Dear Medical College of Georgia Friends,

Taking on the challenges of booming baby boomers

We’ve talked about our aging population of baby boomers, and the unique and increasing health care challenges they do and will present. The US Census Bureau tells us that by 2030 all baby boomers — an estimated 73 million people — will be at least 65. One of the already common and increasing health care problems they face is osteoporosis, a potentially disabling weakness of our bones that has risk factors like a family history; being a slender, smaller boned individual; being a white female or male or an Asian female; low estrogen or testosterone, which is generally related to aging; a poor diet growing up and/or excessive dieting. You get the idea: Many of us are at risk for what is already a major public health problem. Some of the medications we take, like glucocorticoids for problems like asthma, can weaken our bones. Even bisphosphonates, widely prescribed to help protect our bones from osteoporosis by seeking to restore a healthier balance of the constant work of bone production and removal, are linked to albeit rare, isolated bone strength problems that include atypical fractures in the strong femoral bone (thighbone) at the top of our leg, and osteonecrosis, or death of bone tissue, in the jaw, which is even more rare.

Bisphosphonates are largely good, inexpensive therapies for osteoporosis

Dr. Laura Carbone, our chief of the Division of Rheumatology who treats and studies bone disease, tells us that many patients worry about these rare risks, particularly the loss of bone in the jaw, and will stop taking their medication as a result. These so called “drug holidays” can be a good thing. In fact, the Food and Drug Administration and other groups recommend that after 3-5 years of taking the oral medication or three years of the intravenous version, the timeframe when these drugs are considered most effective, a patient’s fracture risk should be regularly reassessed to see if a holiday is a good idea for them. Dr. Carbone wants to make sure that all patients and doctors have the facts they need to make the best decision at these junctures, because there also are reports of fractures occurring soon after the therapy stops and the unhealthy balance of bone production and loss resumes. Faced with the reality of what patients are saying and doing, our expanding older population and the unlikely availability of cost-effective treatment alternatives any time soon, she is leading a national initiative to develop what she calls a CLUB, or calculator for length of use of bisphosphonates. In keeping with the great trend toward more personalized or precision medicine, Dr. Carbone wants this CLUB to help better determine the benefits and risks to an individual both in continuing to take their medication and in taking a holiday. Please note that how long you use the drug is a risk factor for the atypical hip fractures. That association is less clear in the loss of bone in the jaw. She also wants to know how long the holiday should be if it’s a good idea. 

Dr. Laura Carbone has been awarded a $5.7 million NIH grant to help us use bisphosphonates more optimally

I am pleased to share that Dr. Carbone has been awarded a $5.7 million grant from the National Institutes of Health to objectively assess the risks and benefits of continuing bisphosphonate therapy versus a holiday by examining several large diverse, datasets of females and males from Kaiser Permanente, HealthPartners and the Veterans Health Administration. Dr. Carbone will involve other leaders in the field of bone health, including other physician scientists as well as consumers to finalize CLUB once the facts are identified. In keeping with finding the facts, the work will include comparing CLUB’s ability to predict fracture rates with actual fracture rates in people. As she rightly states, osteoporosis can literally rob us of our independence, so let’s get the facts and take the best steps we can to keep our bones strong. Congratulations and thank you Dr. Carbone. More great news right here probably next time about some of your MCG colleagues who are working to find those needed new therapies that will keep our bones and the muscle that supports our bones strong as we age. Stay tuned.

Members of our Class of 2026 hit the road Monday to visit our educational partners across Georgia

While this is not technically a “holiday,” I am pleased to also share today that our students will be on the road again Monday. You all know that as Georgia’s only public medical school, Georgia is our Campus. That means we have regional campuses strategically located across our state — Southeast Campus based in Savannah and Brunswick, Southwest Campus based in Albany and Northwest Campus based in Rome and Dalton — where students can spend their clinically focused 18 months of medical school living and learning in any of these awesome locations or, of course, right here at our home base of Augusta. As we have talked about, it is only because of the graciousness and commitment of physicians and hospitals across our state to Georgia’s future that our students have the incredible opportunity to truly experience any kind of medicine there is, from a complex care facility like our own right here to spending time in some of Georgia’s smaller cities like Tifton where Dr. David Johnson, a 1985 MCG graduate and family medicine physician has a solo physician practice where he has been welcoming our students for years. You may remember we used to do bus tours of the campuses so our students could really get a taste of what is out there before settling in on where they will go. I am happy to report the buses will load again with a big contingent of the Class of 2026 (more are going in December) at 7:30 a.m. Monday. Dr. Mike Brands, vice dean for academic affairs, Dr. Nancy Havas, associate dean of learner affairs, and Dr. Kathryn Martin, associate dean for regional campus coordination will be going along for this important ride. Our students will see these beautiful cities that are bases for our campuses, meet some of the MCG students already there as well as the faculty and educators up and down our state. They will also visit some of the incredible clinical facilities like the famed Harbin Clinic based in Rome. I will be hitting the road Monday as well, headed for super Savannah, where I will talk with longtime friends and colleagues like Paul Hinchey, president and CEO of St. Joseph’s/Candler. Please know I never grow weary of telling all our friends across Georgia and all of you right here how amazing you are and how MCG would not and could not be without you. Thank you.

Dr. Faizal Asumda, clinical geneticist and genomics expert, joins the MCG faculty and CHOG

It is also my distinct pleasure to welcome new colleagues to the MCG family. Many of you may already know that Dr. Valera Hudson, chair of our Department of Pediatrics and a classmate of Dr. Johnson’s, has been very busy recruiting key faculty to ensure that we have all pieces in place to take the best possible care of children at our Children’s Hospital of Georgia and that we can best educate the next generation of physicians who will take care of children. We talk very often here and elsewhere about the genetic problems that plague us and that often surface in babies and children. I know some of you remember experts like Dr. David Flannery, pediatric geneticist who was on our faculty for 20 years, and like so many of you handled many responsibilities including serving as chief of the Genetics Division and medical director for Pediatric Ambulatory Care. Dr. Flannery was named medical director of the American College of Medical Genetics and Genomics in 2014, and in fact is a founding fellow of the college and has already served several leadership positions. He is now director of Telegenetics and Digital Genetics at the Cleveland Clinics Genomic Medicine Institute. We were and are fortunate to have Carolyn Lovell, genetic counselor, with us, for the past eight years since Dr. Flannery’s departure, but I am also pleased to announce that Dr. Faizal Asumda, who this past summer completed a clinical genetics and genomics residency at the Mayo Clinic Department of Clinical Genetics in Rochester, has joined our Department of Pediatrics faculty. I had the pleasure of meeting Dr. Asumda recently and we are fortunate to have him, because he is accomplished and nice but also because medical geneticists are hard to find. Dr. Asumda’s research interest ultimately include design of gene-based therapies, for problems like hereditary cancers, that may help correct the genetic aberrations he now helps children and their families at CHOG understand. A solid welcome Dr. Asumda. Thank you, Dr. Hudson for your diligence on behalf of children and your alma mater.

Dr. Luis Velasquez-Zarate, pediatric pathologist and cytopathologist, also joins us

It pays to have good neighbors, because in the building next door to Pediatrics, Dr. Ravi Kolhe, interim chair of the Department of Pathology, just made another terrific hire for children and families. Dr. Luis Velasquez-Zarate has joined us as (we think) our first pediatric pathologist. Dr. Velasquez-Zarate actually is coming back to us because he completed his surgical pathology fellowship here in 2019. He then went to Baylor College of Medicine’s Texas Children’s Hospital in Houston for his pediatric pathology fellowship then to the University of Texas Medical Branch in Galveston for a cytopathology fellowship. Let me tell you pediatric pathologists also are tough to find (Dr. Velasquez-Zarate tells us there were only 21 people taking the boards for this subspeciality, when he took his last year), never mind those who also are trained cytopathologists, so this was another win-win. Cytopathology is fundamentally looking at cells, which are typically obtained from a minimally invasive approach, like drawing fluid from a bump on the neck, and works well for identifying problems like cancer or infections. Examination of Pap smears is a good example, and those fine-needle aspirations are another.  A pediatric pathologist can help diagnose disease in a baby from the time of development inside of mother’s womb throughout their childhood development. It’s a subspecialized field because, again as we like to say, children are not small adults and their problems are not either. For example neuroblastoma, a cancer of the immature nerve cells, is the most common cancer in infants, according to the American Cancer Society, but is exceedingly rare in adults. Pediatric pathologists also can help investigate the cause behind a miscarriage with the hope of preventing future problems if possible. His research interests to date include comparing which techniques provide the best results in his chosen subspecialties. He tells us he came back to us because he likes the people and the place. I couldn’t have said it better. Welcome home, Dr. Velasquez-Zarate.

Paul Marsh passes

Finally today, we say goodbye to an old friend. Paul Edward Marsh Jr., an IT specialist and lead for research client services, who served our Cancer Research Building like it was his own. Paul died unexpectedly Sept. 17. Our chair of Biochemistry and Molecular Biology Dr. Vinata Lokeshwar and administrative assistant Karen Hensley share that he was “awesome.” Paul was always there to help avert a computer disaster and get a new computer up and running (without losing valuable data) and always wearing a flower on the lapel of his jacket because “everyone needs some cheer.” In fact, when they learned of his passing, his many friends in the cancer building wore a flower. Our thoughts are with his many friends and family.

All my very best to you,

Upcoming Events

Oct 16 – PaceDay 2022, Georgia Cancer Center Paceline Ride

Oct 21 – MCG Faculty Senate Meeting, noon, Natalie and Lansing B. Lee Jr. Auditorium

Oct 21 – Raft Debate, 6 p.m., J. Harold Harrison, MD Education Commons

Oct 22 – White Coat Ceremony, 2 p.m., Bell Auditorium

Nov 11 – Annual Body Donor Memorial Service, 1 p.m., Natalie and Lansing B. Lee Jr. Auditorium