ON HOW OCCUPATIONAL THERAPISTS CAN HELP

ALLEVIATE PAIN

More than 130 million Americans suffer from chronic, or frequently occurring, pain. What can an occupational therapist do?

• Identify specifi c activities or behaviors that aggravate pain and suggest alternatives.

• Teach methods for decreasing the frequency and duration of painful episodes.

• Implement therapy interventions that may decrease dependence on or use of pain medications.

• Facilitate the development of better function for daily activities at work and home.

• Collaborate with the client’s team of health care professionals, such as physicians, physical therapists, psychiatrists, and psychologists, to determine the best course of treatment and intervention.

• Recommend and teach the client how to use adaptive equipment to decrease pain while performing tasks such as reaching, dressing, bathing, and performing household chores.

For more information, visit http://www.aota.org/ +

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by Danielle Wong Moores

For occupational therapist Paula Myers, every day is different. Caring for up to 10 patients a day in her role as an OT at Walton Rehabilitation Health System, she uses a carefully selected mixture of equipment, real-life practice and plain old common sense to help those recovering from neurological conditions like stroke and brain injury, spinal cord injury, and orthopedic conditions like tendonitis and fractures. Even with all the variety there’s one thing that’s always the same—as an OT, she focuses on helping all of her patients improve their ability to take care of themselves. “I love it,” said Myers, who has been an OT at Walton for the past fi ve years. Prior to that, she worked with a pediatric practice and for the Board of Education

in Washington County. “I love the patients I work with, I love hearing their history and their life stories. And I love the people I work with.” Myers briefl y considered physical therapy, but occupational therapy just clicked. As a high schooler, she took a health occupations class and had the opportunity to observe both fi elds. “I was following the physical therapist, but then she had to be out for most of a day, so I saw a lot of OT,” said Myers. “It really hit home that that’s what I wanted to do.” Myers laughs a little as she’s asked to explain the difference between physical and occupational therapy. It’s a common question. For Myers, the difference comes down to exercise and function. Although both disciplines work toward returning function in the individual, OT goals and treatment are more directed at

addressing activities of daily living (called “ADLs” in the OT world). What attracted her to being an OT was the focus on occupational goals such as self care, home management and leisure tasks. While there is a lot of overlap between what physical and occupational therapists might do—for example, both might work on balance—a physical therapist is looking at gait and progressing the individual to using the least restrictive device with walking, while an occupational therapist is thinking how a person might best negotiate themselves so they can take care of basic needs at home, like maintaining balance while reaching for a book or a glass of water.

“The way I explain it to patients, I’m there to help them with their upper body, fi ne motor skills, and their ability to take care of themselves. We talk about the goals they want to achieve and getting their independence back.” On the other hand, physical therapists might focus on building strength in a patient’s trunk or a weak extremity, improving balance for mobility and gait, or focus on pain management. Whether patients are receiving physical or occupational therapy, they do so with a physicians’ referral. When Myers fi rst sees a patient, she starts out with an overall evaluation.

THE SKINNYA Day in the Life of an OT

Although April is Occupational Therapy Month, OTs like Paula Myers celebrate their craft every day. (OT photos by Danielle Wong Moores)

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Working in conjunction with the patient, she develops a plan of care, which is updated monthly, as well as goals that the patient wants to achieve. One recent patient, for example, had a goal of being able to wrap Christmas presents, to type, and to be able to put her hair up in a ponytail. Myers might also use tools like an arm bike, simple weights, or the SciFit, partly visible in the page one photo, both of which focus on loosening and warming up arm muscles. The Dynavision is a fun piece of technology—a wall covered with dozens of small electronic buttons. Patients press the buttons as they light up, helping them regain mobility in their arms, assisting with visual scanning, as well as building endurance and dynamic balance. Patients without full range of motion or strength may be guided or assisted in simple exercises to rebuild strength and improve tone in shoulders and arms. Balance work can be as simple as having a patient sit on the edge of a mat to simulate the balance needed for them to sit on the edge of their bed at home. With therapists’ assistance, patients might also practice fi ner movements, like managing buttons or zippers, or tying shoelaces. A completely outfi tted kitchen is also an important tool for patients who want to practice home skills. “We might make a pan of brownies, working on following instructions,” said Myers, “or complete a

kitchen safety checklist, where we have patients identify danger zones in the kitchen and how to prevent them.” Other practical skills that an occupational therapist like Myers might assist with include time and money management, driving evaluations to see if patients are ready to return to driving—or should no longer drive—and assistance with work-related issues, such as ergonomics or conditioning patients for return to work. Myers might also make house calls to evaluate a patient’s home for any safety concerns. “My day is back to back,” laughs Myers.

Along with the hands-on care, she also has conversations with case managers to help patients with referral needs and other resources, and will sometimes call physicians for prescriptions and any medical concerns. Regular team meetings and a collegial work environment with the other therapists are also important factors in Myers’ day-to-day work life. “When you have a team approach, it really reinforces that continuum of care,” she said. Because Walton is a fi eldwork training site for Georgia Health Sciences

University, Myers also helps train future occupational therapists for three months out of the year. For Myers herself, there has never been any question that occupational therapy was what she was meant to do. That feeling she had as a young student intrigued by OT has never left. “My team makes it very easy to come to work every day, but it’s really all about the patients,” said Myers. “If I were to sum up my job, it’s to promote as much independence in patients as possible, to retrain them in the daily activities they did before, to provide resources, and to educate caregivers. “And I love what I do every day.”

For anyone who thinks they may be interested in pursuing a masters in occupational therapy, Paula Myers offers this advice: “Be sure to shadow and make sure this is what you’re interested in—and shadow in more than one setting. Outpatient OT is very different from occupational therapy in a nursing home or acute care setting, and there are also different specialties.”

During an occupational therapy visit at Walton, Myers assists patient Ollie Hornsby with the Dynavision, technology that helps patients regain mobility while improving visual scanning, balance and endurance.

THINKING ABOUT AN OT CAREER?

Honest criticism is hard to take, particularly from a relative, a friend, an acquaintance, or a stranger.

—Franklin P. Jones

AUGUSTA MEDiCAL EXAMINER 3 +APRIL 20, 2012

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Why subscribe to the Medical Examiner? Why would anyone pay for a subscription to a free newspaper? That’s certainly a legitimate question. The answer: as a major regional medical center, patients come to Augusta hospitals and physicians from all over the Southeast. The MCGHealth Medical Center alone sees patients from every single county in Georgia, not to mention South Carolina, Florida, and beyond. Add to that the regional reach of Eisenhower Army Medical Center and both Veterans Administration hospitals, the Joseph M. Still Burn Center at Doctors Hospital, MCGHealth Children’s Medical Center, Walton Rehab and University Hospital, and it’s clear that many people seeking treatment in Augusta are not local residents. Furthermore, some of our most loyal readers are in town only occasionally. Or their treatments and visits to Augusta are only temporary. Even local residents may fi nd it more convenient to walk to their mailbox than visit one of our many newsstands. Subscriber copies are mailed the day prior to the issue date so they will be received by most readers no later than the publication date printed on the paper. Copies are sent by First Class mail in a sealed envelope so they’ll arrive promptly and in crisp condition. Rates are $16 for a 6-month subscription (12 issues), $32 for a full year (24 issues). Complete the form below and drop it in the mail with your payment. Thank you!

Terrie’s storyM E D I C I N E I N T H E F I R S T P E R S O N

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THIS ISSUE!

What’s your story? Nearly all of us — even doctors and nurses — are sometimes patients. Perhaps you were recently injured playing your favorite sport, or years ago you somehow got hurt without even leaving your favorite recliner. Maybe you were diagnosed with a dreaded disease, mugged in a dark and lonely parking lot, or you stubbed your toe in the safety of your own bedroom. On the other hand, perhaps you needed medical attention 5,000 miles from home. Whatever your medical experience, we’d like to hear your story for our Medicine in the First Person feature. It can be frightening or funny, ordinary or extraordinary, just a few paragraphs long or quite a lengthy tale. We’ll publish your encounters with the medical profession as often as we receive them.

Send your submissions for Medicine in the First Person to the Augusta Medical Examiner via e-mail: info@AugustaRx.com or to

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n high school, Terrie was a pretty cheerleader who competed on the cheer circuit. Her father was

a smoker, and with more and more of her friends smoking, Terrie soon found herself lighting up in social settings. “It was the cool thing to do,” she says. She would come to smoke up to two packs a day and felt the adverse effects of tobacco from as early as 25 years old — a sore throat that never seemed to go away. In 2001, at the age of 40, Terrie Hall was diagnosed with oral cancer. As she recalls, “I had a sore in my mouth and had to go through all these grueling radiation treatments. It was awful.” Terrie continued to smoke throughout her radiation treatments. “I didn’t think I had to quit. The radiation was getting rid of the cancer, so I could still smoke,” she says. Later that same year, Terrie was diagnosed with throat cancer. It was then that she quit for good. The doctors informed her that they would need to remove her larynx. “It’s hard to wrap your mind around cancer, and when they told me that they were going to remove

my voice box, I thought I would never speak again,” says Terrie. Today, at 51, Terrie speaks often with the help of her electrolarynx. She works tirelessly to educate young people about the dangers and consequences of tobacco use.

She’s as active as she can be, lending her time and support to several health and advocacy organizations. “I’m busier now than before I got cancer,” Terrie says. Unfortunately, cancer has

returned numerous times since she was fi rst diagnosed, and she continues to battle it today. Through the Tips From Former Smokers campaign, Terrie wants to encourage teens to never start smoking. “If you don’t start, you never have to worry about stopping,” she says. She believes that if she could prevent just one person from smoking, then she has done something great.

Editor’s note: This installment of Medicine in the First Person is part of “Tips From Former Smokers,” a new initiative of the Centers for Disease Control. We will run Tips from time to time when we don’t have an article submitted by one of our readers.

To watch a 30-second video message from Terrie, visit the Medical Examiner website.

(www.AugustaRx.com, click on News and Blog)

Tell us your story for Medicine in the First Person

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AUGUSTA MEDiCAL EXAMINER APRIL 20, 20124

Hope IS Possible

Love, engagement and marriage

have several women friends getting married this summer.

These are women who have been married before – one of them two times. I have other friends who are engaged and they are happy as they can be. And I am happy for them too. My sister is celebrating her fi rst anniversary in May. I am thrilled for her and her husband. Yes, I am a hopeless

romantic. When it comes to emotional well-being, love can do wonders. Sure, there are risks when one opens his heart, to love and to be loved. And that’s where some of the challenges occur. Relationships, especially in the beginning stages, can be quite perplexing at times. We have preconceived ideas on how they should work – on how our partners are supposed to act – what we think their behavior is supposed to be. No relationships are perfect. People tend to rush things. When one wants to take it slow and the other wants to move a bit faster, there’s confl ict. I have learned from experience that if you want the relationship to grow and fl ourish, you will have to fi nd a middle ground. You have to learn to compromise. Of course, all too often one of the people involved will choose to move on. Why? Impatience! We live in

a microwave age. We want instant gratifi cation. A lasting, true relationship that has some semblance of being long-term — and marriage too — simply doesn’t work that way. Want to know why? It’s not in God’s order. The Holy Spirit led me to a scripture recently and it was Philippians 4:6 - 7 (see above). The message in these two verses made an incredible impact on me and my attitude toward relationships. Slowly re-read those verses again. In listening to the tales and woes of many women on the subject of relationships, the complaints, the sense of despair and hopelessness are really amazing. If you go to any bookstore there are aisles and aisles of books on relationships.

My thought is that too many of us simply do NOT get it right. Me included. Until now. Our expectations of others are too high. Our unwillingness to take the time to get to know ourselves so we know what we really want is a major problem. We think our mate should think like us, act like us, and do what we would do in a situation. That is really an unacceptable attitude to have. I would guess that too many of us have these issues at least sometimes in our lives. If not, as my late grandfather would say, “keep on living.” Let’s go back to the scripture. Two poignant words to me are “about anything.” For years I tried to apply this scripture to my business and professional life – but not my personal life. Honestly, I never thought

about it. About anything means just that. So when God says don’t be anxious, in relationships he’s saying don’t be anxious that your man is not returning your text – or your phone calls - or that he didn’t return them as quickly as you want him too. Or that he failed to call you to let you know he was running late for a date – or that he didn’t show up at all. Don’t be anxious that he’s not available when you are. We women get anxious about many things when we don’t get what we want. Next week we will dig a little deeper into the scripture. Here’s to healthy relationships!

Helen Blocker Adams is President/CEO of The HBA Group, Intl and Executive Director of the Southeast Enterprise Institute, Inc. Visit her website at www.helenblockeradams.com. If you like politics, visit her blog at www.projectlogicga.com. You can reach her via email at hba@hbagroup-intl.com Helen’s new book, Unlikely Allies: 8 Steps to Bridging Divides that Impact Leadership can be purchased by visiting www.hbagroup-intl.com or www.authorhouse.com

Helen Blocker-Adams

“I remember studying about Gluteus Maximus in history class. Didn’t he kill Caesar?”

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“Do not be anxious about anything, but in everything by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends

all understanding, will guard your hearts and your minds in Christ Jesus.”

— Philippians 4:6,7

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There’s no excuse to be bored. Sad, yes. Angry, yes. Depressed, yes. Crazy, yes. But there’s no excuse for boredom, ever.

— Viggo Mortensen

Part I

by Bad Billy Laveau

Belinda’s bright smile hid a shy personality and nimble brain that did not chase after the latest fad or clothing style in her high school. But shadows lurked behind the bright facade. She fell in love and got bit by the pregnancy bug because she could not bring herself to tell her mother she had become sexually active with the young man she planned to marry. Her mother had warned her, and she had promised to consult with her mother before the panties came off. But as is the case with many teens, one night it just happened. Instead of dropping out of school and going on welfare and food vouchers and moving into Section 8 housing, Belinda gritted her teeth and gutted it out. She had spunk. Responsibility tugged at her heart. She wanted to do right and get back on the right track. A bit heavier, she graduated with child and academic honors plus a full ride scholarship to Morris Brown College. But Belinda refused to abandon the unplanned child to her mother and dash off to enjoy college life. Belinda declined the Morris Brown scholarship and took a Pizza Hut job, set up her own household, and paid her own bills. She did that for 10 long years. In the process she had twins via C-section, worked her way through technical college, and got a degree in accounting and eventually landed a job with the State of Georgia. That lasted several years.Then good luck hit her. Her

dream job arrived: Teaching math to special needs middle school kids. (You know what good luck is, don’t you? Good luck is when preparedness meets opportunity.) Was everything pie in the sky and peaches and cream thereafter? You better believe it wasn’t. Her abdomen had a nagging, cramping, uncertain feeling that grew daily and interfered with her sense of wellbeing. And on top of that, one of her twin boys began emulating semi-hoodlums he saw at school. But Belinda was no quitter. She forgot about her belly and turned on her sternest voice that dripped in partially fake anger, disgust, and ghetto boisterosity. “Boy, you keep this up and you’re going straight to jail or hell! Or both. And I ain’t having it. I ain’t wasting my life raising no street trash. Get yo’ butt in this car before I go up side yo’ head.” Fear and uncertainty leapt out of the abyss to grip his soul. He had never seen his mother in such a state. The High Sheriff met them at the Dairy Queen. The boy cowered before the High Sheriff’s laser stare that could melt icebergs at 30 paces. It lasted a couple minutes, but seemed like hours to the youth. The High Sheriff gave the thug-to-be a stern, threatening, hell-fi re-and-brimstone lecture about the horrors of boys jailed with real thugs. Unanswered screams in the night. Beatings. Homosexual rape. The boy was wild eyed, but still not totally ready to come to Jesus because he

couldn’t imagine those horrors happening to him. Belinda thanked the High Sheriff properly and hauled he son off to the local funeral home. The Funeral Director stuck his massive fi nger in the boy’s chest and demanded, “Boy, come in here. Pick out a cheap wooden coffi n for your burial. No sense in wasting your Momma’s hard earned cash on a good one. Then, you show up here every Saturday at 6 AM to clean the morgue in exchange for an insurance policy to bury you.” The boy’s stomach churned. His face turned several shades of puke green. He tried to run away, but the Director grabbed his arm and shoved him into the morgue. Formaldehyde seared his nose. Four naked bodies lay on cooling boards. One was a teenage boy. “Boy, my wife gets a nice new car every year, and I send my kids to college off dead thugs like these. You wanta

be one of these? I got another cooling board in the back room just waiting for you. You wanta try it out today?” Silent tears burned his eyes. His heart nearly exploded. He shook, but didn’t speak. His brain had severed connections with his tongue. Belinda mercifully took him home. No need to embarrass him further by letting strangers see a young man cry in public. Behavioral therapy was over for the day. Hopefully forever, Belinda secretly prayed. Since then he has been a better, but not entirely perfect kid. Even though he doesn’t do his best every day, Belinda sees improvement. Better grades. No tattoos. No sagging pants. No gang slang. He talks about college. But still Belinda’s belly hurt. It was not psychosomatic. Her doctor said, “Adhesions from the C-section, but we have to rule out cancer.” They operated. Stirred in

her guts for 7 hours. Busted up adhesion galore. Sent her uterus to pathology. (And just as I suspected, no cancer cells found there. It just wouldn’t be right to unjustly deprive society of such a strong, forthright woman. But one day Jesus will call her home to thank her personally.) Now, she is recovering from surgery. Doing quite well, I might add. Her formerly wayward son is most attentive. Come August, she will be back in the classroom and at peace with the world. Her students will be happy to see her, having no idea of the horrors she survived “while she was away.” He son will fi ll out college applications and seek scholarships to spare his mother of fi nancial worries. Her tummy won’t hurt. And her smile will be back. Can we all do as well as Belinda? Depends upon how much we care.

Bad Billy Laveau is a retired MD with a pointed sense of humor. Bad Billy speaks and entertains at public and private events for audiences not subject to cardiac seizure secondary to overwhelming laughter and glee BadBilly@knology.net or 706-306-9397

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WHAT EVERYBODY OUGHT TO KNOWABOUT WAYWARD KIDS AND BELLY PAIN

AUGUSTA MEDiCAL EXAMINERAPRIL 20, 2012 5

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MEDICAL EXAMINEREVERY 1ST AND 3RD FRIDAY

t seems like the older we get the more we focus on our bowels. That really

isn’t unusual and, if you think about it, there is probably a good reason for it. The GI tract (that’s short for gastrointestinal) is made up of both voluntary and involuntary muscles. The involuntary ones work on their own. The movement of food through the GI tract is something that requires no thought or effort on our part. It’s an automatic or involuntary response to the pressure of food to make it pass down the GI tract. For babies there is no voluntary control over bowel movements. For them, when food moves on down to the bottom of the GI tract, a baby lets it move on out. Normally there are about 5 to 8 urges to eliminate a day. As we get older we learn that it isn’t always convenient to move our bowels, so we learn to suppress the urge until a convenient time. As a young child we may have 3 to 6 urges daily, and we may respond to 2 or 3. The longer we suppress the urges,

the fewer times our body recognizes them. Gradually, voluntary control over that involuntary movement wins over. As adults we try to train our bowels to move about once a day, but if some days we just don’t have the time the suppression takes over and the urge goes away.Stool at the end of our intestines hardens as the body extracts water. The longer it stays there the more diffi cult it becomes to push out of the intestines. The pressure can cause some swelling of the membranes and hemorrhoids can develop from the blood vessels swelling. Chronic constipation can cause abdominal pain and even nausea and vomiting. The best approach is to try to keep your bowels as regular as possible. Make time for regular movements, whether daily, every other day, or twice

a day — whatever is most comfortable for you. Many people learn that certain foods help keep them regular: coffee in the morning or prune juice or fruit or vegetables. Increased digestible roughage helps provide bulk in your diet so foods move through the GI tract in a more regular pattern. The skin on vegetables and fruit, whole grains, and also supplements like Citracel or Benefi ber help provide bulk. A healthy diet means getting at least 20 grams of fi ber in our diet a day to help with regularity. Some medicines will slow motility or movement down and contribute to constipation. Narcotics and muscle relaxants can also do that and some blood pressure medicines (calcium channel blockers) may also affect the GI tract. Yogurt has been found to be helpful in promoting the health of the benefi cial bacteria in the GI tract which aids digestion, especially if there is a problem with diarrhea. Sometimes when a person takes strong antibiotics, the bacteria that is needed to help digestion is killed off, so eating yogurt that has active cultures of bacteria in it will help put them back in the system. When you think about it, there are few things in our life that are regular, so it isn’t surprising that our insides sometimes have such a hard time keeping up.

HEALTH 101 – Information to help you make positive changes in your life to improve your health by Sandy Turner, RN, EdD, Family Nurse Practitioner, Director of the Good Samaritan House, A Free Community Health Center Open Mondays 1-5 pm. 213 N Main St., Dearing, GA 706-556-9080.

AUGUSTA MEDiCAL EXAMINER APRIL 20, 20126+

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by Naomi D. Williams, MPH, CHES, CIC®

What would you do if you saw a child throwing a tantrum in the grocery store? What if you were in a restaurant and you saw someone having diffi culty navigating a wheelchair around the space that led them to their table? What if you saw someone with facial or anatomical disfi gurements? Have you ever found yourself in any of the above situations? What did you do or what would you do? And what would you do if someone or a group was making fun of or making a scene in one of the above scenarios? I have encountered each of the above scenarios as either participant or spectator. I know most people are taken aback when they see things that are outside of what’s considered normal. Most aren’t used to seeing kids in a wheelchair, toddlers with glasses, a burned or disfi gured individual, or people with tracheostomies (a hole in the throat usually covered with a round, white piece of plastic) and that’s okay. It’s natural to be curious and to have questions. What’s not okay is to ogle. It’s not okay to laugh, point and stare (these are things parents should teach their children as well). It’s not okay to tell parents that they should stay home until they can control their kid(s). Parents of differently-abled children already have enough pressure on them without total strangers complicating matters. We already know that we are “the odd ones” and we learn (or are trying to learn) to be okay with that. From time to time many of us feel obliged to explain the situation or our children to others so we aren’t harshly judged, or to soften the cross-eyed stares that we encounter. I continue to be amazed at just how immature, ignorant, classless and clueless some people can be. For instance, nationally syndicated radio host Michael Savage said “I’ll tell you what autism is. In 99 percent of the cases, it’s a brat who hasn’t been told to cut the act out. That’s what autism is. What do you mean they scream and they’re silent? They don’t have a father around to tell them, ‘Don’t act like a moron. You’ll get nowhere in life. Stop acting like a putz. Straighten up. Act like a man. Don’t sit there crying and screaming, idiot.’” It grieves me to even repeat his words just knowing what life is like for some of my friends who have children on the Autism Spectrum. It has been said that ignorance is bliss, yet in these cases ignorance is just that: ignorant. And it’s far from bliss for people who are targets of the ignorance of others. How would you respond if one of the situations above was you and your child or someone that you cared about? Would you stand by and just watch what will happen next? I hope and tend to think not. So, even though this may not be your everyday life it is the life someone leads. I hope the next time you fi nd yourself in the grocery store, bank, restaurant, park, elevator or wherever you may be, your compassion fl ows enabling you to assist rather than just stop and stare. Think. What would you do?

Naomi Williams is a health educator by training, an entrepreneur by nature, mom, and advocate of the best kid ever, Noah Samuel.

What would you do?Exceptional Living

Editor’s note: Exceptional Living appears exclusively in the Medical Examiner each month, addressing issues that all of us can benefi t from involving people with special — let’s call them exceptional — needs.

“If we did all the things we are capable

of doing we would literally astound

ourselves.”

— Thomas Edison

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CONSTIPATION: A “GRIPPING” PROBLEM

Health 101

by Sandy Turner, RN, EdD, Family Nurse Practitioner, and Assistant Dean for Administration in the GHSU College of Nursing

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AUGUSTA MEDiCAL EXAMINERAPRIL 20, 2012 7 +

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Preventive tests every guy needsHave you heard those Public Service Announcements from AHRQ.gov — the Agency for Healthcare Research and Quality? Tackling the old stereotype that guys don’t do doctor visits, they’re trying to get guys to make the experience pleasant. Otherwise we will wait until we’re practically terminal before we’ll break down and go. Instead, how about some preventive measures like the following:

Screening tests can fi nd diseases early, when they’re easiest to treat. Talk to your doctor about which preventive medical tests you need to stay healthy.

Body Mass Index Your body mass index, or BMI, is a measure of your body fat based on your height and weight. It is used to screen for obesity. You can fi nd your BMI by visiting http://www.nhlbisupport.com/bmi.

Cholesterol Once you turn 35 (or once you turn 20 if you have risk factors like diabetes, history of heart disease, tobacco use, high blood pressure, or BMI of 30 or over), have your cholesterol checked regularly. High blood cholesterol is one of the major risk factors for heart disease.

Blood Pressure Have your blood pressure checked every 2 years. High blood pressure increases your chance of getting heart or kidney disease and for having a stroke. If you have high blood pressure, you may need medication to control it.

Cardiovascular Disease Beginning at age 45 and through age 79, ask your doctor if you should take aspirin every day to help lower your risk of a heart attack. How much aspirin you should take depends on your age, your health, and your lifestyle.

Colorectal Cancer Beginning at age 50 and through age 75, get tested for colorectal cancer. You and your doctor can decide which test is best. How often you’ll have the

test depends on which test you choose. If you have a family history of colorectal cancer, you may need to be tested before you turn 50.

Other Cancers Ask your doctor if you should be tested for prostate, lung, oral, skin, or other cancers.

Sexually Transmitted Diseases Talk to your doctor to see whether you should be tested for gonorrhea, syphilis, chlamydia, or other sexually transmitted diseases.

HIV Your doctor may recommend screening for HIV if you:• Have sex with men.• Had unprotected sex with multiple partners.• Have used injected drugs.• Pay for sex or have sex partners who do.• Have past or current sex partners who are infected with HIV.• Are being treated for sexually transmitted diseases.• Had a blood transfusion between 1978 and 1985.

Depression If you have felt “down” or hopeless during the past 2 weeks or you have had little interest in doing things you usually enjoy, talk to your doctor about depression. Depression is a treatable illness.

Abdominal Aortic Aneurysm If you are between the ages of 65 and 75 and have smoked 100 or more cigarettes in your lifetime, ask your doctor to screen you for an abdominal aortic aneurysm. This is an abnormally large or swollen

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Pharmacy 411Pharmacy 411EDITOR’S NOTE: Very little if anything about healthcare is inexpensive, and that includes medicine. Tiny pills can command large prices. Over-the-counter medications may be less expensive, but are they also less effective? Find the answers to lots of your drug store questions in this column written by Augusta pharmacists Chris and Lee Davidson exclusively for the Medical Examiner.

DIETING WITH & WITHOUT PHARMACEUTICAL ASSISTANCE Diet pills and weight loss supplements are everywhere these days. There are websites, stores and 800 numbers devoted to meal replacement shakes and weight loss pills designed to boost the metabolism and burn extra calories. If you listen to the claims some products make, you’d think can eat anything you want and lose weight. Here’s a dose of common sense: You only lose weight if you burn more calories than you consume in a given day, week or month. So let’s look at the different ways to attack this math equation. There are products designed to decrease the calories being consumed every day. Meal replacement bars and shakes are plentiful and some are actually healthy and good for you. Focus on products that give both carbs and protein together. Your body needs both nutrients to function effectively. Rule of thumb is replace one meal a day to start, and eat more vegetables and fruits the rest of the day. This will decrease the amount of calories consumed in a day. Starvation diets are not the way to go. Remember, to lose weight you simply need to burn more calories than you consume so here is the other side of the equation. Burning more calories means exercise. This does not mean go out and run a marathon. Rather gradually increase your activity level. Taking stairs instead of an elevator is a good start. Walking burns calories too, so start slow and build up to a level where you begin to lose weight. You should lose no more than one to two pounds per week so that you do not throw your body into a starvation mode where it will try to retain everything that is consumed. You can get as detailed as you want about the level of exercise and track every calorie going in and out, but one simple key: remember where you started. Just make small improvements on both sides of the equation and you will in time see results. Gradual results are better than overnight results. I know that this does not sound like a pharmacy article, and I’m about to give you even more: I do not recommend diet pills and appetite suppressants. Unless these are accompanied by a lifestyle

change in terms of activity and serving size consumed, you will gain the weight you lose back when you quit taking these pills. In fact, you will probably add a few pounds in addition to what you lost. Either that or stay on diet pills for the rest of your life, which is a terrible idea since it stresses your heart and cardiac system, raises blood pressure, and interferes with the natural system of checks and balances within your body. There are a couple of natural products that can help your

program of lifestyle modifi cation and increase your positive results. On the vitamin front there is Vitamin B-12

(cyanocobalamin), which can give you energy and make a workout more endurable. This is safe for people with

high blood pressure or heart problems. Chromium is a mineral that will shift your metabolism toward utilizing fat instead of protein, and that can help

you lose more fat during your workouts. Once you get past these basic supplements I would steer clear of the herbal as well as prescription weight loss products. Ginseng is known to give you energy to a slightly greater degree than B-12, but is also stressful to the heart, so why take the chance. Stay safe. A workout helps you burn calories but you

can’t work out eight hours a day. After all, most of us have jobs and time commitments in our hectic lives. A trainer once told me that all

workouts are not equal. They all burn calories as you work out, but what happens after you work

out and you’re home resting? Workouts will also increase your base metabolism rate for a

number of hours after you work out. This is like a free bonus! You are at home watching your favorite TV program and your body is still burning calories at an increased rate. Aerobic workouts boost your metabolism for approximately eight hours after the workout, while strength workouts can boost metabolism for up to twenty-four to forty-eight hours. Remember that with strength workouts your muscles need a day to recover, so either alternate muscle groups so you do not work the same muscles two days in a row, or alternate strength and aerobic workouts from one day to the next. In closing, there is no magic pill, supplement, or product that will cause weight loss without a little effort on your part. And for the record, when I say weight loss I mean a loss of weight that can be maintained for a lifetime. Your lifestyle got you into this condition, and a new lifestyle is required to create and maintain a new and healthier you. SORRY! FACTS ARE FACTS! Questions about this article or suggestions for future columns can be sent to us at cjdlpdrph@bellsouth.net

Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson (cjdlpdrph@bellsouth.net )

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OUR NEWSSTANDSMedical locations:• Department of Veterans Affairs Medical Ctr, 15th St., Main Entrance• Dept. of Veterans Affairs Medical Center, Uptown Div., Wrightsboro Rd., main lobby• Doctors Hospital, 3651 Wheeler Rd, ER Lobby Entrance• Doctors Hospital, 3651 Wheeler Rd, Employee Entrance (near the Joseph M. Still Burn Center entrance)• Eisenhower Hospital, Main Entrance, Fort Gordon• George C. Wilson Drive (by medical center Waffl e House and mail boxes)• GHSU Hospital, 1120 15th Street, South & West Entrances• GHSU Medical Offi ce Building, Harper Street, Main Entrance• GHSU Medical Offi ce Building, Harper Street, Parking Deck entrance• GHSU Hospital, Emergency Room, Harper Street, Main Entrance• GHSU Children’s Medical Center, Harper Street, Main Lobby• GHSU, Laney-Walker Boulevard transit stop, Augusta• Select Specialty Hospital, Walton Way, Main entrance lobby• Trinity Hospital, Wrightsboro Road, main lobby by elevators• Trinity Hospital Home Health, Daniel Village, main lobby• University Health Federal Credit Union/ University Hospital Human Resources, 1402 Walton Way, Main Lobby• University Hospital, 1350 Walton Way, Emergency Room lobby area• University Hospital, 1350 Walton Way, Outside Brown & Radiology/Day Surgery• University Hospital - Columbia County, 465 N. Belair Road, Main Lobby• University Hospital Prompt Care, 3121 Peach Orchard Road, Augusta

Around town:• Barney’s Pharmacy, 2604 Peach Orchard Rd.• Birth Control Source, 1944 Walton Way• ASU Student Bookstore• Blue Sky Kitchen, 990 Broad Street• Columbia County Library, main branch lobby, Ronald Reagan Drive, Evans• Enterprise Mill (North Tower), 1450 Greene Street, Augusta• Daniel Village Barber Shop, Wrightsboro Road at Ohio Ave.• Hartley’s Uniforms, 1010 Druid Park Ave, Augusta• International Uniforms, 1216 Broad Street, Augusta• Marshall Family Y, Belair Rd, Evans• Mellow Mushroom, 12th and Broad Streets, Augusta• Southside Family Y, Tobacco Road, Augusta• Surrey Center, Surrey Center Pharmacy, Highland Avenue, Augusta• Top-Notch Car Wash, 512 N. Belair Road, Evans• Wild Wing Cafe, 3035 Washington Road, Augusta

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AUGUSTA MEDiCAL EXAMINERAPRIL 20, 2012 9 +

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Editor’s Note: This column ariginally appeared in the April 2010 Medical Examiner. “With Mother’s Day approaching, I want to share this with you. I found it online and the author is unknown, but it could easily be any of us. I hope it makes you laugh out loud. Share it with your mothers, sisters, children and friends — and have a wonderful Mother’s Day!!!”

Things my mother taught me

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Here’s an easy recipe you can prepare for a deserving Mom or Grandma. It is easy to prepare, but she will be impressed with your baking skills!

Key Lime PieIngredients• 5 egg yolks, beaten• 1 (14 ounce) can sweetened condensed milk• 1/2 cup key lime juice (I use Nellie and Joes)• 1 (9 inch) prepared graham cracker crustDirections1. Preheat oven to 375° F.2. Combine the egg yolks, sweetened condensed milk and lime juice. Mix well. Pour into unbaked graham cracker shell. 3. Bake in preheated oven for 15 minutes. Allow to cool. Top with whipped topping and garnish with lime slices if desired. 4. Serve Mom the fi rst slice!

Thanks for reading. Eat well and be healthy!

Cindy CrawfordCindy’s Catering

What’s Cooking with Cindy

1. My mother taught me TO APPRECIATE A JOB WELL DONE. “If you’re going to kill each other, do it outside. I just fi nished cleaning.”2. My mother taught me RELIGION. “You better pray that will come out of the carpet.”3. My mother taught me about TIME TRAVEL.“If you don’t straighten up, I’m going to knock you into the middle of next week!”4. My mother taught me LOGIC. “Because I said so, that’s why.”5. My mother taught me MORE LOGIC. “If you fall out of that swing and break your neck, you’re not going to the store with me.”6. My mother taught me FORESIGHT.“Make sure you wear clean underwear, in case you’re in an accident.”

7. My mother taught me IRONY. “Keep crying and I’ll give you something to cry about.”8. My mother taught me about the science of OSMOSIS.“Shut your mouth and eat your supper.”9. My mother taught me about CONTORTIONISM.“Will you look at that dirt on the back of your neck?”10. My mother taught me about STAMINA. “You’ll sit there until all that spinach is gone.”11. My mother taught me about WEATHER. “This room of yours looks as if a tornado went through

it.”12. My mother taught me about HYPOCRISY.“If I told you once, I’ve told you a million times. Don’t exaggerate!”13. My mother taught me the CIRCLE OF LIFE.“I brought you into this world, and I can take you out.”14. My mother taught me about BEHAVIOR MODIFICATION.“Stop acting like your father!”15. My mother taught me about ENVY. “There are millions of less

AUGUSTA MEDiCAL EXAMINER APRIL 20, 201210+

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

Don’t Lick the Beaters and other interesting food facts

The Scoop About Coffee: Good or Bad?

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For time to time, coffee gets a bad rap for being detrimental to health. Then suddenly the news switches to how benefi cial coffee can be. So which one is it? Before you make any drastic changes to your coffee-drinking habits, read on to get the full story.

It May Actually Be Good For You A recent large study published in the American Journal of Clinical Nutrition found that, contrary to earlier belief, drinking coffee does not increase your risk of developing chronic disease such as heart disease, Type 2 Diabetes or cancer. In fact, a number of studies are fi nding that besides giving you that much-needed burst of energy, coffee may actually have a number of health benefi ts.

Possible Health Benefi ts of Coffee Include:• May reduce the risk of developing Type 2 Diabetes• May reduce the risk of cirrhosis and liver cancer • May reduce risk of Parkinson’s disease in men• May reduce the risk of Alzheimer ’s disease and other dementia• In women, may help to keep depression away • May also lower the risk of stroke in women. Coffee is high in antioxidants and minerals such as magnesium and chromium. These components, as well as the caffeine in coffee, may be responsible for the associated health benefi ts. With these potential health benefi ts, however, there are possible drawbacks that, for some people, may outweigh the benefi ts.

Drawbacks and Side Effects Both coffee and the caffeine it contains can have a number of undesirable side effects. Some of the common side effects include anxiety, poor sleep and heartburn. It may also interact with medications to increase irritability, heart rhythm changes and trouble sleeping. Certain compounds in coffee have shown to increase serum cholesterol levels. These compounds are fi ltered out with paper fi lters but may be high in unfi ltered coffee, such as espresso and the brewing method of French Press. In addition, there is always what you put in your coffee that may not be that good for you, especially if you drink multiple cups a day. Calories and fat from sugar and cream can add up pretty fast, leading to weight gain and increased risk for heart disease.

Who Should Refrain from Coffee Some people are more sensitive to coffee and caffeine and are more likely to experience negative side effects mentioned above. If coffee keeps you up at night or gives you a heart burn, you are better off without it. Children are particularly sensitive to caffeine and should limit their intake. Women who are pregnant or are trying to get pregnant should also limit their coffee intake. While a moderate intake (about 12 oz. of coffee per day) appears to have no negative effects on the fetus, high amounts of coffee may delay conception or increase risk of miscarriage or low birth weight. Although coffee may decrease the risk of developing Type 2 Diabetes, it may cause blood sugar spikes in people who already have diabetes. If you have diabetes, you may want to monitor your blood sugar in relation to your coffee intake. If it causes blood sugar levels to go up, limit your coffee intake.

To Drink or Not to Drink If you fall into the category of people who should refrain from coffee, the risks and side effects may outweigh the benefi ts, in which case you would be better off avoiding it. Also, if you are not currently a coffee drinker, there is not enough evidence to encourage picking up that habit to improve your health. If you are, however, a generally healthy adult who has been drinking coffee for years and on whom coffee and caffeine does not have an evident negative effect, go ahead and enjoy that cup of Joe! It may be doing your body and mind good. Just remember everything in moderation and go easy with the cream and sugar.

— Julie Tokarev, Dietetic Intern

blood vessel in your stomach that can burst without warning.

Diabetes If your blood pressure is higher than 135/80, ask your doctor to test you for diabetes. Diabetes, or high blood sugar, can cause problems with your heart, eyes, feet, kidneys,

nerves, and other body parts.

Tobacco Use If you smoke or use tobacco, talk to your doctor about quitting. For tips on how to quit, go to http://www.smokefree.gov or call the National Quitline at 1-800-QUITNOW.

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fortunate children in this world who don’t have wonderful parents like you do.”16. My mother taught me about ANTICIPATION.“Just wait until we get home.”17. My mother taught me about RECEIVING.“You are going to get it when you get home!”18. My mother taught me MEDICAL SCIENCE.“If you don’t stop crossing your eyes, they are going to freeze that way.”19. My mother taught me HUMOR. “When that lawn mower cuts off your toes, don’t come running to me.”20. My mother taught me

HOW TO BECOME AN ADULT. “If you don’t eat your vegetables, you’ll never grow up.”21. My mother taught me GENETICS. “You’re just like your father.”22. My mother taught me about my ROOTS. “Shut that door behind you. Do you think you were born in a barn?”23. My mother taught me WISDOM. “When you get to be my age, you’ll understand.”24. And my favorite: my mother taught me about JUSTICE.“One day you’ll have kids, and I hope they turn out just like you!”

MEN… from page 7

CINDY… from page 9

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PARAMEDIC

AUGUSTA MEDiCAL EXAMINERAPRIL 20, 2012 11

The blog spot+

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Prostate cancer breakthrough A new treatment for prostate cancer that doctors say provides “the perfect outcome” is recruiting patients in the UK for large scale trials, says an April 16 article in England’s The Guardian. The treatment attacks tumors with heat using high-intensity focused ultrasound (HIFU). While current strategies (surgery and/or radiotherapy) offer success in only about half of all cases, says The Guardian, HIFU treatment was way more effective against cancer without the common side effects: 12 months after HIFU treatment, 95 percent of study participants were cancer free; zero percent experienced incontinence; only 10 percent suffered impotence. That’s the good news. The not-as-good-news is that The Guardian article was, in turn, reporting on study results published in Lancet Oncology. And that study involved only 41 men treated with focal HIFU and followed up after one year. In the world of medicine, that’s

a tiny trial, barely a step above anecdotal fi ndings, and a very short-term follow-up period. More research needs to be done, but the results so far have medical researchers excited that HIFU could soon be the automatic treatment for prostate cancer. Ask your doctor.

It’s the grandkids!Quick! Hide everything! There’s nothing like grandchildren, right? Cute. Shiny with promise. And when they give you any trouble, you can ship them right back home. But you defi nitely don’t want to ship them to the ER, and that’s happening to a lot. The culprit is granny and grandpa and their non-childproof homes, and in particular those non-childproof medicine bottles. A new University of Michigan study released this week says as many as 25 percent of grandparents leave drugs where children can easily fi nd them. The director of the survey

noted that nationwide, every 10 minutes a young child is treated in an emergency room for possible poisoning from swallowing prescription or over-the-counter medicine. Somebody needs to keep an eye on that kid. Ha ha. But seriously, if kids aren’t normally in your house but medicines are, make sure the meds are out of reach when kids visit.

Pencil-lifting to lose weight Do not adjust your Medical Examiner. Well, you can a little. You can adjust pencil to “pen.” Or even “keyboard.” The idea is this: use one of those three things to keep a food diary. Write down everything you eat or drink in meticulous, specifi c detail. Studies show this works as a weight loss strategy— as long as you faithfully record every crumb. Why? Because it makes you very conscious of what you’re eating — and also reluctant to record some stuff: “Do I want to record that?”

theClipping File

Posted at http://thisibelieve.org/ and heard The Bob Edwards Show March 23, 2012

This I Believe Around three forty-fi ve on a rainy Saturday morning, I was startled awake by the sound of my pager beeping. As a volunteer fi refi ghter and emergency medical technician, I can never count on a full night of sleep. I groggily pulled myself out of bed and staggered toward the desk to grab my radio. Our crew was being dispatched to a nearby home where a man was in cardiac arrest. We found the man lying on his kitchen fl oor with his hysterical wife beside him. My partners initiated CPR, while I hooked up the defi brillator. We rushed the patient to the hospital, but despite our efforts, we were unable to save his life. In my line of work, I rarely get any recognition from the patients we treat, or from their loved ones. But this night, the man’s wife approached us, and through her tears, whispered, “Thank you,” and hugged each of us. She knew we answered her late-night call for help, and even though the ending was not positive, she was grateful for our efforts. There is something deeply rewarding about helping people in vulnerable circumstances. Sometimes, I’m able to make their worst day a little better: like seeing the tears of an injured child turn into a smile when I gave him a stuffed animal; or watching a terrifi ed mother’s screams turn into tears of joy when she realized her baby was going to be okay; or sitting beside a woman in her mangled car talking about funny TV shows just long enough to take her mind off her situation and actually eliciting a laugh from her. I have also been screamed and cursed at. I have been pepper-sprayed, and I have watched a mentally ill patient assault my partner. I have seen the terror in a friend’s eyes while I performed CPR on her father, and I still get chills when I recall her desperate cries of “please tell me my dad is going to be okay.” Despite all of the sad things I have seen and the nasty people I have encountered, my desire to help people has only grown stronger. Experiences like these allow me to see the impact my work has on others. At the same time, I also know the effect it has had on my own life. As a teenager, I felt awkward when my dad hugged me and said he loved me. I was equally uncomfortable telling him, “I love you.” But then I envisioned him being the man lying on the kitchen fl oor that rainy night and realized that my opportunity to say those three words could – at any moment – be taken away forever. I’ve learned to appreciate every relationship I have, to tell people I care for how I feel about them, and to never take anything in life for granted. So my work as an EMT has confi rmed what I believe: I will continue to roll out of bed in the middle of the night to answer a stranger’s call for help.

— by Matt Rizzotti, a sophomore at Pennsylvania State University’s Schreyer Honors College, studying economics and marketing. After graduation, he hopes to attend medical school and pursue a career as a trauma surgeon or emergency room physician. Rizzotti continues to work up to 25 hours a week as an emergency medical technician.

“I have been

pepper-sprayed.

”

From THE Bookshelf The National Library of Medicine (NLM) in Bethesda, Maryland, has been stashing stuff away since, oh, about 1837. They’ve got 17 million items in their collection spanning ten centuries. Literally. Obviously then, this book, at a mere 240 pages, is a pathetically small slice of their treasure trove. Rumor is that they were originally going to make the book all-inclusive, but it was going to weigh 964 pounds. So they went back to the drawing board and whittled it down to the best of the best. And here it is, hot off the press and waiting for everyone interested in fascinating medical ephemera, imagery, and rare biomedical artifacts. Every page is something completely different. Like the 1772 “Notes on the Dissection of Cadavers” from Japan; a selection from the Civil War-era Surgical Card Collection, which offers pictorial and written guidance in Flash Card style on how to handle particularly diffi cult surgical techniques on the battlefi eld; a circa 1950 International Nurse Uniform Guide for identifying nurses from such disparate locations

as Denmark and Hong Kong, just by identifying their colorful native nursing uniforms; and quaint medical trade cards from the 1920s through the 1940s from all over the world. There are the expected anatomical engravings and woodcuts from days of yore, as well as stuff like the report of the fi rst medical team to enter Hiroshima after the bomb was dropped, and “magic lantern slides” used to entertain and cure inmates at hospitals “For The Insane.” All in all, there are 450 full-color illustrations, each accompanied by a brief essay by a prominent scholar, journalist, artist, collector, or physician. Suffi ce it so say that this is the coolest way to tour the

National Library of Medicine there is that doesn’t involve a road trip or using a single gallon of gas. There’s stuff in here that, in all likelihood, even people who work at the NLM have never seen. In this season of graduations, homecomings, reunions and alumni gatherings, this book could be the perfect gift for that special medical person in your life.

Hidden Treasure: The National Library of Medicine, 240 pages, published March 27, 2012 by Blast Books Like this kind of book? Then also check out The Art of Medicine: Mapping the Body in 2,000 Years of Images and Imagination. It’s chock full of mankind’s evolving body image, from ancient etchings to medieval parchments to modern art and scanning electron micrographs. Seeing the primitive old images, it’s amazing to realize that today’s “sophisticated” imagery will someday look similarly antiquated.

256 pages, published Feb. 1, 2012 by University of Chicago Press

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May 4OUR NEXT ISSUE:

EL QUATRO DE MAYO!

!

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The Mystery Word for this issue:IPADMARCE

Simply unscramble the letters, then begin exploring our ads. When you fi nd the correctly spelled word hidden in one of our ads — enter at AugustaRx.com

1.TTTTTTWWWAAGROBI 2.EEEEFOOHHHHASSI 3.KLEATSDEEYA 4.EMTTRY 5.MIR 6.AEN 7.GR 8.K 9.E 10.T 11.E 12.R

AUGUSTA MEDiCAL EXAMINER APRIL 20, 201212+

SAMPLE: 1 2 3 4 1 2 1 2 3 4 5L O V E B L I N DI S

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

WORDSNUMBER

BY

PUZZLE

by Daniel R. Pearson © 2012 All rights reserved. Built in part with software from www.crauswords.com

Solution p. 14

� � � � � � � � � �� �� ���� �� ���� �� �� �� �� ���� ��

�� �� �� � ��� �� �� �� ���� �� ��� � ���� �� ��

�� �� �� �� �� �� �� ���� �� �� ���� � ��� �� ��

THE MYSTERY WORD

All Mystery Word fi nders will be eligible to win by random drawing. We’ll announce the winner in our next issue!

VISIT WWW.AUGUSTARX.COM TO ENTER!Click on “Reader Contests”

EXAMINER

SUDOKU

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 © 2012 All rights reserved. Built with software from www.crauswords.com

QUOTATION PUZZLE

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each

vertical column to fi ll the boxes above. 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.

by Daniel R. Pearson © 2012 All rights reserved

by Daniel R

. Pearson © 2

01

2 A

ll rights reserved

� � � � � � � � �� � � � � � � � �� � � � � � � � �� � � � � � � � �� � � � � � � �� � � � � � � � � � � � � � � � �� �� � �

THE EXAMiNERS+

B

Y ’

1 2

Use the letters provided at bottom to create words to solve the puzzle. All the listed letters following 1 are the 1st letters of each word; the letters following 2 are 2nd letters of each word, and so on. Try solving words with letter clues and entering unique and minimal choice numbers (such as 5 thru 12 in this puzzle). A sample is shown. Solution on page 14.

1 2 3 1 21 2 3 4 1

Solution on page 14.

1 2 3 4

F

by Dan Pearson

I

Y1 2 3

1 2 31 2

1 2 3

How is your Gamma Knife

training coming? The Gamma Spork.What comes after that?

Great. It’s a wonderful tool to help people.

How far along are you? Pretty early. I’m still learning

the Gamma Spoon.

© 2012 Daniel Pearson All rights reserved.

1 2 3

— William Temple

DNN

ITEA

H’C

DTE

NIH

NWNN

EWC

SER

PYHE

DAN

HOY

NIA

’PC

POTD

EOI

E1 2 3 4 5 6 71 2 3 4 5 6

DOWN 1. Compel 2. African plague 3. Progressive emaciation, atrophy 4. A little cupid 5. Dana Owens’ stage name 6. Foot-operated lever 7. By mouth 8. Average 9. Feminine hormone 10. Columbia County community 11. Capital of Western Samoa 12. Ain’t properly 13. Counsel or advise 21. Sever 23. Dash 25. Grain stores 27. Stephen Vincent _______ 28. Not closed 29. Secondhand 30. Disrespectful back talk 31. How hospital size is gauged

32. Image 33. Ostrichlike bird 34. Serf 37. Resident of Papeete 38. Fatal; mortal 40. Chem. safety sheets 41. Study of trees 43. Humans 44. At a great distance 46. Kitten 47. Elude 48. Extent 49. ____ over (teen party) 50. _____ Team 51. Intro for meter and scope 52. Heavy metal 53. Letters for so-called Crib Death 56. Prefi x for life

ACROSS 1. Alcohol syndrome beginning? 6. Bishop of Rome 10. Follicle output 14. Bush successor 15. Periods of history 16. Church recess 17. Automaton 18. Flit 19. Peel 20. Partner to collar or error 22. Narrate 24. Restful 25. Only 26. Make lace 27. Having two+ wives 31. _____ Certifi cate 34. Georgia mountain town 35. Prostate ltrs. 36. Refl ected sound 37. Mortise partner 38. Dimpled ball holders 39. Female deer 40. Men 41. Transmits 42. Quick photograph 44. Evergreen tree 45. Prepare for publication 46. Former riverfront restaurant 50. Sales tax letters 53. Fittest activity? 54. Shed tears 55. Large wading bird 57. Silly 58. Once one of the largest lakes on earth (now almost completely dried up) 59. Immune disorder acronym 60. Beg; sponge 61. NASCAR’s detergent? 62. Prying 63. Euphemism for death

A1 2 1 2 3 4

1 2 3 4 5 6 7 8 9 10 11 12

AUGUSTA MEDiCAL EXAMINERAPRIL 20, 2012 13 +

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The Patient’s Perspectiveby Marcia Ribble

Happily, I can announce progress made since discovering that my platelets were down to 30,000. With coordination among my doctors, my platelet count is now over 100,000 thanks to short term use of dexamethazone, and successful VNUS surgery. Both of those things were of both short and long term benefi t to me, the patient. Best of all my leg no longer feels like it’s cemented to the fl oor and unwilling to be lifted up. I’ve already had a knee replacement in that leg and wasn’t too surprised when, even after the replacement, my leg felt heavy and awkward. The pain was gone, so I didn’t think to complain that the leg still left me feeling very old and draggy. The spring that used to be in my steps didn’t come back after surgery. Today I try to imagine and remember when I fi rst felt that sluggish sense in my legs. It was the late 1980s and we’d just moved to Salt Lake City, 5000 feet above sea level. My breathing was labored. My legs felt anchored to the ground as I climbed up and down the hills at the University of Utah. Just walking on campus was exhausting and I no longer had the energy to play with my children like I used to. I was put on a 10 mg per day dose of dexamethazone for two years. I blamed the dex and I blamed the altitude, but I never guessed problems with veins in my legs might be responsible. At one point in the late 2000s, my legs started to swell badly, become purplish and discolored, and to have skin so easily broken that just touching it wrong would leave it blistering and oozing. I started to bring it up in offi ce visits for my diabetes. The usual comments made were that they had seen legs way worse than mine. The end result would be that nothing was done. This lasted until I broke my shoulder and was sent to be seen at the Joseph M Still Burn and Wound Clinic for a wound on my leg caused by the fall. Dr. Mullins ordered a Doppler done, and the

vein problem was diagnosed. Then there was a period during which less invasive means to fi x the problem were tried before I could be eligible for the VNUS closure. Now I have one more VNUS closure to be done and then the second knee replacement, and I’m looking forward to having two legs with some of the spring of youth left in them. If asked why my doctors didn’t diagnose and fi x the problem many years ago, it all comes down to the fact that until something was really wrong and obvious, the changes in my legs were gradual enough that I didn’t notice and report them, and when I did begin to report them, I underreported. I didn’t begin to give the doctors suffi cient information for them to get to that “Ah hah,” moment. Because of taking dexamethazone, I also gained a lot of weight, and that made me think weight gain was to blame, too. There were probably twenty or more times in the past two decades when better, more accurate self-reporting of my medical issues would have made a difference. As patients we all need to pay attention to our medical issues and work to report them so our doctors can give us the best medical care. Our doctors can’t fi x what we don’t tell them about. Marcia Ribble received her PhD in English at Michigan State University and recently retired from the University of Cincinnati where she taught composition. She has taught writing at the college level since 1985, and loves giving voice to people who have been silenced. She can be reached with comments, suggestions, etc., at marciaribble@hotmail.com.

USE US!

Talk is cheap.Not talking can be deadly.

+

MEDICAL EXAMINER?WHERE DO YOU GET YOUR CSRA

Among our many delivery destinations: Burke County Hospital, downtown Aiken, St. John Towers, Brandon Wilde, Washingtom Commons, Wild Wing Cafe, Surrey Pharmacy, Select Specialty Hospital, Augusta Back & Neuroscience, and Barney’s Pharmacy.

Who: CSRA Parkinson Support GroupWhat: Kay Jenkins, a Parkinson’s patient, will be sharing her personal story of Parkinson’s and Deep Brain Stimulation surgery during her presentation “I Just Wanna Dance.” She also has a video that she will be showing.

When: Tuesday, April 24, 2012 at 6:00pm

Where: St. John Towers dining room 724 Greene Street Augusta, GA

Contact: Eva Erwin (706) 364-1662

SAVE THE DATES

Earth Day event Golden LivingCenters will host a vendor table at the Georgia Health Sciences University Earth Day Event on Friday April 20, 2012 from 10:00-2:00, at Pavilion 3 (CJ Bldg) & Student Center Courtyard. Stop by and see what Golden Living has to offer. For more information on Golden LivingCenters, contact Frances Winburn at 706-550-4846. You may also contact each facility directly. Golden Living Augusta, 706-738-3301, Golden Living Windermere, 706-860-7572

Nursing Showcase nears The 13th annual Nursing Showcase will be held April 27 at First Baptist Church of Augusta Fellowship Hall. This event precedes the national observance of Nurses Week, to be commemorated this year May 6 - May 12 with the theme “Nursing: Advocating, Leading, Caring.” Nursing Showcase is an event that brings together hospitals and healthcare agencies throughout the CSRA to recognize and reward registered nurses who excel in their profession. At Showcase, nurses receive special honors for their “Spirit of Nursing” as recognized by their supervisors and peers. Nominees for “Nurse of the Year” receive recognition for providing care beyond expectations. One nominee will be announced as recipient of the “Nurse of the Year” award. Showcase begins at 6:00 p.m. with a reception and poster presentations that will provide continuing education credits. Dinner tickets can be purchased from any Georgia Nurses Association (GNA) board member or by mail request to PO Box 1936, Evans, GA 30809. The GNA’s CSRA Chapter website address is www.csra-gna10.org.

PLEASE USE OUR ADVERTISERS WHENEVER POSSIBLE.

WITHOUT THEIR SUPPORT THIS PAPER WOULD NOT BE POSSIBLE.

WITHOUT YOUR SUPPORT OF THEM, THEIR SUPPORT WOULD NOT BE POSSIBLE.

THANK YOU FOR YOUR SUPPORT.

APRIL

27FRIDAY

APRIL

20FRIDAY

APRIL

24FRIDAY

+

+

+

+

+

+

+

The Mystery Word in our last issue was:DERMATOLOGY

AUGUSTA MEDiCAL EXAMINER APRIL 20, 201214+

THE MYSTERY SOLVED...carefully hidden in the page 9 ad for

WILD WING CAFE Congratulations to Pam McCaslin, who scores a $20 Wild Wing Cafe gift certifi cate, two free movie passes courtesy of Health Center Credit Union, a free Top Notch Car Wash gift card,

and anything else we may be able to scrape together on short notice. Win this stuff! The new Mystery Word is on p. 12. Start looking!

...wherein we hide (with fi endish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then be the fi rst to fi nd it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries you’ll score our goodie package: gift certifi cates from Wild Wing Cafe, Top Notch Car Wash, Cheddar’s, and movie passes from Health Center Credit Union! SEVEN SIMPLE RULES: 1. Unscramble and fi nd the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (WInners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher.

The CelebratedMYSTERY WORD CONTEST

HOMES, APARTMENTS, ROOMMATES, LAND, ETC.

LOFT APT. Above commercial building on Walton Way; newly renovated, updated and private; nice 1-BR 900sqft layout; $675/mo, references; 706-589-3548. 51812

GETAWAY 14 acres natural wooded with beautiful rocky creek fl owing through. Available immediately to enjoy while planning future devel. Hiking trails cleared, hunting, fi shing, golf near outstanding Glascock school system. Call owner: 706-798-4359 81712

HOUSE FOR SALE 3 bedroom, 2 full bath, 2-car garage. Off Dyess Pkwy near Ft. Gordon. $99,900. Call 706-339-5548 or 706-210-4334

TOWNHOME large furnished room (dresser, bed, night stand, linens) for rent with private bathroom in convenient and very nice neighborhood near Doctors Hosp. $445 a month includes utilities and Internet service. Please contact 706-589-0238 ask for May.

APARTMENT One bedroom, one bath ga-rage apartment, $595/mo. TOWNHOME Two bedroom, 1.5 bath townhome, $645/mo. Quiet West Augusta area. 706.951.3598 or 706.855.5986 31612

TOWNHOME Great location, everything

new, 2 master suites, sunroom, all appli-ances. $98,000 (706) 504-4023

HOMESBYOWNER.COM

Sell • Buy • Rentals • 706.564.5885

WEST AUGUSTA Luxury 3 BR / 2 BA Townhouse, 1-car attached garage lo-cated off Pleasant Home Road $725 /mo 706-228-4655

TOWNHOME 3 bedroom, 3 full bath townhome. 2 master suites, like new, end unit with extra parking, single garage, covered patio, $125,000. 706-799-0394

SERVICES

HOME HEALTH CHECK-UP Biological and chemical contamination will make you sick. Help your doctor! We Cure Sick Homes. 706-772-9898 www.comman-donow.com

LYNN’S CLEANING SERVICE over 20 years experience in the CSRA with an eye for detail. Call 706.833.2658 or email lynn_dubose@hotmail.com 1612

BIBLE BY PHONE - Free daily Bible readings; for Spiritual Encouragement and Growth. Call 706-855-WORD (9673)

SPARKLING CLEAN Looking for offi ces to clean. No contract req. Husband & wife team have years experience and give FREE

on-request estimates. Call 706.831.8552 or 706.831.8553

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

LAWN SERVICE Commercial, residential. Call Vince: (704) 490-1005

PERSONAL TRAINER Certifi ed by United States Sports Academy in Science of Bodybuilding and Strength Training for Athletes. Signifi cant improvements for all sports at all ages. Natural techniques for relief of all common sports-related injuries employing positioning and myofascial release. Rapid recovery and strength gains.One free session to 1st 10 applicants.E-mail Hme3065805@aol.com or call 803-257-5421

CAREGIVER/COMPANION Need a ride to the doctor, store, etc. or someone to come in to visit and help you. Great References, reasonable rates. Call (706) 589-1698 or email msmagic4@yahoo.com.

EXAMINER CLASSIFIEDS

QUOTATION

WORDS BY NUMBER“The best way to get rid of a telemarketeris to ask them what they’re wearing.”

— Unknown

www.AugustaRx.com

The Sudoku Solution

QUOTATION PUZZLE SOLUTION: Page 12: “When I pray coincidences happen and when I don’t they don’t.” — William Temple

SENDING US A CLASSIFIED?

The new scrambled Mystery Word is found on page 12

USE THE FORM BELOW AND MAIL IT IN, OR GO TO WWW.AUGUSTARX.COM AND PLACE & PAY CONVENIENTLY AND SAFELY ONLINE. THANKS!

CLASSIFIED ADVERTISING FORMAugusta Medical Examiner Classifi eds

NameAddressWork number (if applicable) ( ) Home phone ( )Category of ad (leave blank if unsure):

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

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

.25

1.00

1.75

2.50

3.25

4.00

4.75

5.50

6.25

7.00

7.75

8.50

.50

1.25

2.00

2.75

3.50

4.25

5.00

5.75

6.50

7.25

8.00

8.75

.75

1.50

2.25

3.00

3.75

4.50

5.25

6.00

6.75

7.50

8.25

9.00

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

Send this form with payment to:AUGUSTA MEDICAL EXAMINER, PO BOX 397, AUGUSTA, GA 30903-0397

Total ad cost by number of words as shown above:

Multiply by number of times ad to run:

Total submitted:

$

x

$

The Augusta Medical Examiner publishes on the 1st and 3rd Friday of every month. Your ad should reach us no later than 5 days prior to our publication date.

COFFEE IS GOOD MEDICINE

VISIT DRUGOFCHOICECOFFEE.COMFOR YOUR REFILLS TODAY

WHAT’S YOUR DRUG OF CHOICE?

(OURS IS COFFEE)SEE PAGE 12

THE PUZZLE SOLVED

Thanks for reading!

� � � � � � � � � � � � � � � � � � � � �� � � � � � �� � � � � � �� � � � � � � � � � � � � �� � � � � � �� � � � � � �

� � � � � � � � � � � �� � � � � � � � � � � � �� � � � � � � � � � �� � � � � � � � � � � � �� � � � � � � � � � � � � � � � � � � �� � � � � � � � � � � �� � � � � � � � � � �� � � � � � � � � � � � �� � � � � � � � � �� � � � � � � � � �� � � � � � � � � � � � �� � � � � � � � � � � � �� � � � � � � � � � � � � � � � � � � � � � � � �

AUGUSTA MEDiCAL EXAMINERAPRIL 20, 2012 15 +

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MEDICAL SERVICES DIRECTORY

TO ADVERTISE HERE CALL 706.860.5455

CENTER FOR PRIMARY CAREFAMILY MEDICINE

CPC-EVANS363 NORTH BELAIR ROAD

706.650.7563

CPC-CENTRAL3614-D DEWEY GRAY CIRCLE

706.868.7380

CPC-SOUTH2011 WINDSOR SPRING ROAD

706.798.1700

CPC-N. AUGUSTA105 HUGH STREET

803.279.6800

Evans, South, Crossroads, Central and North Augusta offi ces open8:30 am-8:00 pm Monday thru Thursday and 8:30 am-5:00 pm Friday

Aiken offi ce hours:8:30 am-8:00 pm Mon & Tue and 8:30 am-5:00 pm Wed thru Fri

CPC-Crossroads open weekends for CPC patients with acute care needs. Please call ahead.

CPC-CROSSROADS1701 MAGNOLIA WAY

(OFF DYESS PARKWAY)

706.922.6600

CPC-AIKEN410 HITCHCOCK PARKWAY

NEW CPC OFFICE AS OF AUG. 1

803.649.6941

26 PHYSICIANS • EVENING HOURS • 6 CONVENIENT LOCATIONS •

Knob HillASSISTED LIVING CENTER, INC.

A specialty care community offering: Spinal Cord Injury Care • Traumatic Brain Injuries

Respite Care • Specialized Rehabilitation CareSpecialized Dietary Requirements

Adult Day Care • Alzheimer’s Care

Approved for VA and Medicaidand private pay

Knob Hill Assisted Living Center is just off Washington Rd. near Windmill Plantation, approx. 3 miles from Evans WalMart

For more information or to make a referral, please contact us:KNOB HILL ASSISTED LIVING CENTER

Ryan Hunt • huntglobalinc@gmail.com2822 Knob Hill Farm Road • Evans, GA 30809

706-860-0541

Home Health CheckBACTERIA, MOLD, MYCOTOXINS, VIRUS AND VOCs

Cause Asthma, COPD, Fibromyalgia, Fatigue, Congestion, Eye Irritation, Respiratory Problems, Stuffy Head, Sore Throat, Skin Conditions and more.

39$ LOCAL HOMEINSPECTION

CALL TODAY!706-772-9898COMMANDO SERVICES

DDOCTOR’SOCTOR’S OOFFICEFFICE CCLEANING LEANING SSERVICEERVICE

THOROUGH • DEPENDABLE • DILIGENT • HONEST ••• DAILY • BI-WEEKLY • WEEKLY • PRN

D . O . C . S . H E L P I N G D O C S

7 0 6.2 8 4.7 2 8 7

F R E E

E ST I M AT E S

F R E E

E ST I M AT E S

ADVERTISE HERE!It’s inexpensive and effective

and provides exposure on paper and online.

CALL 706.860.5455 FOR INFORMATION TODAY!

by Kathy Crist

In 2010, the U.S. Senate designated April as the country’s annual Parkinson’s Awareness Month to help educate the public about the neurological

disease and promote cutting-edge treatment and care for people with Parkinson’s. Parkinson’s disease is a progressive disorder often associated with tremor, slowness of movement and muscle stiffness. Approximately 1 million people in the U.S. have Parkinson’s, and 50,000 new cases are diagnosed each year. In addition to a month-long focus on helping improve the lives of people with Parkinson’s disease through education, research and outreach efforts, April 11 was World Parkinson’s Day when people across the globe are encouraged to be advocates for Parkinson’s disease patients and their families. Everyone — especially everyone in healthcare — should help increase understanding of this

degenerative disorder and advocate for new research and treatment to assist the countless people affected by Parkinson’s. In spreading the word about Parkinson’s and fi nding a cure, people are challenged to join the cause in a variety of ways: Spend time with someone who has Parkinson’s; volunteer for a local chapter event; participate in a local fundraiser; join a local support group or start your own; or start a daily exercise routine. Early diagnosis of Parkinson’s gives individuals the best possibility for healthier living. Initial warning signs of Parkinson’s disease include:• Tremor or shaking• Small handwriting• Trouble sleeping• Trouble moving or walking• Constipation• A soft or low voice• A masked or serious-look face• Dizziness• Fainting• Stooping or hunching over Anyone experiencing any of these symptoms associated with Parkinson’s disease is encouraged to see a doctor to help diagnose the

illness and rule out other possible symptom causes. Parkinson’s disease is not fatal itself, but the Centers for Disease Control and Prevention lists Parkinson’s complications as the 14th leading cause of death in America. Currently there is no cure for this neurodegenerative brain disease, and cases are expected to rise signifi cantly worldwide in the next 20 years as the aging population increases.

For information about Parkinson’s disease, and Parkinson’s Awareness Month visit www.parkinson.org or call 1-800-327-4545.

About Right at Home of the CSRAKathy Crist, co-owner of Right at Home of the CSRA is available to discuss your family care giving needs. Right at Home is dedicated to helping the elderly by providing private-duty care giving services; personal emergency buttons from LIFELINE; and computerized medication dispensers. Right at Home serves Augusta, North Augusta, Aiken and surrounding areas in SC. If you have further concerns about caring for a loved one, please contact them at 803-278-0250 or on the web at www.rightathome.net/csra

April is Parkinson’s Awareness Month

2012 2013

Qualifi ed Dividends

Capital Gains Tax

Medicare Tax

Lifetime Gift Exemption

Top Federal Estate Tax Rate

Annual Gift Exclusion

JOINT TAX BRACKET:

$0 to $17,500

$17,500 to $59,300

$59,300 to $71,000

$71,000 to $143,350

$143,350 to $218,450

$218,450 to $241,900

$241,900 to $390,050

$390,050 and up

15%

15%

0.0%

$5 million

35%

$13,000

10.0%

15.0%

15.0%

25.0%

28.0%

33.0%

33.0%

35.0%

39.6%

20%

3.8%

$1 million

55%

$13,000

15.0%

15.0%

28.0%

28.0%

31.0%

36.0%

36.0%

39.6%

AUGUSTA MEDiCAL EXAMINER APRIL 20, 201216+

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(803) 441-0007www.jurypest.com

Protecting food, health and property

Request a FREE est imateonline or by phone

Request a FREE est imateonline or by phone

RESIDENTIAL • COMMERCIAL • REALTOR SERVICES • GREEN PRACTICES

Our Service Makes the Difference...You Be The JUDGE!

ROGER M. SMITH, M.D.OPHTHALMOLOGY

706.724.3339820 St. Sebastian Way • Suite 5A

• Augusta, GA •• Medical & Surgical Treatment •

• Cataract Surgery •

Thursday evenings:

Wine & Tapas A sterling selection of

Chef Heinz’ unique culinary skills and Augusta’s most extensive

wine list. $25 per person

Friday evenings:

Specialty Martinis

Half price

ON TELFAIR

Our May Wine DinnerA 7-Course Dining Experience

featuring superbly matched foods & wines

Sunday, May 20, 5:30 pmLIMITED SEATING

RESERVATIONS REQUIRED(BY PHONE OR ON OUR WEBSITE)EARLY RESERVATIONS SUGGESTED

$80 PER PERSON PLUS TAX & GRATUITY

706.722.4805 • 404 Telfair Street • Hours: Mon - Sat: 6:00 pm to 9:30 pm • www.LaMaisonTelfair.com

La Maison

Chef Heinz welcomes youCelebrating Chef Heinz’ 20 years at La Maison

s many of you are just fi nishing up 2011 taxes, the political debate is

starting to heat up about what your taxes will be starting in 2013. Election years are always uncertain, but this year is even more uncertain as the Bush tax cuts for everyone are set to expire (again) at the end of the year. This means income tax, capital gain, and dividend tax rates will all go up assuming nothing is done. Both parties have stated a desire to extend many of these breaks, but have different views on how this should be done. We look to another frustrating period of uncertainty in tax rates as, more than likely, legislation will not be passed until the fi rst part of 2013 and made retroactive to January 1, 2013. Just think of all the unproductive and wasted energy our country goes through in implementing tax policy. The move to a simpler, understandable, and less complex system in our opinion would add materially to the long-term growth of our economy. Below is a summary of the key changes assuming nothing is done (estimated brackets for 2013).

New Medicare contribution tax on unearned income Beginning in 2013, a new 3.8% Medicare contribution tax will be imposed on the unearned income of high-income individuals. The tax is equal to 3.8% of the lesser of:• Your net investment income (generally, net income from interest, dividends, annuities, royalties and rents, and capital gains, as well as income from a business that is considered a passive activity or a business that trades fi nancial instruments or commodities), or• Your modifi ed adjusted gross income (basically, your adjusted gross income increased by any foreign earned income exclusion) that exceeds $200,000 ($250,000 if married fi ling a joint federal income tax return, $125,000 if married fi ling a separate return).So, effectively, you’re only subject to the additional 3.8% tax if your adjusted gross income exceeds the dollar thresholds listed above. It’s worth noting that interest on tax-exempt bonds, veterans’ benefi ts, and excluded gain from the sale of a principal residence (married couples can still exclude $500,000 of gain, singles $250,000 assuming they meet the

applicable rules) that are excluded from gross income are not considered net investment income for purposes of the additional tax.

Planning and Thoughts• A recent summary of two dozen tax “experts” by the Wall Street Journal noted a majority of them thought that the top tax rate would remain at 35%, probably with a one year extension to give a new Congress time for a more substantive proposal. Most also expect the top capital gains rate to stay at 15% and the estate exemption to stay at $5 million.• Planning - Any decision to sell a business or other assets should be based on economic fundamentals, together with your investment goals; however, the tax aspects and transaction costs associated with implementing any transaction are also very important. Take a business owner with a $1 million business that is selling in the next 5 years. Since we will not know what tax rates are going to be next year until probably next year, does the business owner sell his business and pay $150,000 in tax (15% assuming all taxable) in or take the chance and risk paying $238,000 next year (20% + 3.8% Medicare surcharge for joint fi lers with income over $250,000)? Given that deals can’t be done in 1-1/2 months, business owners contemplating a sale will need to make this decision earlier in the year rather than waiting to see who is elected in November. • We view it as highly unlikely that dividend tax rates would go back to 39.6% given the fact these dollars are already taxed at the corporate level. President Obama has stated he does not want to raise taxes on anyone making under $250,000, so it is likely some compromise will be made once the election plays out. The main goal of this summary is for you to have the background and understanding as the tax

discussion heats up over the next several months. As applicable, you should consult with your CPA and advisors early in the year to understand your options, especially if you have large unrealized capital gains and/or planning on selling a business this year or the next several years. As the year plays out, some advisors may decide to recommend incurring additional income and tax in 2012, to avoid possible higher taxes in the future.

by Bill Cleveland, CPA and certifi ed fi nancial planner (CFP) with Preston & Cleveland Wealth Management, LLC (www.preston-cleveland.com) in Augusta and Atlanta. Medical Economics magazine has called him one of the 150 Best Financial Advisors for Doctors in the nation.

FISCAL HEALTH

The Money DoctorPlan now for possible tax increase in 2013A