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APRIL 19, 2013

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APRIL 19, 2013

AUGUSTA MEDiCAL EXAMINER

Editor’s note: Healthcare is a whole new ballgame with the passage of the Patient Protection and Affordable Care Act (PPACA). How will healthcare providers be affected? What about patients? And how about employers who provide health coverage as an employee benefit? How will Medicare and Medicaid recipients be affected?

Look to this column for the answers.

HEALTHCARE REFORM & YOU

by Russell T. Head, CBC, CSA

Portrait of a serial killer

MORE ON THE INDIVIDUAL MANDATE

I

checked online to see what the dictionary had to say about a word new to the world of health insurance. Healthcare Reform/PPACA/ACA has created a new job title for us to embrace in all of the processes being introduced: NAVIGATOR Here’s how it is defined as a noun and a verb from http:// www.merriam-webster.com.

D

o you remember these paragraphs from the June 6, 2008 issue of Medical Examiner? To this day, they’re still almost unbelievable:

According to Wikipedia, the online encyclopedia, mosquitoes are “the most deadly disease vector known to man, killing millions of people over thousands of years and continuing to kill millions per year by the spread of diseases.”

Do not adjust your Medical Examiner. Yes, mosquitos kill millions of people per year, and have been doing so for thousands of years.

Those figures are not exaggerations. The best guess is that mosquitos infect about 700 million people with disease every year. Malaria alone accounts for more than 5 million deaths each year. According to The New York Times Magazine, mosquitos will eventually be responsible for the deaths of 1 in every 17 people currently alive today.

By comparison, even a fiend like Adolf Hitler was a rank amateur. While it may be true that many deaths that are mosquito-related happen in places far away from Augusta and even the United States, we’re far from immune.

In view of the health threat posed by mosquitoes, it was no surprise to receive the following information from Pam Tucker, Director of Columbia County’s Emergency and Operations Division. After all, when we originally ran the article above, we also reported that mosquito-borne cases of West Nile Fever had been reported in Richmond, Columbia, and Aiken Counties.

Mosquitoes are a definite threat to public health. And without further ado, on to Pam Tucker’s information: During 2012, the 3-1-1 Customer Service & Information Center received a total of 48 mosquito related complaints between April and October. The highest number of complaints were made during the month of August.

Russell Head

nav·i·ga·tor noun: na-ve-ga-ter Definition of NAVIGATOR one that navigates or is qualified to navigate

nav·i·gate verb: na-ve-gat nav·i·gat·ed nav·i·gat·ing Definition of NAVIGATE intransitive verb 1: to travel by water 2: to steer a course through a medium; specifically: to operate an airplane transitive verb 1a: to sail over, on, or through b: to make one’s way over or through 2a: to steer or manage (a boat) in sailing b: to operate or control the course of Here’s how Centers for Medicare and Medicaid Services or cms.gov describes the Navigator Program: The Marketplace (Public Exchange) must establish a grant program to fund entities or individuals called “Navigators” that will: • Provide consumer assistance.

Navigators will help you understand your new health insurance options available through the Marketplace and will help you select a health plan.

• The primary goals of Navigators are to raise public awareness

about the Marketplace, reach out to diverse populations, help consumers understand their coverage options, and provide referrals.

• To ensure that Navigators provide unbiased and accurate information, the Marketplace must develop conflict of interest standards and training programs for Navigators.

• Navigators can’t receive commissions from health insurance companies for enrolling consumers, employers, or employees in Qualified Health Plans or in non-Qualified Health Plans outside of the Marketplace. However, they can help consumers with other non-Navigator assisted enrollment functions, as set forth in in 42 CFR 155.220.

• Agents and brokers may serve as Navigators as long as all other Navigator standards are met.

Source: http://marketplace.cms.gov/GetOfficialResources/ Training-materials/the-health-insurance-marketplace-cmsnational-training-program.pdf

Note: Georgia House Bill 198 2013-2014 Regular Session has passed the House and Senate. This will require that Title 33 of the Official Code Georgia Annotated be amended to require that navigators in Georgia be licensed through the Commissioner of Insurance and are trained and knowledgeable in the subject matter of health insurance.

Using the word navigator makes sense based on the outline of the anticipated program objectives. We are not yet sure of who will be navigators or who they will be employed by.

They may be public employees working for a state or federal agency. As October 1, 2014 gets closer, we will all start hearing more about the Navigator just as we will all be more familiar with “The New” health insurance buying process called Health Care Reform. + Russell T. Head is a Partner and Chief Visionary Architect with Group & Benefits Consultants, Inc., Augusta’s largest, privately held employee benefits consulting firm. He can be reached at 706-733-3459 or rthead@gandbc.com. Visit Group & Benefits Consultants at www.groupandbenefits. com.

Please see MOSQUITOES page 3

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APRIL 19, 2013

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AUGUSTA MEDiCAL EXAMINER

MOSQUITOES… from page 2

Check your home for the

Abandoned or neglected swimming pools accounted for the following common mosquito majority of these complaints, amounting to 54% of the total breeding problem areas: number of calls. General nuisance complaints accounted for Swimming pools, bird baths, 25%. Drainage issues account for 15% and retention/private gutters and downspouts, ponds accounted for 6%. Evans reported the majority of decorative ponds, containers, mosquito complaints, followed by Martinez and Grovetown, tarps, leaky spigots, low spots with no complaints coming in from the Harlem or Appling in yard, tires, tree holes and areas. screens and remove them as Larviciding is the current mosquito abatement program used soon as possible. To report

by Columbia County. This is the most effective, cost-efficient, mosquito problems in Columbia and eco-friendly method of mosquito control because it prevents County, please dial 3-1-1 to the larvae from hatching into mosquitoes. The Larvicides are provide information needed by distributed by Roads & Bridges Department, Code Enforcement, the IMMP Team to respond. + Water Utility Division, and Public Health Officials in county owned retention ponds, storm drains, stagnant water sources in right-of-ways, abandoned swimming pools and other mosquito breeding sources of water.

While larviciding is highly effective, it will only do so much to prevent mosquitoes and the diseases that they may transmit. We need each citizen to help reduce mosquitoes by taking personal protective measures to prevent your exposure to mosquitoes and - most importantly - eliminating all breeding sources of standing water around their homes. Remember, anything that can hold water for more than a few days can produce mosquitoes.

The link posted below is a short video showing the development of a mosquito. Sometimes, people don’t realize that this is what is growing in that bird bath, potted plants and other items in the yard – so we hope that this will help you identify and empty out that water before they hatch. Mosquito “wiggler” and “tumbler” are informal terms for the larval and pupal (immature) life stages of a mosquito. Mosquito wigglers live in water, and as soon as temperatures get warm enough to drive their development, they quickly mature and emerge from pools and containers wherever they may be found.

Also, remember to use EPA registered mosquito repellents, make sure your windows and door screens are “bug tight,” and wear clothing that will protect your skin when in areas with high mosquito populations. +

What’s your story?

Nearly all of us — even doctors and nurses — are sometimes patients. Perhaps you were recently injured playing your favorite sport, or years ago you somehow got hurt without even leaving your favorite recliner. Maybe you were diagnosed with a dreaded disease, mugged in a dark and lonely parking lot, or you stubbed your toe in the safety of your own bedroom. On the other hand, perhaps you needed medical attention 5,000 miles from home. Whatever your medical experience, we’d like to hear your story for our Medicine in the First Person feature. It can be frightening or funny, ordinary or extraordinary, just a few paragraphs long or quite a lengthy tale, bylined or anonymous. We’ll publish your encounters with the medical profession as often as we receive them. + Send your submissions for Medicine in the First Person to the Augusta Medical Examiner via e-mail: info@AugustaRx.com or to PO Box 397, Augusta, GA 30903-0397. (The Medical Examiner reserves the right to accept, reject, or edit any submission at its sole discretion.)

Can you get AIDS from skeeters?

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“Mosquitoes cannot transmit HIV because the virus neither survives nor replicates in mosquitoes and the blood from the last bitten person is not flushed into the next person during subsequent feeds. In addition, the circulating viral load of most HIV-infected persons is so low that the theoretical risk that a mosquito bite would transmit HIV is estimated to be less than 1 in 10,000,000.” + — American College of Physicians

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 news within every part of the Augusta medical community.

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Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com Augusta Medical Examiner photography: H + D Photography www.handdphoto.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397

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Opinions expressed by the writers herein are their own and their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., or its agents or employees take any responsibility for the accuracy of submitted information, which is presented for informational purposes only. For specific medical advice, diagnosis, and treatment consult your doctor.

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APRIL 19, 2013

AUGUSTA MEDiCAL EXAMINER

Hope IS Possible

Spring forward: it has nothing to do with clocks

Helen Blocker-Adams

T

here is something special about this time of the year that makes my heart sing.

The dogwood trees are in full bloom. The weather is a little shaky to say the least. Early in the morning the temperature can be cold and then later on mid 70s or low 80s. But we Southerners tend to get used to that, even though many complaint.

That little golf tournament (AKA The Masters) is history for another year, and of course Easter and the message of the death and resurrection of Jesus is hopefully still on many people’s minds.

It’s a special time of year.

The added hour or more of daylight we’ve been enjoying

for a few weeks is pretty cool too. Spring forward.

Spring gives us the impression of a rebirth. The freshness in the air. The birds singing in the early morning.

I think this time of the year is a perfect time to not only clean up one’s house, but to remove some of the negative clutter formed in our minds.

It’s a perfect time to clean up and/or recommit to our mental health.

Attitudes soften up in the spring. People who have been hidden away in winter hibernation are taking off the thick sweaters and putting them away to make room for their spring and summer wardrobe. For people who prefer the spring weather versus the fall and winter – I would think their attitudes are positive right now. And that is a good thing.

Have you noticed your slacks are feeling a little tighter than usual? Yes, those late night snacks, hot homemade soup and excuses not to exercise all winter long have caught up with you.

But although you’d be long overdue if you’re just changing your clocks, it’s not too late to spring forward

ISN’T IT A LITTLE LATE FOR A STORY ON DAYLIGHT SAVING TIME?

THIS IS MORE ABOUT “FORWARD” THAN “SPRING”

SPRING FORWARD

with a strong and effective exercise routine. I have to admit I’m feeling pretty good because I forged through the cold weather and rarely missed my weekday 5 a.m. workouts. It should be easy now that winter is long gone.

Although spring brings a much needed energy boost and optimism to many of us, for many suffering from depression it can have quite the reverse effect. There has been extensive research carried out by Harvard

The

psychiatrist John Sharp into the effects that the changing seasons have on our mental health and emotional well being.

“We are exquisitely sensitive to the effect of physical influences on our mood and behavior. At the same time as most of us are rolling up our sleeves and spending more time outdoors, others struggle with trying to get into that kind of mode, and counterintuitively, they feel worse.

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If you’re not being carried along with the natural energy of the season it can be really hard,” says Dr Sharp.

There are many opportunities to take a healthy advantage of the spring time weather and outdoors. The Saturday Market in downtown Augusta has recently teamed up with The Family Y for an 8 am walk or run. This occurs each Saturday right before the popular event begins. The first two weeks there were more than a hundred walkers and runners. You do not have to register. All you have to do is show up. It is a lot of fun and I recommend you try it.

It’s up to you, young or old, to spring forward. It is a conscious decision for us all to make.

I know you can do it. + Helen Blocker-Adams is Executive Producer/Host of “The Helen Blocker Adams Show with Co-Host Sammy Lilly”, which airs Monday through Thursday 1 p.m. – 3 p.m. on 103.7 FM/1600 AM WKZK The Spirit. She is also Founder of Unlikely Allies Emerging Leaders Conference. You can contact her at hba@hbagroup-intl.com or visit her at www.helenblockeradams.com

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appears exclusively in the Medical Examiner’s 3rd Friday issue of even months, written by Augusta’s own Bill Cleveland, a Certified Financial Planner named by Medical Economics magazine as one of the “150 Best Financial Advisors for Doctors” in the U.S.

Read it and reap

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APRIL 19, 2013

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AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW

L

ABOUT THE HEALTH BENEFITS OF LYNYRD SKYNYRD

ynyrd Skynyrd is correctly spelled with 4 y’s and named after a gym teacher.

They play high energy, highly electrified Southern Rock with an upbeat blues underpinning.

I like that.

The ticket price was a bit steep, I felt, but I wanted to experience their concert. So I got a Media Pass and crashed the backstage looking my Bad Billy best: jeans, tennis shoes, light windbreaker, and black Bulldog cap. I was overdressed.

Their clothes were older (and certainly more expensive) than mine. Their hair was longer than most women I know. Their amplifiers can pump out more power than the Savannah River Plant.

Before I gave up counting, I saw 40 speakers strategically angled to provide professional sound to unknown distances.

Not knowing what all those buttons and knobs in the control room were connected to, I touched nothing for fear of accidentally launching a nuclear missile toward North Korea (not that that would be a bad thing.) But WWIII would have to wait for another time.

Tonight was set aside for fun, entertainment, and minor eardrum damage. But what do I care? My wife says I can’t hear it thunder now.

Lady Antebellum Pavilion may never be the same again.

The crowd was well mannered

and orderly, sipping beer, and anticipating thunderous sounds in the night the way God intended concerts to be.

Ages ranged from no-teeth to no-teeth. There were wellmannered bikers, doctors, lawyers, laborers, teachers, nurses, and many other productive, taxpaying citizens.

I love those kinds of people.

The dress code, if one existed, was confusing. Men wore comfortable fitting outdoor duds. Women were easy on the eye in clothes that looked like they were born in them and grew considerably thereafter. Many took pride in wearing tee shirts from tours ten years back.

No one had purple hair, pants below their butts, nose rings, nor tee shirts with obscenities. I did not see anyone who thought it was a dressed rehearsal for the next Inter-Galactic Transvestite Vampire Association Conference. And there were no Walking Dead. Everyone was vividly alive, regardless of their age. There was not one hint of illegal substances, violence, or rudeness. Their manners were well suited for a southern Sunday dinner on the grounds.

Concessioners sold everything from Harley Davidson motorcycles to beer ‘n burgers to sunscreen. A pretty lady rubbed sunscreen on my hand. The veins on

E

TH

Best the back of my hand dilated.

Now she has a new marketing tool: sunscreen that improves circulation.

My Media Pass got me into the Sponsor’s Pavilion.

My nose took me to the food bar: lobster and shrimp salad, grilled filets, and other finger foods country boys like me don’t recognize by name, but admit they tasted wonderful.

You could bid on high end memorabilia. Autographed Mohammed Ali boxing gloves and trunks: $2,750. Signed Johnny Cash proof album: $2,300. Not wanting to deprive others, I passed. Never mind that I only had $27 in my pocket.

Precious few Columbia County deputies stood around looking professionally bored because they had no rowdiness to control and they were not supposed to enjoy the concert while on duty. With this crowd, the deputies were unneeded.

For a while, I sat beside

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e n i c i d ME

transplanted Yankees: Patrick Sprow (retired military father) and Cathleen (preteen daughter). It was her first Southern Rock outing and black Lynyrd Skynyrd tee shirt. Judging from the awed look in her eye, it will not be her last. We sat on the ground.

Our jeans did not get too damp because we got up and down a lot.

Drake White opened with considerable expertise. He is a relatively new Nashville talent we will hear more from in the future.

Fog machines sprang to life. Lasers reflected off a huge rotating, faceted globe.

A galaxy of lights flashed incessantly. Lynyrd Skynyrd erupted into a feverish pitch.

Bass notes rattled my dental fillings. High notes sent my adrenals into over-production.

My eyes dilated. Chills ran up my spine. They were too excited to go back down.

Diehard Skynyrd fan Cheryl Arrington was under the influence of Southern Rock, no illegal substances needed.

She sang and screamed on key.

She invented new dance steps galore. She exuded happiness,

energenicity, athleticism, and self-fulfillment. She might have had ovarian fibrillation.

If I could bottle and sell her exuberance and joyfulness, I would be so rich I could hire Tiger Woods to be my limo driver.

The lights and sounds made it no place to be for migraine suffers. The high crowd energy was enough to give one an impromptu cardiac stress test.

No Medicare co-payment required. And a heck of a lot more fun.

Lynyrd Skynyrd ripped through Sweet Home Alabama, Give Me Three Steps, and Free Bird. They prominently displayed Old Glory. The Confederate Flag had a Golden American Eagle sitting proudly atop. They did two separate tributes to our troops in harm’s way, each with a heart-felt, patriotic soliloquy that brought tears to the eyes of the most jaded. They made it easy to be proud to be an American.

These are the kind of patriotic Americans (band and audience) that I would want at my side when I go to war ... or church. + Bad Billy Laveau is a retired MD with a pointed sense of humor.

Bad Billy speaks and entertains at public and private events for audiences not subject to cardiac seizure secondary to overwhelming laughter and glee BadBilly@knology.net or 706306-9397

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Worrying is like a rocking in a chair: it keeps you busy, but doesn’t get you anywhere.

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AUGUSTA MEDiCAL EXAMINER

Right at Home supports Parkinson’s Awareness Month

by Kathy Crist April is annual Parkinson’s Awareness Month. Parkinson’s is a progressive neurological disease often associated with tremors, slow or uncontrolled movement, Crist and impaired balance. Approximately 1 million Americans have Parkinson’s, and 50,000 to 60,000 new Parkinson’s cases are diagnosed each year in the United States.

April 11 was designated World’s Parkinson’s Day when people across the globe were encouraged to better understand the disease and be advocates for Parkinson’s patients and their families. In America, Moving Day® events help celebrate movement’s pivotal role in treating Parkinson’s and symbolizing hope and progress in fighting the disorder. In the CSRA, the 2013 Moving Day Walk is October 19 at the Wilson Family Y on Wheeler Rd, Augusta.

Moving Day is sponsored by the National Parkinson Foundation (NPF), one of the leaders in Parkinson’s cuttingedge research, education and outreach.

In hosting Moving Day, NPF partners with select agencies

including Right at Home, a local provider of in-home companion and personal care to senior citizens and others.

Each Moving Day event features family friendly walk routes, food and music, plus a Movement Pavilion with activity stations such as yoga, Tai Chi, dance and Pilates, which are proven to help manage Parkinson’s symptoms.

A champion of helping NPF fighting Parkinson’s disease, Right at Home works to improve the quality of life for people with Parkinson’s and provides an extra hand to loved ones caring for anyone dealing with limitations of the troublesome disease.

Early diagnosis of Parkinson’s gives individuals the best possibility for healthier living. Initial warning signs of Parkinson’s disease include: • Tremor or shaking • Small handwriting • Trouble sleeping • Trouble moving or walking • Constipation • A soft or low voice • Masked or serious-look face • Dizziness or fainting • Stooping or hunching over Anyone experiencing symptoms associated with Parkinson’s disease is encouraged to see a doctor to help diagnose the illness

and rule out other possible symptom causes.

In spreading the word about Parkinson’s and finding a cure, people are challenged to join the cause in a variety of ways.

Participation includes spending time with someone who has Parkinson’s; volunteering for a local chapter event or joining a support group. In the CSRA, a Parkinson’s support group meets the last Tuesday of each month at St. John’s Towers at 6:00 pm at 724 Greene Street, Augusta.

The muscle-movement disease is not fatal itself, but the Centers for Disease Control lists Parkinson’s complications as the 14th leading cause of death in America. Currently, there is no cure for this disease, and cases are expected to rise significantly as the aging increases. For information about Parkinson’s disease, visit www.parkinson.org or call 1800-473-4636. + About Right at Home Right at Home of the CSRA, a leading provider of in-home care and assistance, supports family caregivers and is dedicated to improving the life of the elderly and disabled. To contact Right at Home call 803-278-0250 or visit them on the web at www.csra.rightathome. net

APRIL 19, 2013

Cookbook published The Georgia Academy of Nutrition and Dietetics is releasing a cookbook, Seasonal Eats: A Recipe Collection of Georgia Products, brought to you by its members, registered dietitians, student and interns. Sales of the book will go towards student scholarships as well as professional stipends.

The cookbook is a compilation of more than 100 tried-and-true recipes featuring Georgia produce and products, organized for creating seasonal menus.

Recipes include those from the family of a Vidalia onion farmer. Other Georgia farms spotlighted include Vesterfield Farms, Le Tre Luna at Glover Farms, Babe and Sage Farm and Kachina Farms.

All recipes include nutritional analysis.

Cookbooks are available for purchase from GAND members or online: www.eatrightgeorgia.org ($12 each plus $5 S&H) + Note: the direct link to the cookbook (below) is not for the faint of heart.

Our suggestion: go to the website address above and look for the grey “search...” box to the right. Type in the word cookbook and look for “Georgia Academy Cookbook” in your search results. http://www.eatrightgeorgia.org/component/content/article/19reminders/273-georgia-academy-cookbook.html

Stay at home alternatives

FRACTURE

from the professionals at Right at Home “Right at Home” owners Celeste Hoffman and Kathy Crist introduce therapy dog Snickers to Mrs. Margaret Lista. Photo by Todd Lista.

For more information and a free in-home assessment, call

803-278-0250 or visit www.rightathome.net/csra.

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APRIL 19, 2013

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AUGUSTA MEDiCAL EXAMINER

by Ross Everett

WHY YOUR PREMIUM IS GOING UP

L

ast time I was home, my mother started talking about the health costs our family would incur this year. A visit here and a visit there. A skin biopsy in the months gone by and a knee replacement in the months ahead. It’s probably for the best to get it all out of the way this year, though, she decided, because rates will be going up soon. It’s true. I expect nearly all aspects of health insurance to rise over the coming years. Premiums alone have been predicted to increase by as much as 30% for some families. Each insurance company points to the abysmal healthcare reform, the Patient Protection and Affordable Care Act (PPACA/ACA), for the increase, citing the influx of unhealthy patients it will cause them to absorb.

They’re right. Well, sort of. Of course PPACA is increasing the costs of care provision. Like they are saying, we’re sending many of the previously “uninsurable� to them. It’s a fair assessment that these unhealthy few will cost them money. Now, PPACA also requires all of those previously uninsured people without preexisting conditions to also enroll in healthcare plans. Many of these are the young and healthy folks who would rather save the money now and then seek insurance when they finally get sick. These enrollees should offset most of the cost of the other group, but, hey, we’ll give the insurance companies the benefit of the doubt and assume that the numbers don’t add up. I’ll tell you this though. They sure don’t add up to losses requiring 30% increases in premiums to offset them.

I’m afraid the world isn’t quite that bleak for the insurers, who haven’t had a bad year in who knows how long. Do you recall the economic recession that so many industries limped through? Well from 2008 to 2010, combined profits for Aetna Inc., Cigna Corp., Humana Inc., UnitedHealth Group Inc., and WellPoint Inc. increased 51%. Collectively they cover about 1/3 of the US. In 2011, the five soared to record profits of $14 billion. I, for one, don’t expect anything to change for them anytime soon.

Why? Because the insurance companies don’t actually carry any risk. They are essentially guaranteed to profit. Each can make their target for the year merely by increasing premiums as they see fit. If they come up short one year they can always just tack on the difference the year after. And for all those mumbling “free market� under their breath, there has been pretty sufficient research showing that most people in this country don’t really have much of a choice amongst providers. This cycle has led to an unhappy general population and a Wall Street that absolutely loves them.

Yet, we continue to buy into the principle that these companies are the best we can get. It just isn’t true. The political system encourages nearly the complete opposite. Most insurers don’t even have a true incentive to keep you healthy. Look at preventative care. We are constantly bombarded with the idea that preventative care is the most cost-efficient, yet most struggle to get their insurers to cover basic screening utilities and tests. The reason is that they don’t really care how you end up. Come age 65, you can be as bruised and battered as you want to be. Then they’re passing you off to Medicare and you’re no longer a liability for them through your sickest and most costly years ahead. They just have to get you that far.

If anything, PPACA may just be convenient for the insurers. Now they can spike premiums, deductibles and co-pays more in a single year than even they would have thought possible before.

As the public outcry comes, they can simply point their finger to the bill that a large portion of the country already disapproves of. Most people will agree with them. Meanwhile, the profits will continue to pour in.

Unfortunately, change is unlikely to occur soon. The best chance we had was with the original PPACA bill that included a public option. Consider it a sort of Medicare-at-any-age type of option that anyone could sign up for. However, the other insurers warded off such serious competition as Medicare, which boasts higher efficiency and higher client satisfaction than any of them. It was the single most lobbied against aspect of the original bill, with an estimated tab of $173 million. Maybe the increased expenses these next few years will serve as a catalyst for real change. Still, times are going to be hard for a whole lot of individuals and businesses. But rest assured, your insurance company won’t be one of them. + Ross Everett is a 2nd year medical student at the Medical College of Georgia. He grew up in Buford, Georgia and graduated from the University of Georgia in 2011. In addition to his coursework, he is interested in health policy, health systems and health management. Please contact him at wideeyedwhitecoat@gmail. com and “Like� him on Facebook at Wide-Eyed White Coat.

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APRIL 19, 2013

AUGUSTA MEDiCAL EXAMINER

Very little if anything about healthcare is inexpensive, and that includes medicine. Tiny pills can command large prices. Over-the-counter medications may be less expensive, but are they also less effective? Find the answers to lots of your drug store questions in this column written

by Augusta pharmacists Chris and Lee Davidson exclusively for the Medical Examiner.

WHY AM I RUNNING TO THE RESTROOM?

L

ast issue we discussed side effects of the overuse of antibiotics. This issue we will give one more example of how antibiotics can be dangerous and how to treat the resulting condition.

This problem is clostridium difficile (C. diff.) infections of the intestines.

This infection is most often caused by antibiotics destroying the good bacteria in your intestines. This is especially prevalent after several antibiotics are used in a short period of time. The good bacteria in these cases are no longer there, and the bad bacteria that are normally suppressed can take over and cause problems. In this

case the result is an extreme case of diarrhea that needs (ironically) an antibiotic to treat.

A more serious complication of a C. diff. infection is pseudomembranous colitis.

This is an inflammation of the colon resulting in offensive smelling diarrhea, pain and fever. This can lead to a condition known as toxic megacolon, which is a swelling of the colon. In this condition the colon becomes distended and may require surgery to remove part, or all, of the colon. An ileostomy may be required after surgery.

There are two main antibiotics used to treat C. diff. infections. These

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are metronidazole and vancomycin. The first line therapy is oral metronidazole, since it will be less likely to result in a superbug as we talked about last issue.

The vancomycin is reserved for more severe infections that are unresponsive to metronidazole. Oral capsules of vancomycin can be extremely expensive if not covered by insurance, so a compounded oral solution may be the better route to take. Vancomycin is not absorbed when taken orally, so the risk of developing a systemic superbug is low while the intestinal tract is cleared of the C. diff. infection.

The elderly are at high risk of C. diff. infections and tend to have more severe consequences. If diabetics contract a C. diff. infection, then careful monitoring of the blood sugar and possible adjustment of the doses of diabetic medicines may be needed. I know one diabetic who contracted C. diff. that ended up with blood sugar readings in the mid-thirties due to lack of being able to keep any food or drink down, and still taking the blood sugar medicine one morning. He ended up in the hospital twice for this

Questions about this article or suggestions for future columns can be sent to us at cjdlpdrph@bellsouth.net Written for the Medical Examiner

by Augusta pharmacists Chris and Lee Davidson (cjdlpdrph@bellsouth.net )

+ I

Try our Pot Head Blend Drug of Choice Brand Coffee is available at Inner Bean on Davis Road.

infection as metronidazole was used after vancomycin in the hospital and in his case did not eradicate the infection. So check with your doctor or pharmacist about whether you should adjust your medicine during bouts of diarrhea, especially severe cases like C diff.

So let’s get back to the philosophy that an ounce of prevention is better than a pound of cure — and cheaper too.

How can you prevent or lower the likelihood of contracting a C. diff. infection? This is done by supplementing your intestinal tract with good bacteria, especially when taking courses of antibiotics. This is accomplished by taking a daily probiotic available from your pharmacy that should be taken daily to prevent intestinal irregularity, or with courses of antibiotics if you choose not to take it every day.

So let’s choose to prevent rather than treat and thus help improve our overall health. +

“Coffee is good medicine.”

— J. Perkins Brewster III.

M.E.

THE AUGUSTA MEDICAL EXAMINER AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

APRIL 19, 2013

9+

AUGUSTA MEDiCAL EXAMINER

Don’t Lick the Beaters and other interesting food facts

by dietetic interns with University Hospital’s Augusta Area Dietetic Internship Program

WHERE GREAT FOOD ROCKS.

SWIMSUIT READY - NO CRASH DIET NEEDED

T

his is that time of year when we are all insanely busy — fiddling with the garden, mowing the lawn, watching our children’s tee-ball games, and trying to hit the course before the infamous Georgia heat sets in — where everything else falls to the back burner, including healthy eating.

That is, until we start panicking about swimsuit season being right around the corner and start yet another crash diet. This time do not start another fad diet, because let’s be honest: those deprivation diets never work.

Want to know why?

It is because we constantly have to remind ourselves not to eat that brownie, yet end up relentlessly thinking about it and straining our will power.

Eventually we give in and eat more than we would have if we were not avoiding that

brownie in the first place. Or we are working so hard to avoid that sweet that we end up mindlessly eating anything else we see.

Instead, this year try something new: mindful eating.

What is mindful eating, you ask? It’s grabbing a bag of Cheetos and sitting down in front of the television, and before we know it hitting the bottom of the bag and the

only evidence that we even ate anything at all is the legendary orange stained fingers. This happens to the best of us in one way or another; whether it is in front of the television, catching up with friends at a dinner party, or grabbing something on the way out the door so we are not late for that early morning meeting. While we are focusing on other things, we mindlessly eat. This is exactly what we want to avoid.

This does not mean that every single bite or sip taken must be deeply reflected upon, but it must be a conscious decision. Unfortunately for us, neither our eyes or nor our stomach can count calories; only our expanding waistline can. This means that we have to help our brains out. By providing external cues and solely focusing on eating, our brain can notice the signal from our stomach telling us that we

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APRIL 19, 2013

AUGUSTA MEDiCAL EXAMINER

THINK… from page 9 are full or content. This takes around 20 minutes, which could be three brownies too late.

Stop overeating from becoming a habit. First, cut out any distractions. Do not eat while watching TV or a movie, reading, or working. Choose only one room to eat in. This way you have to think about what you are doing. Make getting seconds hard work.

After putting dinner on your plate, keep serving platters

off the table. Have you ever realized how at the grocery store, sweet treats are always at eye level tempting you? This toys with your willpower. Use this concept in your favor at home; keep snacks and desserts out of sight and out of reach!

Even before taking that first bite, our eyes try to determine how much to eat. Our eyes dislike white space (the open space around the food on the plate). The more white space,

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the less food our brain thinks we are eating. Trick your brain into thinking you are eating more by using smaller plates with the “correct” portion sizes.

The brain uses external cues to determine when it is full, whether this be when company is done eating, our plate is licked clean, or like that bag of Cheetos, you reach the bottom.

However, sometimes these are not the best cues to use. Some food companies use packages that hold more than one serving, instilling the belief that once the bag is empty enough has been eaten, but in reality some of those bags contain as much as an entire day’s worth of calories.

Also Southern hospitality has instilled in us that we must continue eating with our guests or must take seconds to show our gratitude. Try being the last one to start eating and stop that “clean your plate” concept. Leave several bites on your plate. Trust me, those last few bites are not going to affect the starving children in Africa!

Sometimes we are unable to reflect on everything we ate because the foods have been cleared from the table or there is no physical evidence of how much we consumed. To show you how important this is, think about the last time you

were out to eat and ordered sweet iced tea. Do you know how many glasses you drank?

Probably not. This is because the waitress constantly refilled your glass any time it was close to being empty (that is if the waitress was any good).

These extra glasses can really add up and slowly pack on the pounds. This is important to keep in mind if you enjoy buffets or bottomless chicken wings.

Next time at a restaurant, ask the waitress to bring a new glass for each beverage refill and to leave any all plates and glasses that you are finished with on the table, so you can see what you have consumed.

So to recap: eat without any distractions, designate one particular room for eating, use smaller dishes, see all you eat and drink by keeping empty beverage glasses and plates on the table, keep snacks and treats and second helpings out of sight and reach, pre-measure single servings, stay away from bottomless deals, and forget that “clean the plate” concept.

These mindful eating tips can have you ready for swim suit season all year round, no crash diet or periodic panicking necessary. + — by Jami Szwargulski University Dietetic Intern

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APRIL 19, 2013

11 +

AUGUSTA MEDiCAL EXAMINER

The blog spot — Posted Mar. 8, 2013 at ednurseasaurus.blogspot.com (edited)

ER GAMES WITH “LADY” Lady’s nonsense urgent attention-seeking issues have logged hundreds of annual calls to 911. Dispatch has been heard to simply say “head on over to Elm St for complaint,” which means Lady’s apartment, for things she sees out the window like moths, meteor sightings, or a well-being check request on a neighbor who has simply gone out for lunch. One would think Lady has a pretty full schedule: her numerous outpatient visits for various maladies are certainly time consuming, and did I mention that she is on 25 DIFFERENT MEDICATIONS which surely takes up a good portion of her day.

But no, she still has lots of free time to call the ER pretty much daily, usually on the evening shift.

Her pattern is gradually ramping up the calls until it culminates with 911 drama and the inevitable ride to the ER in the Big White Taxi with the Flashing Lights.

It is our policy not to give out the names and schedules of the doctors. It’s pretty obvious when individuals are “shopping” for a doc who gives out narcotics or are looking to avoid the doc who piss tests first. This is not the case with Lady. She has her favorites and those she can’t stand, usually because they have had the temerity to bring up the subject of her weight, the elephant in the room (no pun intended).

She is not fond of me. I have honestly tried with her, but when your best effort gets rewarded with some BS complaint, well, sorry. You get the bare minimum from me, especially if I have an Actual Sick Patient to deal with. I don’t want to chat about your day. Or mine. Partner in Crime talks to her a lot and nearly always tells her to call her doctor in the morning. Still, Lady likes Partner in Crime.

I drew the short straw when Lady was brought in by EMS. She rolled by on the super-duper heavyweight cart like she was the queen on her parade float, waving and smiling, surrounded by her contingent of EMS personnel as reluctant honor guards. She was making the usual sarcastic remarks meant to be funny (they weren’t) and behaving as if we are all bosom buddies.

“Where is Partner in Crime?” Lady bellowed as she was wheeled in, proving that she was not, in fact, having the lifethreatening shortness of breath which precipitated her 911 call.

“I want Partner in Crime for my nurse.”

“Sorry, she’s busy with an Actual Sick Patient and you don’t get to pick your nurse. Here is a nebulizer treatment since you are speaking in full sentences, have normal skin color, have normal oxygen saturation and your lungs are clear. Dr. Parvati will be along shortly.”

Parvati might be abrupt, lack communication skills, and be blind to the fact that she is a poor team player, but she is never unkind on purpose. I have to give her that.

Parvati dealt with Lady’s BS complaint empathetically with the therapeutic equivalent of patting her on the shoulder and telling her she was just perfect in every way. Which is not what Lady wants to hear because if true it would mean she would have to take up a new hobby to fill her days. Eventually she was kicked to the curb like she is 99.99% of the time.

As usual it took Lady about 15 minutes to vacate the exam area, then there was the requisite lurking at the desk to engage Partner in Crime about something that occurred 12 visits ago.

Partner in Crime was too busy to play though, so Lady turned her attention to Parvati on her excruciatingly slow egress from the department.

She paused dramatically before heading out, planted herself in the middle of the hallway, raised her arms and announced, “This is the best doctor of all time,” punctuated by bestowing upon Parvati a big smelly hug before waddling out. +

“ She rode in like the queen of the parade ”

From THE Bookshelf What’s your very favorite food? Pizza? A crunchy colorful salad? Warm pecan pie?

Whatever it is, it’s a safe bet you’re not giving it much thought hours later, or the next day.

But let’s face it: food doesn’t just disappear once we swallow it. It may be out of sight and out of mind, but it’s going to be awhile before today’s meals have an out-ofbody experience.

If you’re beginning to cringe already, perhaps you should read the children’s picture book Everybody Poops for a reality check.

Yes, everyone does. Even the Queen of England. But before we do, what we eat takes a remarkable journey, and that’s the subject of Mary Roach’s latest book, Gulp, subtitled “Adventures on the Alimentary Canal.”

Just to refresh your memory, alimentary is an adjective that means “of or relating to nourishment.” The alimentary canal, all 126 miles of it, is two words which describe the entire tortured route taken by every bite of food we take, from lips and tongue to the esophagus, the stomach,

about these hot dog eating contests? Why are the winners often skinny people who seemingly don’t have very big stomachs? How does the system cope with such sudden overloads? And let’s all pretend for a moment that flatus (a.k.a. farting) never happens to us.

So we might find it interesting to read about the experience other people have and the science behind it.

It’s high time someone has come along and given the poop making process the attention it deserves. As has been noted by a scant few others, the Circle of Life would not exist as we know it without the Circle of Poop. Or if you prefer, the Circle of Fertilizer. Fertilizer puts food on our table so we can survive.

And create more fertilizer. +

intestines, and eventually, the aforementioned out of body experience. Parts of the process may be considered disgusting, but try to avoid it and see how long you make it.

Considering what we throw down the hatch, the processing system is nothing short of amazing. Whether animal, vegetable, or mineral, everything is broken down and its key nutritional components efficiently extracted.

What part does saliva play in the digestion process?

And speaking of digestion, if stomach acids can dissolve nails, how is it that the stomach itself isn’t eaten away? And speaking of disgusting, what

Note: Roach has written quite a library of interesting books about the natural world, including Stiff, The Curious Lives of Human Cadavers, and Bonk: The Curious Coupling of Science and Sex. Gulp by Mary Roach, 352 pages, published in April 2013 by W.W. Norton & Company.

the

What triggers your migraines?

Is it diet? Stress?

You might think you know, but earlier this month a study released by Wake Forest Baptist Medical Center found it is nearly impossible for patients (or doctors) to conclusively determine the true cause.

A person may think that drinking wine is their trigger, for instance, and fail to realize other unknown factors are the real cause. The list of easily overlooked culprits might include hormones, weather, physical activity, certain foods, sleep, menstrual cycles, and stress.

Researchers suggest keeping a thorough, comprehensive diary and working with your physician to devise the best way to determine your triggers.

Contradictions Life expectancies have been steadily increasing for the past several decades.

Good news, right?

Sort of. The flip side of longer lifespans is that those

Clipping File

additional years are being spent in poor health. Yes, our grandparents may have lived fewer years, but those years were healthier, according to a large study done in the Netherlands and released last week (April 10).

As measured by metabolic risk factors, every ten years marks a further decline in health yardsticks and greater medical interventions necessary to prolong life.

To take one example, 40 percent of a baseline group of males in their 30s were classified as overweight. Ten years later, 52 percent of males who had subsequently aged into the 30-39 ager group were overweight.

Similar deteriorations were seen in rates of obesity, hypertension, and hypertension. While exact causes need further study, one early suspect is increasing rates of inactivity.

Meanwhile, another study found that the rise in childhood obesity in the United States

is accompanied by a parallel increase in undernourished children.

Sound impossible? It isn’t.

Simply put, a growing number of children are subsisting on inexpensive, high calorie, high fat junk food.

Read on, however.

Good food cheaper Recent studies have reconfirmed the health benefits of the so-called Mediterranean diet, one rich in fresh produce, olive oil, whole grains, nuts, etc, but light on red meat.

Now comes news of a Rhode Island study which followed a group of low-income participants who attended cooking classes that focused on the Mediterranean diet (MD).

Six months of follow-up on the participants (which included collecting their grocery receipts) found that by following the MD, participants cut their grocery bills by more than half.

Key to their savings was buying significantly less meat, soda, snack foods and desserts. +

+ 12

THE EXAMiNERS +

You got a new job?

APRIL 19, 2013

AUGUSTA MEDiCAL EXAMINER

by Dan Pearson

As cosmetic surgeons, we support America’s That’s near Right. We have a lot droops.

Ft. Gordon, right? of military patients. That makes sense.

Sure did, at that cosmetic surgeon on Jimmy Dyess Parkway.

© 2013 Daniel Pearson All rights reserved.

EXAMINER CROSSWORD

PUZZLE ACROSS 1. Category of drinks 5. _____ Sano 10. Dishonest scheme 14. ____ of Man 15. It sometimes follows credit 16. Fuse 17. Precipitation 18. Enclosed automobile 19. Right-angle additions 20. Vomit inducer 22. Nine times out of ten 24. Nostrils 25. S of JMS 26. Eat sparingly 29. Type of certificate 33. Dental org.

36. Bifida intro 39. Jelly bean flavoring 40. Applies friction to 42. In an unfriendly way 44. Growl 45. Stair surface 47. Inhabitant of Cambodia 49. Rapping Dr. 50. Simultaneous firing of artillery 51. First king of Israel 53. Second US president 57. Facial hair 61. Queen of Palmyra, A. D. 267-272 63. Superior 64. Capital City of Germany 65. Rust 67. Tramp 68. New Age singer 69. _____ Cinemas 70. ______ Corner 71. Yes, informally 72. Fish with a net 73. Julia’s former husband

BY

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Click on “Reader Contests”

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VISIT WWW.AUGUSTARX.COM TO ENTER!

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All Mystery Word finders will be eligible to win by random drawing.

We’ll announce the winner in our next issue!

QUOTATION PUZZLE

23

28

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

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The Mystery Word for this issue: AURCREFT

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D T U A U A H S D O Y R T

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O K E E H F O G R R F N H S T O Y N F I T L U O L O E M A T L U W I Y T — Author unknown

by Daniel R. Pearson © 2013 All rights reserved

by Daniel R. Pearson © 2013 All rights reserved. Built in part with software from www.crauswords.com

33. Crafts partner 34. Augusta’s _______Med 35. Second son of Adam and Eve 37. Nat Inst Health 38. Donations to the poor 41. SE city and river 43. Affirmative vote 46. Extinct flightless bird 48. Hick 52. Death-dealing 54. Cancel or end prematurely 55. Blending appliance 56. Goatlike Asian antelope 58. Mote; minute particle 59. Star Wars Alliance 60. Unmanned aircraft 61. Type of defense (in sports) 62. Mistaken repetition of 68-A 63. Downtown auditorium 64. Ottoman governor 66. Jackdaw, for short

DOWN 1. Emergency alert 2. Once the world’s mostwanted man 3. Aviator 4. Shaped like a tent 5. SC med school 6. Single unit 7. Focus of infection (med) 8. Local seller of adult beverages 9. Boredom 10. Edema 11. Room at 401 12. Supporter 13. Docs 21. Egyptian goddess of fertility 23. Good Luck Chuck star 27. Pen prefix 28. Clock sound 30. Outer covering 31. Former Russian ruler 32. Not there

Solution p. 14

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 only be used once.

Black squares indicate spaces between words, and words may extend onto a second line.

Solution on page 14.

E

8 1 5

X A M I N E R

8

9

7

3

4

5

2

S

8

U D O K U

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

by Daniel R. Pearson © 2013 All rights reserved. Built with software from www.crauswords.com

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

Use the letters provided at bottom to create words to solve the puzzle. All the listed letters following 1 are the 1st letters of each word; the letters following 2 are 2nd letters of each word, and so on. Try solving words with letter clues and entering unique and minimal choice letters (such as 5 thru 8 in this puzzle). A sample is shown. Solution on page 14.

F 1 2 3 4 5 6 7 8 N 1 1 2 3 4 1 2

1 2 2

3

I 1 2 3 1 2 1 2 3 4 5 I ’ 1 2 3 4 5 6 1 2 3 4

— Adlai Stevenson

1.SLIFYIDARA 2.NOOLOOLISS 3.NNULAGH 4.THAGT 5.TLT 6.EE 7.R 8.Y

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

by Daniel R. Pearson © 2013 All rights reserved

WORDS NUMBER

1

THE MYSTERY WORD

APRIL 19, 2013

13 +

AUGUSTA MEDiCAL EXAMINER

THE BEST MEDICINE

The Patient’s Perspective

Famous Medical Quotes

guy is taken to the hospital after a serious motorcycle accident. Waking up from the anesthesia he sees his doctor standing at his bedside.

“So tell me Doc, am I gonna be okay?”

The doctor says, “Son, we have some good news and some bad news. The good news is that we were able to save your private parts.”

“That is good news. What about the bad news?”

“We put them under your pillow.”

Doctor, I think I need glasses You certainly do, sir. This is a butcher shop.

Patient: Doctor, doctor, I feel like a pair of curtains.

Doctor: Well pull yourself together.

Patient: Doctor, I snore so loud I keep myself awake.

Doctor: Sleep in another room then!

Patient: Doctor, I’ve completely lost my memory!

Doctor: When did this happen?

Patient: When did what happen?

1. My doctor is wonderful. Once when I couldn’t afford an operation, he touched up the X-rays for me. - Joey Bishop 2. She got her looks from her father: He’s a plastic surgeon. - Groucho Marx 3. I’m not feeling very well, I need a doctor immediately. Call the nearest golf course. Groucho Marx 4. A woman went to a plastic surgeon and asked him to make her like Bo Derek. He gave her a lobotomy. - Joan Rivers 5. Whiskey is by far the most popular of all remedies that won’t cure a cold. - Jerry Vale 6. Anyone who goes to a psychiatrist should have his head examined. - Samuel Goldwyn 7. Never go to a doctor whose office plants have died. - Erma Bombeck 8. I’m always amazed to hear of plane crash victims so badly mutilated that they have to be identified by their dental records. What I can’t understand is, if they don’t know who you are, how do they know who your dentist is? - Paul Merton John: I got this great new hearing aid the other day.

Mary: Are you wearing it now?

John: I sure am. Cost me four thousand dollars, but it’s worth it. It uses some kind of new technology.

Mary: What kind is it?

John: Let’s see...Twelve-thirty.

Q: Does an apple a day keep a doctor away?

A: If you aim it well enough. +

Why subscribe to the Medical Examiner?

Because no one should have to make a trip to the doctor or the hospital just to read Augusta’s Most Salubrious Newspaper.

+ +

SUBSCRIBE TO THE MEDICAL EXAMINER By popular demand we’re making at-cost subscriptions available for the convenience of our readers.

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

NAME ADDRESS CITY

STATE

T

oday it’s sunny, after a series of cold, rainy days that had my knees complaining (along with my shoulders and ankles and fingers). I used to kind of wonder about older folks when they could tell what the weather would be from their bones, but now that I’m one of them, I know it’s for real. We might be surprised sometimes by what we learn in our visits to doctors and hospitals in just a year’s time.

For me the knowledge I’ve acquired in dealing with nine doctors and four hospitals in the past year is proving to be very useful in the class I’m teaching at Virginia College.

Many of my students are studying some aspect of various medical careers, and what I have learned helps to increase my ability to talk with them about possible subjects for their upcoming research papers in their fields.

For example, this week my students and I had quite a long discussion about forming attachments to patients or clients, etc. with whom they work, regardless of the field they work in. During the week I found a short piece by Alice Walker about just that topic, and she said she has learned to value all the people who pass through her life as contributors to who she is becoming as a person.

Because my students seemed to be conflicted between allowing themselves to care for the people they work with and behaving in a cold and “professional” way, this was one way for us to talk about seeing all patients, all clients, as valuable and special, even the cranky ones, the complainers, and the curmudgeons. From my experiences in the past year, I know that healing is not just a medical process, but also an interpersonal one.

When I have been in pain, confused, frightened, or hesitant, those feelings have often been allayed by a warm and personal smile, a gentle touch on my arm or shoulder, or just an acknowledgement that it’s going to be OK. When

ZIP

Choose ____ six months for $16; or ____ one year for $32. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

Less

+

t ha n a m i l l

Talk is cheap.

Not talking can be deadly.

I feel as though someone cares about me on a personal level, my need for pain medication is greatly reduced, I relax more, sleep better, and have a better appetite, and thus I heal faster and better. So, while it’s wrong to allow feelings for patients and clients to cross into inappropriate expressions of familiarity, being sensitive to and caring about the human beings we encounter is actually good medicine.

This is an issue faced by teachers, too. Caring for my students and making sure they feel cared about is often “the spoonful of sugar that helps the [sometimes bitter] medicine [of making them revise papers] go down.” I will tell them, “I want you to be the best you can be, not just mediocre,” or “I know you are capable of excellence, and I’ll accept nothing less than that from you.”

Believing that we are cared about is one important step in increasing patient compliance with drug, diet, and exercise regimens ordered by the doctor. It helps us to use the energy needed to take the pills at the right time, buy healthy foods at the grocery store, and walk further each day. Best of all, when others care about us, those of us who grew up without much in the way of being cared for can learn to care for ourselves. + Marcia Ribble received her PhD in English at Michigan State and recently retired from the University of Cincinnati where she taught composition. She taught writing at the college level and loves giving voice to people who have been silenced. She is now teaching again at Virginia College in Augusta. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.

ion people can’t be wr

ong.

Advertise here companies who already support us !

A

by Marcia Ribble

s of the ten Join

ha... ha...

+

+ 14

APRIL 19, 2013

AUGUSTA MEDiCAL EXAMINER

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

...cleverly hidden (on the blue at right) in the page 9 ad for THE JB WHITE BUILDING Congratulations to SHARON DAVIS, who scores a $20 Wild Wing Cafe gift certificate, two free movie passes courtesy of Health Center Credit Union, a free Top Notch Car Wash gift card, a $40 Scrubs of Evans Gift Card, and for coffee drinkers, a jar of Drug of Choice gourmet coffee. Win this stuff!

The new Mystery Word is on p. 12. Start looking!

The Celebrated MYSTERY WORD CONTEST ...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then be the first to find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries you’ll score our goodie package: gift certificates from Wild Wing Cafe, Top Notch Car Wash, and movie passes from Health Center Credit Union!

SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (WInners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher.

The new scrambled Mystery Word is found on page 12

EXAMINER CLASSIFIEDS 706.833.9787

HOMES, APARTMENTS, ROOMMATES, LAND, ETC. LAND Unique thirteen acres. Bold, beautiful rocky creek running through perfect getaway from the urban rat race, to raise kids, or retire. 706-798-4359 or 706-831-9015 WEST AUGUSTA House for rent. 3 bdrm, 2 bath, 1500 sqft, 1-car garage, 3024 Sterling Road, located off Stevens Creek at Riverwatch Pkwy. $850/mo. Call 678467-7187.

FOR SALE Brand new contemporary townhome/end unit in The Vista on Hwy 1, minutes from MCG. 1450 sqft. Two bdrm, two baths, office. Walk-in closets, lots of upgrades. Hardwood throughout, custom tiled kitchen/bathrooms. Floor to ceiling windows, pristine condition.

Ready today. $125K - OBO. 803-5078991.

HOMESBYOWNER.COM Buy • Sell • Rent Apartments available 706-564-5885

WEST AUGUSTA Luxury 3 BR / 2 BA Townhouse, 1-car attached garage located off Pleasant Home Road $725 /mo 706-228-4655 TOWNHOME 3 bedroom, 3 full bath townhome. 2 master suites, like new, end unit with extra parking, single garage, covered patio, $125,000. 706-799-0394

MISCELLANEOUS ENTERTAINMENT SHOPPING: Online penny auction, play and win for 80-95% off. Lots of fun. www.WorldwideOnlineBids.com Income positions available. Go to www.

ExtraMoneyInterview.com MATTRESS We have a Queen Pillowtop Set that is new and still in the wrapping $150 Call or Text 762-444-7615.

BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673) FULL-SERVICE MOVER Anthony’s Professional Moving, 28 years serving the CSRA moving hospital equipment, offices, homes, apartments, etc.

Estimates are FREE. Call 706.860.3726 or 706.814.8141 NOTICE! ATTENTION! If any current or past employer has failed to pay you min. wage or time and a half overtime pay, you may be entitled to an order from US Federal Court awarding you twice the amount of your unpaid wages plus atty. fees. For info, call Arthur H. Shealy, Attorney at Law, 803-278-5149, 1010 Plantation Rd, North Augusta SC 29841. You may be entitled to a similar award for unpaid wages if your employer required you to perform duties during your lunch hour, before clocking in, or after clocking out.

SERVICES 1.1.13

TOWNHOME Great location, everything new, 2 master suites, sunroom, all appliances. $98,000 (706) 504-4023

HOUSE CLEANING Want someone to clean your home the way you would if you had the time? I take the time to make sure nothing is overlooked and clean as if it were my personal home. Call

LAWN SERVICE Commercial, residential.

Call Vince: (704) 490-1005

GOT A CLASSIFIED? SEND IT IN TODAY! THE PUZZLE SOLVED

SENDING US A CLASSIFIED? WHAT’S YOUR DRUG OF CHOICE? USE THE FORM BELOW AND MAIL IT IN, OR GO TO WWW.AUGUSTARX.COM AND PLACE & PAY CONVENIENTLY AND SAFELY ONLINE. THANKS!

(OURS IS COFFEE)

Augusta Medical Examiner Classifieds

S I R E N

O S A M A

F L I E R

A R T S

D U R A

A B E L

Z B O E N Y E

E N Y A

T M E U N S T I C E S D I E S P S I A D V O A D A N O B N O A R H T

CLASSIFIED ADVERTISING FORM Name Address Work number (if applicable) ( ) Home phone ( ) Category of ad (leave blank if unsure):

.75

1.00

1.25

1.50

1.75

2.00

2.25

2.50

2.75

3.00

3.25

3.50

3.75

4.00

4.25

4.50

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5.00

5.25

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6.25

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7.00

7.25

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7.75

8.00

8.25

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9.00

(Copy this form or continue on additional sheet if more space needed.)

Send this form with payment to:

AUGUSTA MEDICAL EXAMINER, PO BOX 397, AUGUSTA, GA 30903-0397 Total ad cost by number of words as shown above: $

C E L L

A M L D L S Y

R I N D

T S A R

R U L B E A R E T T E H O B A M E L Y L

H E R E D R O N E

QUOTATION

QUOTATION PUZZLE SOLUTION: Page 12: “Do something today that your future self will thank you for.”

— Author unknown

AD COPY (one word per line; phone numbers MUST include the area code): .50

A L B A

S W E L L I N G

SEE PAGE 12

In case we need to contact you. These numbers will not appear in the ad.

.25

O N T E N I O N E D A N U S U S T I T I N A C I L Y K H M E S A M S I A B X I D E E G A L R A W L

The Sudoku Solution

COFFEE IS GOOD MEDICINE VISIT DRUGOFCHOICECOFFEE.COM FOR YOUR REFILLS TODAY

8 6 4 9 1 2 7 5 3

1 5 2 8 7 3 6 4 9

3 7 9 4 5 6 2 1 8

9 8 6 7 4 5 1 3 2

5 2 7 3 6 1 9 8 4

4 3 1 2 9 8 5 6 7

7 9 5 1 8 4 3 2 6

6 4 3 5 2 9 8 7 1

2 1 8 6 3 7 4 9 5

WORDS BY NUMBER “Flattery is all right so long as you don’t inhale.”

— Adlai Stevenson

Multiply by number of times ad to run: x Total submitted: $

The Augusta Medical Examiner publishes on the 1st and 3rd Friday of every month.

Your ad should reach us no later than 5 days prior to our publication date.

Thanks for reading!

www.AugustaRx.com

APRIL 19, 2013

15 +

AUGUSTA MEDiCAL EXAMINER

The Money Doctor

Important Dates for the Financially Savvy Retiree

O

ne area in which I help clients is planning for retirement. This includes discussing retirement income needs, investment portfolio allocation, generating retirement projections, and helping clients comply with various rules and regulations.

It is easy to visualize a carefree retirement without deadlines to meet; however, not keeping track of important dates in retirement can lead to reduced savings, unnecessary expenses, and penalties. The following is a list of important ages that should be noted as you work towards retirement.

Age 50 According to the Center for Retirement Research at Boston College, the average age for a male to enter retirement in 2010 was 64 years old. Thus the question you may be asking yourself is, “Why is age 50 an important retirement date?” This age is important in regards to retirement because, beginning in the year in which you turn 50, the IRS allows catch-up contributions to employer sponsored retirement plans and IRAs. In 2013, the IRS will allow you to contribute an additional $5,500 to employer provided retirement plans ($23,000 total) and an additional $1,000 to a traditional or Roth IRA ($6,500 total).

Age 59½ Prior to turning 59½, you would incur a 10% penalty, in addition to any tax consequences, for withdrawing funds from retirement accounts under most circumstances.

In the year in which you turn 59½ you can begin taking

distributions from retirement plans penalty-free. This withdrawal will cause you to receive a 1099-R at the end of the tax year. The 1099-R will indicate the total withdrawal amount and the taxable portion to be included in your taxable income.

Age 62 If you are a homeowner, be prepared to begin receiving mail, email, and telephone solicitations regarding reverse mortgages around age 62, which is the first year that you will be eligible for these types of loans. Reverse mortgages allow you to tap one of your largest assets, home equity, to receive monthly payments, a line of credit, or a lump sum payment. Although these loans can generate capital to be used in retirement, as with any nontraditional income stream they should be approached with caution due to the many pitfalls including high interest rates, high fees, and loan repayment requirements at the time the home is sold or the owner dies.

It is imperative to meet with an estate planning attorney or financial professional before entering into any agreements.

benefit increases if you choose to defer receiving benefits. For more information on deferring benefits, see our June 15, 2012 Money Doctor article at http:// issuu.com/medicalexaminer.

(Look for the front page with a pipe-smoking dad; the Money Doctor is on the back page.) Another important task to complete prior to filing for benefits is determining the accuracy, particularly your earnings history, of the information entered at the Social Security Administration.

You can request a summary of your benefits at www.ssa.gov to help with this.

Age 65 At age 65, you become eligible for one of the most significant programs offered to senior citizens – Medicare.

The significance stems from the rapidly increasing cost of health care in the United States and Medicare’s ability to mitigate a portion of it. There are four parts to Medicare; Part A, B, C, and D. You must apply for your Medicare benefits during the Initial Enrollment Period which extends from 3 months

before the month in which you turn 65, until 3 months after.

Medicare Part A, which the majority of 65 year olds qualify for, helps to cover inpatient hospital care. You will not directly pay Part A premiums as these are paid for by Social Security taxes. Premiums for Medicare Part B, C, and D are paid for individually by the insured. Part B helps cover doctors’ fees and other outpatient hospital visits.

Medicare Part C, also known as Medicare Advantage, is a privately offered plan. Lastly, Medicare Part D helps cover the cost of prescription drug coverage. You will also need to consider private Medicare supplemental plans. Given the complexities of these programs and many changes that are coming about as a result of the new health care legislation, we encourage you to talk with an independent health insurance consultant to learn more about your options.

Age 70½ Beginning in the year in which you turn 70½, you must take required minimum

distributions from tax deferred retirement accounts on an annual basis. Distributions from tax-deferred accounts will be taxed as income at your ordinary income tax rate. The calculation of your required minimum distribution should be approached diligently as there are numerous lifeexpectancy tables and steep penalties (50% of the amount that should have been withdrawn paid yearly until corrected!) that need to be considered. +

by Tony Welch. Tony is a financial planner with Preston & Cleveland Wealth Management, LLC (www. preston-cleveland.com). Tony has a MBA from Augusta State University along with a BBA in Accounting from the University of Georgia. Preston & Cleveland is a fee-only financial planning and investment advisory firm with offices in Augusta, GA, Atlanta, GA, and Nashville, TN.

Age 62 – 70 For your entire working life a portion of your paycheck has been withheld for Social Security. Finally, at the age of 62, you can begin receiving your Social Security benefits!

Now before running out and filing for benefits on your 62nd birthday, familiarize yourself with the many rules surrounding Social Security including limitations on other sources of income and yearly

Serving the Medical, Dental and Education Communities since 1976 Visit us at any of our 5 locations or at www.hccu.coop 706-434-1600

THANKS FOR READING!

There is only one. +

MEDICAL EXAMINER Augusta’s only independent publication dedicated to medicine, health and wellness

TM

+ 16

AUGUSTA MEDiCAL EXAMINER

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APRIL 19, 2013