Medical Examiner 7-21-23

Page 1

THE END OF THE ROAD IN THE SWIM

There is an article about road safety in every issue of the Medical Examiner for a very simple reason: more Americans have died on US roads just since 2006 than in World Wars I and II combined. That is a startling and sobering statistic.

CRASH COURSE

As a result, everywhere you turn you see people driving cautiously and defensively, carefully observing all applicable traffic laws, particularly speed limits and red lights.

Or not.

It’s pretty much the opposite, isn’t it? Speeding, tailgating, red light running, and aggressive driving in general are the order of the day.

None of us can claim ignorance. We know the rules of the road, but we sometimes ignore them, or temporarily forget them.

However, some former drivers (or more correctly, their family members) have kindly and generously erected roadside reminders for us. They are everywhere, all around the Aiken/Augusta area and beyond, each one marking the spot where someone (or several someones) lost their life.

It’s a safe bet that 99% of these people had no clue their life was about to end, even just 5 seconds before it did. That’s probably especially true of the ones who were model drivers and got creamed anyway.

Every one of these memorials offers a somber reminder that driving carries inherent risks and deserves care and caution. See Crash Course in its usual spot on page 10 for more information and a gallery of these sad shrines.

Whew it’s hot! So what better place to cool off than the lake, the river, or the pool?

It’s an absolutely great idea, and it’s all fun and games until someone disappears under the water and doesn’t come back up. It’s an absolutely horrible thing to even think about, but every summer some of our CSRA neighbors have to endure the unendurable. We are saddened to hear such news stories even though we may not know the family personally, but our sorrow is fleeting. For the families affected, their lives will never be the same.

Surprisingly perhaps, drowning is the #1 cause of death for children ages 1 to 4 and the second leading cause of death for children 5-14, according to the Centers for Disease Control and Prevention. Drowning is considered to be one of the most preventable large-scale causes of death. As one expert said in an interview, no one would ever to say, ‘Oh well, some people just drown.” July is peak season for drowning too.

How can these terrible tragedies be prevented?

Federal action is always a possibility, although the US is currently one of the only developed nations without a national plan to address the problem of drowning. Think about other aspects of health and safety, and the regulations are there: seat belts, smoke detectors and other fire prevention laws, smoking cessation, etc. But laws addressing drowning prevention are lacking.

But realistically, a significant part of the problem — and Please see IN THE SWIM page 9

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THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

provide those opportunities.

If you answered:

A. There is something to be said for making a decision and sticking with it. However, there may be a way to let him be around other kids too. Try after school activities.

B. Decisions about his education are your responsibility. It’s not up to him to choose.

You home-schooled your 10 year-old son during COVID. He was having problems in school anyway, and it seemed to be worth a try. He did very well, and you decided to continue home-schooling. However, he now wants to go back to regular school and be with other kids. What do you do?

A. If you decided that home-schooling is best for him, there is no reason to change

your mind. Keep him at home.

B. Let him try regular school again if that’s what he wants.

C. Let him try regular school, but tell him that at the first sign of academic or behavior problems, he will have to go back to home-schooling.

D. Keep home-schooling him, but provide him with increased opportunities to be with other kids. Activities such as sports, arts, or scouts would

C. You have already decided that he does better in a home-schooling environment. Putting him in a situation that you don’t think is best and waiting for him to fail in it is not a good strategy.

D. This is by far the best response. It addresses both the best educational setting for him and his desire to spend more time with kids.

Most things with children are not either/or choices. With a little creativity, there are ways for both to happen.

Dr. Proefrock is a retired local clinical and forensic child psychologist.

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MEDICALEXAMINER
years

Who is this?

is characterized by rod-cone dystrophy, truncal obesity, cognitive impairment and postaxial polydactyly.” So there you go.

MEDICAL MYTHOLOGY

GIANTS AREN’T REAL

Imagine yourself as a student of physics, delving into this deep and fascinating subject with great enthusiasm. As you continue to learn and your understanding grows, you find yourself reading and rereading the writings of the giants in the field, the true pioneers of physics. But you aren’t rereading them to fully grasp their meaning; you’re rereading them because they don’t make sense to you. In fact, it seems like they’re wrong. But how can that be? You’re relatively new to the field, and what you’re reading has been read and studied and accepted by the greatest minds in physics for well over a thousand years. Surely you are mistaken. What you’re reading must be correct. How could you know more than Einstein?

So you continue to study and experiment, as much to prove the field’s founding fathers are correct as any other reason. But it doesn’t work. Your research and experiments and observations continue to cast doubt on the accepted wisdom.

What are you going to do?

That very question had to be faced by the man pictured above, except the field of knowledge he found to be so flawed and riddled with errors wasn’t physics; it was medicine and human anatomy.

His medical school studies led straight through the revered writings of Galen, a Roman/Greek physician, surgeon, and philosopher considered to be one of the most accomplished of all medical researchers of antiquity. Galen was born in the year 129. And the man above, William Harvey, didn’t come along until 1578. That’s well over 1,400 years! So no one over 14 centuries of time saw what Harvey saw? It didn’t seem possible. Surely he was mistaken.

But he was not. True, when he published his masterpiece in 1628, a work usually referred to by the abbreviated title De Moto Cordis — The Motion of the Heart, the first time the human circulatory system had ever been accurately described — much of the world’s medical community categorically rejected the idea. His medical practice suffered greatly and he was subjected to much scorn and ridicule. That is often the cost of being a trailblazer, even a true and accurate one.

By reexamining long held beliefs, William Harvey disproved a number of basic “facts,” among them that blood in both veins and arteries is all from one source. In fact, it’s the same liquid in different locations along its journey, not two different substances manufactured in different parts of the body. He discovered that blood circulates continuously instead of the previously held to-and-fro, flow forward, flow back action. He also discovered that the heart, not the liver, is the circulatory system’s pump.

Fortunately, Harvey saw much of his discoveries about circulation accepted and embraced as correct within his lifetime. He accepted the situation philosophically:

“I have often wondered and even laughed at those who fancied that everything had been so consummately and absolutely investigated by an Aristotle or a Galen or some other mighty name, that nothing could by any possibility be added to their knowledge.” +

No doubt some giants are indeed the creation of fable writers and ancient folklorists, but it would be false to claim that all giants are fictional characters. Say the word giant and who comes to mind? No doubts for many it’s the Bible’s Goliath, but he is not presented in the Bible record as a symbolic creature as are, let’s say, the figurative dragons of Revelation.

No, Goliath is presented as a real live honest-to-goodness giant with his physical dimensions (“six cubits and a span” tall), hometown (Gath), and several relatives all part of the Bible record.

Some extensive research about this ancient man has found its way into medical literature. One article was published in the May 2014 issue of Ulster Medical Journal, the abstract of which opens with,

“The biblical giant Goliath has an identifiable family tree suggestive of autosomal dominant inheritance. We suggest that he had a hereditary pituitary disorder possibly due to the AIP gene, causing early onset and familial acromegaly or gigantism.”

The article goes on to create a family tree for the Goliaths that includes the giant’s brother and three sons, all described as of gigantic stature. Goliath’s third son, not named in the Bible, “had on every hand six fingers and on every foot six toes,” again, say the authors “suggestive of a hereditary autosomal dominant pituitary gene, such as AIP.” And about that polydactyl son, since you asked: “The Bardet-Biedl gene, BBS1, is located close by on chromosome 11q13.2. Bardet-Biedl syndrome type I

The Bible record describes others in big terms, such as the pre-flood Nephilim, a descriptor transliterated from the Hebrew verb na-phal (fall), making them literally “fellers; those who cause others to fall down.”

The UMJ article references other giant clans of Bible times, such as the Rephaim and the Anakites, noting that the Hebrew word anaq may mean necklace, or possibly goiter. “This could suggest hyperthyroidism, possibly due to underlying pituitary gland, or other endocrine, dysfunction.” Gath was known as a stronghold of the Anakim. And King Og of the Rephaim was buried (according to Deut. 3:11) in a 14-foot long coffin.

Even the manner of Goliath’s death may have had a pituitary component, says the Journal “A pituitary tumour pressing on his optic chiasm, and consequent visual disturbance due to pressure on his optic nerve, would have made it difficult for him to see the stone [cast by David] in his lateral vision.” Other journals have also presented evidence of Goliath’s pituitary tumor.

The UMJ concludes, “Goliath may have had an AIP mutation causing early onset autosomal dominant pituitary gigantism.” But only until he met David.

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CUTICLE

Middle Age

This week, I was faced with a simple decision. My doctor put it to me this way: I could either keep doing what I’m doing and die in the next ten years or so, in pain, maybe with some amputations, more heart attacks, and various and other sundry nightmares, and if I was “lucky” enough to live longer than that I could look forward to some serious dementia; or I could take door #2. That option would mean changing all my eating and exercise habits for life: avoiding sugar as much as possible, cutting back severely on carbs like bread, potatoes (in all their glorious forms), and most other foods and drinks that make life worth living, or at least bearable. When I didn’t speak for several seconds and the pause got awkwardly long, the doctor prompted me again, “Well?” And of course, I replied, “I’m thinking about it. I’m thinking about it.” Jack Benny made that line famous when a would-be robber asked him, “your money or your life?” In that case, I would have said take the money. But chocolate? Fresh baked bread? French fries? I really had to think about giving those up.

OR I COULD CHOOSE DOOR #2

being. I learned a lot of interesting things about diabetes, some of which I will share here in mostly non-scientific speak. Keep in mind, I am not a trained or licensed medical professional, so this is not medical advice. Don’t take my word for any of the things I am about to tell you. Talk to your medical professionals. Seek out respected experts on diet and nutrition, but keep in mind that nobody knows it all, and it is a fluid situation as we strive to understand the complex mechanisms of our metabolic systems. I have even gotten conflicting messages in the past from nutritionists, nurses, and doctors who all worked in the same hospital. Some of the advice was conflicting to the point of being the opposite of each other, even during the same visit. Not everyone keeps up with the latest medical research so we must count on ourselves for that. It isn’t a passive game. We have to take responsibility for our own health.

QUESTIONS, QUESTIONS...

Studies show that patients don’t often ask their doctors questions about their care during appointments. Maybe they have questions they intend to ask, but they forget. Or they only think of the questions long after the appointment.

Why don’t patients ask questions? It’s not because they understand the information they’ve been given. Multiple studies have established the dismal fact that about 50% of the information given to patients is forgotten immediately, and half of what they do recall is incorrect. Those are averages; the numbers are even lower for patients who are older, have lower literacy levels or are in general less educated.

Doctors and other healthcare providers, for their part, may view this situation in one of two ways. First (and hopefully this rarely happens), “I hope they don’t have any questions,” they may think. “I’m an hour behind schedule as it is.” Secondly, they might be frustrated by the lack of questions. Doctors who have been around the block a few times fully realize the truth of the studies referenced in the preceding paragraph. They’ve seen the evidence first-hand a thousand times. So they may be a little frustrated or disappointed by a lack of questions. They know people need to ask questions and get clarification.

What made the difference for me was thinking about my grandchildren who really depend on me now. Our five-year-old granddaughter with special needs will likely need help all her life, and while I know I won’t be around for all of that, I need to stick around as long as I can to help her as much as I can.

What did I choose? I chose life without some of my favorite foods, or at least with them making up a significantly smaller percentage of my diet. I’ve made attempts before to buy back my health, but I never took the two-pronged approach. I’d go on a diet. Or I’d exercise. Or maybe I would diet a little and walk some, but never in a regularly scheduled way for any length of time. Not long enough to make it a habit. As time passed, the novelty of eating better and trading TV viewing and web browsing for sweating, breathing hard, and feeling sore, wore thin.

I was most successful with the diet part of the equation and most of the credit should go to my wife, who would either find or concoct healthy versions of some of my favorite foods. But she too, would tire of that, especially when she would find out that I cheated on the diet anyway. It got to the point where I’d almost rather tell her that I had cheated on her in a marital way (not really, but that isn’t too far from the truth) than on my diet, such was her disappointment when she would find a Little Debbie zebra cake wrapper in my truck or in the trash. Once she saw that I had lost the will to keep the diet up, she would stop supporting me in it.

Will this time be different? Only time will tell. However, this time I joined a gym and I really got into studying what I needed to change about my eating habits to get back to a healthy (or at least healthier) state of

What I found out was that medicines I take for type 2 diabetes (like Metformin), for example, or medicines others take for diabetes (like insulin) aren’t fixing the real problem, but only compensating. My problem is insulin resistance. What does that mean? The best illustration I heard went something like this: If your father is losing his hearing and keeps turning up the volume on his TV, the louder it gets the worse his hearing will get. Eventually, no volume is loud enough for him. It works the same with our cells. Insulin helps our cells utilize sugar, but with type 2 diabetes our cells start becoming resistant to the insulin. In response the pancreas makes even more insulin in an attempt to get the cells to take in the sugar. This is triggered by higher blood glucose (sugar) levels in our blood that couldn’t get into the cells. It becomes a feedback loop, and our poor pancreas works hard to fix it, but it’s actually making it somewhat worse. The excess sugar goes to fat, and it can end up in your liver to the point that you get fatty liver disease, and that is serious. What causes it? They are not sure, but we do know what can potentially reverse it. That is where my focus will be.

Diet plays a big part in managing type 2 diabetes as it does with many other illnesses and conditions. The CDC says we should avoid foods that will cause our blood sugar to rise to levels that will trigger large dumps of insulin, and that is challenging these days with so many foods having added sugars. My doctor stressed the importance of sufficient fiber in the diet and some leading researchers explained this well. It turns out that fiber isn’t just about getting your waste products moving smoothly through your internal septic system as I had thought. Fiber helps the overall health of the bacteria and other necessary components of good gut health. I was told to

Conversely, a 1994 study discovered that primary care doctors attempted to elicit questions from their patients in only 25% of encounters.

Unfortunately, sometimes the question-seeking doesn’t work as well as it should because of the most (seemingly) insignificant details. “Do you have any questions?” sounds okay on first hearing, but when you compare it to the open-ended, “What questions do you have?” the latter is clearly the better choice. Even so, the tiniest nuance could make or break the moment: if a doctor puts her hand on the exam room doorknob to leave and then turns to ask, “What questions do you have?” she probably shouldn’t expect much.

People on both sides of the stethoscope obviously have to do better. Patients have been told over and over again: write down your questions ahead of time. Be sure to ask them. Write down the answers. And doctors: when patients forget to ask you, ask them. And ask like you mean it.

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ADVENTURES IN
{ {
Please see MIDDLE AGE page 9 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. © 2023 PEARSON GRAPHIC 365 INC. 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. AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER 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 TMMEDICALEXAMINER www.Facebook.com/AugustaRX +

THE FUTURE TOLD

I wish Coke was still Cola And a joint was a bad place to be.

Back before Nixon

Lied to us all on TV. Back before microwave ovens,

When girls could still cook And still would.

We’re rolling downhill like a snow ball headed for hell. With no chance for the flag or the liberty bell. Is the best of the free life behind us?

Are the good times really over for good?

(Reverently stolen from the legendary Merle Haggard)

It is unfair to single Nixon out as the only president who lied to us. Many of them have. Some worse than others. Some lied now and then. Others lied every day. You don’t need me to tell you which is which. You must wade through the Swamp of Lies on your own.

ÂMerle Haggard laid out the

BASED ON A TRUE STORY

(most of the time)

Merle did not give us a solution, only an observation and questions. Each of us is tasked with finding a solution.

series

future for us in May, 1982. But we did not listen back then. We plunged head on, like water over Niagara Falls in flood season.

We became progressive. Modern. Woke. And many other misleading terms. Our music became bloated with profanity. We lost moral bearing. Moral fiber no longer exists in the main stream. Self-importance is paramount. Demand for immediate reward robs our youth of the joys of dedication and long-term planning, work, and accomplishment. How many 16-year-olds can change oil and filter in a car?

How many 16-year-olds can make and bake a pecan pie?

Surely we can do that. A problem necessarily precedes a solution. We have plenty of problems, real and imaginary. It is time for solutions that really help.

Maybe Merle left it to John Anderson from whom I also reverently steal herein: Black Sheep.

Yeah, I drive me a big ol’ semi-truck.

I’m makin’ payments on a two-room shack.

My wife, she waits on tables

And at night she rubs my back.

And I tell her what my papa said to my mama

When he got off a highball train:

Wake me up early, be good to my dogs,

And teach my children to pray.

Sounds like a good man to me. Our nation would do well to copy John Anderson. Get a job. Work hard. Pay your bills. Provide for your family. Teach your children a moral life. We don’t seem to have enough of that these days.

A California store reports an incidence of shoplifting … every 10 minutes. Twenty national stores have left San Francisco in the past two years due to shoplifting. Think how morally defunct those people are. Somehow, I don’t think they grew up in the home John Anderson sang about.

Shaquille O’Neal told one of his kids: “You are not rich. I am rich.” His kids will be educated and self-sufficient. Shaq has hundreds of millions of dollars, but rears his kids to be real women and men. He is a good man. A good father. We need men more like Shaq.

Charles Bronson (and his wife, Jill Ireland who died prematurely with cancer) adopted 17 street kids of many races. They lived in a huge ranch style home. Each kid was supported as long as each had a job and stayed in school. Each could pursue any degree they wished. Charles paid the bills. Charles left each kid zero dollars in his will. He

gave them something more important: he gave them tools for successful lives. It is likely each will accomplish much. We need more men like Bronson too.

People who are unhappy with their immediate situation in life sometimes take short cuts to “feeling better about themselves.” Drugs make them feel different. Temporarily at least. Drugs take no effort. No long term plans. Just “purchase and pop.” The results are gone in a flash, and then the user wants more … and then more. Eventually, the money supply runs out. The user sinks into immorality: a dealer or a thief or a sex worker to survive.

Notice I use the word “survive,” not “live.” There is a huge difference. Merle Haggard longed for the past when things were better and livable. John Anderson told us how to live the life Merle warned us about.

Bob Dylan wrote, “The times, they are a-changing.” He was dead on right. We get to choose our futures, but a bountiful future is not free nor is it simply handed to you. You must plan for, and work for, a better future. Afterall, our poets and singers told us yesterday what was to be if we fail to do our parts. Enjoy the beat and the music, but heed the words.

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TRYTHISDISH

PICKLE SLAW & ROAST BEEF TORTILLA

Lately I have had a craving for fried pickles (not the healthiest way to eat pickles). In order to get my pickle fix while maintaining a healthier meal I created this recipe using pickle juice to flavor slaw. Both slaw and pickles seem to be trending right now, and for good reason: they are delicious.

Ingredients

• ¼ cup olive oil

• 3 tablespoons pickle juice

• 1 tablespoon apple cider vinegar

• 1/8 teaspoon pepper

• 3 cups slaw mix

• 1 cup chopped kale

• ½ cup chopped dill pickles

• 8 ounces roast beef

• 4 whole wheat tortillas

Directions

In a large bowl, whisk together the olive oil, pickle juice, vinegar, and pepper. Add the slaw mix and kale and toss well to combine. Refrigerate

for 2 to 4 hours. To assemble, place 1/3 cup slaw mix down the middle of the tortilla. Next layer on 2 slices of roast beef. Carefully roll up the tortilla pressing one end in “burrito style” to help hold in the juices and roll up. This may be a little juicy, so eat carefully.

Yield: 4 Servings

Nutrition Breakdown: Calories 260, Fat 8g (1g saturated fat), Cholesterol 25mg, Sodium

820mg, Carbohydrate 29g, Fiber 4g, 16Protein g.

Percent Daily Value: 2%

Vitamin A, 6% Calcium, 15% Iron, 70% Vitamin C Carbohydrate choices: 2 Carbohydrate

Diabetes Exchanges: 1 Vegetable, 2 Starches, 2 Lean Meats

• Sodium Alert: This is a high sodium meal --- To reduce the sodium by 100-200 mg replace the tortilla with a whole wheat pita round. +

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The good news is that one area publication is alive and well and going strong, and for that we have our loyal advertisers and loyal readers to sincerely thank. If you’re wondering, the name of that publication is shown below:

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ARE YOU A CO-SIGNER?

You can be one without signing your name in pen and ink! To “co-sign” is to assume responsibility for another’s actions. Believe it or not, it is not too far from being a “co-conspirator.”

I was educated on this when a friend sought a divorce a few years ago. He was self-employed and sometimes received cash for payment of services without reporting the income on his tax returns. His wife knew of his practice and did not report it to the IRS, yet cosigned their joint tax returns for years. After the divorce when she sought more compensation from her ex-husband, she decided to report it. She quickly backed off her claims against him when she learned that she could be charged as a co-conspirator, knowing of his practice and not exposing it, and that she

could receive the same legal consequences as her ex!

Of course, co-signing isn’t limited to financial schemes. Family members of addicts are famous for co-signing. In other words, for endorsing addictive behavior and accepting responsibility for the consequences of addiction. Here are some of the ways you can self-assess to see if you are one:

• If you turn a blind eye or a deaf ear. You ignore the problem and hope your loved one is just “going through a phase.” Know that when drug use starts causing problems, without intervention or treatment the roller coaster is going downhill from there… guaranteed. You may’ve thought, “Well son, I smoked weed when I was a teenager and it never hurt me, so you can too.” Know that THC now is not the THC of your youth, dad!

(See: learnaboutsam.org)

• If you are addicted to an

addicted person. Do you think about their actions 24/7? Wake up at night thinking about them? Give them money, time, food, shelter, clothing, transportation against your better judgment? Make excuses for their negative actions versus calling a spade a spade? I knew a lady years ago who was hospitalized with various organ issues over anxiety about her addicted son. She went to counseling for that “addiction” and got well mentally, saving thousands of dollars in medical bills and sleeping pills. • If you do things for a substance abuser that they could and should do for themselves. Call in sick to their job for them? Get them to bed if they come home drunk and sick? The alcoholic/addict is thinking, at least subconsciously, “Hmmm…. if I get wasted my wife will see that I get to bed and cleaned up and off to work in the morning. What a deal!” I

know of a case in which the wife quit sponge-bathing her hung-over husband and getting him to bed and instead started letting him spend the night in his vomit on the floor. After a few episodes of that he decided to be a big boy and stop drinking after work every day!

• If you allow him or her to steal from you without reporting it to the authorities You just yell at them and believe it when they promise not to do it again. I know of parents and spouses who chose to sleep with their valuables in their PJ pockets or pillowcases, and others who locked (yes, with a double-sided deadbolt!) their bedroom door at night to prevent stealing. And others whose children have drained their bank accounts to buy drugs. It’s a similar story every time…”the bank will give me my money back but then they will prosecute and I can’t bear the thought.”

One father initially didn’t report his son, instead giving him the choice to either join the military or be reported. Junior chose the military and spent 10 years there learning about cyber security and is now employed full time in that field. I guess I can’t fault him for his choice!

If you find yourself in even one of the categories above, there is (free!) help for you. Go to ga-al-anon.org, as just one example, for a meeting schedule. You’ll find a lot of help there from adults who have “been there, done that.”

Then read the fine print under “co-signer.” It’s a sobering alert.

AUGUSTAMEDICALEXAMiNER JULY 21, 2023 8 + +
A monthly series by an Augusta drug treatment professional THIS IS YOUR BRAIN
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IN THE SWIM

… from page 1

the solution — is personal, person by person, family by family.

Personal action can start today, versus legislation that can take years to enact and even longer to go into effect.

What can an individual or a family do immediately? As suggested by the picture to the right, it might seem counterproductive, but get kids in the water — with certain caveats, of course.

Water interaction #1: swimming lessons. Knowing how to swim is a huge factor in drowning prevention. It isn’t an iron-clad guarantee, since experienced swimmers have been known to drown, but it cuts the odds significantly.

You can’t afford swim lessons? Are you sure? Have you checked prices? There are very reasonably-priced options, especially when you consider the unbearable potential cost of not knowing how to swim. A few weeks of lessons can offer a lifetime of protection, to say nothing of the enjoyment offered by being able to swim in weather like this week’s.

Another extremely important step to take in drowning prevention: never allow children to swim unsupervised. Always have them carefully watched when they are in the family pool or at the lake. An adult watcher should be designated, and watching should be that person’s sole job:

MIDDLE AGE from page 5

never eat a carbohydrate “unopposed.” I had to find out what that meant. The short answer is that you should balance any carbohydrates you eat with protein eaten at the same time. In other words, don’t eat that biscuit unless you slap some eggs, cheese, sausage and/or bacon on it. At least that’s what my ears heard when I was told that, and I intend to follow this advice zealously.

It turns out too that there are good fats and oils, and bad ones. Who knew? I would have thought that any vegetable oil was good. At least that is what we were told a long time ago. However, most of them are not. Most of them are omega-6 oils, which compete with the good oil (omega-3) for enzymes in the body, and from what I have read, a good ratio is no higher than 2:1 of bad omega-6 to good omega-3 oils. Olive oil and avocado oil are the good ones, but canola, peanut, soybean, cottonseed, sunflower, sesame, and rice bran oil are from the wrong side of the tracks, so to speak. We can get the omega-3 fatty acids from eating wild-caught fish, but not so much from farm-raised, usually. This is because the fish don’t manufacture it. They get it from something they eat, that in

no paperback, no magazine, no cell phone. Just vigilant watching. Contrary to popular belief, drowning is a silent event. A semi-vigilant watcher cannot depend on screams or cries for help; they will not come.

Kids should be taught that they are never to go into the pool for any reason or even play around it unless an adult is nearby and watching alertly. Kids and adults can be in the swim - and stay there - with only a few common sense steps.

turn gets it from some algae in the sea. The good health people also say we need to reduce stress in our lives (good luck with that) and get enough sleep. These two things may prove the most difficult for some, but they are important. I’m not sure how to reduce stress any more than I have already. I could go to jail for what I’d have to do to eliminate some of my stress, but sleep usually comes to me easily. Staying asleep is the hard part. I wake up to go to the bathroom more than I want, but I learned that even this can be related to diabetes. If you get too much sugar, you will need to go more often, so hopefully, my new diet will fix this.

Well, I have more than run out of space for this issue. We will have to take up the other part of the plan — exercise — next time. Until then, take care of yourselves. You’re not getting any younger.

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

AUGUSTAMEDICALEXAMiNER JULY 21, 2023 9 + +
Hometown. Not big box. 437 Georgia Avenue, North Augusta, SC 803-279-7450 ARKS HARMACYP STORE • DRIVE-THRU • DELIVERY • PARKSPHARMACY.COM 5 OUT OF 5 DOCTORS AGREE: PARKS PHARMACY IS IN DOWNTOWN NORTH AUGUSTA WE’RE IN OUR NEW LOCATION! Visit us at www.danielvillagebarbershop.com OPEN FOR BUSINESS: Tue - Fri: 7:30 - 5:00 Saturday: 7:30 - 11:30 COME SEE US REAL SOON! OUR ADDRESS IS 3351 WRIGHTSBORO RD, SUITE 204 IN BROYHILL PARK NEAR AUGUSTA MALL OLD SHOP HIGHLAND AVE JACKSON RD NORTH LEG MARKS CHURCH RD I-20 AUGUSTA MALL WRIGHTSBORO ROAD BROYHILL PARK X Augusta Barber Post 3351 Wrightsboro Road • 736-7230 FORMERLY DANIEL VILLAGE BARBER SHOP facebook.com/DVBSAugustaGA1 PLEASE SUPPORT OUR ADVERTISERS. And let them know you do! 461 Greene Street at 5th • www.gregleopardlaw.com • 706-724-7511 GREG LEOPARD
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When he’s on your case he’s on their case.
“My barber is dumb.”
“He always puts my cape on me backwards.”
+
SORRY ABOUT THAT, KID. WE’LL DO BETTER NEXT TIME. PROMISE.

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

Not every state allows roadside memorials at the site of fatal accidents, but Georgia does. “The Georgia Department of Transportation (GDOT) supports the placement of memorial markers within the State Highway rights of way...to increase public awareness of highway safety and to memorialize people who have died as a result of a vehicle crash,” reads a portion of the state’s official policy. For the

non-DIY crowd, the state will erect an official marker at or near the site of a fatal accident for a nominal fee. (https://mydocs.dot.ga.gov/ info/gdotpubs/Publications/6160-9.pdf).

The people whose deaths are marked along our roadsides surely would want us to notice their memorials and learn from their experiences, sad as they are, so we don’t end up as they did.

Will we notice? Will we learn? +

AUGUSTAMEDICALEXAMiNER JULY 21, 2023 10 + + MEDICAL EXAMINER HEALTH MEDICINE WELLNESS • HEALTH MEDICINE WELLNESS HEALTH MEDICINE WELLNESS • HEALTH MEDICINE • WELLNESS HEALTH • MEDICINE WELLNESS • HEALTH MEDICINE • WELLNESS HEALTH • MEDICINE WELLNESS HEALTH MEDICINE AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006 Read it for life. Never reads the Examiner Reads the Examiner occasionally Never misses an issue On paper. Online. CRASH COURSE
Read us online at AugustaRX.com OUR NEXT ISSUE AUGUST 04 2023 ROLLED SANDWICHES • SOUPS • SALADS 3626 Walton Way Extension (Walton’s Corner) Phone: 706.736.1099 Fax: 706.736.4401 OrderRolyPoly.com THINK INSIDE THE WRAP 526 Georgia Avenue • North Augusta • 803.441.0144 ART & FRAME Custom Framing Custom Mirrors Art Installation Reframing
Two adults and a small child died near this South Carolina interstate guardrail. These two friends were born 13 years apart, but they died on the same day. This Riverwatch memorial is at the site of a fatal wrong-way collision. No one is immune, unfortunately, including law enforcement officers. The site of this fatal accident north of Columbia features a basketball, a teddy bear, planted shrubs, and solar lights. Friends of a motorcyclist who lost his life on Riverwatch left personal messages on this mrmorial.

the blog spot

— posted by Christine J. Ko, MD, on July 16, 2023 (edited for space)

DR. APPOINTMENTS: 10 INSIDER TIPS

Since last December I’ve had over 60 medical appointments, some as short as 15 minutes, while others took more than 3 hours. Based on my experience, here are my top 10 tips:

1. Check the location and plan ahead. Before your appointment, make sure you know where you are going. Some medical offices can be difficult to find, so it’s wise to ask about parking arrangements, specific floor and room numbers, or any other relevant details.

THECWORD

What if you had the opportunity to take a blood test to see if you had cancer before you had any symptoms? Would you take it? How would you prepare yourself ahead to time for the results? How might you react if you learned you have cancer? For cancer survivors, in retrospect, would you have taken a cancer blood test before your symptoms became apparent? Given your cancer journey, would you encourage family members to get a cancer blood test, if one is available? These are not hypothetical questions, because blood tests designed to detect multiple cancers before symptoms show up are on the horizon.

BE PREPARED.

2. Schedule multiple appointments in advance. This is especially beneficial for treatments that require a series of visits, such as infusions over many weeks. Booking in advance can secure more convenient time slots for you.

3. Advocate for yourself. Don’t hesitate to ask how you can streamline the process. For example, I recently needed weekly infusions possible only if my white blood cell count was within certain limits. By arranging to have the required blood tests a couple of days before each infusion, I saved time and avoided unnecessary waiting on the day of the treatment.

4. Be prepared to wait. Bring something to pass the time, such as a book, emails to catch up on, or materials for upcoming meetings. Having a distraction can help make the waiting more bearable.

5. Understand medication side effects. Familiarize yourself with the potential side effects of any medications you are prescribed. Ensure you are taking only what is necessary and talk to your doctor if you experience any issues or discomfort.

6. Minimize medication side effects. Ask your health care provider for strategies to minimize any unwanted side effects of necessary medications. While some side effects are unavoidable, there may be ways to mitigate their impact.

7. Prepare a list of questions. Even if it’s just one question, having it written down ensures you won’t forget to discuss it. If you’re prone to misplacing physical lists, put it on your phone. Handing your list over to your doctor allows for a comprehensive discussion within the limited time available.

8. Maintain a positive mindset. Focus on keeping your spirits up. Find what works best for you. It could involve reaching out to friends or loved ones, engaging in exercise to the extent possible, treating yourself to something enjoyable like chocolate, or simply seeking out moments of beauty and inspiration in the world around you.

9. Cultivate emotional intelligence. Work to manage not only your own emotions but also those around you, including health care professionals. This can be challenging, but start by recognizing basic emotions like sadness or anger and gradually expand your emotional awareness.

10. Share your emotions with your doctor. I value a doctor who understands my concerns. Don’t hesitate to share your emotions and allow your doctor to genuinely care about your well-being.

I hope these tips prove helpful to you based on my own experiences. Remember to tailor these suggestions to your specific circumstances.

Christine J. Ko is a dermatopathologist.

Cancer Screening

Two major benefits from cancer screening tests are the “detection of abnormal cells that can be removed or treated before they become cancer (pre-cancers), and discovery of cancer at an earlier stage when it may be more treatable and lead to improved survival” according to the National Cancer Institute (NCI).1

Recommended specific cancer screening tests are done semi-regularly depending on age and family history of cancer. The NCI describes four major types of screening tests: physical (i.e. skin cancer mole check), imaging (breast mammogram or a low dose CT scan for lung cancer), observational (colonoscopy), and laboratory tests to examine tissue, blood, urine, or other bodily substances (for example, a Pap test to detect cell changes in the cervix or the prostate-specific antigen test (PSA)).

What is a Multi-cancer Detection Test?

First, we need to distinguish between cancer blood tests used after a cancer diagnosis to monitor treatmenteffectiveness, and those tests designed to detect the presence of cancer before symptoms show up. This edition of The C Word explores the latter, a type of laboratory liquid biopsy test also known as multi-cancer detection (MCD) tests or MCD assays that measure biological signals (molecules) that cancer cells shed in bodily fluids.1

Although the MCD tests target molecules (genes and proteins) released by cancer cells, they differ from genetic testing for cancer. The DNA targeted by the MCD test is “cellfree DNA” that is circulating in the blood. Genetic testing looks for “specific inherited patterns in a person’s genes, including healthy cells” according to NCI. While not widely available in the U.S., and lacking FDA approval, MCD tests are undergoing study in clinical trials research. The greatest utility of MCD tests is for people with high risk for cancer based on family history and their genomic predisposition, says Dr. Ravindra Kolhe, Professor of Pathology at the Medical College of Georgia. He states, “Once we have enough knowledge on high-risk patients the MCD technology will improve so that it can be used for the general population beyond those with high risk.”

One multi-cancer early detection test (MCED), Galleri, is available by prescription only for people 50 years of age and older with an elevated risk for cancer, who are immunocompromised, or who have a family history of cancer. Galleri identifies a

augusta.edu/cancer/community

‘cancer signal’ to predict where in the body the signal originated.2 Galleri detects more than 50 types of cancer including cancers of the anus, breast, cervix, esophagus, kidney, and liver, and the more lethal ovarian and pancreatic cancers.2,3 Its accuracy varies depending on the cancer type, says Healthline 4 Cleveland Clinic reports Galleria found 51.5% of cancers and was 89% accurate in predicting where the cancer started. “It’s a great tool using amazing technology that will be refined,” says Dr. Kolhe.

Benefits, Risks & Precautions

A positive result from a MCD or MCED test is an indicator and does not mean you have cancer. “The MCD test only provides a signal for a possible cancer” and can indicate the likely organ site of the cancer.1 Follow-up protocols for a positive or negative MCD test fall within a grey zone – they are evolving and are not standardized. To be clear, MCD tests are not diagnostic but are considered screening. A cancer diagnosis is confirmed through tissue biopsy and analysis, imaging (such as scans), and/or surgery, not through screening.

The benefits and harms of MCD tests, whether they will improve survival, will result in fewer cancer deaths, and whether they can help reduce cancer disparities requires large-scale study which the NCI is facilitating.

“The C Word” is a news brief of the Georgia Cancer Center at Augusta University. For cancer information, visit: augusta.edu/cancer/community.To request exhibits or speaking engagements, contact Maryclaire Regan at mregan@augusta.edu or 706-721-4539. Arrange for virtual presentations in order to follow Coronavirus precautions.

Sources:

1. National Cancer Institute (NCI). Questions and answers about MCD Tests. https://prevention.cancer.gov/ major-programs/multi-cancer-detection-mcdresearch/ questions-and-answers-about-mcdtests#:~:text=Multi%2Dcancer%20detection%20(MCD)%20tests%2C%20also%20 referred%20to,may%20shed%20in%20body%20fluids.

2. GRAIL https://grail.com/galleri-test

3. Healthliine. healthline.com/health/cancer/galleri-cancer-test

4. Cleveland Clinic health.clevelandclinic.org/the-galleri-test/#:~:text=Galleri%20can%20detect%20these%20 cancers,your%20bloodstream%2C%20like%20brain%20 cancer

AUGUSTAMEDICALEXAMiNER JULY 21, 2023 11 +
+
+

Do you have a retirement plan?

Not really.

Why not?

I don t need one. I should have all the money I will ever need

What do you mean should ?

I ve got all the money I ll ever need - provided I don t live past next Tuesday.

THE MYSTERY WORD

The Mystery Word for this issue: UCCIETL

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

We’ll announce the winner in our next issue!

ACROSS

1. VHS tape successor 4. Capital of Yemen 9. Respiratory prob. 13. From a distance 15. Graven images 16. Entreaty 17. Significant life events 19. Islamic call to prayer 20. Pager 21. Average Joe’s last name 22. Christian’s name 23. One-time Chronicle political cartoonist Rick 25. Shady recess

WORDS NUMBER

1. Thurmond, for example

2. Heart quivers, for short

3. Evans’ name

4. South Augusta call center company

5. Worship

6. Invasive beginning

7. Ginger beverage

8. Donkey

9. Room

10. Dementia

11. Quantity of paper

12. Monte follower

14. South African antelope

18. Surplus

21. Pelt

23. Alcoholic drink of fermented honey

24. Cordele’s County (GA)

25. Accumulate in large amounts

26. Ran swiftly

27. Capital of Slovakia

28. Before surgery, in brief

30. Rubio of note

31. Clean and straighten feathers

33. Wednesday’s number during Masters Week

38. Nestlings

41. Boast

43. Public perception

44. Young bird of prey

49. Corny 50. _____ Market

51. There are five Great ones 52. Impressed 53. Heavy metal 55. Capital of Western Samoa 56. Require 58. Leg (esp. female; dated slang) 59. MD’s org. 60. Egyptian pharaoh (in brief) 61. Nutrition label abbreviation

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

QUOTATIONPUZZLE

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.

The Examiners
AUGUSTAMEDICALEXAMiNER JULY 21, 2023 12
Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, JULY 30, 2023 + +
by Daniel R. Pearson © 2023 All rights reserved
by Dan
BY SAMPLE: 1 2 3 4 1 2 1 2 3 4 5 LOVE BLIND IS 1. ILB 2. SLO 3. VI 4. NE 5. D = Solution p. 14
by Daniel R. Pearson © 2023 All rights reserved. E
S U D O K U
X A M I N E R
EXAMINER CROSSWORD by Daniel R. Pearson © 2023 All rights reserved
EXAMINER CROSSWORD by Daniel R. Pearson © 2023 All rights reserved.
PUZZLE
© 2023 Daniel Pearson All rights reserved. ,
,,
,, , , , 6 2 4 1 7 6 3 3 6 9 2 4 8 4 2 5 5 3 7 3 8 6 4 9 3 4 7 6 9 8 2 1 1 7 9 6 2 5 3 4 3 9 7 2 5 8 1 8 4 9 6 7 5 2 6 1 4 3 7 1 3 6 8 5 2 6 5 4 1 9 9 4 8 3 7 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67
DOWN
of
restaurant 34. Purple _____ 35. Impair 36. Obamacare acronym 37. Listens and obeys 39. Before (poetic) 40. Become firm 41. Cold prefix 42. Georgia county named for the 14th US president 45. Reagan-era defense abbrev. 46. Harvest 47. Stoneworker 48. Footwear 50. Variety of football 52. Permit 54. Sleeve style 57. Like a lame excuse 58. Access controller 62. Roof overhang 63. Entertain 64. Bound 65. June 6, 1944 66. Mathematics 67. DDS’s org. A S E E V L F E I M A E S H U S A H B I O T L S A H C U R O L O I B L D W O I E D U S U — Benjamin Franklin H H H N W F B L W T H W M 1.
2.
3.
4. TEMKNRY 5. OE 6. RN 7. E 1 2 1 2 3 4 1 2 1 2 3 4 1 2 3 1 2 3 4 5 6 1 2 1 2 3 4 5 6 7 1 2 3 4 1 2 3 1 2 3 4 1 2 3 1 2 3 4 1 2 3 T
28. Meter prefix 29. Mischievous child 32. Middle name
Surrey Center
WAAYYLIBISOFTT
VOOOOSTEWERHAL
AALLUUMOTTE

Aman applied for a job posting that read, “Hiring welders $15-$24 per hour.” An in-person interview was arranged that included a welding test.

He turned in two sets of welds, one that looked like a 5-year old did it and one that was absolutely perfect.

The boss looked at the two welds and asked for an explanation. The man replied, “The first one is a $15 an hour weld, and the second one is a $24 an hour weld.”

Knock knock.

Who’s there?

A priest, a minister and a rabbi.

A priest, a minister and a rabbi who?

A priest, a minister and a rabbi walk into the wrong joke setup. The barman says “You shouldn’t be in here.” The priest replies “Well, we did knock.”

Knock knock.

Who’s there?

Hawaii.

Hawaii who?

Fine. Hawaii you?

A new patient is being evaluated on his first day in a mental health facility.

To begin the interview, one of the doctors asked him what his name is.

“JFK, sir,” the man replied.

“Great,” muttered the doctor under his breath but loud enough for the patient to hear. “Just what we need, another president.”

“No!” said the patient. “I’m not the president. I’m the airport!”

A snail couple, Marvin and Marla, happened to be on a turtle’s back when the turtle started to walk.

“Hang on Marla!” said Marvin. “Here we go!”

Moe: I’ve heard that joke.

Joe: What joke?

Moe: The snail joke. You know what Marla screams back? She says, “Slow down, Marvin! You’re going to kill somebody!”

Moe: Plenty of hats have flat brims.

Joe: What does that have to do with anything?

Moe: Nothing really. I’m just wondering why cowboy hats curl up on the sides.

Joe: Oh, that’s easy. It’s so you can fit three cowboys in a pickup truck.

Moe: Do you know how to make gold soup?

Joe: Never heard of it. What’s the recipe?

Moe: You start with 24 carrots...

Moe: What is a Kraken’s favorite meal?

Joe: Fish and ships.

The Advice Doctor

Dear Advice Doctor, My niece paid over $1,500 for a single Taylor Swift ticket, and when she got to the arena the seat was so far away it made the nosebleed section look like front row seats. Is that even legal?

— Not So Swift After All

Dear Not So Swift,

Thank you for submitting this question, and I hope the answer will be beneficial to many people since, let’s face it, many of us have had the experience you describe. I had a nosebleed myself a few months ago.

There are a number of factors that can cause a nosebleed (in medical terms, an epistaxis - ep-ih-STACK-sis), but most of them are nothing to worry about from a medical standpoint (even though nosebleeds are always annoying and inconvenient). An epistaxis can be brought on by things as simple as scratching an itchy nose or blowing the nose a little too vigorously, especially when the air is extremely dry in wintertime. Aside from such mechanical or physical triggers, medical contributors can include high blood pressure, hemophilia, or the regular use of aspirin or blood thinners.

For treatment of a simple nosebleed, doctors suggest sitting up straight, leaning forward a little, and applying direct pressure, just as you would to stop acute bleeding anywhere else in the body.

Of course, there is the minor detail of breathing to consider, so breathe through the mouth while pinching the nose closed for at least 10 minutes, and even better 15. If bleeding continues after that, repeat for another 15 minutes; don’t stop the pressure for any reason. That should do the trick, but if it does not it’s probably time to go to the ER or an urgent care clinic.

Once a nosebleed is stopped, don’t do any heavy-duty lifting, nose picking, or nose blowing for 24 hours, and do your best to keep your head (and the nose on it) above the level of your heart.

Most of us probably have nosebleeds very rarely; maybe you can’t even remember your last one. For others, however, they are regular events. If that is the case for you (or your niece), check in with your doctor. He or she can offer solutions.

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

AUGUSTAMEDICALEXAMiNER JULY 21, 2023 13 ha... ha...
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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 ZIP Choose six months for $22 or one year for $40 . Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903- 0397 + SUBSCRIBE TO THE MEDICALEXAMINER + Because try as they might, no one can stare at their phone all day. Why subscribe to
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READING AFTER READING
Why read the Medical Examiner: Reason #22 BEFORE

THE MYSTERY SOLVED

...cleverly hidden in the toothbrush in the p. 14 ad for WILSON

FAMILY DENTISTRY

THE WINNER: ANNE CATHERINE ROBERTSON!

If that’s your name, congratulations! Send us your mailing address using the email address in the box on page 3. The new Mystery Word is on page 12. Start looking!

The Celebrated MYSTERY WORD

...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package!

SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.

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TERM CARE
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was: BEDSIDE
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PERIPHERAL ARTERY DISEASE (P.A.D.)
J. Shah, MD Vascular Surgery Alain Domkam, MD Vascular Surgery
Paul Butros, MD Interventional Radiology Salman Mufti, MD Interventional Radiology ENDOCRINOLOGY
Risha Malik, MD Endocrinology Sergei
Sobolevsky, MD Interventional Radiology
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