Medical Examiner 11-5-21

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NOVEMBER 5, 2021

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

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DIFFICULT CONVERSATIONS What to Expect When You Share the News of Your Diagnosis

by Carolyn Byrd RN-BSN

Sharing the news of a cancer diagnosis with your family, friends, and coworkers is hard. But you have total control over how and when these conversations take place. Here’s a guide on what to expect:

39 WINKS

There are two weeks every year that cause insomnia and generally play havoc with people’s sleep schedules, and one of them happens next week.

The occasion is the semi-annual changing of the clocks to begin and end Daylight Saving Time (DST). Humans are creatures of habit, and when we go to bed at roughly the same time every night, and nearly always get up at exactly the same time every day for work or school, any change, even if only an hour, messes with the circadian rhythms we have established since we sprang forward or fell back.

This year’s fall back date (Nov. 7) was established by Congress in 2005, extending the end of DST from the last Sunday in October to the first Sunday in November, reportedly at least partly as the result of pressure from candy lobbyists who wanted longer daylight for trick-or-treaters.

The myth is that we gain back the extra hour of sleep we lost last spring when at, say, 11:00 pm on Nov. 6, we reset the clock for 10:00 pm before we crawl into the sack.

But then the aformentioned circadian rhthyms kick in. Right after changing their clock some people will think, “Hey, it’s only 10 o’clock now.

No sense going to bed this early.” Their body doesn’t know anything about the time change, of course; it’s dark in there. But eventually they do go to bed — late — and quickly fall asleep.

Phase II of the problem happens the next morning: even though their alarm might be set for 7, that’s just the time the clock says. Internally, in the person’s body clock, 7 o’clock will happen at 6 o’clock.

By such means, 40 winks become 39. Or even less. What is the solution?

Please see 39 WINKS page 6

You just found out that you have cancer. You’re trying to wrap your brain around the devastating news you have just received.

Your entire life seemingly flashes before your eyes. Thoughts of your family and friends’ reactions to the news begin to crowd your brain. Your emotions are all over the place, and you haven’t had time to process the news. This is a normal response.

Allow yourself time and space before sharing the news. Only you know when it’s time to share. It is important to know the facts before you share with extended family and friends. You may get a lot of questions that you are unable to answer, causing still more emotional turmoil. If you are unable to deliver the news, you can appoint someone to speak on your behalf. After sharing your diagnosis, you should expect many different emotions from others. People cope with bad news in different ways.

If your spouse or significant other wasn’t present when you received your diagnosis, you may need to inform them right away. More than likely they will be your greatest support throughout your cancer journey. They can assist you in making decisions about your care. If at all possible, keep them in the loop of what is going on because they are concerned about your health and well-being. Remember that this diagnosis will affect your personal relationship with your spouse or significant other, so don’t shut them out. Normally they are there to assist you in making decisions about your care.

Telling younger children may be a little challenging. It is important to take the child’s age into consideration when having this conversation. As parents, it is natural for us to protect our children. Children are very smart and can sense when something is wrong. Be truthful with them and assure them that you will be getting the care that you need. Hopefully this will alleviate some of their fears. Allow them time to process this inPlease see DIFFICULT page 10

At times like this...

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AUGUSTAMEDICALEXAMiNER

THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD

by David W. Proefrock, PhD

Your 16 year-old son has been cutting classes and sometimes skipping school altogether. He got a parttime job over the summer and kept it when school started. He never misses work. Until this year, he had been a very good student with no serious behavior problems.

What do you do?

A. Warn him that he will be in danger of failing if he keeps cutting classes, but don’t do anything else. Let whatever happens happen and hope he learns from it.

B. Tell him that the next time he skips a class or cuts school, he will have to quit his job.

C. Arrange to check with his school every day to make sure he has attended all of his classes. Make sure he is allowed no privileges, including going to work, on days that he misses any classes or cuts school.

D. Make arrangements to take him to school and pick him up to make sure he has attended.

If you answered: A. Natural consequences are often the best punishments, but you cannot just stand by and allow him to fail without trying to intervene. That’s not good parenting.

B. This plan doesn’t necessarily fit the unwanted behavior. Besides, it appears that his job is one of the positive things in his life. It’s a little extreme to make him quit altogether.

C. This is probably the best response. You will need to clear it with his employers, but they should be supportive of him attending school. This gives him plenty of chances to figure out how to both work and go to school. Lots of kids manage it.

D. This places the responsibility on you, not on him.

It also does not address the problem of cutting classes when he is at school.

At 16, a youth’s primary responsibility should be education. Everything else, including work, is a privilege.

It is important for him to learn that his responsibilities must be fulfilled in order to earn his privileges. + Dr. Proefrock is a retired clinical and forensic child psychologist.

NOVEMBER 5, 2021

PART J OF A 26-PART SERIES

IS FOR JOINT PAIN

What happens when a rock-hard object meets another rock-hard object?

If it happens in the human body you call it a joint: a hip, a knee, a shoulder, etc.

And with any luck, the rock-hard objects never touch. Bone-on-bone is a recipe for pain and misery.

In normal circumstances, cartilage and synovial fluid cushion joints and make effortless and pain-free motion possible.

Abnormal circumstances, however, are certainly common.

They include arthritis in its various forms (osteoarthritis and rheumatoid arthritis are two), gout, lupus, fibromyalgia, and injuries new and old. Arthritis, incidentally, is not just for older people; it can even affect children.

The prescription for better joint health might be a little surprising: it includes exercise, even for people who suffer from joint pain. That might sound counterintuitive, but when you think about it, it makes perfect sense.

For one thing, exercise strengthens joints. Regular exercise keeps the muscles around joints strong and working the way they should.

Secondly, exercise can contribute to weight loss.

Excess weight is one of the primary contributors to joint pain. The CDC reports that for every pound of body weight lost

there is a corresponding 4-pound reduction in the load exerted on knees, adding that “[even] a modest weight loss (5%, or 12 pounds for a 250 pound person) can help reduce pain and disability.”

If exercise just sounds too daunting because of joint pain, start with low-impact options like walking, bike riding or swimming, and make frequency your goal instead of distance. Over time you can gradually build up distance as your joints get stronger, healthier, and less painful.

Joints are a classic example of the old “less is more” axiom. In this case it’s less movement means more stiffness.

One thing that shouldn’t be overlooked: see your doctor early and often for an accurate diagnosis of the exact source of your joint pain and the best plan to treat it.

A salubrious diet also helps joints, providing vital nutrients and contributing to healthy weight. +

Michael Sharkey, MD Lauren Ploch, MD Caroline Wells, PA-C Chris Thompson, PA-C John Cook, MD, Emeritus GENERAL, SURGICAL & COSMETIC DERMATOLOGY

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NOVEMBER 5, 2021

The Technobabble-Free Zone: EXTENDING THE REACH OF PATIENT CARE

by Dr. Chuck Cadle

Twenty-five years ago, businesses did not have websites.

Smartphones with applications like GPS were in their infancy.

Google and Facebook did not exist, email was not prevalent, Amazon was only beginning to sell more than books, and the opportunity to use technology to improve life sciences was only beginning to emerge. Today, technology is changing the way we live and work at breakneck speed. The Fourth Industrial Revolution is upon us. Should the medical community embrace the myriad of technology’s new healthcare applications? Can technology be friendly and not disruptive?

Who manages the ethical concerns of privacy?

This new monthly Examiner column will explore truth versus perception of technological change related to health, medicine, and wellness. The column’s goal will be to inform readers with facts and real-life stories which express users’ experiences and lessons learned. This column will examine emerging technologies to determine if they are a sign of increasingly impersonal care, or a salubrious addition to wellness.

With change, the pressures of daily life (professional, academic, or personal) can become obstacles. Problems separate where we are from where we want to be. We instinctively try to build bridges to cross this divide. Each of us approaches problems and challenges in our own way, trying to find practical solutions to attain the most significant benefit, put the problem behind us, and move on. Fortunately, new applications for technology can alleviate many problems. Technology is the application of knowledge, tools, and skills to solve problems and extend human capabilities. In this article and future articles, we will explore new and emerging technologies relating to improving health.

Although the speed of change for disruptive technology has been fast, businesses and consumers have only recently begun recognizing how to use technology for health benefits. One example is The Internet of Things (IoT), where devices and objects share information through the Internet. Monitoring, alerts, actions, and storage are benefits of this connectivity.

Many of us wear so-called smart watches, an example of device connectivity. These watches send data through the Internet to our smartphones. New applications translate this data into desired health statistics such as heart rate, sleep quality, calories burned, and activity levels. Some companies are now beginning to produce smart clothing to monitor breathing patterns, VO2 max (your body’s maximum ability to use oxygen), stress levels, and assisted living patient or baby monitoring. These watches and clothes make it possible for us to take control of health-related goals.

Please see TECHNOBABBLE-FREE page 5

Why are there so many unruly passenger incidents on airlines?

This is a new and (forgive this next word) skyrocketing problem. Not that it has never happened before, but for comparison, the FAA reported 128 unruly passenger events in all of 2010 that were big enough to trigger an investigation; there were 183 in 2020. So far this year (as of October 26) 923 investigations have already been launched, an increase of more than 500% over all of 2020, with the busy holiday travel season still ahead. In total, there have been nearly 5,000 unruly passenger reports to date this year. Here is a description of one passenger’s actions from the FAA’s website: on a May 24, 2021, jetBlue Airways flight from New York, N.Y., to Orlando, Fla., allegedly throwing objects, including his carry-on luggage, at other passengers; refusing to stay seated; lying on the floor in the aisle, refusing to get up, and then grabbing a flight attendant by the ankles and putting his head up her skirt. The passenger was placed in flexi-cuffs and the flight made an emergency landing in Richmond, Va. For this performance the passenger was fined $45,000 by the FAA and also has legal issues to face. Total fines for this year levied by the FAA against passengers have already exceeded $1 million, another record.

A significant number of the 5,000 incidents (3,580, in fact) are about mask-wearing rules. Passengers who disagree with a rule made at the federal level (or in some cases the airline’s corporate level), can’t attack the people ultimately responsible for the rule, so they take out their frustrations against the nearest convenient target: a hapless employee just doing his or her job. The targeted employee may even personally disagree with the mask mandate, but has a job they’re being paid to perform.

Similar events have happened in retail, where a perhaps minimum-wage employee gets accosted for asking a customer to mask up in accordance with company policy (which, again, the employee may not even agree with).

All of us should remind ourselves that we are adults, and we should act like it, even in (especially in) stressful situations. If not, there could be handcuffs in our immediate future. Or worse. +

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AUGUSTAMEDICALEXAMiNER

#150 IN A SERIES

Who is this?

ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE

A

sk any of your acquaintances who have Type 1 diabetes if it annoys them that the milder, non-fatal version of the disease (Type 2, that is) gets the lion’s share of research dollars and pharmaceutical assistance, and you’re likely to get quite an earful. To them, it’s like devoting millions of dollars to heartburn research, but only a fraction of that amount to heart attacks.

Well, the lady above is trying to change that. And as strange as it may sound to say it, she is not exactly making many fans along the way.

Her name is Denise Faustman, and she is the director of the immunology laboratory at Massachusetts General Hospital. Her entire medical career has been devoted to diabetes treatment and research, much of it focused on using the bacillus CalmetteGuerin (BCG) vaccine. Mainly used to prevent tuberculosis, it is one of the oldest, safest, least expensive, longest-studied and best-understood vaccines there is. Up to 100 million newborns across the planet receive it each year.

Faustman’s unusual approach was based on BCG’s known ability to kill the type of T-cells that cause or contribute to Type 1 diabetes. After very promising initial trials with mice, whose diabetes was in effect reversed, Faustman administered the vaccine to 9 diabetic human patients — known in the business as a statistically insignificant sample — giving two doses four weeks apart. Although the effects were not immediate, at three- and five-year followups, the A1C readings of the participants, all 9 of them, was significantly lower than those who received a placebo (6.18% vs. 7.07%). Every participant at the 3-year mark experienced anywhere from a 10 to 18 percent reduction in A1C, and their insulin needs had decreased by at least a third. Even though very preliminary and very small, the study generated a lot of excitement in the diabetes community.

But there was a problem.

Aside from the minuscule sample size (the original 9 had shrunk to 3 at the 8-year check), researchers in other labs around the world were unable to duplicate Faustman’s results. That’s usually a huge red flag, and sure enough, some of the heavy hitters in the diabetes world, the American Diabetes Association and JDRF, issued a joint statement throwing a wet blanket on the hype created by the study and rejecting any change in therapy based on Faustman’s findings.

A profile of Faustman in Healthline earlier this year described her as “shunned by the research community.”

That doesn’t seem to bother her in the slightest: her research continues, generously funded to the tune of tens of millions of dollars by private donors. Her diabetes study participants are still small — in the hundreds — but growing. Along the way, she and others around the world are discovering new applications for the BCG vaccine in treating fibromyalgia, allergies, various autoimmune disorders, Alzheimer’s, and other conditions, including COVID-19.

While the research community as a whole seems to be less than impressed so far, Faustman has one major factor on her side there: major medical breakthroughs are nearly always initially met with scorn and skepticism. It’s up to the researcher to produce the data that in the end always defeats disbelief and doubt. +

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

by Marcia Ribble It’s another Saturday morning as I write this and the living is easy…. Fish are jumping and the cotton is high…. Couldn’t resist adding that phrase because it is so iconic and so relevant to this time of year.

From north to south and in between it’s harvest time. And that reminds me of plump tomatoes bending the plant branches down to the ground, unless we put wire cages around them to keep them off the ground and out of the reach of slugs, but those big fat ugly green tomato worms go after them anyways. Nothing quite disappoints like picking a juicy red tomato and then to turn it over and find that a critter has taken a bite out of it. A travesty, I say, a travesty!

But I learned growing up that it’s OK to simply cut out that disgraceful hole and eat the tomato anyway. Why? Well because my mother grew up in the Great Depression when food was precious and not to be wasted. The same was true of apples and the apple worms we used to encounter in the days before farmers and gardeners sprayed growing fruits and vegetables with all manner of pesticides. I wonder how many young people today have ever bitten into an apple and found an apple worm in it. Or if they even know that such a thing is possible.

In these days of pandemic threats, many people have begun not just growing their own gardens, but also canning extras so they aren’t wasted. I learned to can tomatoes sitting across from my mother-in-law in her kitchen as she showed me how to skin tomatoes for canning. There was a trick to it as she’d cut s tiny X on the bottom before plunging it briefly into a vat of boiling water, then pull it out with a scoop, and cool it off by putting it in cold water. Then we would

take our paring knives and strip off the skins.

At that point we would either cut them in chunks or squish them, depending on the kind of tomatoes we wanted to can. After that they would go into a large pot to be cooked before canning. The objective was to kill any lingering bacteria. The entire process had to be clean. The jars would be boiled, along with the lids and rings, and only lifted out one sterile jar at a time, to immediately be filled with boiling tomatoes, then capped with the sterile lids and rings and then tightened down. After that, each jar would be lowered into a pressure cooker and cooked to ensure that not one particle of bacteria could survive. We canned a bushel of tomatoes at a time, which yields about 20 quarts. I will never forget how satisfying it was to take those tomatoes out of the canner, line them up on the counters, and wait for the ping which indicates a perfect seal had been obtained.

We canned for weeks, usually during the hottest days of late summer. We canned all manner of vegetables and fruits. Many a young married woman in those days was judged by how many rows of those colorful jars she had “put up” to ensure her family would have food all winter. We canned, we pickled, we preserved, and we were not dependent of grocery stores for most of our food. One thing I didn’t can was meat, but my sister-in-law, Cookie, talks about them killing, defeathering, and gutting upwards of 300 chickens and then canning them. I still get irritated when someone talks about women in those days not working. We definitely worked. The heat and steam in our kitchens made sure that we deserved our iced tea when the jars had pinged and we could take off our aprons and rest a minute before starting supper. +

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age

EVERYBODY LOVES A GOOD STORY

BY J.B. COLLUM

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As my wife and I venture into middle age, I else says as I watch her lips carefully and am appreciating the “two become one” aspect focus and then inevitably turn down the radio to marriage more and more. When I was or television and again say, “What?” younger, I felt more independent. I could do It is the same with our vision. I need glasses anything and do it all by myself. Now, someto see anything closer than about two feet, but times I am dependent on her and vice versa.

I can see fine without glasses beyond that. She Of course, that is just part of the journey of can see close just fine without glasses but from life. We start out as babies, dependent on our 100 feet she can’t tell a Waffle House sign from parents for everything. Indeed, we would die a McDonalds sign. So, we help each other out. without their constant care. Even Tarzan and We complement or complete each other. And Mowgli needed some helpful parents from the that is the way marriage is supposed to be. It animal kingdom. Then once we mature some- took us years to grow into this, so I don’t know what, we become independent — or we are how people who remarry later in life ever get supposed to, current culture not-withstandused to each other the way old married couples ing. However, when we reach do. It was a long hard struggle full maturity, we recognize that for us to get here and I would Selective we are all truly interdependent. never want to start down that We all need each other. That path again with someone else, hearing loss was brought home to me in a but to each his own. is real. recent exchange with my wife.

It reminds me of an eccentric We were back at the beach older man I used to know who again this past weekend visiting had two nearly identical classic two of our adult children who had booked a cars. They were the same make and model, beachfront condo and kindly invited us along. but two different colors and he usually had As I was driving, she was talking to me while only one running at a time because he wasn’t there was something playing on the radio, so well off and couldn’t afford or sometimes I didn’t understand her. I’ve increasingly been even find new parts for these classic beauties unable to understand people talking with any that rolled off an assembly line before I was other noise going on. It isn’t that I don’t hear born. So, the two cars supplemented and them, it’s just that they essentially sound like complemented each other like a long married the adults in a Charlie Brown movie. That’s the couple. What one had, it shared with the othworst part of it; I hear just fine. In fact, even the er, as needed. I feel like that is where we are slightest noise can wake me up, disturb, or disin life after nearly 35 years of marriage. What tract me. I’ll hear a faint noise my wife doesn’t I lack, she has and shares with me, and what hear at all, but don’t ask me what she just said few things she lacks, I readily share with her in the car with something playing on the radio. to the best of my ability. We’re classic now So, we have our two jobs relating to and parts are hard to come by, but we are hearing. I hear the noises at night that she managing just fine together. + doesn’t, and it is also my job to investigate those noises. I wouldn’t have it any other J.B. Collum is a local novelist, huway. After all, I grew up in an age of chivalry. morist and columnist who wants to I still say Yes ma’am, yes sir, and I open doors be Mark Twain when he grows up. for ladies always, and men most times. And He may be reached at johnbcollum@ then her job is to repeat what she or someone gmail.com

AND EVERYBODY HAS A STORY. WE’D LOVE TO HEAR YOURS. MEDICINE IN THE FIRST PERSON Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx. com. Tell us if you want it “by you” or if it needs to be anonymous. Thanks!

REALITY … from page 3 TECHNOBABBLE-FREE … from page 3

Other IoT systems that benefit life sciences and patient care infrastructure include IoT-enabled sensors connected to health facility equipment to manage environmental factors (filtration, HVAC, security, temperature, lighting) and alert staff should a reading be detected outside acceptable parameters. Assisted living centers use IoT-enabled sensors to lock doors automatically should certain patients enter restricted areas or leave specified living areas. Additionally, when IoT-enabled sensors connect to medical facility equipment, maintenance and monitoring costs go down. These sensors can be programmed to notify staff or service providers if repairs are needed automatically or when unauthorized access to containers or off-limits areas takes place.

One significant application for the future of IoT-connected health will be Remote Patient Monitoring (RPM). RPM typically refers to IoT devices and mobile technology that monitor patients who are not in a clinical setting. Remote health management can improve a patient’s quality of life through increased freedom, mobility, comfort, call center connectivity for alerts, and trend management. RPM examples include home dialysis, cardiac rhythm monitors, glucose monitoring, respiratory monitoring, and much more.

Don’t blink. The future for connected health is here, and new applications are just around the corner. Hopefully, readers will discern the benefits of these technological enhancements from reading this column. Should you have a technology story that you would like to share, or if you want to know more about an emerging or existing technology, please send me a note at drchuckcadle2@gmail.com. +

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NOVEMBER 5, 2021

39 WINKS… from page 1

An interesting point was made by a daylight saving proponent in England more than a century ago. In 1907, William Willett of London was one of the earliest advocates of Daylight Saving Time (in other words, the idea that this is all an invention of Benjamin Franklin is largely a myth).

Willet proposed advancing the clocks by just 20 minutes at a time on each Sunday in April and then turning them back by the same amount during the four Sundays in September.

The idea was to do the deed and then some — 80 minutes of additional summertime evening daylight instead of our 60 — without the jolt to the system of a full hour’s change all at once.

As we all know, that proposal didn’t see the light of day, so to speak, but Willet’s principles could apply to protecting our precious and all-important sleep.

Some people actually start adjusting to the change several days before DST officially ends. To illustrate how that strategy might work over the coming few days, let’s say someone has a normal bedtime of 11 pm. After clocks change, that will be 10 pm (both on the clock and in their body’s own internal clock). So a few days prior to the end of DST they start going to bed a little later than usual. Perhaps they’ll go to bed a few nights in a row at 11:15 or 11:20. A week from now that very moment will be 10: 15 or 10:20.

They gradually go to bed a little bit later each night over a period of time until eventually they’re going to bed at “midnight.” Except that “midnight” is about to magically transform itself into 11:00 pm, and voila, they have eased themselves right into the normal routine.

Every week of the year, sleep is vital to good health. To protect sleep, experts say we should start to wind down with quiet and relaxing activities an hour or two before bedtime, go to bed and get up at about the same time 7 days a week, and make our bedrooms an oasis of calm and serenity. That means no screens allowed in bedrooms. Now sleep tight! +

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AUGUSTAMEDICALEXAMiNER

FOR A COMPANY THAT’S 100 YEARS OLD

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

GARLIC ROASTED POTATOES & CARROTS ....and Green Beans too.

This simple veggie blend is seasoned with a delicious garlic and fresh herb blend, then roasted to perfection.

It’s an excellent go-to side dish that pairs well with just about anything.

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Ingredients • 1 pound baby red potatoes, halved (larger ones quartered) • 1 pound medium carrots, cut into 2-inch pieces and thicker portions halved • 2-1/2 tablespoon olive oil, divided • 1 tablespoon minced fresh thyme • 1 tablespoon minced fresh rosemary • 1/2 teaspoon salt • Freshly ground black pepper • 12 ounces green beans, ends trimmed, halved • 1-1/2 tablespoon minced garlic (4 cloves) Instructions Preheat oven to 400 degrees. In a large bowl toss together potatoes, carrots with 2 1/2 Tbsp olive oil, thyme, rosemary and season with salt and pepper to taste.

Spread onto a rimmed 18 by 13-inch baking sheet. Roast in preheated oven 20 minutes.

Toss green beans in bowl

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Custom Framing Custom Mirrors with remaining 1/2 Tbsp olive oil and season lightly with salt. Add to baking sheet with other veggies, add garlic and toss everything and spread into an even layer. Return to oven and roast until all of the veggies are tender and slightly browned, about 20 minutes longer.

Serve warm. +

Yield: 6 Servings Nutrition Breakdown: Calories 170, Fat 6g (1g saturated fat), Cholesterol 0mg, Sodium 260mg, Carbohydrate 26g, Fiber 5g, Protein 3g.

Percent Daily Value: 8% Vitamin A, 35% Vitamin C, 8% Iron, 6% Calcium Diabetes Exchange Values: 3 Vegetables, 1 Starch, 1 Fat Recipe source: Cooking Classy

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NO NONSENSE

NUTRITION

Leonard, from West Palm Beach, Florida, asks: “I’ve been reading that cranberries are high in antioxidants - and Thanksgiving is right around the corner.

Is it a good idea to take antioxidant supplements and shop for foods like cranberries that are high in antioxidants?”

The short answer is no, especially if you are asking about the heavily advertised and expensive antioxidant foods and dietary supplements.

The simple assumption might be that eating specific molecules or taking certain dietary supplements 1) is a healthy thing to do and 2) can actually change the oxidation state of your body. The fact is that it may or may not be healthy.

And, if you think that these foods or supplements will change the overall oxidation state of your body, well, they most likely won’t. The popular use of the word antioxidant, or the phrase “free radical scavenger,” is nothing more than a marketing and advertising gimmick, so ignore the hype.

A good piece of nutrition advice is to always focus on eating foods, not seeking out and eating molecules in those foods. When you eat a healthy food, you get hundreds, maybe even thousands of different molecules, some of which are there for nutritional reasons and some of which serve other purposes. The idea is to eat food that is nutrient-rich, not pills or “molecules.” When you start seeking out and eating “molecules,” you may not be enjoying a diet that is adequate overall. In addition, supplements may not deliver the biological benefit you seek. As an example, smokers who eat foods rich in beta-carotene may have a decreased risk of lung cancer, while smokers who take beta-carotene supplements have an increased risk of lung cancer.

How would you prefer to get your antioxidants? Pills? Or delicious foods?

Why is this? The carotene found in supplements and vitamins may not be equivalent to the molecule found in food and therefore it does not have the same biological action or overall benefit.

“Antioxidants” is neither a food nor a food group. Fruits, vegetables, meat, fish, dairy, and whole grain breads and cereal…these are food groups.

Eat and drink different foods, not simply because they contain antioxidants. You may be surprised to know there

NOVEMBER 5, 2021 is quite a bit of difference between eating a piece of fruit and eating a supplement. A fruit, for example, is usually high in fiber, vitamins (Vitamins A and C, niacin, folic acid and much more), minerals (such as potassium), and low in fat, sodium and calories.

There is a popular misconception that oxidants are “bad” and eliminating them with antioxidants is “good.”

That is not necessarily true.

Let me give you a simple example: one key component of your immune system is the ability of certain immune cells, called macrophages, to actually produce oxidants and use them to destroy bacteria in your body. These immune cells normally surround foreign bacteria, engulf them, and then destroy them by oxidizing them. In this case, oxidation and the generation of free radicals is “good.”

There are a few unfortunate individuals whose immune systems cannot oxidize foreign bacteria. What happens instead is that the engulfed bacteria multiply inside the immune cells, using them like their own personal petri dish, eventually pouring out into the bloodstream, leading to virulent infections. So the ability to produce free radicals to destroy germs serves as a protective mechanism.

There are many other examples of “good” oxidants in the

body; for example, we now understand that you need free radicals in your body to assure that your heart beats with the proper force.

The most basic way we use oxidation in our body is to get energy from the food we eat.

Without oxidation, life is not possible. On the other hand, oxidizing the wrong biological compounds, such as genetic material or cell membranes, causes damage.

So the whole concept of free radicals and oxidation is a yin-yang concept. We need oxidants, but we don’t need them in the wrong places or in the wrong amounts. Because oxidation is so essential to life, our bodies have many free-radical scavenging systems that keep oxidation under control.

So this Thanksgiving, when you are eating your cranberries, eat them for many reasons, not just because they also happen to contain molecules that are marketing buzz words at the moment.

Besides, what’s turkey without cranberries?

What is the “no-nonsense” nutrition advice for today?

Simply this: eat healthy FOODS. Don’t waste your time and money searching for “molecules” or supplements to eat or drink. +

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

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NOVEMBER 5, 2021

Ask a Dietitian

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NOVEMBER IS AMERICAN DIABETES MONTH

by Kim Beavers, MS, RDN, CDCES Diabetes Educator for Rural Health Services

do not meet the recommended goals. As someone who works with patients every day, it seems intuitive to me that part of our national health crisis is in fact related to a lack of vegetable intake (and not enough of other things). Depending on age and gender, federal health guidelines recommend that adults eat at least 2 to 3 cups of vegetables each day as part of a healthy eating pattern. Are you eating enough vegetables each day? Can you make increasing your vegetable intake a goal? What can you take off your plate and replace with vegetables?

Part of my job as a dietitian is to market veggies in such a way that patients and clients want to eat them more often. To get you more excited about eating them I will share one of my favorite strategies for getting more veggies in the diet. Make vegetable soup 1-2 times a month in the fall and winter.

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have the power to change the course of your health. How awesome is that?

So... what do you have to invest to get a 58% reduction in your diabetes risk?

Participate in a local or on-line Diabetes prevention program. To find out what is available locally, use this link: https://www.cdc.gov/ diabetes/prevention/find-aprogram.html Participation has many benefits, but for someone trying to attempt it on their own, consider the two major program goals that lead to decreased diabetes risk.

First, exercise, specifically 150 total minutes of activity per week, which can be broken down into 30 minute increments 5 days a week. I think 6 days a week is even better! Movement is good for mental as well as physical health. Move it, move it!!!

Modest weight loss (5-7%) through dietary improvement and activity is the second building block. Note: this should be a moderate diet focused on healthful eating, allowing for gradual weight reduction.

“Healthful eating” is a vague term that can mean different things to different people. As a dietitian, when I think about the meaning of healthy eating I automatically think “eat more vegetables.”

Vegetables come to mind because according to the Center for Disease Control, only 9 percent of adults meet the dietary recommendations for vegetables. That means 91%

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Approximately 84 million American adults have prediabetes, a condition where blood glucose levels are higher than normal but not high enough for a type 2 diabetes diagnosis. Nearly 90 percent of those people are unaware they have the condition. It is critical for Americans to learn their risk, be screened regularly and take the steps necessary to delay or prevent diabetes or prediabetes. To find out your risk, visit diabetes.org/diabetes-risk, then click on “Learn Your Risk” for a 60-second risk test for yourself or someone else.

To address the increasing burden of prediabetes and type 2 diabetes in the United States, the National Diabetes Prevention Program (DPP) was created. This effort created partnerships between public and private organizations to offer evidence-based, cost-effective interventions that help prevent type 2 diabetes in communities across the United States. A key feature of the National DPP is the CDC-recognized lifestyle change program based on a Diabetes Prevention Program study that evaluated if modest weight loss through dietary improvement and physical activity can be as effective or more effective than metformin in diabetes prevention. The study substantiated that lifestyle alone reduced the incidence of diabetes in high-risk individuals by 58%. That is an outstanding return on investment, and it also means YOU

9 +

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CRASH

COURSE

More Americans have died on US roads since 2000 than in World Wars I & II combined

Something strange is happening on American highways.

After decades of progress in traffic safety, we seem to be having a relapse.

It’s an unexpected situation because in the past few decades countless safety measures have been built into the design of both roads and vehicles. Cars have lane warning systems now, as just one example, and roads do too: grooves are cut along the edge of many roads that provide an immediate warning that you’ve drifted out of your lane. There are dozens of additional examples of physical and mechanical improvements to our highways and the cars that travel on them.

So it was a bit surprising that a preliminary report released last week by the National Highway Traffic Safety Administration (NHTSA) says that more than 20,000 people died in highway accidents during the first half of this year, a more than 18 percent increase over the same period last year.

“Well there’s your explanation,” some will say. “Everybody was in lockdown for a big chunk of the first half of last year. The roads were empty. No wonder there’s more accidents this year.”

That would be a great argument if it was true. Actually, 2020 statistics were some of the worst in recent memory. It is correct to state that miles driven dropped dramatically in 2020, but despite that the number of traffic fatalities increased by more than 7 percent over 2019. The exact numbers have not been officially released, but if they hold to the preliminary figures, 2020 was the worst year for highway fatalities since 2007.

And it’s getting worse: this year’s numbers are not a first-half-of-one-year trend. In fact, the 2021 jump is the biggest 6-month numerical spike since 2006 (yes, even worse than 2020), and the biggest half-year percentage increase in the history of NHTSA’s fatality tracking.

And it isn’t just drivers who are being killed. As we have noted in this space before, pedestrians are dying too. More pedestrians and cyclists were killed in 2018 than in any year since 1990. Deaths of pedestrians have jumped by 42% in the last decade.

What is behind it all?

Highway engineers aren’t sure, although the US Department of Transportation announced last week that speeding and lack of seatbelts were two factors that have been identified in the high death toll so far in 2021, both occurring at greater rates than were noted during pre-pandemic years.

Additionally, some experts point to cell phone use while driving coupled with what seems like a complete lack of enforcement in areas (like Georgia) where even touching a cell phone while driving is illegal. But other experts, just as qualified, note that other countries where cell phone use is just as common have only a fraction of the fatality rate we do. Similarly, speeding and not wearing seatbelts is not something on which American drivers have a monopoly.

The official stance of NHTSA and the US Department of Transportation is that, “It will take all levels of government, industries, advocates, engineers, and communities across the country working together toward the day when family members no longer have to say goodbye to loved ones because of a traffic crash.”

Let’s be realistic: that day will never happen.

But that doesn’t mean we need to helplessly watch this trend continue to get worse. There are steps that can be taken starting today. Just a few can make a huge difference. Here are two: Step 1 Drivers have the ultimate first-line responsibility. You and me. Let’s stop speeding. Stop tailgating. Stop driving aggressively. Stop driving while talking on cell phones. It is against the law, even if cops haven’t gotten the memo. Stop sailing through intersections after the light turns red. Start wearing seat belts at all times when driving. In general, be careful. Drive with manners.

Step 2 Law enforcement, do you know who you are? We see your cars, the ones marked with words like “Traffic Division,” so we know that someone is supposed to be keeping things in check on the highways and byways. But anyone who does even a little bit of driving in the Augusta area sees people running red lights on a regular basis. We see speeders all the time. We also see tailgaters (and sometimes we are tailgated). We can sit at red lights and watch drivers turn left in front of us and see that many of them are talking on their phones. We have all seen cars ahead of us driving somewhat erratically, and when we pass them we see the drivers on their phones. And by the way, all of us are at some point guilty of some driving infraction or another. None of us would enjoy getting a ticket, but the more enforcement there is, the sooner people are going to get the message that breaking the law behind the wheel has consequences. Ask anyone if they would rather those consequences be a traffic citation or a trip to the ER in an ambulance (or maybe even a roadside cross with some plastic flowers around it) and everyone will make the same choice: let me have that ticket, please. +

NOVEMBER 5, 2021

DIFFICULT… from page 1

formation and ask questions. They may not know how to deal with your diagnosis. Look for little clues that they are having difficulty coping. This may include a decline in their schoolwork, decreased interest in other activities, or just wanting to be with you all the time. Children respond in many different ways when they are concerned about the well-being of their parent.

Many teenage children and young adults have had friends who had to deal with a cancer diagnosis. They may have more knowledge because of news feeds and other social media outlets that discuss cancer. This knowledge may cause them to ask more appropriate questions that you may not have the answers to. Be honest and up front with them. They may not know how to appropriately express their emotions, so keep that line of communication open. Teens and young adults have their own set of challenges that they deal with on a daily basis. They may need to be pointed in the direction of some appropriate resources to help them cope, which may include support groups or professional counseling.

When informing your family and friends about your cancer diagnosis, be sure that you are ready to have that conversation.

Remember there is no rush. Make sure it’s on your timetable and no one else’s. Try not to be disappointed if you do not get the response that you expected or hoped for. Some may have a lot to say about your diagnosis, and others may not know what to say. Recognize that everyone receives and processes this news in different ways. It is important to embrace your circle of family and friends. You may find that some will volunteer to help with cooking, cleaning, childcare, running errands, or whatever else you need assistance with. Accept offers of help, because there may be days that you may not feel well enough to perform some of these responsibilities. Don’t be embarrassed to ask for help.

Notifying coworkers can sometimes be more daunting. You can decide to share only with your immediate supervisor, or with all your coworkers. If you decide to inform your coworkers, you may want to consult with your supervisor regarding the best form of communication—e-mail, group meeting, or an appointed individual to deliver the news. It is important to keep your supervisor informed if you are unable to carry out your work duties. You may want to reach out to your human resources department to learn about possible resources available to you.

Remember, there is no right or wrong way to share the news with others. You have total control on how and when these conversations take place. Remember that the best decision you make is your own. + Carolyn Byrd was a Registered Nurse for more than 37 years before retiring in 2020. In 2009 she was diagnosed with stage 3 breast cancer, but she was able to transform her health and prognosis through nutrition and other healthy lifestyle changes. Through her experience she was inspired to become an advocate and resource for others. Today she considers herself to be a breast cancer “THRIVER.” Carolyn is a member of Phi Chi Chapter Incorporated of Chi Eta Phi Sorority, Inc., which is comprised of professional registered nurses and student nurses in an accredited school of nursing. Phi Chi Chapter is located in Augusta and serves the CSRA. Our nurses are available to present information on most health issues including vaccination hesitance.

NOVEMBER 5, 2021

the blog spot — posted by Suneel Dhand, MD, on October 30, 2021 (edited for space)

THE DREAM PATIENT Mr. Williams is a 52-year old male who has been with me for some time. He has just been started on metformin for newly diagnosed diabetes. Lisinopril is his only other medication for high blood pressure. When he had his yearly physical, he was also found to have a high LDL cholesterol of 150. His body mass index (BMI) is 29 -- significantly overweight and touching obesity levels.

I sat down with him to talk about his lifestyle habits. He was a college athlete, but from his 30s onwards, like so many people, had become extremely busy with work and family, letting his health slip. He stopped regularly exercising and ate whatever was put in front of him. His brother had recently suffered a non-fatal heart attack, which had really shaken him. He wanted to improve his current health situation and expressed great motivation. I talked to him about his everyday habits and referred him for more intensive dietary and exercising coaching. So began his journey. He joined the local gym and started eating more thoughtfully.

Williams began a calorie-controlled healthy yet tasty well-balanced diet. He moderately restricted carbohydrate intake (carbs are the devil of modern-day society, and cutting back on them is the quickest way most people lose weight!), ramped up whole natural foods including vegetables and fruits, cut back on processed packaged foods and sugars, and controlled portion size and cut back on snacking.

He strictly blocked out an hour a day for exercise, no matter how busy he was. Nothing would come before his own health (yes, not even family), and he would have this “me time” each and every day (occasionally throwing in meditation too).

As well as burning calories, this also quickly resulted in other noticeable amazing benefits including improved energy levels, mood, stress, sleep -- and also better focus and productivity for the test of the day.

When I saw him again 3 months later, he had already lost several pounds. Six months later he was down over 10 pounds. Today at the 1-year mark, he is down 25 pounds! He sits in front of me telling me how great and energized he feels.

Compliments are flying his way and his BMI is now exactly 25. He is performing better at work and feels like his personal and family life has improved in leaps and bounds too. Best of all though, his HbA1C has normalized and his blood pressure is also low (110 systolic). We are giving a go at stopping both his metformin and lisinopril.

Williams is, of course, a fictional character made up for the purposes of this blog post. His story, however, is not uncommon -- I’ve seen dozens of such success stories in my outpatient preventive medicine practice. At a time when 70% of the country is overweight or obese, with all the associated comorbidities and staggering healthcare costs, Williams is the best! He has reversed his decline into chronic illness by seizing control of his health, and taking care of his most precious gift, his body. The more folks like Williams we have, the more healthy and happier our population, combined with billions of dollars in healthcare savings.

I have always considered myself a conservative minimalist physician.

Prevention is better than cure, and empowerment is better than treatment. The less you need to see me, the better news it is for you. There is no better feeling for me as a doctor than those occasions when I get to stop a patient’s medications because they have made sweeping positive changes to their lifestyle. Good riddance to those prescriptions. These stories, albeit currently the minority of patients, make my job worth it. +

We had a long talk. And it paid off.

Suneel Dhand MD is an internal medicine physician

11 +

AUGUSTAMEDICALEXAMiNER

From the Bookshelf This brand new release is about as timely as a book can be. We happen to be living in an era of medical history where doubt, mistrust and suspicion are the order of the day.

Some of our ancestors in ancient times (the 1950s) stood in line for hours to get the polio vaccine. The entire population of schools, 100% — every kid in every grade, plus teachers, custodians, lunch ladies, and office staff — could be vaccinated in an hour.

The same scenario would never happen in today’s social climate. The current maelstrom of controversy centers around the COVID vaccine, of course, and questions about its safety and effectiveness, and still more concerns about liberty and personal freedom.

This book could actually provide talking points for people on both sides of the argument.

Anti-vaxxers can cite its voluminous evidence that, to paraphrase an old quote, “the history of medical progress is written on tombstones.”

And it’s true. “Trial and error” may be an abbreviated combination of “medical trial” and “medical error,” and this

book examines the extensive history of both.

The irony is that the arguments in favor of medical innovations (such as the COVID vaccine) are looking at the same facts from a different perspective, that virtually everything carries risk. If taking the vaccine is risky, so is not taking the vaccine.

All medical breakthroughs come at a human cost, even the ones which went on to save millions of lives.

Offit writes about the early days of anesthesia, chemotherapy, heart transplants, X-rays, vaccines, and gene therapy, among

others, and tells the fascinating personal stories of individual doctors and patients who are complete strangers to most of us, but each of them played a key role in the often costly journey that is medical progress.

In the context of this moment in history, it’s instructive to read the sometimes tragic back stories behind these breakthroughs.

A reader might well conclude, “if they were trying to introduce X-rays or chemotherapy or the polio vaccine in the year 2021 as an exciting new medical discovery, they might never see the light of day. The opposition might be too great.”

As one reviewer noted, we (the general public) cannot afford to lose trust in medical science “despite the inevitable tragedies that occur in pursuit of progress.”

Life itself is a gamble, and every choice carries risks.

We simply have to choose the option with the greatest benefit and the least risk. + You Bet Your Life by Paul A. Offit, MD; 258 pages, published in September 2021

by Basic Books.

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AUGUSTAMEDICALEXAMiNER

The Examiners

NOVEMBER 5, 2021

THE MYSTERY !WORD

+

by Dan Pearson

I bet you’ve gotten a Oh yeah. I told this other new million congratulations dad in the nursery, “That’s my on your new baby. son, just born today.”

He pointed to his daughter, born yesterday, and said to me, “Hey, maybe they’ll grow up and get married.”

Aww.

I told him no son of mine is going to marry someone twice his age.

You never know.

The Mystery Word for this issue: BLOMMSAITE

© 2021 Daniel Pearson All rights reserved.

N O I T Simply unscramble the letters, A then begin exploring C A V our ads. When you find the correctly spelled word N O hidden in one of L our ads — enter at AugustaRx.com L I T SWe’ll announce the winner in our next issue!

EXAMINER CROSSWORD

PUZZLE

ACROSS 1. Jump 5. Fundamental 10. Riverwatch TV station 14. Scratch 15. Bacteria 16. Inwardly (literary) 17. Cougar 18. Mamie had one 19. Jeweler’s magnifier (var.)

20. _____ Club 22. Fish or dress starter 23. ______ cap 24. Tread ending 26. Magician or learned person (archaic or literary) 28. Founder of Islam 32. Fenway site 36. Egg 37. ______ Cinemas 39. The Wire network 40. Dull grayish-brown 41. Christian or Doug 43. Mars’ color 44. Medical College beginning 45. Poetic or literary word for a bottomless chasm 46. ____ liner 47. Take advantage of 49. Effortlessness 53. On sheltered side 55. Tibetan oxen 56. _____ gas 59. Chatter 61. One of three words repeated on every Medical Examiner front cover 65. Ardent; eager 66. Fragrance 68. Hawaiian honeycreeper 69. Basic monetary unit of Ghana 70. Male singing voice 71. Like some pockets

BY

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

39 43

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EXAMINER SUDOKU

13

9

42

53 56

26

37

12

23

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68

by Daniel R. Pearson © 2021 All rights reserved.

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

by Daniel R. Pearson © 2021 All rights reserved.

72. Family diagram 73. Swelling 74. Takes to court

30. Clock pointers 31. Compact 33. Opposite of nine?

34. Follows orders 35. Lymph structures 38. Dry red Beaujolais wine 41. Post _____ 42. Renounce or reject 48. Augusta’s Davis 50. World’s largest desert 51. Eisenhower’s nickname 52. Class of drugs that includes aspirin 54. Dog-______ 56. Diplomacy 57. At any time 58. Helper 60. Part of a skeleton 62. Stead 63. Affectedly dainty (British) 64. Rose fruit 67. Dad’s partner

DOWN 1. Kissers 2. Sewing case 3. Peak 4. Drug prefix 5. Pacify 6. Obamacare acronym 7. Weeps 8. Hip bone 9. Vermilion 10. Lincoln assassin’s middle name 11. Soon, in poetry 12. Adhesive 13. Class 21. Outer edge 25. Mr. Sconyers 27. Element #79 28. McCormick County town 29. Throat dangler

QUOTATIONPUZZLE N R I B E D E W E L F R

J A S K A E S R E E C A B F P U L U W T S P R L N H R I

by Daniel R. Pearson © 2021 All rights reserved

9 7 E T L3 M P A2 Y W4 I S8 6 1 — Anonymous 5

2 4 6 9 5 1 8 7 3

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once.

Black squares indicate spaces between words, and words may extend onto a second line. Solution on page 14.

Solution p. 14

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

1 2 3 4 O 1 2 3 4

5

1 ’

C 2 3 6

4

5

6

1 2 3 4

7 1

1

2

2

3

’

3 4

’

4 5

N 1 2

5 1

2

L 1

O 2

3

3 L 4 5

K 1 2 3 4 6

1.SDYHJYMBN 2.OOOOEEEUI 3.AACCSUUTE 4.NRLAKTRS 5.EUNET 6.HTS 7.YE

SAMPLE:

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

V 3

E 4

I 1

7

— Welsh proverb

S 2

B 1

L 2

I 3

N 4

D 5

by Daniel R. Pearson © 2021 All rights reserved

WORDS NUMBER

1

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, AUG. 30, 2021

5 8 1 3 7 6 4 9 2

6 2 9 7 8 5 1 3 4

4 5 8 1 3 9 7 2 6

NOVEMBER 5, 2021

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

A

man placed a phone call that began with him saying, “Mom? Don’t freak out, but I’m in the hospital...”

“Peter,” she said, “you’ve been a doctor for almost ten years now. Would you please not start every single phone conversation we have with that same stale joke?”

HOT SINGLES IN YOUR AREA! said the banner on the man’s computer screen. He clicked it and an ad popped up for a company that does air conditioning repair.

Moe: How many grammar Nazis does it take to change a lightbulb?

Joe: Too. Moe: How many country singers does it take to change a light bulb?

Joe: I’m going to go with two. One to change the bulb and one to sing about how much they miss the old one.

Moe: Remember that singer Bonnie Tyler?

Joe: Yeah, but it seems like it’s been years.

Moe: That’s because she’s not doing music

The

13 +

Advice Doctor

anymore. She got a medical degree and she’s a cardiologist now.

Joe: Wow. Where did you hear this?

Moe: I just got a copy of her new DVD, Totally Clips of the Heart.

©

Moe: Why should you never brush your teeth with your left hand?

Joe: I have no idea. Why? Moe: Because a toothbrush does a better job.

Moe: How was your fraternity initiation? Was the hazing pretty grueling?

Joe: It wasn’t too bad. I had to do all kinds of crazy stuff, though.

Moe: Like what?

Joe: Well, one thing I had to do was drink an entire bottle of dishwashing liquid.

Moe: That must have been horrible.

Joe: Actually, it filled me with joy.

Medical Dictionary definition of laziness: Resting before becoming fatigued. Because prevention is always better than a cure.

Moe: Hey, here’s a cool game. Whatever the last thing you Googled was, that’s what will end up killing you.

Joe: Oh, what fun. But I don’t think “Italian restaurants near you” qualifies.

Moe: Pasta la vista, baby.

Joe: That was not funny.

Moe: Well, you know what they say...

Joe: No, I don’t. What do “they” say?

Moe: One bad joke is a coincidence. Two bad jokes is a pattern. Ten bad jokes is this page in the Medical Examiner. +

Why subscribe to theMEDICALEXAMINER? What do you mean?

Staring at my phone all day has had no Effect on ME!

Because try as they might, no one can stare at their phone all day.

Dear Advice Doctor, Here’s my situation: my wife’s brother is out of a job — again — and he has turned to her (which means to me, ultimately) for a loan. I don’t even know why anyone involved calls it a loan. The minute we hand him that money it’s gone forever. I know that. He knows that. My wife even knows it.

And it’s not like we have money to spare. We do not. She thinks we should give him what he needs. I say you’ve got to look out for Number One. What do you say?

— Do I Look Like a Bank?

Dear Do I, This might surprise some people, but I agree with you on this one. You’ve got to look out for number one. In fact, variations from the norm in urination often suggest a trip to the doctor .

Polyuria is a common issue, and involves frequent urination. The first thing a doctor might do with such a patient would be to check that the person isn’t drinking too much coffee, water or other liquids prior to bedtime.

Eliminate the simple and most readily fixable possibilities first.

Assuming that isn’t the problem, frequent urination could be a symptom of diabetes, a kidney or urinary tract infection (UTI), an enlarged prostate gland, or perhaps a side effect of medications the person is taking. Once a doctor identifies the cause, appropriate treatment can usually take care of the problem.

Urine with a strong odor can often be the result of nothing more serious than the last meal the person ate. If that is the culprit the problem will go away as quickly as it appeared.

Blood in the urine (urine with a pink tint) would seem like cause for great alarm, but in many cases it is nothing serious at all. It could be caused by recent strenuous physical activity, taking aspirin, an enlarged prostate, or once again a UTI or kidney infection. Even it goes away (or seems to), it’s not a bad idea to make an appointment to see your doctor.

Blood could still be present, but in quantities too small to change the color of urine.

In short, you are correct: look out for number one.

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

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DIABETES… from page 9

This will keep your refrigerator stocked with some good-for-you food that is nourishing, comforting, and most importantly, delicious. It is important to make vegetables easy to eat, and when they are delicious they are easy to eat. Here is one of my all-time favorite soups. Enjoy as an appetizer, snack or main dish. +

RIDICULOUSLY GOOD CARROT SOUP Ingredients • Vegetable oil cooking spray • 1 pound of carrots (5 large or 10 medium peeled & chopped into ¼-inch pieces) • 1 medium onion peeled and cut into 8 pieces • 1 tablespoon extra-virgin olive oil • 4 cups unsalted vegetable or chicken broth • 1 Bay leaf • 2 teaspoons grated ginger • ¼ teaspoon salt Instructions Preheat the oven to 425 degrees.

Line a baking sheet with aluminum foil and spray with cooking spray.

Place the carrots and onion on the lined baking sheet and drizzle with oil. Toss the carrots and oil together with your hands. Bake the carrots for 25 minutes or until the carrots are mostly tender. A little char on the onions is okay.

Combine carrots and onion in a large pan with vegetable broth and

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Yield: 4 servings (serving size: 11/4 cups) Nutrition Breakdown: Calories 120, Fat 4g, Cholesterol 0mg, Carbohydrate 21g, Sodium 590mg, Fiber 5g, Protein 2g.

Diabetes Exchanges: 4 vegetables, 1 fat

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