Medical Examiner

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APRIL 19, 2013AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

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checked online to see what the dictionary had to say about a word new to the world of health

insurance. Healthcare Reform/PPACA/ACA has created a new job title for us to embrace in all of the processes being introduced:

NAVIGATOR Here’s how it is defi ned as a noun and a verb from http://www.merriam-webster.com.

nav·i·ga·tornoun: na-ve-ga-terDefi nition of NAVIGATORone that navigates or is qualifi ed to navigate

nav·i·gateverb: na-ve-gatnav·i·gat·ed nav·i·gat·ingDefi nition of NAVIGATEintransitive verb1: to travel by water2: to steer a course through a medium; specifi cally: to operate an airplane transitive verb1a: to sail over, on, or through b: to make one’s way over or through2a: to steer or manage (a boat) in sailing b: to operate or control the course of Here’s how Centers for Medicare and Medicaid Services or cms.gov describes the Navigator Program: The Marketplace (Public Exchange) must establish a grant program to fund entities or individuals called “Navigators” that will:• Provide consumer assistance. Navigators will help you understand your new health insurance options available through the Marketplace and will help you select a health plan.• The primary goals of Navigators are to raise public awareness

about the Marketplace, reach out to diverse populations, help consumers understand their coverage options, and provide referrals.• To ensure that Navigators provide unbiased and accurate information, the Marketplace must develop confl ict of interest standards and training programs for Navigators.• Navigators can’t receive commissions from health insurance companies for enrolling consumers, employers, or employees in Qualifi ed Health Plans or in non-Qualifi ed Health Plans outside of the Marketplace. However, they can help consumers with other non-Navigator assisted enrollment functions, as set forth in in 42 CFR 155.220.• Agents and brokers may serve as Navigators as long as all other Navigator standards are met.Source: http://marketplace.cms.gov/GetOffi cialResources/Training-materials/the-health-insurance-marketplace-cms-national-training-program.pdf Note: Georgia House Bill 198 2013-2014 Regular Session has passed the House and Senate. This will require that Title 33 of the Offi cial Code Georgia Annotated be amended to require that navigators in Georgia be licensed through the Commissioner of Insurance and are trained and knowledgeable in the subject matter of health insurance. Using the word navigator makes sense based on the outline of the anticipated program objectives. We are not yet sure of who will be

navigators or who they will be employed by. They may be public employees working for a state or federal agency. As October 1, 2014 gets closer, we will all start hearing more about the Navigator just as we will all be more familiar with “The New” health insurance buying process called Health Care Reform. Russell T. Head is a Partner and Chief Visionary Architect with Group & Benefi ts Consultants, Inc., Augusta’s largest, privately held employee benefi ts consulting fi rm. He can be reached at 706-733-3459 or [email protected]. Visit Group & Benefi ts

Consultants at www.groupandbenefi ts.com.

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Editor’s note: Healthcare is a whole new ballgame with the passage of the Patient Protection and Affordable Care Act (PPACA). How will healthcare providers be affected? What about patients? And how about employers who provide health coverage as an employee benefi t? How will Medicare and Medicaid recipients be affected? Look to this column for the answers.

HEALTHCARE REFORM & YOUby Russell T. Head, CBC, CSA

MORE ON THE INDIVIDUAL MANDATE

Russell Head

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Please see MOSQUITOES page 3

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

still almost unbelievable:

According to Wikipedia, the online encyclopedia, mosquitoes are “the most deadly disease vector known to man, killing millions of people over thousands of years and continuing to kill millions per year by the spread of diseases.” Do not adjust your Medical Examiner. Yes, mosquitos kill millions of people per year, and have been doing so for thousands of years. Those fi gures are not exaggerations. The best guess is that mosquitos infect about 700 million people with disease every year. Malaria alone accounts for more than 5 million deaths each year. According to The New York Times Magazine, mosquitos will eventually be responsible for the deaths of 1 in every 17 people currently alive today. By comparison, even a fi end like Adolf Hitler was a rank amateur. While it may be true that many deaths that are mosquito-related happen in places far away from Augusta and even the United States, we’re far from immune.

In view of the health threat posed by mosquitoes, it was no surprise to receive the following information from Pam Tucker, Director of Columbia County’s Emergency and Operations Division. After all, when we originally ran the article above, we also reported that mosquito-borne cases of West Nile Fever had been reported in Richmond, Columbia, and Aiken Counties. Mosquitoes are a defi nite threat to public health. And without further ado, on to Pam Tucker’s information:

During 2012, the 3-1-1 Customer Service & Information Center received a total of 48 mosquito related complaints between April and October. The highest number of complaints were made during the month of August.

Portrait of a serial killer

AUGUSTA MEDiCAL EXAMINER 3 +APRIL 19, 2013

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Opinions expressed by the writers herein are their own and their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., or its agents or employees take any responsibility for the accuracy of submitted information, which

is presented for informational purposes only. For specifi c medical advice, diagnosis, and treatment consult your doctor.

© 2013 PEARSON GRAPHIC 365 INC.

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The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of news within every part of the Augusta medical community.

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

Send your submissions for Medicine in the First Person to the Augusta Medical Examiner via e-mail: [email protected] or to

PO Box 397, Augusta, GA 30903-0397. (The Medical Examiner reserves the right to accept, reject, or edit any submission at its sole discretion.)

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MOSQUITOES… from page 2

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THE MONEY DOCTOR: SEE PAGE 15

Abandoned or neglected swimming pools accounted for the majority of these complaints, amounting to 54% of the total number of calls. General nuisance complaints accounted for 25%. Drainage issues account for 15% and retention/private ponds accounted for 6%. Evans reported the majority of mosquito complaints, followed by Martinez and Grovetown, with no complaints coming in from the Harlem or Appling areas. Larviciding is the current mosquito abatement program used by Columbia County. This is the most effective, cost-effi cient, and eco-friendly method of mosquito control because it prevents the larvae from hatching into mosquitoes. The Larvicides are distributed by Roads & Bridges Department, Code Enforcement, Water Utility Division, and Public Health Offi cials in county owned retention ponds, storm drains, stagnant water sources in right-of-ways, abandoned swimming pools and other mosquito breeding sources of water. While larviciding is highly effective, it will only do so much to prevent mosquitoes and the diseases that they may transmit. We need each citizen to help reduce mosquitoes by taking personal protective measures to prevent your exposure to mosquitoes and - most importantly - eliminating all breeding sources of standing water around their homes. Remember, anything that can hold water for more than a few days can produce mosquitoes. The link posted below is a short video showing the development of a mosquito. Sometimes, people don’t realize that this is what is growing in that bird bath, potted plants and other items in the yard – so we hope that this will help you identify and empty out that water before they hatch. Mosquito “wiggler” and “tumbler” are informal terms for the larval and pupal (immature) life stages of a mosquito. Mosquito wigglers live in water, and as soon as temperatures get warm enough to drive their development, they quickly mature and emerge from pools and containers wherever they may be found. Also, remember to use EPA registered mosquito repellents, make sure your windows and door

screens are “bug tight,” and wear clothing that will protect your skin when in areas with high mosquito populations.

http://insectsinthecity.blogspot.com/2013/04/spring-rains-and-warmer-weather-usually.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+InsectsInTheCity+%28Insects+in+the+City%29

Check your home for the following common mosquito breeding problem areas: Swimming pools, bird baths, gutters and downspouts, decorative ponds, containers, tarps, leaky spigots, low spots in yard, tires, tree holes and screens and remove them as soon as possible. To report mosquito problems in Columbia County, please dial 3-1-1 to provide information needed by the IMMP Team to respond. +

Can you get AIDS from skeeters? “Mosquitoes cannot transmit HIV because the virus neither survives nor replicates in mosquitoes and the blood from the last bitten person is not fl ushed into the next person during subsequent feeds. In addition, the circulating viral load of most HIV-infected persons is so low that the theoretical risk that amosquito bite would transmit HIV is estimated to be lessthan 1 in 10,000,000.” — American College of Physicians

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Today and every day we’re on a quest to fi nd the Augusta area’s best doctors. Write us! E-mail us! Tell us who did what that was above and beyond the call of duty.

here is something special about this time of the

year that makes my heart sing. The dogwood trees are in full bloom. The weather is a little shaky to say the least. Early in the morning the temperature can be cold and then later on mid 70s or low 80s. But we Southerners tend to get used to that, even though many complaint. That little golf tournament (AKA The Masters) is history for another year, and of course Easter and the message of the death and resurrection of Jesus is hopefully still on many people’s minds. It’s a special time of year. The added hour or more of daylight we’ve been enjoying

for a few weeks is pretty cool too. Spring forward. Spring gives us the impression of a rebirth. The freshness in the air. The birds singing in the early morning. I think this time of the year is a perfect time to not only clean up one’s house, but to remove some of the negative clutter formed in our minds. It’s a perfect time to clean up and/or recommit to our mental health. Attitudes soften up in the spring. People who have been hidden away in winter hibernation are taking off the thick sweaters and putting them away to make room for their spring and summer wardrobe. For people who prefer the spring weather versus the fall and winter – I would think their attitudes are positive right now. And that is a good thing. Have you noticed your slacks are feeling a little tighter than usual? Yes, those late night snacks, hot homemade soup and excuses not to exercise all winter long have caught up with you. But although you’d be long overdue if you’re just changing your clocks, it’s not too late to spring forward

with a strong and effective exercise routine. I have to admit I’m feeling pretty good because I forged through the cold weather and rarely missed my weekday 5 a.m. workouts. It should be easy now that winter is long gone. Although spring brings a much needed energy boost and optimism to many of us, for many suffering from depression it can have quite the reverse effect. There has been extensive research carried out by Harvard

psychiatrist John Sharp into the effects that the changing seasons have on our mental health and emotional well being. “We are exquisitely sensitive to the effect of physical infl uences on our mood and behavior. At the same time as most of us are rolling up our sleeves and spending more time outdoors, others struggle with trying to get into that kind of mode, and counter-intuitively, they feel worse.

If you’re not being carried along with the natural energy of the season it can be really hard,” says Dr Sharp. There are many opportunities to take a healthy advantage of the spring time weather and outdoors. The Saturday Market in downtown Augusta has recently teamed up with The Family Y for an 8 am walk or run. This occurs each Saturday right before the popular event begins. The fi rst two weeks there were more than a hundred walkers and runners. You do not have to register. All you have to do is show up. It is a lot of fun and I recommend you try it. It’s up to you, young or old, to spring forward. It is a conscious decision for us all to make. I know you can do it.

Helen Blocker-Adams is Executive Producer/Host of “The Helen Blocker Adams Show with Co-Host Sammy Lilly”, which airs Monday through Thursday 1 p.m. – 3 p.m. on 103.7 FM/1600 AM WKZK The Spirit. She is also Founder of Unlikely Allies Emerging Leaders Conference. You can contact her at [email protected] or visit her at www.helenblockeradams.com

+ AUGUSTA MEDiCAL EXAMINER APRIL 19, 20134

Helen Blocker-Adams

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READ THE EXAMINER ONLINEwww.AugustaRx.com/news

Hope IS Possible

Spring forward: it has nothing to do with clocks

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The Money Doctorappears exclusively in the Medical Examiner’s 3rd Friday

issue of even months, written by Augusta’s own Bill

Cleveland, a Certifi ed Financial Planner named by

Medical Economics magazine as one of the “150 Best

Financial Advisors for Doctors” in the U.S.

Read it and reap

SEE PAGE 15!

VOTE

Today and every day we’re on a quest to fi nd the Augusta area’s best doctors. Write us! E-mail us! Tell us who did what that was above and beyond the call of duty.

IM.E.

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SPRINGFORWARD

ISN’T IT A LITTLE LATE

FOR A STORY ON DAYLIGHT SAVING

TIME? THIS IS MORE ABOUT

“FORWARD” THAN “SPRING”

ynyrd Skynyrd is correctly spelled with 4 y’s and

named after a gym teacher. They play high energy, highly electrifi ed Southern Rock with an upbeat blues underpinning. I like that. The ticket price was a bit steep, I felt, but I wanted to experience their concert. So I got a Media Pass and crashed the backstage looking my Bad Billy best: jeans, tennis shoes, light windbreaker, and black Bulldog cap. I was overdressed. Their clothes were older (and certainly more expensive) than mine. Their hair was longer than most women I know. Their amplifi ers can pump out more power than the Savannah River Plant. Before I gave up counting, I saw 40 speakers strategically angled to provide professional sound to unknown distances. Not knowing what all those buttons and knobs in the control room were connected to, I touched nothing for fear of accidentally launching a nuclear missile toward North Korea (not that that would be a bad thing.) But WWIII would have to wait for another time. Tonight was set aside for fun, entertainment, and minor eardrum damage. But what do I care? My wife says I can’t hear it thunder now. Lady Antebellum Pavilion may never be the same again. The crowd was well mannered

and orderly, sipping beer, and anticipating thunderous sounds in the night the way God intended concerts to be. Ages ranged from no-teeth to no-teeth. There were well-mannered bikers, doctors, lawyers, laborers, teachers, nurses, and many other productive, taxpaying citizens. I love those kinds of people. The dress code, if one existed, was confusing. Men wore comfortable fi tting outdoor duds. Women were easy on the eye in clothes that looked like they were born in them and grew considerably thereafter. Many took pride in wearing tee shirts from tours ten years back. No one had purple hair, pants below their butts, nose rings, nor tee shirts with obscenities. I did not see anyone who thought it was a dressed rehearsal for the next Inter-Galactic Transvestite Vampire Association Conference. And there were no Walking Dead. Everyone was vividly alive, regardless of their age. There was not one hint of illegal substances, violence, or rudeness. Their manners were well suited for a southern Sunday dinner on the grounds. Concessioners sold everything from Harley Davidson motorcycles to beer ‘n burgers to sunscreen. A pretty lady rubbed sunscreen on my hand. The veins on

the back of my hand dilated. Now she has a new marketing tool: sunscreen that improves circulation. My Media Pass got me into the Sponsor’s Pavilion. My nose took me to the food bar: lobster and shrimp salad, grilled fi lets, and other fi nger foods country boys like me don’t recognize by name, but admit they tasted wonderful. You could bid on high end memorabilia. Autographed Mohammed Ali boxing gloves and trunks: $2,750. Signed Johnny Cash proof album: $2,300. Not wanting to deprive others, I passed. Never mind that I only had $27 in my pocket. Precious few Columbia County deputies stood around looking professionally bored because they had no rowdiness to control and they were not supposed to enjoy the concert while on duty. With this crowd, the deputies were unneeded. For a while, I sat beside

transplanted Yankees: Patrick Sprow (retired military father) and Cathleen (preteen daughter). It was her fi rst Southern Rock outing and black Lynyrd Skynyrd tee shirt. Judging from the awed look in her eye, it will not be her last. We sat on the ground. Our jeans did not get too damp because we got up and down a lot. Drake White opened with considerable expertise. He is a relatively new Nashville talent we will hear more from in the future. Fog machines sprang to life. Lasers refl ected off a huge rotating, faceted globe. A galaxy of lights fl ashed incessantly. Lynyrd Skynyrd erupted into a feverish pitch. Bass notes rattled my dental fi llings. High notes sent my adrenals into over-production. My eyes dilated. Chills ran up my spine. They were too excited to go back down. Diehard Skynyrd fan Cheryl Arrington was under the infl uence of Southern Rock, no illegal substances needed. She sang and screamed on key. She invented new dance steps galore. She exuded happiness,

energenicity, athleticism, and self-fulfi llment. She might have had ovarian fi brillation. If I could bottle and sell her exuberance and joyfulness, I would be so rich I could hire Tiger Woods to be my limo driver. The lights and sounds made it no place to be for migraine suffers. The high crowd energy was enough to give one an impromptu cardiac stress test. No Medicare co-payment required. And a heck of a lot more fun. Lynyrd Skynyrd ripped through Sweet Home Alabama, Give Me Three Steps, and Free Bird. They prominently displayed Old Glory. The Confederate Flag had a Golden American Eagle sitting proudly atop. They did two separate tributes to our troops in harm’s way, each with a heart-felt, patriotic soliloquy that brought tears to the eyes of the most jaded. They made it easy to be proud to be an American. These are the kind of patriotic Americans (band and audience) that I would want at my side when I go to war ... or church. Bad Billy Laveau is a retired MD with a pointed sense of humor. Bad Billy speaks and entertains at public and private events for audiences not subject to cardiac seizure secondary to overwhelming laughter and glee [email protected] or 706-306-9397

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WHAT EVERYBODY OUGHT TO KNOWABOUT THE HEALTH BENEFITS OF LYNYRD SKYNYRD

AUGUSTA MEDiCAL EXAMINERAPRIL 19, 2013 5

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Right at Home supports Parkinson’s Awareness Monthby Kathy Crist

April is annual Parkinson’s Awareness Month. Parkinson’s

is a progressive neurological disease often associated with tremors, slow or uncontrolled movement, and impaired

balance. Approximately 1 million Americans have Parkinson’s, and 50,000 to 60,000 new Parkinson’s cases are diagnosed each year in the United States. April 11 was designated World’s Parkinson’s Day when people across the globe were encouraged to better understand the disease and be advocates for Parkinson’s patients and their families. In America, Moving Day® events help celebrate movement’s pivotal role in treating Parkinson’s and symbolizing hope and progress in fi ghting the disorder. In the CSRA, the 2013 Moving Day Walk is October 19 at the Wilson Family Y on Wheeler Rd, Augusta. Moving Day is sponsored by the National Parkinson Foundation (NPF), one of the leaders in Parkinson’s cutting-edge research, education and outreach. In hosting Moving Day, NPF partners with select agencies

including Right at Home, a local provider of in-home companion and personal care to senior citizens and others. Each Moving Day event features family friendly walk routes, food and music, plus a Movement Pavilion with activity stations such as yoga, Tai Chi, dance and Pilates, which are proven to help manage Parkinson’s symptoms. A champion of helping NPF fi ghting Parkinson’s disease, Right at Home works to improve the quality of life for people with Parkinson’s and provides an extra hand to loved ones caring for anyone dealing with limitations of the troublesome disease. Early diagnosis of Parkinson’s gives individuals the best possibility for healthier living. Initial warning signs of Parkinson’s disease include:• Tremor or shaking• Small handwriting• Trouble sleeping• Trouble moving or walking• Constipation• A soft or low voice• Masked or serious-look face• Dizziness or fainting• Stooping or hunching over Anyone experiencing symptoms associated with Parkinson’s disease is encouraged to see a doctor to help diagnose the illness

and rule out other possible symptom causes. In spreading the word about Parkinson’s and fi nding a cure, people are challenged to join the cause in a variety of ways. Participation includes spending time with someone who has Parkinson’s; volunteering for a local chapter event or joining a support group. In the CSRA, a Parkinson’s support group meets the last Tuesday of each month at St. John’s Towers at 6:00 pm at 724 Greene Street, Augusta. The muscle-movement disease is not fatal itself, but the Centers for Disease Control lists Parkinson’s complications as the 14th leading cause of death in America. Currently, there is no cure for this disease, and cases are expected to rise signifi cantly as the aging increases. For information about Parkinson’s disease, visit www.parkinson.org or call 1-800-473-4636.

About Right at HomeRight at Home of the CSRA, a leading provider of in-home care and assistance, supports family caregivers and is dedicated to improving the life of the elderly and disabled. To contact Right at Home call 803-278-0250 or visit them on the web at www.csra.rightathome.net

Crist

Stay at home alternatives

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

or visit www.rightathome.net/csra.

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

from the professionals at Right at Home

803-278-0250

The Georgia Academy of Nutrition and Dietetics is releasing a cookbook, Seasonal Eats: A Recipe Collection of Georgia Products, brought to you by its members, registered dietitians, student and interns. Sales of the book will go towards student scholarships as well as professional stipends. The cookbook is a compilation of more than 100 tried-and-true recipes featuring Georgia produce and products, organized for creating seasonal menus. Recipes include those from the family of a Vidalia onion farmer. Other Georgia farms spotlighted include Vesterfi eld Farms, Le Tre Luna at Glover Farms, Babe and Sage Farm and Kachina Farms. All recipes include nutritional analysis. Cookbooks are available for purchase from GAND members or online: www.eatrightgeorgia.org ($12 each plus $5 S&H)

Note: the direct link to the cookbook (below) is not for the faint of heart. Our suggestion: go to the website address above and look for the grey “search...” box to the right. Type in the word cookbook and look for “Georgia Academy Cookbook” in your search results.

http://www.eatrightgeorgia.org/component/content/article/19-reminders/273-georgia-academy-cookbook.html

Cookbook published

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Lby Ross Everett

WHY YOUR PREMIUM IS GOING UPast time I was home, my mother started talking about the health costs our family would incur this year. A visit here and a visit there. A skin biopsy in the months gone by and a knee

replacement in the months ahead. It’s probably for the best to get it all out of the way this year, though, she decided, because rates will be going up soon. It’s true. I expect nearly all aspects of health insurance to rise over the coming years. Premiums alone have been predicted to increase by as much as 30% for some families. Each insurance company points to the abysmal healthcare reform, the Patient Protection and Affordable Care Act (PPACA/ACA), for the increase, citing the infl ux of unhealthy patients it will cause them to absorb. They’re right. Well, sort of. Of course PPACA is increasing the costs of care provision. Like they are saying, we’re sending many of the previously “uninsurable” to them. It’s a fair assessment that these unhealthy few will cost them money. Now, PPACA also requires all of those previously uninsured people without preexisting conditions to also enroll in healthcare plans. Many of these are the young and healthy folks who would rather save the money now and then seek insurance when they fi nally get sick. These enrollees should offset most of the cost of the other group, but, hey, we’ll give the insurance companies the benefi t of the doubt and assume that the numbers don’t add up. I’ll tell you this though. They sure don’t add up to losses requiring 30% increases in premiums to offset them. I’m afraid the world isn’t quite that bleak for the insurers, who haven’t had a bad year in who knows how long. Do you recall the economic recession that so many industries limped through? Well from 2008 to 2010, combined profi ts for Aetna Inc., Cigna Corp., Humana Inc., UnitedHealth Group Inc., and WellPoint Inc. increased 51%. Collectively they cover about 1/3 of the US. In 2011, the fi ve soared to record profi ts of $14 billion. I, for one, don’t expect anything to change for them anytime soon. Why? Because the insurance companies don’t actually carry any risk. They are essentially guaranteed to profi t. Each can make their target for the year merely by increasing premiums as they see fi t. If they come up short one year they can always just tack on the difference the year after. And for all those mumbling “free market” under their breath, there has been pretty suffi cient research showing that most people in this country don’t really have much of a choice amongst providers. This cycle has led to an unhappy general population and a Wall Street that absolutely loves them. Yet, we continue to buy into the principle that these companies are the best we can get. It just isn’t true. The political system encourages nearly the complete opposite. Most insurers don’t even have a true incentive to keep you healthy. Look at preventative care. We are constantly bombarded with the idea that preventative care is the most cost-effi cient, yet most struggle to get their insurers to cover basic screening utilities and tests. The reason is that they don’t really care how you end up. Come age 65, you can be as bruised and battered as you want to be. Then they’re passing you off to Medicare and you’re no longer a liability for them through your sickest and most costly years ahead. They just have to get you that far. If anything, PPACA may just be convenient for the insurers. Now they can spike premiums, deductibles and co-pays more in a single year than even they would have thought possible before. As the public outcry comes, they can simply point their fi nger to the bill that a large portion of the country already disapproves of. Most people will agree with them. Meanwhile, the profi ts will continue to pour in. Unfortunately, change is unlikely to occur soon. The best chance we had was with the original PPACA bill that included a public option. Consider it a sort of Medicare-at-any-age type of option that anyone could sign up for. However, the other insurers warded off such serious competition as Medicare, which boasts higher effi ciency and higher client satisfaction than any of them. It was the single most lobbied against aspect of the original bill, with an estimated tab of $173 million. Maybe the increased expenses these next few years will serve as a catalyst for real change. Still, times are going to be hard for a whole lot of individuals and businesses. But rest assured, your insurance company won’t be one of them.

Ross Everett is a 2nd year medical student at the Medical College of Georgia. He grew up in Buford, Georgia and graduated from the University of Georgia in 2011. In addition to his coursework, he is interested in health policy, health systems and health management. Please contact him at [email protected] and “Like” him on Facebook at Wide-Eyed White Coat.

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

WHY AM I RUNNING TO THE RESTROOM?

ast issue we discussed side effects of the

overuse of antibiotics. This issue we will give one more example of how antibiotics can be dangerous and how to treat the resulting condition. This problem is clostridium diffi cile (C. diff.) infections of the intestines. This infection is most often caused by antibiotics destroying the good bacteria in your intestines. This is especially prevalent after several antibiotics are used in a short period of time. The good bacteria in these cases are no longer there, and the bad bacteria that are normally suppressed can take over and cause problems. In this

case the result is an extreme case of diarrhea that needs (ironically) an antibiotic to treat. A more serious complication of a C. diff. infection is pseudomembranous colitis. This is an infl ammation of the colon resulting in offensive smelling diarrhea, pain and fever. This can lead to a condition known as toxic megacolon, which is a swelling of the colon. In this condition the colon becomes distended and may require surgery to remove part, or all, of the colon. An ileostomy may be required after surgery. There are two main antibiotics used to treat C. diff. infections. These

are metronidazole and vancomycin. The fi rst line therapy is oral metronidazole, since it will be less likely to result in a superbug as we talked about last issue. The vancomycin is reserved for more severe infections that are unresponsive to metronidazole. Oral capsules of vancomycin can be extremely expensive if not covered by insurance, so a compounded oral solution may be the better route to take. Vancomycin is not absorbed when taken orally, so the risk of developing a systemic superbug is low while the intestinal tract is cleared of the C. diff. infection. The elderly are at high risk of C. diff. infections and tend to have more severe consequences. If diabetics contract a C. diff. infection, then careful monitoring of the blood sugar and possible adjustment of the doses of diabetic medicines may be needed. I know one diabetic who contracted C. diff. that ended up with blood sugar readings in the mid-thirties due to lack of being able to keep any food or drink down, and still taking the blood sugar medicine one morning. He ended up in the hospital twice for this

infection as metronidazole was used after vancomycin in the hospital and in his case did not eradicate the infection. So check with your doctor or pharmacist about whether you should adjust your medicine during bouts of diarrhea, especially severe cases like C diff. So let’s get back to the philosophy that an ounce of prevention is better than a pound of cure — and cheaper too. How can you prevent or lower the likelihood of contracting a C. diff. infection? This is done by supplementing your intestinal tract with good bacteria, especially when taking courses of antibiotics. This is accomplished by taking a daily probiotic available from your pharmacy that should be taken daily to prevent intestinal irregularity, or with courses of antibiotics if you choose not to take it every day. So let’s choose to prevent rather than treat and thus help improve our overall health.

Questions about this article or suggestions for future columns can be sent to us at [email protected]

Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson ([email protected] )

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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his is that time of year when we are all insanely

busy — fi ddling with the garden, mowing the lawn, watching our children’s tee-ball games, and trying to hit the course before the infamous Georgia heat sets in — where everything else falls to the back burner, including healthy eating. That is, until we start panicking about swimsuit season being right around the corner and start yet another crash diet. This time do not start another fad diet, because let’s be honest: those deprivation diets never work. Want to know why? It is because we constantly have to remind ourselves not to eat that brownie, yet end up relentlessly thinking about it and straining our will power. Eventually we give in and eat more than we would have if we were not avoiding that

brownie in the fi rst place. Or we are working so hard to avoid that sweet that we end up mindlessly eating anything else we see. Instead, this year try something new: mindful eating.What is mindful eating, you ask? It’s grabbing a bag of Cheetos and sitting down in front of the television, and before we know it hitting the bottom of the bag and the

only evidence that we even ate anything at all is the legendary orange stained fi ngers. This happens to the best of us in one way or another; whether it is in front of the television, catching up with friends at a dinner party, or grabbing something on the way out the door so we are not late for that early morning meeting. While we are focusing on other things, we mindlessly eat. This is exactly what we want to avoid. This does not mean that every single bite or sip taken must be deeply refl ected upon, but it must be a conscious decision. Unfortunately for us, neither our eyes or nor our stomach can count calories; only our expanding waistline can. This means that we have to help our brains out. By providing external cues and solely focusing on eating, our brain can notice the signal from our stomach telling us that we

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are full or content. This takes around 20 minutes, which could be three brownies too late. Stop overeating from becoming a habit. First, cut out any distractions. Do not eat while watching TV or a movie, reading, or working. Choose only one room to eat in. This way you have to think about what you are doing. Make getting seconds hard work. After putting dinner on your plate, keep serving platters

off the table. Have you ever realized how at the grocery store, sweet treats are always at eye level tempting you? This toys with your willpower. Use this concept in your favor at home; keep snacks and desserts out of sight and out of reach! Even before taking that fi rst bite, our eyes try to determine how much to eat. Our eyes dislike white space (the open space around the food on the plate). The more white space,

the less food our brain thinks we are eating. Trick your brain into thinking you are eating more by using smaller plates with the “correct” portion sizes. The brain uses external cues to determine when it is full, whether this be when company is done eating, our plate is licked clean, or like that bag of Cheetos, you reach the bottom. However, sometimes these are not the best cues to use. Some food companies use packages that hold more than one serving, instilling the belief that once the bag is empty enough has been eaten, but in reality some of those bags contain as much as an entire day’s worth of calories. Also Southern hospitality has instilled in us that we must continue eating with our guests or must take seconds to show our gratitude. Try being the last one to start eating and stop that “clean your plate” concept. Leave several bites on your plate. Trust me, those last few bites are not going to affect the starving children in Africa! Sometimes we are unable to refl ect on everything we ate because the foods have been cleared from the table or there is no physical evidence of how much we consumed. To show you how important this is, think about the last time you

were out to eat and ordered sweet iced tea. Do you know how many glasses you drank? Probably not. This is because the waitress constantly refi lled your glass any time it was close to being empty (that is if the waitress was any good). These extra glasses can really add up and slowly pack on the pounds. This is important to keep in mind if you enjoy buffets or bottomless chicken wings. Next time at a restaurant, ask the waitress to bring a new glass for each beverage refi ll and to leave any all plates and glasses that you are fi nished with on the table, so you can see what you have consumed. So to recap: eat without any distractions, designate one particular room for eating, use smaller dishes, see all you eat and drink by keeping empty beverage glasses and plates on the table, keep snacks and treats and second helpings out of sight and reach, pre-measure single servings, stay away from bottomless deals, and forget that “clean the plate” concept. These mindful eating tips can have you ready for swim suit season all year round, no crash diet or periodic panicking necessary.

— by Jami Szwargulski University Dietetic Intern

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OUR NEXT ISSUE: MAY 3


What triggers your migraines? Is it diet? Stress? You might think you know, but earlier this month a study released by Wake Forest Baptist Medical Center found it is nearly impossible for patients (or doctors) to conclusively determine the true cause. A person may think that drinking wine is their trigger, for instance, and fail to realize other unknown factors are the real cause. The list of easily overlooked culprits might include hormones, weather, physical activity, certain foods, sleep, menstrual cycles, and stress. Researchers suggest keeping a thorough, comprehensive diary and working with your physician to devise the best way to determine your triggers.

Contradictions Life expectancies have been steadily increasing for the past several decades. Good news, right? Sort of. The fl ip side of longer lifespans is that those

additional years are being spent in poor health. Yes, our grandparents may have lived fewer years, but those years were healthier, according to a large study done in the Netherlands and released last week (April 10). As measured by metabolic risk factors, every ten years marks a further decline in health yardsticks and greater medical interventions necessary to prolong life. To take one example, 40 percent of a baseline group of males in their 30s were classifi ed as overweight. Ten years later, 52 percent of males who had subsequently aged into the 30-39 ager group were overweight. Similar deteriorations were seen in rates of obesity, hypertension, and hypertension. While exact causes need further study, one early suspect is increasing rates of inactivity. Meanwhile, another study found that the rise in childhood obesity in the United States

is accompanied by a parallel increase in undernourished children. Sound impossible? It isn’t. Simply put, a growing number of children are subsisting on inexpensive, high calorie, high fat junk food. Read on, however.

Good food cheaper Recent studies have reconfi rmed the health benefi ts of the so-called Mediterranean diet, one rich in fresh produce, olive oil, whole grains, nuts, etc, but light on red meat. Now comes news of a Rhode Island study which followed a group of low-income participants who attended cooking classes that focused on the Mediterranean diet (MD). Six months of follow-up on the participants (which included collecting their grocery receipts) found that by following the MD, participants cut their grocery bills by more than half. Key to their savings was buying signifi cantly less meat, soda, snack foods and desserts.

theClipping File

From THE Bookshelf

+

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

ER GAMES WITH “LADY” Lady’s nonsense urgent attention-seeking issues have logged hundreds of annual calls to 911. Dispatch has been heard to simply say “head on over to Elm St for complaint,” which means Lady’s apartment, for things she sees out the window like moths, meteor sightings, or a well-being check request on a neighbor who has simply gone out for lunch. One would think Lady has a pretty full schedule: her numerous outpatient visits for various maladies are certainly time consuming, and did I mention that she is on 25 DIFFERENT MEDICATIONS which surely takes up a good portion of her day. But no, she still has lots of free time to call the ER pretty much daily, usually on the evening shift. Her pattern is gradually ramping up the calls until it culminates with 911 drama and the inevitable ride to the ER in the Big White Taxi with the Flashing Lights. It is our policy not to give out the names and schedules of the doctors. It’s pretty obvious when individuals are “shopping” for a doc who gives out narcotics or are looking to avoid the doc who piss tests fi rst. This is not the case with Lady. She has her favorites and those she can’t stand, usually because they have had the temerity to bring up the subject of her weight, the elephant in the room (no pun intended). She is not fond of me. I have honestly tried with her, but when your best effort gets rewarded with some BS complaint, well, sorry. You get the bare minimum from me, especially if I have an Actual Sick Patient to deal with. I don’t want to chat about your day. Or mine. Partner in Crime talks to her a lot and nearly always tells her to call her doctor in the morning. Still, Lady likes Partner in Crime. I drew the short straw when Lady was brought in by EMS. She rolled by on the super-duper heavyweight cart like she was the queen on her parade fl oat, waving and smiling, surrounded by her contingent of EMS personnel as reluctant honor guards. She was making the usual sarcastic remarks meant to be funny (they weren’t) and behaving as if we are all bosom buddies. “Where is Partner in Crime?” Lady bellowed as she was wheeled in, proving that she was not, in fact, having the life-threatening shortness of breath which precipitated her 911 call. “I want Partner in Crime for my nurse.” “Sorry, she’s busy with an Actual Sick Patient and you don’t get to pick your nurse. Here is a nebulizer treatment since you are speaking in full sentences, have normal skin color, have normal oxygen saturation and your lungs are clear. Dr. Parvati will be along shortly.” Parvati might be abrupt, lack communication skills, and be blind to the fact that she is a poor team player, but she is never unkind on purpose. I have to give her that. Parvati dealt with Lady’s BS complaint empathetically with the therapeutic equivalent of patting her on the shoulder and telling her she was just perfect in every way. Which is not what Lady wants to hear because if true it would mean she would have to take up a new hobby to fi ll her days. Eventually she was kicked to the curb like she is 99.99% of the time. As usual it took Lady about 15 minutes to vacate the exam area, then there was the requisite lurking at the desk to engage Partner in Crime about something that occurred 12 visits ago. Partner in Crime was too busy to play though, so Lady turned her attention to Parvati on her excruciatingly slow egress from the department. She paused dramatically before heading out, planted herself in the middle of the hallway, raised her arms and announced, “This is the best doctor of all time,” punctuated by bestowing upon Parvati a big smelly hug before waddling out.

The blog spot

+

“She rode in like the

queen of the parade

”+

What’s your very favorite food? Pizza? A crunchy colorful salad? Warm pecan pie? Whatever it is, it’s a safe bet you’re not giving it much thought hours later, or the next day. But let’s face it: food doesn’t just disappear once we swallow it. It may be out of sight and out of mind, but it’s going to be awhile before today’s meals have an out-of-body experience. If you’re beginning to cringe already, perhaps you should read the children’s picture book Everybody Poops for a reality check. Yes, everyone does. Even the Queen of England. But before we do, what we eat takes a remarkable journey, and that’s the subject of Mary Roach’s latest book, Gulp, subtitled “Adventures on the Alimentary Canal.” Just to refresh your memory, alimentary is an adjective that means “of or relating to nourishment.” The alimentary canal, all 126 miles of it, is two words which describe the entire tortured route taken by every bite of food we take, from lips and tongue to the esophagus, the stomach,

intestines, and eventually, the aforementioned out of body experience. Parts of the process may be considered disgusting, but try to avoid it and see how long you make it. Considering what we throw down the hatch, the processing system is nothing short of amazing. Whether animal, vegetable, or mineral, everything is broken down and its key nutritional components effi ciently extracted. What part does saliva play in the digestion process? And speaking of digestion, if stomach acids can dissolve nails, how is it that the stomach itself isn’t eaten away? And speaking of disgusting, what

about these hot dog eating contests? Why are the winners often skinny people who seemingly don’t have very big stomachs? How does the system cope with such sudden overloads? And let’s all pretend for a moment that fl atus (a.k.a. farting) never happens to us. So we might fi nd it interesting to read about the experience other people have and the science behind it. It’s high time someone has come along and given the poop making process the attention it deserves. As has been noted by a scant few others, the Circle of Life would not exist as we know it without the Circle of Poop. Or if you prefer, the Circle of Fertilizer. Fertilizer puts food on our table so we can survive. And create more fertilizer.

Note: Roach has written quite a library of interesting books about the natural world, including Stiff, The Curious Lives of Human Cadavers, and Bonk: The Curious Coupling of Science and Sex.

Gulp by Mary Roach, 352 pages, published in April 2013 by W.W. Norton & Company.

ON

THE EXAMiNERS+

by Dan Pearson

The Mystery Word for this issue:AURCREFT

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


PUZZLE

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 CROSSWORD

+

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

Solution p. 14

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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 © 2013 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 them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may only be used once. Black squares indicate spaces between words, and words may extend onto

a second line. Solution on page 14.

by Daniel R. Pearson © 2013 All rights reserved

by Daniel R

. Pearson © 2

013

All rights reserved

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

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

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ACROSS 1. Category of drinks 5. _____ Sano 10. Dishonest scheme 14. ____ of Man 15. It sometimes follows credit 16. Fuse 17. Precipitation 18. Enclosed automobile 19. Right-angle additions 20. Vomit inducer 22. Nine times out of ten 24. Nostrils 25. S of JMS 26. Eat sparingly 29. Type of certifi cate 33. Dental org. 36. Bifi da intro 39. Jelly bean fl avoring 40. Applies friction to 42. In an unfriendly way 44. Growl 45. Stair surface 47. Inhabitant of Cambodia 49. Rapping Dr. 50. Simultaneous fi ring of artillery 51. First king of Israel 53. Second US president 57. Facial hair 61. Queen of Palmyra, A. D. 267-272 63. Superior 64. Capital City of Germany 65. Rust 67. Tramp 68. New Age singer 69. _____ Cinemas 70. ______ Corner 71. Yes, informally 72. Fish with a net 73. Julia’s former husband

— Author unknown

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As cosmetic surgeons, we support America’s

droops.Right. We have a lot of military patients.

That’s near Ft. Gordon, right?

You got a new job?

Sure did, at that cosmetic surgeon on

Jimmy Dyess Parkway.

© 2013 Daniel Pearson All rights reserved.

That makes sense.

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

1 2

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— Adlai Stevenson

I


The Patient’s Perspectiveby Marcia Ribble

oday it’s sunny, after a series of cold, rainy

days that had my knees complaining (along with my shoulders and ankles and fi ngers). I used to kind of wonder about older folks when they could tell what the weather would be from their bones, but now that I’m one of them, I know it’s for real. We might be surprised sometimes by what we learn in our visits to doctors and hospitals in just a year’s time. For me the knowledge I’ve acquired in dealing with nine doctors and four hospitals in the past year is proving to be very useful in the class I’m teaching at Virginia College. Many of my students are studying some aspect of various medical careers, and what I have learned helps to increase my ability to talk with them about possible subjects for their upcoming research papers in their fi elds. For example, this week my students and I had quite a long discussion about forming attachments to patients or clients, etc. with whom they work, regardless of the fi eld they work in. During the week I found a short piece by Alice Walker about just that topic, and she said she has learned to value all the people who pass through her life as contributors to who she is becoming as a person. Because my students seemed to be confl icted between allowing themselves to care for the people they work with and behaving in a cold and “professional” way, this was one way for us to talk about seeing all patients, all clients, as valuable and special, even the cranky ones, the complainers, and the curmudgeons. From my experiences in the past year, I know that healing is not just a medical process, but also an interpersonal one. When I have been in pain, confused, frightened, or hesitant, those feelings have often been allayed by a warm and personal smile, a gentle touch on my arm or shoulder, or just an acknowledgement that it’s going to be OK. When

I feel as though someone cares about me on a personal level, my need for pain medication is greatly reduced, I relax more, sleep better, and have a better appetite, and thus I heal faster and better. So, while it’s wrong to allow feelings for patients and clients to cross into inappropriate expressions of familiarity, being sensitive to and caring about the human beings we encounter is actually good medicine. This is an issue faced by teachers, too. Caring for my students and making sure they feel cared about is often “the spoonful of sugar that helps the [sometimes bitter] medicine [of making them revise papers] go down.” I will tell them, “I want you to be the best you can be, not just mediocre,” or “I know you are capable of excellence, and I’ll accept nothing less than that from you.” Believing that we are cared about is one important step in increasing patient compliance with drug, diet, and exercise regimens ordered by the doctor. It helps us to use the energy needed to take the pills at the right time, buy healthy foods at the grocery store, and walk further each day. Best of all, when others care about us, those of us who grew up without much in the way of being cared for can learn to care for ourselves.

Marcia Ribble received her PhD in English at Michigan State and recently retired from the University of Cincinnati where she taught composition. She taught writing at the college level and loves giving voice to people who have been silenced. She is now teaching again at Virginia College in Augusta. She can be reached with comments, suggestions, etc., at [email protected].

Talk is cheap.Not talking can be deadly.

ha... ha...

THE BEST MEDICINE

guy is taken to the hospital after a serious motorcycle accident. Waking up from

the anesthesia he sees his doctor standing at his bedside. “So tell me Doc, am I gonna be okay?” The doctor says, “Son, we have some good news and some bad news. The good news is that we were able to save your private parts.” “That is good news. What about the bad news?” “We put them under your pillow.”

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

Patient: Doctor, doctor, I feel like a pair of curtains.Doctor: Well pull yourself together.

Patient: Doctor, I snore so loud I keep myself awake.Doctor: Sleep in another room then!

Patient: Doctor, I’ve completely lost my memory!Doctor: When did this happen?Patient: When did what happen?

Famous Medical Quotes

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

John: I got this great new hearing aid the other day.Mary: Are you wearing it now?John: I sure am. Cost me four thousand dollars, but it’s worth it. It uses some kind of new technology.Mary: What kind is it?John: Let’s see...Twelve-thirty.

Q: Does an apple a day keep a doctor away?A: If you aim it well enough. +

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gourmet coffee. 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, 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.

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The Money DoctorImportant Dates for the Financially Savvy Retiree

O

Serving the Medical, Dentaland EducationCommunities

since 1976

Visit us at any of our 5 locations or atwww.hccu.coop

706-434-1600

ne area in which I help clients is

planning for retirement. This includes discussing retirement income needs, investment portfolio allocation, generating retirement projections, and helping clients comply with various rules and regulations. It is easy to visualize a carefree retirement without deadlines to meet; however, not keeping track of important dates in retirement can lead to reduced savings, unnecessary expenses, and penalties. The following is a list of important ages that should be noted as you work towards retirement.

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

Age 59½ Prior to turning 59½, you would incur a 10% penalty, in addition to any tax consequences, for withdrawing funds from retirement accounts under most circumstances. In the year in which you turn 59½ you can begin taking

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

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

Age 62 – 70 For your entire working life a portion of your paycheck has been withheld for Social Security. Finally, at the age of 62, you can begin receiving your Social Security benefi ts! Now before running out and fi ling for benefi ts on your 62nd birthday, familiarize yourself with the many rules surrounding Social Security including limitations on other sources of income and yearly

benefi t increases if you choose to defer receiving benefi ts. For more information on deferring benefi ts, see our June 15, 2012 Money Doctor article at http://issuu.com/medicalexaminer. (Look for the front page with a pipe-smoking dad; the Money Doctor is on the back page.) Another important task to complete prior to fi ling for benefi ts is determining the accuracy, particularly your earnings history, of the information entered at the Social Security Administration. You can request a summary of your benefi ts at www.ssa.gov to help with this.

Age 65 At age 65, you become eligible for one of the most signifi cant programs offered to senior citizens – Medicare. The signifi cance stems from the rapidly increasing cost of health care in the United States and Medicare’s ability to mitigate a portion of it. There are four parts to Medicare; Part A, B, C, and D. You must apply for your Medicare benefi ts during the Initial Enrollment Period which extends from 3 months

before the month in which you turn 65, until 3 months after. Medicare Part A, which the majority of 65 year olds qualify for, helps to cover inpatient hospital care. You will not directly pay Part A premiums as these are paid for by Social Security taxes. Premiums for Medicare Part B, C, and D are paid for individually by the insured. Part B helps cover doctors’ fees and other outpatient hospital visits. Medicare Part C, also known as Medicare Advantage, is a privately offered plan. Lastly, Medicare Part D helps cover the cost of prescription drug coverage. You will also need to consider private Medicare supplemental plans. Given the complexities of these programs and many changes that are coming about as a result of the new health care legislation, we encourage you to talk with an independent health insurance consultant to learn more about your options.

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

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

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

TMMEDICAL EXAMINER+

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