Of course, there are additional steps that can be taken, but those four are excellent starting points for all of us (even non-heart patients). For those who want extra credit — and healthier hearts — consider a moderate exercise program. The CDC says it can be as simple as walking for 10 minutes (walk 5 minutes, turn around, walk back) 3 times a day 5 days a week. That’s doable. Another simple strategy for extra credit — and one that happens to be delicious — is eating a healthy diet, one low in fat and sodium. That doesn’t mean tasteless. There are all kinds of healthy foods and tasty spices that aren’t sinful in the fat and salt departments. One other important component of being a responsible heart owner is being a good patient. Most people with a heart issue are under a doctor’s care. Do what your doctor has told you to do. Take the medicine you’ve been prescribed. Refill when you run out. Communicate when the medicine makes you feel bad. Give the effort to be heart-healthy your whole heart and there’s an excellent chance your heart will repay you handsomely. +

The desire and will to live are among the most basic human instincts. At least one would think so. But an August 2020 survey conducted by the Centers for Disease Control found that more than 25% of people between 18 and 24 had seriously contemplated suicide within the past 30 days. The same survey revealed the number for the 25 to 44 age group was 16%. Indeed, between 2000 and 2020, more than 800,000 Americans died by suicide, a stretch of time during which SUICIDE the suicide rate rose by 30%. The & CRISIS latest numbers are for the year 2020, when nearly 46,000 people in this LIFELINE country took their own life (although due to the stigma associated with suicide, all suicide statistics are considered to be under-reported). Added to that figure are the countless unsuccessful attempts which can leave behind serious injuries with long-lasting effects. Another significantly affected group are the friends, family, loved ones, and co-workers of those who die by suicide. They experience grief, shock, anger, guilt, symptoms of depression or anxiety, and may even have thoughts of suicide themselves. It’s a huge and growing public health issue with no simple solution in sight. Read the proposals of various agencies targeting this plague and they seem long-term and very ambitious (translation: unlikely to happen anytime soon). Things are not completely hopeless. But people do have to avail themselves of the abundance of available help. It’s out there all day and all night every day of the year for people who are in a bad place. The problem is often mustering the motivation to seek help while in the depths of despair. But the people who answer at the 9-8-8 Lifeline are happy to talk to someone who wants to help a possibly suicidal friend. We can all help. +

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THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

MEDICAL MYTHOLOGY

PARENTHOOD “I HAVE A CHEMICAL IMBALANCE” by David W. Proefrock, PhD

Your 10 year-old son was diagnosed with attention deficit hyperactivity disorder last year and placed on medication. The medicine worked well. His grades improved dramatically, he began doing his homework, and his teacher reported that his behavior had become excellent. Recently, however, his grades have begun to drop and his teacher has noticed that his focus and his behavior have declined during the afternoon. What do you do? A. Try doubling his dose and see if that helps. B. Maybe his medicine has stopped working. Stop giving it to him and see what happens. C. Children shouldn’t be on medication for attention problems anyway. Stop giving it to him. D. Let his pediatrician know what’s been happening. His dosage or the medication itself may need to be changed. If you answered: A. Never make changes to prescription medications without informing the physician. Let his doctor decide what’s best. B. Again, never make changes to prescription medications, including stopping it, without informing the physician. C. This is a popular, but often misguided, belief. Remember that this medication had facilitated very positive changes in his school experience. If you have doubts about him taking it, talk to his pediatrician before doing anything else. D. This is the best response. Always keep the physician informed when children are taking medication.

We feel pretty safe in saying that most readers of this article have heard those words. Some may have even said them. The belief that “chemical imbalances” are responsible for various health problems is common. But we also feel pretty confident in saying that very few if any of us have heard a physician, a psychiatrist or a psychologist pronounce a patient’s problem to be the result of a “chemical imbalance.” Granted, there is no question that the human body is just one big chemistry set. There’s all kinds of stuff going on that qualifies as literal chemistry. And there are fluctuations in the levels of various chemicals too, and those fluctuations can have an effect on health. As one example, a doctor

might say, “Your blood sugar is dangerously high (or low).” Or maybe, “Your potassium levels are way out of whack.” Those imbalances will definitely cause problems and generate symptoms. But to say that someone has a problem stemming from a “chemical imbalance” would be like giving a gourmet meal a critique by telling the chef, “Your ingredients are a little low.” Could you be any more vague if you tried? In the same way, “chemical imbalance” is completely useless in a medical setting, and just isn’t the way information is communicated. “Chemical imbalances” often get blamed (in conversation or pop culture, not by doctors) for various mental conditions. If it

was really that simple, doctors could run a blood test or some other kind of lab procedure and tell a patient, “Based on the bloodwork, you have schizophrenia,” or “When we ran the tests on your thyroid, we discovered that you are depressed. Oh, you may feel wonderful, but trust me, you have severe depression.” It doesn’t work that way. It should be noted that mental states can be altered by drugs - and drugs are chemicals, after all. Doesn’t that prove that chemical imbalances can affect moods and mental health? Well, yes if you’re talking about drug-induced moods, moods that are artificially manipulated. But that isn’t the same as a naturally occurring situation. As one clinical study reported, “it remains to be demonstrated that the behavioral changes produced by these drugs have any relation to naturally occurring biochemical abnormalities which might be associated with the illness.” It would be a great convenience if crippling anxiety or depression was simply a serotonin deficiency, for example. There are clues here and there and research is always underway, but the exact cause of mental disorders like depression remains unknown. Chemical imbalances are a myth, at least for now. +

All decisions about medication must include the prescribing physician. There could be extremely serious negative results in making changes that you have no information about. + Dr. Proefrock is a retired local clinical and forensic child psychologist.

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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

(706) 860-5455 www.AugustaRx.com • E-mail: Dan@AugustaRX.com www.Facebook.com/AugustaRX Opinions expressed by the writers herein are their own and/or their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., nor its agents or employees take any responsibility for the accuracy of submitted information, which is presented for general informational purposes only. For specific medical advice, diagnosis, and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2022 PEARSON GRAPHIC 365 INC.

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WHAT IS RSV? It seems to be the latest of our current plague of plagues. RSV is short for respiratory syncytial (sin-SISH-uhl) virus, a common problem for infants and young children, and sometimes teens and older adults. It isn’t rare or new (RSV was first discovered in 1956), but it has become a topic of concern for physicians and many parents because while it has traditionally seen fall and winter surges, in many areas since the pandemic RSV has become a year-round event. In fact, if you’ve heard news reports referring to a “tripledemic,” RSV is one of the three (along with COVID and the flu), and right now seems to be the one causing the most stress to families and the healtcare system. Its symptoms are similar to a cold: runny nose, fever, cough, and chest congestion. But they tend to last longer than cold symptoms do. And RSV can lead to dangerous lung problems (like bronchiolitis, inflammation in the small airways of the lungs and pneumonia), especially in children under a year old. Anyone who already has breathing issues, such as asthma, or heart disease, muscular dystrophy, multiple sclerosis, or a weakened immune system, will be hit by RSV especially hard. Unfortunately, there is no specific treatment for RSV itself, so parents and doctors focus their efforts on relieving symptoms, like managing fever and pain and staying hydrated. Most RSV infections go away on their own in a week or two, but those can be some pretty long and miserable weeks with a sick baby. RSV spreads by ways we have all learned well during the past two and a half years: coughing and sneezing and their infamous airborne droplets; touching a surface that has the virus on it, and then touching your face before washing your hands; brothers and sisters or parents playing with or kissing a child who has RSV. As for prevention, we know the drill: Cover coughs and sneezes with a tissue or upper shirt sleeve (not hands). Regularly wash your hands with soap and water for at least 20 seconds. Avoid close contact with others, as well as sharing cups and eating utensils, shaking hands, et cetera. Clean frequently touched surfaces like doorknobs and mobile devices. As common-cold-like as RSV may often be, it can also lead to hospitalizations for respiratory distress and dehydration. Researchers are working to develop an RSV vaccine, but none are yet available. +

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#176 IN A SERIES

Who is this? ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE

his noted surgeon left a mark on the world of medicine that has reached all over the world, including Augusta, and even on the lives of many people reading this article. Dr. René Favaloro was revered in his native Argentina and beyond as a pioneer in cardiovascular surgery. Born and raised near Buenos Aires (La Plata), Favaloro earned his medical degree in 1949. At the time, any position of medical responsibility required political membership in the Peronist Party, which Favaloro rejected. Instead he took a position as the town doctor in a remote area in that even today is little more than a wide spot in the road. It was an early indication of a career-long focus on service over money. During a visit back to La Plata, one of his old medical school professors suggested that his interests in cardiology would benefit from additional specialized training, specifically at the Cleveland Clinic. Although Dr. Favaloro had misgivings about leaving his rural post, he ultimately decided that in the long run the brief time in Cleveland would reap long-term benefits. A providential pairing at the Cleveland Clinic with Dr. Mason Sones, a worthy subject for his own profile here in some future issue, led Dr. Favaloro to a major innovation. Sones had created perhaps the largest library of coronary angiograms on the planet, and Favaloro pored over these images at every opportunity, resulting in a world’s-best understanding of the relationship between coronary arteries and the heart. He came to the gradual realization that veins from other places in the body — legs especially — could be used to restore vital blood supply to the cardiac muscle. He attempted the procedure for the first time in May of 1967. He called it coronary artery bypass surgery, or simply bypass surgery for short. Perhaps you’ve heard of it. By 1971 he was back in Argentina with a great vision: to develop a center there like the Cleveland Clinic, combining research, education, and patient care. Favaloro brought his vision to reality in a number of variations, opening comprehensive medical facilities, a training institute which today is known as Favaloro University, extensive research facilities, and sponsoring public education focused on disease prevention. The realization of these dreams was largely funded from Dr. Favaloro’s own pockets, and it is said that he performed bypass operations virtually every day on indigent patients. The plan was that once the facilities were up and running, payments from insurance companies and government funding would keep them going. Alas, things didn’t work out that way. Over time other hospitals and the state came to be in debt to Favaloro entities to the tune of some $18 million, and gave no indication of any intention to pay. Overwhelmed by his debt and seeing no way out, Favaloro shot himself — in the heart — in July 2000 at age 77. Two ironies emerged in the aftermath of his suicide: Argentine president Fernando de la Rúa, who had never even read Favaloro’s pleas for financial support, proclaimed a national day of mourning in his honor. And the publicity surrounding his death resulted in an outpouring of financial support. Dr. Favaloro’s dreams in all their incarnations — the clinics, the university, the training facilities and seminars, the non-profit foundation — are alive and well to this day. +

Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com by Marcia Ribble

What are your thoughts on the upcoming election? Most folks are responding with relatively normal levels of dismay, excitement, hope, or other emotions. Some folks, however, no matter what the outcome, may have a more extreme response of anger or depression, violent or even suicidal thoughts. And some have a mixture of those extreme responses. An example of an extreme response happened in Michigan when a number of men in state militias decided that they were going to kidnap the Governor, Gretchen Whitmer, try her for treason, convict and kill her. They also had made plans to attack the State House and Senate and violently start a war against the state. Most citizens, regardless of party affiliation, find such behavior to be far outside the boundaries of reasonable responses no matter what they may think of her policies. They may be upset by her or angry about what she has done, but they do not resort to violence. They try to limit her power and its effects on their lives by litigation or electoral efforts. Those men are in jail now, an outcome that is certainly well-deserved, but they are not the only ones who will pay for their acts of aggression. If they are married, their wives and children will lose so much of their lives, too. Even with many women working, men still often contribute a lot to the family economy. Will the family lose their home as a result? Will the children experience bullying that assumes they will do the kinds of things their fathers have done? What about their parents and their friends? How will they be affected by the trials, the newspaper articles and television reports? Thankfully, Whitmer and her family are safe, but will some other person or group decide to finish what those men started? What if the next time violent individuals are not

caught in time? We all are affected when the normal boundaries of human behavior are violated. The other side of the same coin occurs when the anger and fear and pain are directed internally, and people decide that their only option is suicide. The person who chooses suicide often believes they are the only one who will be affected, but everyone in their lives will also be harmed. Today we have suicide hotlines where help can be obtained, and suicide prevented. Strategies for dealing with unbearable pain also exist. Many support groups are willing to help, providing many resources for people who want to kill themselves. We have few such mechanisms, though, for people contemplating violent responses to society’s ills. No one is there at the end of a hotline to talk them into a more positive frame of mind. Rather than helping them find better coping tools, society presents them with few viable options to save themselves, their families and friends, and all the rest of us from the tragedies they unleash. If we look only at the CSRA, at all the murders that occur, at all the families and communities which are devastated, it is clear that interventions are necessary. Mechanisms need to be put into place to help our citizens learn to control and express negative feelings in positive ways. Too many people are given tacit permission to behave violently by a society which has decided that nothing can be done until after a murder is committed, that our only recourse is to put the bad guys in prison after their deeds. The police have been working to reduce the number of guns, but that’s not enough when our citizens are dying. The health of our communities is at stake. + Editor’s note: This installment of A Patient’s Perspective appeared in a previous edition of the Medical Examiner.

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age BY J.B. COLLUM

brick ledge of the house, but she didn’t think it was the Milwaukee. I figured she was mistaken because I hadn’t lost another red and black screwdriver, so I was thinking about taking the new one back but decided to keep it so I could have one in my truck and one in my office. Once I got home, it turned out to be a completely different screwdriver that I lost so long ago that I had forgotten that I forgot about it. Whoa. That’s kind of meta. Most of you middle-aged folks will be looking up that word meta right about now. I only know it because the word is used in my field. Example: meta-data is data that describes data. You’ll have to do a search if you want more than that here. Some of you have already fallen asleep at this point and we can’t risk that in case any of you are driving while reading this. If you are, stop right now! Put the phone or paper down and concentrate. We middle-aged folks already have a bad reputation when it comes to driving. You don’t want to contribute to that. Do you? Well, do you? Okay then. Back to our discussion. I’ve added an Apple Tag to both my keychain and my wife’s because one of us, I won’t say who to protect the guilty, (hint: it wasn’t me) lost a very expensive key fob recently and we don’t want to pay almost $400 again for another one. The tags are cheaper when you buy four at a time, so I think I’m going to make that investment soon to help us not lose any more important or valuable things. What is really baffling is why I put some things where I put them, like the pills in the fridge. Unlike the example of the fridge, I often can recall that I was thinking something like, “oh, this is great place to leave this. It makes perfect, logical sense. I won’t forget it if I leave it here.” Six months later, when I find my measuring tape in a drawer of my desk, after buying a new one, it will hit me, “oh, yeah. I remember putting that there.” So, you see, as I have aged, my memory has become an I-told-you-so nag. When I finally find it, my brain says, “of course it was there.

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.com

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I forgot! No, wait. Did I? It’s on the tip of my tongue… Nope. It’s gone. I was just thinking of something, and I was going to tell you all about it, but I forgot it. I need to remember to write things down. What am I to do? I had the outline for a great column for this week in my head just this morning, but it moved out faster than a bunch of kids when grandma turns the TV to Lawrence Welk. “And a one-a, and a two-a!” Wait, what were we talking about? Oh yes, forgetting. Something that I seem to be more afflicted with as I advance in my march through middle age. I know that I have left a virtual treasure trove behind me in that march. Just this past week, I somehow misplaced my brand new Milwaukee 11-in-1 screwdriver. I was so proud of it too. I carried it everywhere that first day, just to look at it and smile. I get that from my dad. He loved tools because he loved to accomplish things with them, and the right tool for the job can make work a pleasure — if you can find it, that is. At this point in my life, I really don’t dread projects around the house. I dread trying to find the tools I need to do the projects. Then I dread the effort of putting them away when I’m done. Hmmm. Those two things might be related. I look everywhere that seems logical and a lot of places that are completely illogical, like in the refrigerator in my office. Crazy, right? Well, maybe. But just yesterday, I did find my medicine dispenser in there after missing it all day long. I had given up and was using the one for the next day, figuring once I found it, I’d just swap them out. Once I found it in the fridge, I went looking for my water cup, and sure enough, it was where I probably meant to put my pills. I finally gave up on finding my screwdriver, so this past Tuesday, I went to Home Depot and bought another one. The price had gone up a dollar. That chafed me even more, but I wanted that screwdriver, so I parted with the cash. About an hour later I was on the phone with my wife, and she told me that our son had found a red and black screwdriver on a

Why didn’t you think of that earlier, you dimwit!” You see, on top of being very forgetful, my middle-aged brain has gotten meaner to me. Oh well. What can you do? If you are having memory problems like me, maybe this tip will help you: I’ve decided to carry a small notepad with me so I can write important things down, like I’m an old-time detective jotting down every clue. When I go to bed, it will be on my nightstand so that when I wake up with inspiration, I can jot it down right away. I’ve bought lots of those neat little notebooks over the years with the intention to do just that. Now I just need to find one. Let me see. Where did I put them? Maybe I’ll use a voice recorder instead. Where did I put that? Wait, what was I looking for again? +

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I CAN’T EVEN REMEMBER THE LAST TIME I FORGOT SOMETHING.

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BLACK FRIDAY

Friday, October 28, 2022 was a most exasperating day. Two famous people with whom I have connections went to meet Jesus. Decades ago, UGA Coach Vince Dooley spent a day at my home along with Coach Erk Russell. They had speaking appearances at lunch and dinner that day. My home was their rest stop before and after the engagements. I took the day off to be unofficial chauffeur. During our conversations, Kirk, my 8-year-old son, invited Dooley to see his room. Not exactly the highlight of the trip for Dooley. But being the gentleman that he is, Dooley enthusiastically agreed. Erk went outside to smoke a cigar. When Dooley and Kirk came back downstairs, Dooley said he had seen photos of Donna Douglas (Ellie Mae on “The Beverly Hillbillies”) and wanted to know if I could get her to attend a UGA football

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

game as a guest and make appearances. I stuck to the truth and said, “No.” Dooley thinned his lips in the classic “Just as I suspected” pose. I continued, “But Kirk probably can. He has her unlisted phone number. Donna did not give it to me.” Kirk called Donna. Left a message. Dooley thinned his lips and nodded his head again. 15 minutes later, Donna returned Kirk’s call. She agreed to do the appearance, combining it with a trip to see her mother in Baton Rouge. Donna came to Atlanta where my wife, Kirk, and I picked her up. We spent the

weekend with Donna and the UGA football team. As Donna’s date (at her insistence) Kirk spent every moment with Donna. Including sleeping with her. Donna said Kirk was not to sleep on a rollaway bed. Donna refused payment for the multiple appearances, but did let Dooley donate money to a Christian charity she favored. But all was not peaches and cream. At a private high-dollar reception at Dooley’s home after the game, I managed to knock over a jade sculpture that had been given to the Dooleys while in China. A tiny chip flew across the floor. My heart sank to the depths of despair. I feared DefCon 4 and armed militia would appear and throw me in a dungeon in a secret tunnel beneath Sanford Stadium. I reported my crime directly to Dooley, prepared for the worst. Being the gentleman that he always was, Coach Dooley

NOVEMBER 4, 2022 did not blink. “I told Barbara not to put it there. It was bound to get knocked over.” That was the last time I spoke to him in person. It is my prayer that he did not retain the haunting memory as I did. I trust he did not. The other intersecting person who died October 28, 2022 was Jerry Lee Lewis, that piano-pumping whirlwind from Faraday, Louisiana. I first saw him on the Ed Sullivan show. I had never heard the piano anywhere except foot-washing Baptist churches and occasionally at school. When Great Balls of Fire burst forth from the ivory keys, a new world opened up for me. And the rest of the world. It was memorable to say the least. Decades later Jerry Lee Lewis played Holiday Beach in Douglas, GA. His private plane landed him in nearby Alma, GA. The sheriff and I picked up Lewis in my Lincoln Continental Mark IV. It was the closest thing we had to a limo. It was a Sunday, but Jerry was already half-lit on whiskey. He said he was out and wanted more. Didn’t matter what kind as long as it was alcohol. Well, Coffee County did not have liquor stores open on Sunday. It was the Lord’s Day. Of course, the High Sheriff would have nothing to do with cutting corners on Sunday, even for Lewis. I dropped off the sheriff and Lewis and made a bee line to the home of James, a friendly alcoholic whom I

trusted would still have some alcohol. James did and I conveyed it to Jerry, who was appreciative. I worried about his ability to perform with all that alcohol coursing around in his blood and traumatizing his liver. His speech was slurring more than a little. But I was not prepared for the practiced professional that Jerry really was. The moment his finger hit those frightened keys, his slur evaporated. His voice cleared. His hair flew about. His fingers pounded the ivory mercilessly. He gyrated like the Energizer Bunny on steroids. Near the end, he stood up and deftly used his heel to send the piano stool whirling high into the air and to its splintered death. The audience (me included) roared. (His contract included a piano stool to be destroyed during his act every night.) His piano stool destruction, spectacular though it was, did not measure up to the jade statue I damaged. Once he was back on his plane, I never saw him again. Two highly influential men died that day, October 28. Vince Dooley was a 90-yearold Southern gentleman. Jerry Lee Lewis was an 87-yearold thrilling entertainer and talented scoundrel of much merit. Each had great impact on society and were know far and wide. Death spared them longer than most. I shall miss them both, but in different ways. So shall the world. +

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BEAUTIFUL HOMES

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

SIMPLE SOUTHWEST BLACK BEANS These simple black bean are, well, simple. Using canned beans and prepared salsa, it only takes minutes to create this fresh-tasting, versatile, and highly nutritious side dish that has all but kicked refried beans to the curb in my house. And while black beans are a great accompaniment to Southwest and Mexican dishes, these beans also go great with eggs at breakfast or tossed onto fresh greens at lunch. Ingredients • 1 teaspoon olive oil • ½ cup chopped onion • 1 (15-ounce) can black beans, drained • ½ cup prepared salsa • ¼ teaspoon ground cumin • 1 to 2 tablespoons finely chopped fresh cilantro Instructions In a medium saucepan, heat the oil over medium-high heat. Sauté the onion until tender, about 3 minutes. Add the beans and salsa. Stir to warm the beans thoroughly.

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Add the cumin and continue to stir until hot. Before serving, sprinkle with cilantro. + Yield: 4 Servings (serving size: ½ cup) Nutrition Breakdown: Calories 90, Fat 1.5g, Sodium 310mg, Carbohydrate 18g, Fiber 6g, Protein 5g. Diabetes Exchanges: 1 Starch Recipe used with permission from Marlene Koch, RDN www.marlenekoch.com

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ASK DR. KARP

NO NONSENSE

NUTRITION

Paige, an employee at my local supermarket, asks: “Dr. Karp, with food prices going up, I need some suggestions on how I can save some money on food without sacrificing nutrition. Any ideas?”

If you are like I am, you usually chitchat with the cashier and baggers at the supermarket as you check out. This morning, Paige commented on how expensive grocery shopping has become and asked me if there was anything that can be done to get that food bill down a bit. My first suggestion is to turn a negative into a positive. If you have been thinking you need to lose a few pounds, higher food prices might be just the motivation you need to get back into a reasonable weight range. Think about lowering your food costs by decreasing your food intake, especially for those high fat, expensive red meats, those chips and other snack foods and soft drinks. In this case, decreasing your food costs will most definitely increase your nutritional health. Suggestion #2. Eat out less; much, much less or not at all. Eating out is extremely stressful to a food budget. Not only is eating out a very expensive way of meeting your food group needs, it is also pretty unhealthy (even if you choose “healthier” menu items). Consider how much more cost is involved for a roll, a salad and some chicken or steak when somebody else makes a profit by preparing it for you. Buying healthy, delicious and nutritious food in the supermarket and quickly preparing it at home in a no-frills manner is much less expensive, for sure. Save eating out for special occasions, or limit it to one time a week, not every day. Start with unpretentious home breakfasts and home-prepared “sack” lunches. Those fast-food breakfasts and lunches add up to quite a bit of money. Having a bowl of cereal with fruit, or avocado/tomato toast takes little time and effort in the

morning, costs much less and is much healthier than that fast food biscuit, donut and expensive cup of coffee. Bring lunch to work. On a nice day, you can find a place to sit outside and enjoy the weather. A simple sandwich with an apple or some whole grain crackers with cheese and an orange cost so much less than going out for lunch, even if you go to very inexpensive places. Do you enjoy the socialization you get with your work friends when you go out to eat? Form an “Lunch Bucket Brigade” at work. Many of your work friends are trying to save a buck, too, but may be too embarrassed to admit it. Break that expensive work culture of going out to lunch every day. Another important tip for reducing food costs is to buy much less meat and get your protein from other healthier and less expensive sources, such as eggs, beans and low-fat dairy. The

NOVEMBER 4, 2022 minute you put meat into your shopping cart, the price of your groceries goes way, way up. For a weeknight dinner, consider making a Southwestern omelet with tomato/cilantro/ cucumber/onion salsa. If you must eat red meat, cut down on this very expensive food item by having it once a week or preparing it a different way. For example, a half pound of steak will feed two people or less, but, when you cut it into cubes and put it on skewers with tomatoes, onions and peppers, that same half pound of meat can serve 4 or more. Want to stretch your chopped meat dollar? Prepare taco salads at dinner, instead of burgers. Choose the cheaper cuts when you buy meat. Usually, but not always, they are healthier, because they are lower in fat. Tenderize the meat before you cook it. Want to save more food money? Always use your leftovers. Do not just put them in the dark corners of your refrigerator to rot and be thrown out a week later. Put them in the front, to remind you to use them. I’ve never met a leftover I didn’t like. “Re-imagineer” leftovers, by serving them in different ways from the original way they were prepared. Some tomato-based pasta, for example, tastes great when added to canned tomato soup for lunch; that leftover chicken quickly turns into a chicken salad sandwich or a chicken omelet for dinner. If you do not think you will use the leftover in a few days, then just freeze it. If you looked in my freezer, you would see all sorts of frozen leftovers waiting to be reincarnated into delicious meals.

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

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Here are a few more suggestions. Don’t buy pre-cut, pre-packaged veggies. It really doesn’t take a lot of time to cut up veggies at home. When you buy veggies pre-cut, they are more expensive. For instance, the other day, I just needed a little cabbage for some coleslaw I was going to make. I was tempted to buy a small package of cut-up cabbage. However, when I compared the cost of a whole head of cabbage to one small package of cut-up cabbage, I changed my mind. So not only did I end up with inexpensive and healthier homemade coleslaw, but I had leftover cabbage for at least two more meals. Microwaving cabbage with red peppers and green onions is a great veggie side dish, for example. Cutting up your own veggies and fruit is much safer, anyway. Haven’t you ever noticed that the majority of veggie and fruit recalls are related to those precut packages? Pre-cut veggies and fruit have a much larger surface to support bacterial growth. Stay away from buying prepared casseroles, frozen dinners and other pre-prepared meals, especially the ones that are shipped to you as part of meal plans. Wow, talk about an expensive way of meeting our nutrition needs! Use your nutrition food dollar more wisely, Get most of your calories from much less expensive high quality, whole grain carbs, not from expensive meats and fish. Also, consider the possibility of growing at least a small part of your own food. Don’t have a garden? Use flowerpots on windowsills. In the Southeast, we are fortunate to have a long growing season. Last week, I just planted some cool weather veggies: parsley, collards and cabbage.

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What is the “No-Nonsense Nutrition” advice for today? There are many ways of reducing your food bill without reducing your nutrition. Don’t eat out so much, especially for breakfast and lunch; don’t buy pre-prepared foods; use up all your leftovers; grow just a small portion of your veggies; and don’t buy pre-prepared foods or pre-cut veggies and fruits. If you have been trying to lose some weight, higher food prices might be just the motivation you need. Your food bill will be lower, you will be thinner, your wallet will be fatter, and you’ll be healthier. +

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CRASH

NOVEMBER 4, 2022

EVERYBODY LOVES A GOOD STORY

COURSE

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

proper air pressure at recommended levels. If you aren’t sure what the proper PSI is, look for the sticker inside your driver’s side door. If you need help with air, plenty of places will gladly check your pressure for free and fill up any low tires. Most experts say the top cause of blowouts is low tire pressure, which causes more flexing of tire fibers, generating more heat and therefore more risk of a blowout. Tire rotation is another preventive maintenance step that’s simple and inexpensive, but contributes to even wear and prolongs the life of tires which, let’s face it, aren’t cheap. But back to that urgent question we asked before:

{

uick: what’s the worst thing about having a blowout when driving? Is it that blowouts are far more likely to happen at high speed, like on the interstate, than on a quiet side street? Is it that they can be extremely dangerous situations that start bad and get worse with literally seconds? Is it that, because of the above, they can result in the cost of repairing the blown tire plus repairs to your car (and maybe to other cars involved) plus hospital and medical bills and increased insurance rates? The correct answer: all of the above. To make matters worse, these random events are not exactly rare. The National Highway Traffic Safety Administration says blowouts cause more than 10,000 “tailspins” every year. You may go the next ten years without one. Or you might have one later today. Who knows?

{

KA-BLEW-EE!!!

What to do when you have a blowout Answer: as little as possible. Really. More about that in just a moment. But first... What to do before you have a blowout This answer might be more important than the answer to the previous question because this one can cut the chances you’ll ever have a blowout in the first place. Let’s start with good tires. If you need new tires, it’s an important investment to make. If you can’t afford new tires, you have to ponder the bigger picture: if I skid out in the rain on my bald tires and total my car, the cost of the tires I should have bought is going to seem pretty insignificant by comparison. Sometimes people get new tires (or they have good tires) and they slide “tires” completely off their to-do list. Focus on other things for a few months or maybe a year or so. Actually, tire maintenance should always be someplace on the to-do list. And in the new-tire honeymoon phase, it’s free: simply maintain

Sparkle

What to do when you have a blowout Where were we? Oh yes: as little as possible. Do not adjust your Medical Examiner. We’re serious. The worst thing you can do when a blowout occurs is slam on the brakes. The next worst thing is to oversteer in response to the car pulling in one direction or another in response to an instantly flat tire. Most drivers instinctively do both: they brake hard and steer hard, and the result can be a (possibly catastrophic) loss of control, usually at high speed. Safety experts say the best strategy is not doing much at all. Just hold the wheel steady and straight and slow down without using the brakes, at least at first. Hit the button for the flashers ASAP and focus on maintaining control. Keep going straight as you slow down. Gradually and gently steer toward the shoulder, keeping an eye on any full-speed traffic coming up behind you. Pull as far off the road as is safely practical so that changing the tire (or hooking your car to a tow truck) is not a lifeand-death experience. A blowout is a highly stressful experience, but a cool response keeps it from being even worse. +

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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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the blog spot — posted by Andrew Ross, MD, on October 16, 2022 (Edited for space)

TELEMEDICINE IS NOT MEDICINE The COVID-19 pandemic ushered in many insidious handmaidens among its foul equipage. From Zoom meetings and school closures to masks and lockdowns, our world was torn asunder and, eventually, rendered anew into a place where almost everything has been changed, by large degrees and small, perceptibly and imperceptibly. It will come as no surprise that medicine is foremost among the areas of life that have been irrevocably changed. One such area in medicine specifically that appears drastically different from the B.C. era (before COVID) is the concept of telemedicine. With the lockdowns of 2020, people became far more open to the possibility of virtual visits with their physicians, and the market took notice. Here was, and still is, a burgeoning market indeed. The telemedicine industry was estimated to be valued at roughly $90 billion in 2021, with predictions of growth well-exceeding $600 billion by 2028. There are clearly a lot of motivated actors hoping to capitalize on the emerging gold rush. While I recognize the futility of standing between such a lucrative market and its profits, I think it important that someone pauses for a moment, not to ask, “Can I participate?” but rather to ask, “Should I?” While it is one thing to use new technology to fill in some gaps of care, it is quite another to create an entirely new side industry. Telemedicine looks set to reimagine the world of medicine for both patients and physicians alike. It would appear, therefore, that one should ask a vital question. Is this good medicine? And, perhaps as a corollary, cui bono? The answer to the latter question (cui bono: “who benefits?”) will help answer the former, for if it is not the patients, it is not good medicine. One must argue further that if that is the case, it cannot be in the physician’s interest either. Medicine, in general, cannot be practiced through a screen between a doctor and a patient. This is representational medicine. Rather than being present to each other, the patient is represented to the physician, and while it is obvious that this would preclude any procedures to be carried out or any significant physical exam to be performed, it is less obvious how antithetical this is to the practice of medicine. A decent analogy might be that if medicine is sexual intimacy with a loving partner, then telemedicine is mere pornography — a representational encounter that mimics a higher good to the detriment of those who would partake in it. This is, of course, a philosophical argument and will not likely convince many, but it is in my opinion the best reason to resist the current trend toward telemedicine. After all, this is a kind of half-medicine removed from any real physician-patient interaction and isolated from medicine’s true purpose of trying to heal a human being who may be filled with terrifying anxiety, hopeless anguish, indescribable pain, tortured heartbreak, bleak malaise, or the grey despondency of modernity. It is, after all, often a kind eye, the perfect word at the right moment, or a gentle touch that is the most therapeutic weapon in a physician’s armamentarium. If we are to keep our beautiful art intact, physicians should avoid the siren song of more technology inserting itself between them and their patients. Patients should avoid the easy allure of a quick video chat. Hospital administration should resist the profits that might accrue to their benefit at the expense of the local citizens whom they ostensibly serve. If social media has taught us anything, it’s that it is much harder to become a cynic when confronted with another human being, and much easier when there is a screen to hide behind. To pretend to care for our fellow man remotely is, in short, not medicine but the representation of medicine. Let us keep telemedicine within its limited and proper scope. Let us be physicians, not technicians, and always, first and foremost, human beings. +

At its very best it’s half-medicine.

Andrew Ross is an emergency physician

11 +

AUGUSTAMEDICALEXAMiNER

From the Bookshelf

The central character in Breakthrough is an elevenyear-old girl. But not just any eleven-year-old girl. This one happened to be the daughter of Charles Evans Hughes. If that name rings a bell, you’re probably something of a student of American history, and Mr. Hughes holds a fairly prominent place on the pages of U.S. history. He was Governor of New York, served as U.S. Secretary of State, as Associate Justice of the Supreme Court, and was finally the Supreme Court’s Chief Justice. In the middle of all that, he also found time to run for President. (He lost to our own Woodrow Wilson.) But aside from all those things, Charlie Hughes (as we used to call him) was a father, and he was the father of a very sick child, the aforementioned 11-year-old. In 1919, Elizabeth Hughes was diagnosed with juvenile diabetes, which at the time was not only incurable and untreatable, but also usually fatal. Fortunately, at about that same time, researchers were making a breakthrough — which just might explain

the title of this book — that led to the isolation and mass production of insulin. Elizabeth was one of the first to benefit from this new discovery. Incidentally, we’ve written about this amazing discovery process before. Check your family Examiner scrapbook/ wayback machine for the February 5, 2010 issue on page 7 for a brief “Insulin bio.” Although there was a fair amount of wrangling between rival scientists and competing claims of discovery, the story ends happily: the Canadian scientists credited

with discovering how to extract and mass produce insulin sold the patent to the University of Toronto for exactly $1. The university, in turn, granted license without royalty to any company producing insulin (which for many years was Eli Lilly Co. and only Eli Lilly Co.). One of the cool things about this book is that it tells the story of a disease once thought to be a death sentence. As was the case with polio and any number of dreaded diseases of the past, there is always hope that in some laboratory someplace — maybe tomorrow or even later today — some researcher might make the key discovery that will lead to the conquest of cancer or another similar bane to humanity. Maybe even the breakthrough that leads to a completely effective vaccine for COVID-19 One can always hope. + Breakthrough: Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle by Thea Cooper and Arthur Ainsberg, 320 pages, published in September, 2010 by St. Martin’s Press.

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OUR NEXT ISSUE DATE 2022

NOVEMBER

+ 12

AUGUSTAMEDICALEXAMiNER

The Examiners

NOVEMBER 4, 2022

THE MYSTERY WORD

Well, the Great American Smokeout is later this month.

by Dan Pearson

I hope you’ll finally be able to quit this time.

I have two ideas guaranteed to work. First, keep that mask on at all times.

But how?

Ok. This will work: all you have to do is skip the first cigarette of the day.

Come on. Be serious.

The Mystery Word for this issue: TBSOREO

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

EXAMINER EXAMINERCROSSWORD CROSSWORD

PUZZLE ACROSS 1. Stay at Mistletoe 5. Salt of uric acid 10. Moron 14. Minerals 15. More pleasant 16. Republic in SW Asia 17. Alpha follower 18. Dew, for instance 20. Sheep’s bleat 21. Dust particle 22. Collection of maps 23. Former Russian rulers 25. Stroke, in short 26. Danzig’s name in Poland 28. Most-decorated Olympian of all time 31. A rich tapestry 32. Flower segment 34. Tree of the genus Ulmus 36. Fight for breath 37. Shankar’s instrument 38. New York canal 39. Doc’s org. 40. With “The,” an Augusta golf course 41. Swelling of tissues 42. Dougherty County (GA) seat 44. Type of school 45. Cover 46. Ambulance feature 47. Indian, for example 50. Augusta _____ 51. Nickname of the 34th US president 54. Confederate facility in Augusta 57. Bucket 58. Fencing sword 59. Research deeply 60. Wings 61. He brought down Capone

E X A M I N E R

25 28 32

40 42

45 48

21 23

We’ll announce the winner in our next issue!

28. Egyptian deity 29. Plants that live from year to year 30. Ball prefix? 32. Feel compassion for 33. Abbrev. for “and the rest” 35. Type of market 37. Castle-building material 38. Verge 40. Augusta College 41. English nobleman ranking above a viscount 43. Shoulder bones 44. Jenkins County (GA) seat 46. Medicinal ointment 47. Sign on many doors 48. Deal with 49. Female sheep 50. Enterprise follower 52. While away, as time 53. Otherwise 55. Food label abbrev. 56. Famed Brooks 57. Noted architect

DOWN 1. #1 player for the Augusta Tourists 2. Part of CSRA 3. Of the foot bones 4. An ad for raising awareness (abbrev) 5. Open a wine bottle 6. Violent protests 7. Teen skin eruption 8. Talk type 9. Before (to a poet) 10. Proximal’s opposite 11. Like most thermometers 12. Word with bank or base 13. Singles 19. Abdominal landmark 21. Spectrometer intro 24. Crack 25. Blacken 26. Very enthusiastic 27. Stage play

6 2 3 5 3

S U 5 D 3 O K 6 U

3 8

6 7 5 4 2 4 8 5

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

62. Congressman Rick 63. _____ of Man

5 7

Solution p. 14

9 6 5 7 1 4 N I E8 1 E U T6 2 3 9 N L E4 5 D 2 3 7 8 — Confucius

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once. Black squares indicate spaces between words, and words may extend onto a second line. Solution on page 14.

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

T 1 2 3 4

1 2 3 1 2

1 2 3 4

T 1 2 3 4 5 1 2

C 1

O 1 2 3 4 5 4

1 3

2 1

U 1 2 3 4 5 6

3 2

A T 1 2

— A. Lincoln

1 2 3 4

1 . A A AT T T T T I C I B O F D 2 . O U A E I B N T T S H H H H 3 . AT M M E E Y E S O I 4 . U U T T N E E 5 . R G S T 6 . E

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

WORDS NUMBER

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, NOV. 13, 2022

2 8 3 4 7 5 9 1 6

5 1 6 3 8 2 7 9 4

3 9 7 6 5 4 1 8 2

8 4 2 7 9 1 6 5 3

NOVEMBER 4, 2022

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

wo Martians are sitting in a bar. After hours of drinking one turns to the other and says, “Ldoejrn tp3hduy pgbTau7!” “Jeez Frank,” says the other one. “Just go home. You’re wasted.” A painter is hired by a preacher to whitewash his church and the fence around the churchyard. To increase his profit, the painter waters down the whitewash, and does so even more than he intended to. A few days after he finished the job, a heavy rain washed it all away. The minister was not happy, and he called the painter to complain. “What do you want me to do about it?” asked the painter. “Repaint!” yelled the preacher. “And thin no more!” Moe: Did you get to visit your grandmother for Halloween? I know you said she loves it when you visit on Halloween. Joe: Yeah, with the pandemic and everything it’s been tough seeing her... I did try, but she wasn’t home.

The

Advice Doctor

Moe: Think she’s okay? Didn’t you tell me you haven’t seen her for several years now? Joe: Oh, she’s fine, believe me. I could tell. She had the house all done up. You know, cobwebs everywhere, creepy bugs all over the windows, a skeleton on the couch...I’ll just try again next year. Moe: Hey, I can’t find my Bryan Adams CD. You know where it is? Joe: Check the dishwasher. Moe: Why would it be there? Joe: I used it to slice my pizza. Moe: Huh? Why would you do such a thing? Joe: It cuts like a knife. Moe: Why did the soccer player take so long to eat supper? Joe: He thought he couldn’t use his hands. A door-to-door salesman knocks on the door of a house. A boy no older than ten answers. He’s wearing a velvet robe, and in one hand is a brandy snifter filled halfway with liquor; in the other hand is a lit cigar. The boy takes a sip, then a puff. The door-to-door salesman, shocked, asks, “Uh, are you parents home?” The little boy says, “What do you think?” Moe: What do you get when you cross a baby bunny with a rottweiler? Joe: A rottweiller. Moe: How long does it take to drive from Alabama to Louisiana? Joe: One Mississippi. +

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.

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Dear Advice Doctor, I hate to air dirty laundry in public, so the anonymous format you’ve provided here is perfect. My question is about my husband. He’s a quiet man, which I don’t mind at all. But when I want him to talk, it’s like pulling teeth. The man is the poster child for poor communication. How can I get him to open up? — Sounds like the sounds of silence Dear Sounds, You used an apt analogy: it’s not easy to pull teeth. It can be when teeth, gums or bones are abnormal in some way. But pulling a healthy tooth, such as an orthodontist does to make way for realigning teeth, is a bit of a job. Fortunately, anesthesia makes it easy for the patient. In fact, if you do feel pain during a dental procedure like an extraction, don’t be afraid to speak up (if your mouth isn’t full of gauze and cotton balls, that is). There’s no need to try to be a hero. In various medical settings patients are sometimes told, “You’re going to feel a little pressure.” In many cases they should probably just go ahead and say pain instead of pressure. But in a dental setting pressure is the perfect word. As we have established, the goal is for dental patients to feel little to no pain. But removing a tooth is a rather physical act. The phrase often used, pulling a tooth, as though pulling a knife from its sheath, paints a very inaccurate picture. After all, teeth are solidly embedded in bone, held in place by ligaments. That’s how we can bite into apples and steak and corn on the cob without our teeth coming out. They are very firmly entrenched. Extracting a tooth requires a little wiggle room, and a dentist or oral surgeon will try to provide that as step two (step one being anesthesia). The composition of bone in the jaws is spongy, comparatively speaking, so wiggling a tooth around with special dental tools enlarges the space around the tooth and makes extraction easier. It might be compared to trying to pull a deeply driven tent stake straight out of the ground versus trying to wiggle it around sideways in all directions to loosen the ground’s grip on the stake before pulling it out. That is basically what a dentist is doing prior to extracting a tooth: moving the tent stake — I mean tooth — around to make it easier to remove. It’s pretty physical. It’s the perfect time to say, “You’re going to feel some pressure.” Best wishes! + 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 only be provided in the Examiner.

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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

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