Subscribe to Featured

Public Health

Football concussions: Amid the fear, UGA research brings some hope

Concerns over football concussions have led to changes in sideline protocols to improve safety for players.

Concerns over concussions have led to changes in football protocols to improve safety.

Headlines about concussions and their effects on professional and college football players are inescapable. The issue is changing the way people talk about the game.

Recently, University of Texas quarterback David Ash quit playing because of continuing symptoms related to a 2013 concussion. And the family of ex-San Diego Chargers player Paul Oliver, a former University of Georgia defensive back, filed a wrongful death suit against the NFL, alleging that repeated concussions on the field drove him to suicide at his Marietta home.

Concussions have been associated with negative changes in memory and thinking ability, as well as movement disorders. There is also mounting evidence that repeated concussions lead to chronic traumatic encephalopathy (CTE), the degenerative disease that doctors found when they examined Oliver’s brain after his death.

From peer-reviewed research to playground hearsay, new awareness about the dangers is changing how some parents think about having their kids play football.

Felicia Harris is one such Georgia parent. The Athens mother pulled her son off the field at age 6.

One day, she watched a boy, about her son’s age, throw up on the sidelines after a hard hit. When she suggested the child might need medical attention, coaches and other parents brushed off her worries. The mentality was, ‘It’s just football, he’s OK,’” Harris says.

When Harris’ son was tackled, a much larger boy kept him pinned down before letting him up. She decided to enroll him in a new sport.


New research


While most concussion research focuses on college and professional players or young children, a team of neuroscientists at the University of Georgia is tackling an often overlooked cohort of athletes.

“A lot of thought is given to professional football players,” says researcher Doug Terry. “But what about the average Joes?”

The average Joes are middle-aged men who played football, but not in any kind of national spotlight. They suffered concussions during their glory days on the high school gridiron.

Doug Terry's research at UGA involved former high school football players in Athens.

Doug Terry’s research at UGA involved former high school football players.

Terry and his colleagues recruited 41 men ages 40-65, all former high school players from Athens. They all had roughly the same IQs and even had right-handedness in common. Of the group, 25 had suffered at least two concussions playing high school football. The other 16 had not.

Each participant underwent an fMRI scan, which measures brain activity by detecting changes in blood flow within the brain. An image of the brain appears on the computer screen, and as the volunteer performs various mental tasks, different regions light up to different degrees, representing activity in those areas.

On the monitor outside the testing room, changes in brain activity look like moving patterns of multicolored splotches.

Researchers expected to find signs of memory deficit in the players who had experienced concussions. But when put to the test, concussed players performed just as well on memory tests as their teammates who had not suffered concussions.

“Which is kind of great news,” Terry says.

Stephen Miller heads the MRI lab. “People are pretty resilient,” he says. And his research indicates that young brains can adapt to maintain normal function after some injuries.

When the two groups of former athletes performed cognitive tasks while being monitored, there were no significant differences in performance. There was no data to suggest cognitive decline in the men who had concussions in the past.

Researchers described seeing differences between the two groups, but not in the brain regions they predicted.

“We expected, if there were deficits, hyperactivation,” Miller explains. “It would mean that those areas of the brain were working harder to sustain the same level of performance.”

Instead, they saw decreased activity in the left hemisphere of the brain. Specifically, there was less activity in regions responsible for verbal understanding. This suggested that there were subtle brain organizational changes, but no overall changes to cognitive function. Essentially, concussed players could be using different parts of their brains to achieve the same results as non-concussed players when given the same memory task.


More to be learned

Terry says the next step is to find out what happens later in life. The teenager’s brain may continue to function normally after the injuries, but will there be some residual effect that’s not obvious until several decades later?

“Two concussions, when you’re 16, could be fine, but what happens when you’re 65, when you’re 70?” Terry asks. “We don’t know.”


A soft padded covering for football helmets, the Guardian Cap, is designed by an Alpharetta company run by Georgia Tech grad Lee Hanson and his wife, Erin.

More research is needed to determine whether multiple concussions in high school athletes whose football careers end with graduation elevates the risk for Alzheimer’s or other forms of dementia, says Terry. But for now, findings suggest that high school players seem to be able to rebound from typical concussions.

These encouraging findings, though preliminary, are good news for parents like Harris. She says she is willing to reconsider the sport as her son grows older.

Meanwhile, the NFL, college football and high schools in Georgia are taking action to prevent concussions and to treat the injuries properly.

The NFL commissioner has pushed for increased safety in football, as the league has toughened its protocols for players who have suffered concussions.

Last August, the NFL agreed to a $760 million settlement with more than 4,000 former players who had sued the league over head injuries.

The Atlanta Falcons and the NFL have supported a program, Heads Up Football, for youth leagues that teaches concussion awareness and proper helmet fitting, and proper techniques for tackling.

And a new Georgia law has established protocols for school athletes who have suffered concussions.


Alyssa Stafford is pursuing her master’s at the University of Georgia, studying health media and communication. She is a freelance writer and her work has appeared in GHN, Piedmont Healthcare and the Association of Health Care Journalists blog. 


‘Water lady’ on front lines in campaign against arsenic in Georgia wells

McMahan preaches the use of water filters to eliminate contaminants in household water from wells.

Janet McMahan preaches the use of water filters to eliminate contaminants in household water from wells.


Janet McMahan figured it out five years ago — just before her son Ben was diagnosed with cancer.

Starting in 2008, she had skin cancers erupting all over her body, including parts “where the sun don’t shine.” Her two dogs had also developed cancer.

McMahan had just given a talk about world hunger at an Irwin County church, and had read about Bangladesh. In that impoverished South Asian country, millions of people were being exposed to arsenic in their drinking water from wells.

She says she woke up in the middle of the night in October 2009, contemplating pieces of a puzzle. “God put it together,” she says.

She told her husband, Dr. Howard McMahan, an Ocilla family physician, “I know what is wrong with me.”

The water.

The McMahans got their water from a private well on their Ocilla property.

They had the water from their tap tested, and it came back with negligible levels of arsenic.

At about the same time, their son Ben, a Valdosta State University student who had been a three-sport athlete in high school, grew sick.

Ben McMahan

Ben McMahan

The family thought at first that Ben’s problem was food poisoning. But he was diagnosed that November with gastro-esophageal junction adenocarcinoma. He was 24.

“It had to be the water,’’ Janet McMahan says now.

Seeing a pattern, the McMahans stopped drinking their well water.

Since that horrible diagnosis five years ago, Janet McMahan has been a crusader on environmental health in South Georgia, and especially on contaminated well water. During that time, health officials in Georgia came to recognize the potential danger of arsenic in well water.

Officials of the state’s Department of Public Health sent alerts last year to elected officials in 10 counties in South Georgia, as well as to UGA Cooperative Extension agents, health care providers, veterinarian facilities and local libraries, urging people to test their well water regularly to ensure what they were drinking was safe. A news release on the issue was sent to local media.

Public Health repeated the warnings this year.

But McMahan says many people across South Georgia haven’t yet gotten the word that the water coming out of their taps should be tested to make sure it isn’t endangering their health.



The unseen contaminant


McMahan says arsenic and other elements in unfiltered water from wells have led to many cancers and other illnesses in the southern part of the state.

She also believes that in agricultural areas, some of the arsenic contained in poultry litter fertilizer has seeped into the water that people drink. The drought of 2008 concentrated the arsenic at an abnormally high level, she says.

The family’s arsenic situation became clearer in early 2010, she says, when a woman who helped with Dr. McMahan’s medical billing said her husband had been hospitalized with arsenic poisoning.

Water contamination issuesAn extension agent had tested that couple’s tap water and found a negligible level of arsenic. Then he tested a sample drawn from their water heater, which showed much higher amounts of arsenic.

So the McMahans tested water that came from their own water heater. That sample had high levels of arsenic, iron and manganese, Janet McMahan says.

The state Department of Public Health estimates that one in five Georgians regularly drinks water from private wells — a figure that might surprise people in developed urban areas.

“We have a lot of rural areas that don’t have access to municipal water,’’ says the Department of Public Health’s Chris Rustin.

Most people in Irwin County drink well water, says Dr. McMahan, a past president of the Georgia Academy of Family Physicians. “There is no safe level of arsenic exposure,” he adds.

At least partly due to Janet McMahan’s advocacy, many people in Irwin County and surrounding counties have begun testing their well water for arsenic and other contaminants.

“Janet started it all,’’ says Wanda McLemore, a longtime UGA extension service employee in Fitzgerald before her retirement this year. “She’s brought a lot of awareness to it.”

“Everybody knows Janet,’’ says Betty Metts, 39, who has survived an extremely rare form of breast cancer.

Together, Metts and McMahan take reporters around an area near the Alapaha River in Berrien County where, they say, many residents have had cancers. All are from households that use well water.


Well-known but poorly understood


Arsenic, classed as a heavy metal, is an element that occurs naturally in certain rocks, ores and soils. The amount varies by region.

Ingested in large quantities, arsenic causes severe gastrointestinal illness and death relatively quickly. From ancient times until fairly recently (when advances in science made it more detectable), it was the favorite poison of murderers. Members of the Borgia clan of Renaissance Italy were infamous for using arsenic to dispatch their political enemies.


The South Health District has 10 counties.

Today at least, the greatest danger from arsenic is not homicidal, but environmental.

When the element is present in drinking water, people can ingest small amounts over a long period of time without realizing it. Though the effect is not as swift or dramatic as what happened to the Borgias’ victims, serious health problems can develop.

Arsenic enters drinking water supplies from natural deposits in the ground or from agricultural and industrial practices, according to the EPA. It does not affect the taste of the water.

According to a fact sheet prepared by the National Institute of Environmental Health Sciences (NIEHS), arsenic is a known human carcinogen associated with skin, lung and bladder cancer, and it has also been connected with kidney and liver cancer. The fact sheet adds that ingesting arsenic can also predispose children to other health problems later in life.

The U.S. government has put limits on how much of this toxic element is allowable in drinking water. The maximum level of inorganic arsenic permitted is 10 parts per billion (ppb). But while public water systems are routinely tested for it, there are no regulations that mandate testing of water from private wells.

Approximately 7 percent of wells in the nation are thought to have arsenic levels above 10 ppb, NIEHS says.

No Georgia or federal regulations govern wells that have fewer than 15 connections (water meters) serving fewer than 25 people. Owners of these wells are under no obligation to check the water for harmful bacteria or minerals.

Given that situation, most people who rely on these private wells “don’t know what they’re drinking,” the head of the University of Georgia’s water-testing laboratory, Uttam Saha, told GHN earlier this year.

A basic water test picks up most common problems affecting private wells. But homeowners can ask for broader testing to detect bacterial contamination or heavy metals. “You should ask for arsenic tests in South Georgia,’’ Rustin of Public Health says.

The arsenic in South Georgia’s water is linked to the Gulf Trough, a natural deposit of sediment underneath the Floridan aquifer that runs from the Florida Panhandle through South Georgia. It slashes straight through the health district that includes Irwin County.

Aside from a few outliers, most water samples that tested higher than the federal limit for arsenic came to the University of Georgia’s testing lab from wells along the Gulf Trough.


Thomas County water study


In 2011, a Thomas County resident told state officials that arsenic concentrations in private drinking water wells in that area exceeded federal standards. The Department of Public Health followed up with a study.

“The resident described health problems and reported that neighbors have health complaints they think may be a result of arsenic exposure, including cancer, weight loss, difficulty swallowing, night blindness, fatigue, hair loss, stomach, kidney and bladder problems, and sick pets,” said a 2012 report written by Jane Perry, director of Public Health’s chemical hazards program.

Thomas County

Thomas County

The University of Georgia Cooperative Extension analyzed 36 private water samples from Thomas County for arsenic. Twenty-five tested positive, and 18 exceeded the maximum level of 10 ppb. The report noted that the rates for several types of cancer were elevated in Thomas County.

As McMahan and others note, arsenic is sometimes used in agriculture, where it can seep into the water supply. (Agriculture is the main business in much of South Georgia.) The EPA says high arsenic levels can come from certain fertilizers and animal feeding operations.

U.S. poultry farmers were allowed for years to feed their chickens an antibiotic called roxarsone, which contains arsenic. The drug was pulled from the U.S. market in 2011. American companies can still use a different arsenic-containing drug, nitarsone, to protect turkeys and other poultry from deadly infections.

Litter is a mixture that includes manure, feathers and other materials from where poultry are kept. Farmers often choose it as a cheap and effective fertilizer. But litter from chickens that have ingested arsenic-containing drugs can retain arsenic, a UGA Extension Service report says.

Wells that have been tested in agricultural areas more often contain trace elements such as arsenic than did those in urban areas, the U.S. Geological Survey reported in 2011.

And in Southern states, including Georgia, farmers would dip their cattle in large vats containing arsenic to ward off pests, up till the 1960s.

When arsenic seeps into the ground, it doesn’t break down or decay over time.

Buying more time


Ben McMahan’s cancer was very unusual, his father says.

“Nobody in their 20s has this,’’ says Dr. McMahan. “He was very healthy — never had a health problem,’’ he adds.

(A decade earlier, Dr. McMahan says, he had noticed some strange esophageal cancers among his patients.)

Ben received treatment at Memorial Sloan Kettering Cancer Center in New York, where surgeons removed most of his esophagus, the top third of his stomach, and lymph nodes in his chest.

“He had a tremendous response,” and his health improved, Dr. McMahan says. The next year, Ben had 10 inches of his colon removed at Sloan Kettering.

Then, in 2012, Ben had a recurrence. He took chemo again. He had surgery on his colon, again at Sloan Kettering.

“They couldn’t find the tumor anywhere,’’ Janet McMahan says.

Again, Ben recovered.


Spreading the word


Public Health officials and extension agents in Georgia have sent out advisories about arsenic and well water since 2011. David Kissel, head of the Agricultural and Environmental Services Laboratories at UGA, sent county extension agents an email about high levels of arsenic (and uranium) in some well water samples. The arsenic samples “were widely distributed geographically in Camden, Irwin, Tift, Bibb and Lowndes counties,” he said in the email.

“It is not our intent to alarm the public,’’ Kissel said, but his message urged agents to “encourage more testing of private wells used for drinking water.”

When Ben McMahan was battling cancer in 2012, Perry of Public Health sent his mother an email that said, in part: “The drought concentrates the levels of arsenic in groundwater.

The two McMahan dogs that developed cancer.

The two McMahan dogs that developed cancer.

“The levels of arsenic are high enough to increase the risk of cancer in south Georgia and we are seeing statistically significant rates of some arsenic associated cancer types in some counties; e.g., lung. . . . But as you know, it is very difficult to prove a cancer cluster, and even harder [to prove] that it might be caused by this or any other environmental exposure. Arsenic is the most complex chemical, in that it causes several different cancers. Most chemicals are organ system specific. However, I am impatient to get the word out too so that people reduce, eliminate exposure, and that those who haven’t tested, do so.”

The agency last year sent out an advisory for people in 10 South Georgia counties to test their well water for arsenic. It sent out another advisory this year.

But Rustin of Public Health, in an email to Georgia Health News on Friday, said that at this time, his agency cannot attribute cancer cases in Georgia to arsenic exposure. “It is important to note while the study indicates elevated incidence of some forms of cancer, they are not cancers typically associated with arsenic exposure.’’

Yet the Thomas County study found elevated levels of lung cancer for males from 2005 to 2009. That’s a type of cancer associated with arsenic.

Arsenic is not easily absorbed by the skin, and does not “stick” easily to hard surfaces (such as dishes) or clothing, so cleaning, laundering, brushing teeth, and bathing are not considered routes of exposure, Rustin added.


Smoking gun is elusive


High cancer rates have been found in the 10-county district that includes Irwin County. The rate of bladder cancer, which can be associated with arsenic, is slightly higher than the state average in four of the 10 counties: Lowndes, Ben Hill, Tift and Turner, according to the National Cancer Institute.

For Georgia as a whole, 18.6 people per 100,000 will be diagnosed with bladder cancer each year.

In the four counties mentioned above, annual incidence rates ranged from 20.4 to 20.8. In the other six counties of the district, the likelihood of being diagnosed was either negligible or no different from the rest of the state.

Irwin County

Irwin County

People living in the 10-county area are also more likely to be diagnosed with lung cancer, another tumor associated with arsenic. Each year, 81.6 new cases of lung cancer will be diagnosed for every 100,000 people, which is significantly higher than the state average of 71 new cases per 100,000.

There’s a competing explanation for this, however: South Georgia generally has higher rates of smoking than other areas of the state, and smoking is the top cause of lung cancer.

Yet an Irwin County nurse who worked with an area hospice says she recalls four people who did not smoke but had lung cancer. “All of them were on well water,’’ says Crystal Brown of Irwinville, who gets water from a well herself. “I have children, and it definitely concerns me.”

The incidence of skin cancers, another common malignancy associated with arsenic, is statistically insignificant throughout most of the counties in the district, according to the National Cancer Institute.

Carcinogens can be identified in an area’s water, but it is very difficult, if not impossible, to determine whether a specific case of cancer is directly attributable to a water source.

Cancer clusters are also notoriously difficult to identify. In a true cluster, according to the CDC, a greater-than-expected number of cancer cases must hit within a specific period of time. Each case must either be the same type, or derived from the same cause.

One problem with establishing direct causation is that cancer is all too common. As the CDC points out, it is the second-leading cause of death in the United States. Nationwide, one out of four deaths are due to some type of cancer.

Since 1990, state and local health agencies around the nation receive about 1,000 inquiries each year from people wondering if deaths in a particular locality constitute a cancer cluster. Very few of these reports qualified as true clusters.

Still, McLemore, the longtime UGA extension service employee in Fitzgerald, says the area surrounding Irwin County has “an awful lot of cancers.”

“Clean and safe drinking water is essential to a healthy environment,’’ says Stephanie Stuckey Benfield, executive director of GreenLaw, nonprofit law firm that works to reduce pollution. “Many Georgians depend on private wells as their primary source for drinking water. Arsenic in well waters can be a health concern, as long-term exposure above the EPA limit increases the risk of some types of cancer.”


Water heater debate


Janet McMahan’s emphasis on water heater samples has raised skepticism among some water experts.

“You’re supposed to drink cool water and cook with cool water,” says Jake Mowrer of the Agricultural and Environmental Services Lab of UGA. “You don’t drink from the hot water heater.”

Sediment from the house’s water pipes builds up inside the tank over time – and since it’s not cleaned out regularly, trace amounts of minerals can accumulate into thick piles, he says.

“Given that drinking hot water heater water is not recommended and that no person would be expected to quaff back a huge Mason jar of orange water, common sense tells me that this water is not representative of what the well owners are actually drinking,” Mowrer adds.

The lab uses a special filtering process for water heater samples, he says.

McMahan argues that arsenic builds up in a water heater like it builds up in a human body.

She takes reporters to a rural area in Ben Hill County where four children were diagnosed with cancer within nine months back in 2008. Each was within a 6-mile radius of the others, and all drank well water, McMahan says. She believes that a severe drought during that period elevated arsenic levels in the water. Two of the children had acute lymphoblastic leukemia, while the other two had different forms of cancer, she says. All four are alive today.

Gage Kicklighter is one of the four. Nicole Kicklighter thinks her son’s cancer was caused at least partly by well water he drank. She admiringly calls Janet McMahan “the water lady.”

A survey conducted by UGA researchers found that Georgia had about 648,000 private wells in 2012. The Soil, Plant and Water Testing Lab receives samples from about 23,000 of those wells every year, or roughly 3.5 percent.

High levels of uranium — a naturally occurring element found at low concentrations in virtually all rock, soil, and water — were recently detected in Monroe County well water. This is a public health concern because drinking water with elevated uranium increases the risk for kidney malfunction.

(Thanks to a federal loan of close to $2 million, Monroe County will finally be able to provide water to the area where many home wells are polluted by uranium, the Macon Telegraph reported Saturday.)

At UGA's Soil, Plant and Water Lab (SPW),  tests determine how much coliform bacteria are in each sample. Each cell in this tray contains E. coli, the most dangerous type of coliform.

Well water can also contain dangerous bacteria. At UGA’s Soil, Plant and Water Lab (SPW), each cell in this tray contains E. coli, the most dangerous type of coliform bacteria.


Public Health officials urge Georgians to test their well water once a year for bacterial contaminants, and every three years for minerals such as arsenic.

Water tests are fairly cheap – $15 for the basic test, $30 for the bacteria test – and highly accurate.

McMahan preaches the use of water filters to eliminate contaminants in household water. She buys such filters “for little old ladies and for kids.”


Grief redoubles resolve

Since Ben’s illness began, Janet McMahan has been an evangelist for water testing.

She has a Facebook group that has topped out at 5,000 friends. “About 1,000 are moms of kids with cancer; about 1,000 have cancer; and about 1,000 have a family member with cancer.”

Janet McMahan with a photo of her son Ben.

Janet McMahan with a photo of her son Ben.


Ben McMahan’s cancer came back again in January 2013. This time it was inoperable. And by that point, his body couldn’t tolerate more chemo.

A third recovery was not possible. But though doctors gave him two to six months to live, Ben lived for 14 more months. He died in April at age 28.

His death has spurred Janet McMahan onward. She is a one-woman clearinghouse for people with possible water contamination or other environmental health problems in Georgia.

She has met Erin Brockovich, whose crusade against contaminated water in California was the basis for a hit movie.

On the importance of testing water and using filters, McMahan says, “I hammer, hammer, hammer it.”

“I have this bulldog tenacity,’’ she adds. “When I take on something like this, I can’t let it go.

“This is how I keep Ben’s story alive.”


Lee Adcock is a master’s degree health and medical journalism student at the University of Georgia. She is also a music critic for various media outlets.


Lee Adcock is a first-year health and medical journalism student at the University of Georgia. She is also a music critic for various media outlets.

– See more at:

Lee Adcock is a first-year health and medical journalism student at the University of Georgia. She is also a music critic for various media outlets. – See more at:
Lee Adcock is a first-year health and medical journalism student at the University of Georgia. She is also a music critic for various media outlets. – See more at:


Challenge against ALS catches on in Georgia’s health community

Georgia Regents University President Ricardo Azziz gets an ice water bath to support ALS research.

GRU President Ricardo Azziz gets an ice water bath to support ALS research.

Amyotrophic lateral sclerosis hasn’t had this much attention since baseball legend Lou Gehrig died of the disease in 1941.

The Ice Bucket Challenge to raise money to fight ALS has dominated social media since July. Videos of the frigid baths have popped up everywhere.

The challenge also has raised a whopping $88.5 million in donations nationally as of Tuesday — compared to $2.6 million during the same time period last year.

ALS, also known as Lou Gehrig’s Disease, is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. There is no cure.

People with ALS lose the ability to initiate and control muscle movement, which often leads to paralysis and death within two to five years of diagnosis.

Up to 30,000 Americans have the disease, and an estimated 600 Georgians, including former Murray County High School football coach Bill Napier. (Here’s an article from the Dalton Daily Citizen on Napier’s condition.)

It’s clear the challenge has raised awareness of ALS, especially among young adults, said Sarah Embro of the ALS Association of Georgia.

YouTube Preview Image

The general rules are that whenever a person accepts the challenge – and pours a bucket of ice water over his or her head – the person also agrees to donate at least $10 to ALS research. If the person doesn’t accept the challenge, he or she has to donate at least $100 for research.

In Georgia, ice water has showered plenty of participants, including Atlanta Falcons quarterback Matt Ryan and coach Mike Smith.

Fifty students at the Mercer University School of Medicine in Macon recently took the plunge, then challenged Georgia’s other med schools to join in the effort.


Funding surge comes at welcome time


Embro of the ALS Association’s Georgia chapter said Tuesday that donations will go to research, patient referral services and advocacy.

Embro added that Emory University and Georgia Regents University are conducting research into treatment and a potential cure.

YouTube Preview Image

The Augusta Chronicle reported that GRU President Ricardo Azziz got doused Friday, then issued his own challenge to Augusta Mayor-elect Hardie Davis, among others, to get iced down within 24 hours or donate to the ALS clinic at Georgia Regents Medical Center or both, as Azziz did.

The donations couldn’t come at a better time. The Washington Post recently noted that the National Institutes of Health expects to spend $40 million on ALS research this year, which is down from $59 million in the 2010 fiscal year.

“Every day, given this dramatic increase in funding [thanks to the challenge effort], the scope of what’s possible when it comes to fighting this disease has changed and continues to change,” Barbara Newhouse, president and CEO of the ALS Association, said in a statement.

YouTube Preview Image

“Under the leadership of our Board of Trustees, we are putting a decision-making process in place to address how this money will be spent. This isn’t a matter of spending these dollars quickly — it’s a matter of investing these dollars prudently to achieve maximum impact in our quest to help people living with the disease and those yet to be diagnosed.”

The Atlanta Walk to Defeat ALS is Saturday, Sept. 13, at the Georgia World Congress Center plaza downtown.

At the Georgia campus of the Philadelphia College of Osteopathic Medicine, Chief Campus Officer Bryan Ginn (left) and DO Council president Bryant Giles accept the challenge.

At the Georgia campus of the Philadelphia College of Osteopathic Medicine, Chief Campus Officer Bryan Ginn (left) and DO Council President Bryant Giles accept the challenge.


A chance at life: Specialty tags help fight breast cancer

By purchasing a special license plate, Georgians can help low-income women obtain breast cancer services and treatment.

For each breast cancer awareness tag purchased or renewed, a Georgia program contributes $22 into a fund that pays for cancer screenings, education and treatment for thousands of uninsured women.

taggerThe Georgia Center for Oncology Research and Education (Georgia CORE) administers the grants to community organizations.

“We’re trying to get the message out: If you buy the tag, you’re helping indigent women in Georgia,’’ said Angie Patterson, Georgia CORE vice president, who is herself a breast cancer survivor.

An estimated 1,200 Georgia women die from breast cancer each year. About 7,000 women in Georgia are expected to be diagnosed with breast cancer this year.

The breast cancer tag program began in 2003. Last year, $1.1 million in grants went to 16 organizations and helped perform 3,289 screenings/mammograms, 2,131 clinical breast exams, 385 ultrasounds, 128 biopsies, and education and training for 15,231 medical providers in more than 60 counties in Georgia.

Six other states have breast cancer license tag programs, Patterson said.


Cutting down the waiting lists


CORE recently announced that Central Georgia Cancer Coalition and Meadows Regional Medical Center in Vidalia won grants of about $100,000 each for treatment programs.

Additional winners were Athens Regional Foundation, Center for Black Women’s Wellness, Center for Pan Asian Community Services, East Georgia Cancer Coalition, Gwinnett Medical Center, Hearts & Hands Clinic, Northside Hospital Cancer Institute, and Susan G. Komen’s Atlanta affiliate. Each won grants of about $50,000 for education programs.

“We congratulate the winners and look forward to seeing the impact of all the work that will come out of their awards, particularly in providing services to those Georgians that need it most,” said Georgia CORE President Nancy Paris.

Patterson added that $48,000 went to the Georgia Department of Public Health for its breast and cervical cancer prevention program.

“This is incredibly good news since many of these women are on waiting lists for mammograms, and the state has not been able to increase funding’’ for that program, she said.

Starting this year, supplemental funds from the license tag program have gone to administer genetic testing for those considered at risk of breast or cervical cancer. Twenty women have been tested thus far with these funds.

To find out how to purchase a breast cancer awareness license tag, please visit the Georgia Department of Revenue website or visit your local county tag office.


Weather disasters and medical facilities: Why readiness is vital

Upturned car in front of Sumter Regional in 2007

Some of the damage from the 2007 tornado that hit Sumter Regional Hospital.

In the event of a natural disaster, resilience is a hospital’s prescription for success.

It’s all about bouncing back, recovering and then moving forward after a violent weather event. The proper response requires developing plans, then practice, practice, practice — and then putting those measures to work when the moment calls for action.

Whether our hospitals and medical facilities are safe and ready to help communities during and after weather events is a vital topic. Some areas are more prone to disasters than others, but it takes only one serious event to ravage a normally safe area.

Hurricanes, tornadoes and floods can cause casualties on a large scale, increasing the need for hospital readiness. But some disasters in recent years, such as Hurricane Katrina in 2005 and “Superstorm Sandy” in 2012, have inflicted damage on hospitals themselves.

Members of the American Meteorological Society (AMS) have recently added their concerns about hospital resilience in the aftermath of “high-impact” weather events throughout the country.

AMS suggestions include having medical centers look at their structural designs and, in some cases, relocate critical components to higher ground. When Katrina left large stretches of low-lying New Orleans submerged for weeks, it demonstrated the importance of having facilities that remain functional and accessible.

Health care’s critical problem in disasters is supply and demand. High-impact weather events create a pragmatic paradox, according to the AMS report. Supply decreases when health infrastructure is damaged, but the demand increases as the number of victims adds up.

Charity Hospital in New Orleans suffered severe flood damage during Hurricane Katrina.

Charity Hospital in New Orleans suffered severe flood damage during Hurricane Katrina.

What the American public needs to know is that “each hospital has the job of seeing how well they are prepared,” said Jim Blair, president of the Center for HealthCare Emergency Readiness, a consulting firm. “It’s a journey, not a destination.”

Blair questions whether hospitals are really ready to handle disasters when it’s been many years since their communities were struck. Institutional memories can fade, and a hospital’s vulnerabilities can become less obvious.

He refers to location intelligence when he’s working with health care clients. “Is there a dam nearby, or is the hospital close to an earthquake fault line?” asks Blair. “Where are the air conditioning, heating and ventilation power systems located?”

What about cesium-137, the most common radioactive material used in radiation therapy? Is it protected?

Sandy hit huge metropolitan areas of the Northeast in late October, leaving many communities in tatters and more vulnerable to the approaching cold weather. The storm did considerable damage to New York hospitals and other health care organizations.

Five acute-care hospitals in New York City alone were closed because of electrical and mechanical system failures, flooding and other storm-related issues. The closures were temporary, but all patients had to be evacuated.

Weeks after Sandy, four hospitals in the nation’s largest city remained closed for inpatients, leaving thousands of patients scrambling to find other medical centers.

Katrina was far worse for hospitals. According to a FEMA report, New Orleans hospitals suffered major interior damage such as collapsed ceilings, and emergency power generators became nonfunctional and shut down HVAC systems used to control temperature and humidity.

The bodies of 45 patients were found at Memorial Medical Center in New Orleans after the 2005 storm. Overall, more than 200 bodies ‘’were recovered from New Orleans hospitals and nursing homes as a result of the hurricane.

Blair says hospitals and health care facilities, in the midst of a disaster, must make the right decisions about sheltering in place or evacuating patients and staff.


It can happen here


History shows that Georgia hospitals are not immune to violent weather.

A communications tower dangles from the Grady Memorial Hospital roof after a tornado hit Downtown Atlanta.

A communications tower dangles from the Grady Memorial Hospital roof after a tornado hit Downtown Atlanta.


In March 2008, Grady Memorial Hospital, downtown Atlanta’s largest and most famous hospital, was damaged by a tornado that hit the heart of the city. According to claims reports, 15 buildings suffered significant damage, including the radiation/oncology center, Georgia Hall, Florida Hall, and the Hughes Spalding Medical Center of Children’s Healthcare of Atlanta.

Other health facilities have also met weather damage head on.

Seven years ago, severe thunderstorms moved across central Georgia, producing tornadoes that resulted in significant damage in several counties. Some of the heaviest destruction occurred at Sumter Regional Hospital in Americus.

That particular tornado’s path measured about 38 miles in length, with a maximum width of 1 mile, as it ripped through Americus. The hospital was evacuated after the tornado hit.

Fifty-five to 60 patients were in the building when it was hit. Three of them were in critical condition. All the patients were transferred to other hospitals.

Sumter Regional suffered major damage and later was demolished to make way for a new facility.

Dr. Thomas Frieden, the CDC director, recently reminded a Rockefeller Foundation audience that the first lesson is to build resilient systems that can be “scaled up” quickly.

In other words, know which systems are already in place that can be expanded on short notice to serve more people in a hurry.

“During the 2014 winter storms in Augusta, we lost power to several area nursing homes,” said Adrianne Feinberg, director of emergency preparedness at Georgia Hospital Association.

“A concerted effort among health care partners and emergency management agencies resulted in generators and other resources being allocated to the affected facilities,” Feinberg said. “Now we are working with a new federal program to help supply generators in the future — ensuring nursing home residents always have heat.”

Medical offices of all varieties and sizes are vulnerable to weather-related problems.

The same ice storm that brought Augusta to a halt also paralyzed Atlanta. There, in vitro fertilization (IVF) specialist Dr. Mark Perloe faced a time-critical challenge. “Retrieving eggs and caring for fertilized embryos are my first priority, no matter what the weather is doing in Atlanta,” he said.

All scheduled egg retrievals must occur as planned. IVF timing is critical for life. Because he and his staff planned ahead for access to the clinic (with some staff and patients staying in hotels close by), their backup system worked.

“You can close schools, banks and post offices, but when eggs are ready for their debut, we cannot let a little ice storm get in the way,” said Perloe.

Now that’s resilience.


Judi Kanne, a registered nurse and freelance writer, combines her nursing and journalism backgrounds to write about public health. She lives in Atlanta.


  • Sign up for our mailing list.