Last spring, Therapeutic Massage was added to the services available at CPC Evans. According to Dr. Clark, therapeutic massage works by stretching muscles and connective tissues while improving blood flow throughout the body. Massage allows more oxygen and vital nutrients to reach cells and tissues and also stimulates the nervous system and circulation, which relaxes muscles and decreases inflammation.

From Our Family To Yours

Antibiotics Can Do More Harm Than Good

Since the 1940s, antibiotics have played a major role in our ability to fight infection, but in recent years, overuse of antibiotic therapy has put us at risk of losing this edge in the war on bacteria. Here are some important facts about antibiotics you should know:

Antibiotics are effective only against bacterial infections. This means that they are completely useless against infections caused by viruses, such as colds and influenza. With viral infections, antibiotics should be used only if a secondary bacterial infection, such as sinusitis, occurs in conjunction with the viral illness. If you are among those who believe taking an antibiotic just in case is a good plan, keep reading.

Overuse, misuse, and underuse of antibiotics can result in bacterial resistance. When bacteria develop resistance to antibiotics, powerful drugs can become ineffective in treating life-threatening diseases, such as pneumonia and tuberculosis, with possibly devastating results. Resistant bacteria create an environment ripe for epidemics like those occurring before we had antibiotics.

Misuse of these valuable drugs has created a dangerous trend: almost all major infectious diseases are becoming resistant to existing medicines. There are numerous factors contributing to this problem. In some countries, antibiotics are available without a prescription, resulting in frequent and otherwise inappropriate use. In the United States, patients often request antibiotics for illnesses that cannot benefit from antibiotic therapy. Further, one third of antibiotic prescriptions are unnecessary; for instance, taken to treat illnesses that would resolve on their own without medication (self-limiting). Other patients, instead of finishing their prescriptions, take antibiotics only until they feel better, saving the leftovers for next time. Without realizing the danger, these patients are helping bacteria adapt and become resistant to typically effective therapies.

The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), along with other health and medical organizations, have identified antibiotic resistance as a pressing global concern and are developing initiatives to address this problem. We can join in the fight against bacterial resistance by using antibiotics wisely. The CDC recommends the following:

Discuss antibiotic use with your doctor: ask if an antibiotic is likely to help your illness and what else you can do to get well sooner.

Do not take an antibiotic for viral infections like colds and flu.

Use antibiotics as instructed by your physician: take all of your prescription and do not save any for the next time you get sick.

Never take an antibiotic that was prescribed for someone else.

To avoid the spread of bacterial infections, and thus, reduce the need for antibiotics, also take these protective measures:

Wash hands often and properly.

Use soaps and other products with antibacterial properties when working with or caring for people who are sick or have weak defenses.

Wash fruits and vegetables thoroughly, and avoid raw eggs and undercooked meat, especially ground meats. Most food-related diseases originate from raw or undercooked foods and animal products, such as meat, milk, eggs, cheese, fish and shellfish.

Source: Alliance for the Prudent Use of Antibiotics (APUA), Consumer Information, 1999 (website); LIBRA: Appropriate Use of Antibiotics and Protecting Health and Life, Bayer AG, 2001 (website); CDC, Promoting Appropriate Antibiotic Use in the Community, 2001 (website).

CPC Physician Profile: Dr. Rich W. Livingston, Jr. of CPC Evans

Between Richard Livingstons high school graduation in 1981 and joining the Center for Primary Care in August 2001, there hasnt been a dull moment. After nearly two decades of service to his country and pursuit of his education and training in medicine, he is now channeling his energy toward putting down roots in Augusta.

Straight out of high school, Richard said goodbye to Rockford, Ill., and his family parents Richard Sr. and Margaret, and siblings Theresia, Lori, and Robert to join the U.S. Army. After basic training at Fort Dix in New Jersey, he moved to Fort Eustis in Virginia for 6 months training in the repair of helicopter armament systems, and then on to Germany, where he lived and worked for 4 1/2 years.

One of the reasons he joined the Army was with hopes of spending some time overseas near his German grandmother. He wasnt disappointed. I loved being in Germany, he recalls. It gave me a chance to visit some of my relatives and connect with my roots.

His next assignment was an 18-month stint at Fort Hood, Texas. As he neared the end of his commitment to the Army, he briefly considered a military career but always knew that whatever he decided to do with his life, he would continue his education.

Richards first steps as a civilian were to move to Augusta, where he once had temporary duty, and enroll in Augusta State University. While stationed here, he made friends in the Garden City and learned to appreciate Augustas educational opportunities and temperate weather. In 1990, at age 27, Richard graduated from ASU, and was accepted to medical school at the Medical College of Georgia.

Thats when the Army came back into Richards life. When I finished college, the Army called and asked, Do you want us to pay for your medical school education? he recalls. The deal they offered was to pay for all tuition and books in exchange for one year of active duty for each year of medical school. It was too good to refuse.

Dr. Livingston did not decide until his third year of medical school what he wanted to specialize in. During his family practice rotation, he found his focus. I realized how important the family dynamic is in a persons health, he says. I wanted to be able to care for the whole family.

Dr. Livingston graduated from MCG in 1994 and began repaying his debt to the Army, choosing to do his residency at Fort Benning, Ga. After 3 years there, he moved to Fort Polk, La., which he describes as nowhere, to work at the Armys Joint Readiness Training Center. Troops destined for foreign military operations in countries such as Bosnia and Serbia trained there in simulations of conditions they might encounter overseas. As part of their training, “They had to set up entire combat supply hospitals, he explains. Dr. Livingston served as acting chief at the training center for 8 months.

While his work there was challenging and enjoyable, leisure time was another story. If you liked to hunt and fish, it was a sportsmans paradise, but otherwise, there was nothing to do, he says. Everything was far away and the humidity, heat, lightning storms, and mosquitoes only made things worse.

When Dr. Livingston completed his military service in July of last year, he joined the Center for Primary Care in Evans. Since then, building his new practice has been his highest priority, but he also makes time to renovate the house off Wrightsboro Road he purchased during medical school. He does some of the work himself painting, sheetrock, and wiring, for example but involves professionals for bigger projects, like his new kitchen.

Much of his time away from work is given to a long-time hobby restoring aging autos. A self-described Car Man, Dr. Livingston has seldom met an old car he didnt love. He rescues mostly GM cars in varying states of disrepair and restores them mechanically and cosmetically. At present, he is the proud owner of a fully restored candy-apple red convertible 69 Chevelle SS, and a couple more that are patiently awaiting his magic touch: a 67 yellow hardtop Chevelle, and a 66 Impala convertible. He also owns a 99 Grand Prix, and of course, the truck he drives to work.

Professionally, CPC and Dr. Livingston are a good match. CPC is benefiting from his unique experience and perspective, and Dr. Livingston is happily settling into his new home at CPC and in the Garden City: building his practice, caring for his new patients, and getting involved in the community.


Therapeutic Massage Promotes Muscle Relaxation, Relieves Pain


Oh, my aching back . . . or shoulders . . .or head. As you mutter those words to yourself, you might be imagining a deep massage and the fabulous sensation of feeling the pain and tension drain from your body. Wouldnt it be better if you could actually experience it instead of just daydreaming about it?

According to Dr. Robert Clark of the Center for Primary Care in Evans, people have used massage as a relaxation technique and a method to combat chronic pain for centuries. Additionally, it has been used to help certain types of injuries heal faster and to relieve muscle soreness and stiffness after rigorous or strenuous activity. Massage is also effective in treating secondary pain symptoms, such as headaches, low back strain, or discomfort in otherwise healthy muscle that can result from protecting an injury to another area of the body. Understanding the healing power of massage, Dr. Clark thought it would be an excellent service for CPC to offer.

Last spring, Therapeutic Massage was added to the services available at CPC Evans. According to Dr. Clark, therapeutic massage works by stretching muscles and connective tissues while improving blood flow throughout the body. Massage allows more oxygen and vital nutrients to reach cells and tissues and also stimulates the nervous system and circulation, which relaxes muscles and decreases inflammation.

Certain techniques of massage can reduce the formation of scar tissue with new injuries, make old scarring more pliable, or even reduce existing scarring. Massage of joint tissue increases circulation to the area and stimulates the secretion of natural lubricants, which is often effective in relieving joint pain. Whether you are a world-class athlete, a dedicated couch potato, or somewhere in between, Dr. Clark says you may benefit from therapeutic massage therapy.

Therapeutic massage is being provided at CPC Evans by Leigh Ann Keels, a licensed massage therapist (LMT) and graduate of the South Carolina Massage Therapy School in Columbia. Ms. Keels is state and nationally certified and has additional training in pain management, myofascial release, and neuromuscular therapy. She also owns and operates the Augusta School of Massage, Inc., and provides physical and occupational therapy services at Health Success.


Ms. Keels is available for appointments at the CPC Evans office 1-5 p.m. Wednesdays and Fridays for half-hour massages ($35)* and 1-hour massages ($60).* Appointments can be made by calling 650-7563. Gift certificates may be purchased at any of the three CPC offices: Evans, Central, and South.


*Insurance usually does not cover the cost of therapeutic massage.

For Me??

Dont forget your sweetheart this Valentines Day!

Send your love with a gift certificate from the


Center For Primary Care

Therapeutic Massage


Massage provided at CPC Evans. Call 650-7563 for details & prices


Microdermabrasion & Laser Hair Removal


Both provided at CPC Central. Call 868-7380 for details & prices

Gift certificates available at any CPC office: Evans, Central or South

Untreated Type 2 Diabetes Associated with Serious Health Risks

About 90 percent of the estimated 13 to 14 million people in the United States with diabetes have non-insulin-dependent or type 2 diabetes. With this type, the pancreas produces enough insulin to convert blood sugar (glucose) into energy, but the cells of the body are resistant to its effects. The result is a dangerously high level of glucose circulating in the bloodstream.

Untreated or under treated type 2 diabetes can be deadly. In the United States, it is the fourth leading cause of death. Each year, an estimated 178,000 people die from type 2 diabetes and its complications, which can include blindness, kidney disease, heart disease, stroke, amputations, and impotence, all stemming from diabetes-related nerve and circulatory damage.

Despite how dangerous this disease can be, some people do not realize they have it. This is because a person can have high glucose levels for many years without experiencing any warning signs. If symptoms occur, they may include increased thirst and appetite, frequent urination, weight loss, blurry vision, fatigue, increased infections, impotence, absence of menstrual periods in women, and tingling or numbness in the hands or feet.

Type 2 diabetes most commonly affects adults, which is why it is often called adult-onset diabetes, but a growing number of children now have it as well. A sedentary lifestyle and obesity are two major contributors in the development of type 2 diabetes at any age. In fact, the incidence of type 2 diabetes has tripled in the past 30 years, directly paralleling the dramatic rise in obesity over the same period. A family history of type 2 diabetes is another strong risk factor.

Early, aggressive treatment with medication and lifestyle modification can lessen or prevent the potential complications. You and your family physician can work together to develop an appropriate diet and exercise regimen that will help you lose weight. Not only will weight loss decrease the likelihood of complications, it may also reduce your need for medication and insulin injections.

Control of type 2 diabetes also depends on regular and frequent monitoring of glucose levels to track how well your treatment plan is controlling your blood glucose. The only type of glucose monitoring device currently available for home use involves a finger-prick, but technology for accurate non-invasive testing is being developed. The safety and effectiveness of these alternatives are being evaluated.

Regular visits to your family physician are also important in controlling diabetes. Your doctor will check your blood and run a laboratory test to determine how well your blood glucose has been controlled over the past several months. Along with home monitoring, these blood tests help your physician develop the most effective approach to treating your diabetes.

There are several different classes of oral medications to treat type 2 diabetes that improve the bodys ability to use insulin. These medications act on the body in various ways, such as lowering cells resistance to insulin, stimulating the production of insulin by the pancreas, and slowing the bodys digestion of carbohydrates, which delays intestinal absorption of glucose. Insulin is another important tool in the management of type 2 diabetes. It is available in several different formulations, including short-acting, long-acting, and a more recently developed 24-hour form.

Diabetes medications often have side effects and some are not recommended for patients with other medical conditions. However, along with insulin injections, these drugs are often an important part of treating patients for whom diet and exercise do not effectively control glucose levels.

Hypoglycemia, or low blood sugar, is one of the problems associated with type 2 diabetes. Typically caused by an insulin reaction, hypoglycemia causes shakiness, dizziness, sweating, hunger, headache, pallor, sudden mood or behavior changes, clumsy or jerky movements, confusion, and tingling around the mouth, and possible unconsciousness. Hypoglycemia can be treated quickly and appropriately with glucose tablets or fruit juice, which raises the glucose level. A person who loses consciousness because of hypoglycemia, however, requires immediate medical assistance. If you are diabetic, make sure your friends and family know what to do in case of emergency.

There is no other disease in which a person has so much control over the outcome as with type 2 diabetes. What you do at home every day affects your blood glucose more than what your doctor can do every few months during your checkups. If you have type 2 diabetes, follow these guidelines to stay healthy:

Keep your appointments with and have laboratory tests completed as ordered by your CPC physician.

Follow your doctors diet and exercise recommendations.

Take prescribed medications as directed.

Monitor your blood glucose and blood pressure at home.

You can find out more information about type 2 diabetes from your CPC physician and from the American Diabetes Association at

Source: American Diabetes Association, Type 2 Diabetes (website); Get Moving on Diabetes, Health Smart, USA Weekend, page 4, Nov 2-4, 2001; and web pages featured on WebMDHealth website, Diseases and Conditions, Diabetes (2001): Medical Library Illustrated Guides, Type 2 Diabetes; Diabetes Demands a Triad of Treatts, FDA Consumer Magazine, Food and Drug Administration, May-June 1997; Understanding Diabetes: Your Guide to Diabetes, The Cleveland Clinic.