The teenage years are a time to establish identity, and thus a time ripe for confusion and vulnerability.  It has become even harder recently with increased incidence of bullying, unrealistic body images portrayed by the media, confusion about gender identity and pressure to drink and try drugs. 

Dealing with these issues while adjusting to fluctuating hormone levels is difficult.  It is normal for some teens to feel angry, sad or confused at times.  However, the warning signs of teenage depression should never be ignored because suicide is the third most common cause of death in this age group. 

Each day, 2,000 people in this world end their own life.  Suicide is the eighth leading cause of death in the United States, according to studies by the Centers for Disease Control and Prevention, and the third leading cause of death in people ages 15-24. 

Teens are more likely to die from suicide than from homicide in this country. For every two homicides there are three suicides.  Some studies show that the number of teens who commit suicide may be falsely low, as suicide by intentional auto accidents, known as “auto-cide” are often reported as unintentional.   

Some of the warning signs of impending suicide in teens are talking or joking about death, thoughts about being reunited with a deceased loved one, loss of interest in activities, giving away possessions and behavioral problems.  Other signs include risk taking behavior such as drinking, drug use, declining grades in school, withdrawing from family and friends, excessive speeding while driving and carelessness about basic safety.  If you hear your teen make statements such as “life is useless” or “I wish I could just disappear,” these may be troublesome signs. 

Risk factors for teenage suicide include being diagnosed with depression or psychiatric disorders, family history of depression or suicide, having a firearm in the home, and alcohol or drug use.  It is important to remember that depression is often a result of chemical imbalance in the brain and the person suffering from these symptoms is not at fault. 

The most important thing you can do is talk to the teen about it.  Do not be afraid to bring this subject up. 

It is important to get an idea of the seriousness of the situation.  You may need to ask questions about specific plans he or she has to end his or her life. 

Teenagers with specific plans should be evaluated by the local emergency department immediately.  Those who are passively suicidal should still be taken very seriously and need to be seen by a health care professional as soon as possible. 

Resources are available to help you and your teen including your pediatrician, your family physician, counselors and the emergency department.  If you are worried about someone at risk for suicide, it is important to lock up all firearms and never leave the person alone.  

Contact the national suicide prevention hotline at 1-800- 273- TALK (8255) or, where trained professionals are available 24 hours a day. 

— Dr. Lee House is an Integrated FM/NMM second year resident.

I was driving home from a soccer match in Pikeville last night when I started to think  of something to write about this week for the editorial page.

So much goes into writing a column than most people realize. Well, at least it does this week.

My wife, Lisa, often tells me she is most proud when I put forth an effort to make a story or column more enjoyable for our readers.

She is my toughest critic – whether it is writing, cooking, cleaning, etc.

Columns can be inspired by what we, in the newspaper business, call a tip.

Every telephone call is a potential storyline. Every now and then, a few calls will turn out to be lame. Listen closely, because the lame suggestion and the great tip often start out sounding about the same.

Over the years, I have developed what we call “informants” in the business. Then you have those anonymous tip-givers. Their information may be lame one day but could turn into something valuable the next.

A funny conversation or a wild idea can also inspire a great column. Or, like today, sometimes nothing at all becomes the focus of your attention.

Am I making any sense?

I cannot tell you how many times I have started to write a column and had no clue where the story line was going.

Case in point: this column.

I started it without having the first idea of what I was going to write about. So far, I have managed to write this much, and I am still not sure what the column is about.

If you feel like turning the page now go ahead. I couldn’t blame you at all.

For those of you who are sticking around, here we go...

There is one thing I do know. Because I work for Pikeville Medical Center, our subject matters are often different than those of a typical, everyday newspaper.

I enjoy the fact that we are, what I describe, as a “feel good” newspaper. We are privileged to write an abundance of informative, educational, and heartwarming articles. 

Columns are utilized by the newspaper to establish personal connections to readers, delivering a regular dose of personal insight with broad and often humorous appeal.

You can always find topics to write about, just like this one. I am writing about nothing but seemingly getting to the point.

There, I made it through another of the many hurdles you face in the newspaper business every day – reaching out to our readers in some form or another.

Have a wonderful Labor Day Weekend and stay safe.

— Teddy Paynter can be reached at (606) 218-4932 or by e-mail at

One of the hallmarks of illegal drug use in Kentucky is that each epidemic tends to hit a region particularly hard before it fans out across the state.

Northern Kentucky and Louisville, for example, have suffered more than most from the recent steep increase in heroin addiction. 

Eastern Kentucky has been the epicenter for prescription drug abuse, while western Kentucky was first to see the rise of locally cooked methamphetamine.

I witnessed one of these regional trends myself when synthetic drugs invaded the southwestern counties I represent along the Tennessee border. 

While most drugs sold illegally are hidden from the public eye, these drugs were displayed prominently on the counters of many of our convenience stores.  Even children could buy them without supervision.

It did not take long before we began hearing horror stories about teenagers and young adults winding up in our emergency rooms, many in a psychotic state. 

They were buying products intentionally mislabeled as bath salts and plant food or known by such other names as K2 and synthetic marijuana.

Law enforcement had a difficult time prosecuting the underground chemists and the retailers selling this poison because the law at the time was geared more toward such “traditional” drugs as heroin, cocaine and marijuana.

Other state officials and I also learned that banning the synthetic drugs individually was not an effective approach.  All it took to make a law toothless was a small tweak in the chemical formula.

In 2012, however, I sponsored legislation that mostly put a stop to this cat-and-mouse game.  That law, the second of its kind in the country and now a national model, made it much easier for state officials to quickly ban new variations of synthetic drugs.  It also cracked down on retailers who refused to stop selling them.  The work we did then, coupled with vigorous enforcement, helped turn back what could have been a far worse problem.

Unfortunately, there is always a need to stay vigilant when it comes to illegal drug use, a reality made all too clear to me earlier this year.

Just days after the 2015 legislative session culminated with a comprehensive and landmark update designed to reduce heroin addiction, law enforcement came to me with concerns about a disturbing return of synthetic drugs ordered online and delivered by mail.

I quickly convened a meeting to hear from many of the same stakeholders I have worked closely with over the past six years as chair of the House Judiciary Committee.  We used this time to gauge just how widespread the problem is and what steps we should take next. 

The issue will be covered more in-depth during the committee’s August meeting, and I will be filing legislation later this fall that will turn these preliminary ideas into something the House and Senate can consider when we convene the 2016 Regular Session in January.

It is admittedly tough for one state to take on internet sales involving shady companies based in other countries, so greater federal involvement will be key.  Nonetheless, Kentucky was at the forefront of stopping rogue pharmacies from illegally shipping prescription drugs here a decade ago, so we do have a blueprint for success to follow.

One area where we can make an immediate difference is modifying the penalties for those selling or possessing synthetic drugs.  The 2012 law was built on the assumption that the drugs at the time were equivalent to marijuana, but it’s becoming increasingly clear that newer versions are much more dangerous and addictive.  It may be time to re-classify these drugs so that dealers face a more serious crime.

As we continue to increase access to treatment, we recognize the need to work together with communities on education and prevention. These new, more dangerous synthetic drugs represent a renewed threat, but Kentuckians have proven time and again that we can come together and lead the country when it comes to taking on illegal drug use.

In readying for the next front in this ongoing battle, I am confident we will continue to shepherd innovative drug policy that protects public safety and promotes public health.

—Rep. John Tilley chairs the House Judiciary Committee.

—The Medical Leader does not endorse political candidates or legislation.

FRANKFORT — The Kentucky Teachers Retirement System pension fund will need an additional $520.4 million in state contributions to be fully funded next fiscal year, a state pension oversight board heard today.

The $520.4 million is in addition to around $380 million paid out to KTRS from the state General Fund this fiscal year, state Deputy Budget Director John Hicks told the Public Pension Oversight Board.

All funds are needed to help KTRS meet 100 percent of its ARC, or annual required contribution.

The $520.4 million would be part of the KTRS “employer contribution,” which Hicks said is “a great big old hunk of General Fund” tied to the state SEEK (Support Education Excellence in Kentucky) appropriation for local school districts.

For the Kentucky Employee Retirement System, State Budget Director Jane Driskell said an additional $60 million in General Fund dollars will likely be needed in fiscal year 2017 to help meet the required ARC for that system.

Around $106 million in additional General Fund dollars are budgeted this fiscal year to meet that pension system’s needs. 

Full funding of the Kentucky Employee Retirement System ARC is required under 2013 Senate Bill 2, which mandates that the Kentucky General Assembly “shall pay the full actuarially required contribution rate” for KERS as well as CERS (County Employees Retirement System) and SPRS (State Police Retirement System) beginning in fiscal year 2015.

The pension needs will be addressed by lawmakers in the upcoming budget session beginning in January, although solutions are not expected to come easy.

“Hard to know where to start,” said Board Co-Chair Sen. Joe Bowen, R-Owensboro, after Driskell and Hicks finished their presentations.

He asked the two if paying the $520.4 million will make the state “flush” on its employer contributions to the KTRS pension system after at least eight years of trying to play catch-up.

“Yes,” said Hicks,” that’s the equivalent of 100 percent full ARC.”

Total General Fund dollars budgeted for the KERS and KTRS this fiscal year was around $990 million, or 68 percent of the total $1.5 billion budgeted for the systems, said Driskell.

Board Co-Chair Rep. Brent Yonts, D-Greenville, asked Driskell’s office to explain data in a handout it provided which shows KTRS is $487 million short this fiscal year.

Hicks said the $487 million added to the $725.9 million budgeted by the state for the current fiscal year represents the full required employer contribution, partially unpaid.

“So we didn’t pay the full ARC to teachers last time and, to be current next time, we’re going to have to put up $520 million on top of whatever the number is for 2017,” Yonts clarified.

Rep. Brian Linder, R-Dry Ridge, said based on prior testimony before the Board, KTRS had not requested any money above the state contribution plus payroll from the General Assembly up until 2008.

He said the additional millions needed now are due to performance on investments “that the General Assembly is being asked to make up,” asking Driskell’s team if he is correct.

Hicks said it is a “shortfall from everything that goes into the performance of the system.”

I have always loved the science of astronomy and have studied it extensively.  On a clear, still night, one can look into the sky and see the same stars that astronomers in King Nebuchadnezzar’s day saw thousands of years ago.  It is believed that the light from the star Deneb in the constellation Cygnus left over a thousand years ago and we are just now seeing it.  In fact, no one can precisely calculate the exact distance of Deneb because it is so far away.   The Universe which we see is like God, it has no beginning nor any finite boundaries, in other words, Big!

How big is God? 

He is omnipresent or everywhere and nothing can contain him.  The Bible refers to him as ‘I Am’ which really says a great deal.  God is also omniscient meaning he knows everything.  There is nothing we can hide from him and he already knows our every need. 

So every time we look around us, we can realize that we are surrounded by God’s presence.  He is truly that Big!

PMC Chaplain Stephen Thacker, Th.D. may be reached at 606-218-3969.

PIKEVILLE — Pikeville MedicalCenter (PMC) proudly announces theaddition of Al Addasi, MD, vascularand endovascular surgeon.

Dr. Addasi received his Bachelorof Medicine and Bachelor of Surgerydegree from the University ofJordan, completed his residency atUnion Memorial Hospital in Baltimioreand completed his vascularsurgery fellowship at Henry FordMedical Center in Detroit.

“I chose to be a vascular andendovascularsurgeon becauseit is a specialtythat can grow withme,” he said. “Itcan change as I dothrough the years.”Dr. Addasi isfocused on hispatients.

“The mostimportant goal formy practice is to strive to provide thebest care possible for my patients,”he said. “I want to be ready to helpmy patients and be available to meettheir needs.”

When choosing to come to PMChe said he came for two reasons.“I want to remain in Kentucky becauseI love the area and the peoplebest,” he said. “And second, Presidentand CEO Mr. [Walter E.] Maypresents lots of opportunity for me.”

In his spare time, he enjoys farming,gardening, cooking and spendingtime with his wife and step-daughter.Dr. Addasi joins Dr. BasharGhosheh on the 2nd floor of thePMC Clinic.

For more information, call 606-218-3500.

PIKEVILLE — Pikeville Medical Center (PMC) is celebrating National Prostate Health Month in September to increase awareness of the importance of prostate health.

Prostate cancer is the most common cancer among men (after skin cancer), in the United States. It affects one in seven men and can often be treated successfully. If diagnosed early, the five-year survival rate is almost 100 percent.

The prostate is a walnut-sized organ located just below the bladder in men and assists in reproduction. The prostate is not essential for life.

While some types of prostate cancer are aggressive and deadly, most prostate cancers are non-aggressive and non-life-threatening.

Men have a greater chance of getting prostate cancer if they are 50 years old or older, are African-American, or have a father, brother or son who has had prostate cancer.

Symptoms of prostate cancer vary.

“Prostate cancer is called the silent killer because it may not exhibit any symptoms at all until it is too late,” said Dr. Brad Collett, radiation oncologist at PMC.

Symptoms of which to be aware include difficulty starting urination, frequent urination (especially at night), weak or interrupted flow of urine, and frequent pain or stiffness in the lower back, hips or upper thighs.

Due to improved screening and early detection, many men with prostate cancer are being diagnosed early, when the cancer is still contained. Digital rectal exams and prostate specific antigen tests are commonly used to screen for prostate cancer.

Surgery or radiation can be used to treat prostate cancer. Some men delay treatment or choose to use anti-hormone shots, which slow, but do not cure, prostate cancer. Treatment options should be discussed with a physician.

Local support is available for men who have prostate cancer. PMC offers a prostate cancer support group on the third Tuesday of each month at 6pm at the Pikeville Medical Leonard Lawson Cancer Center, 172 South Mayo Trail in Pikeville. Call 606-218-4628 for more information about the support group.

For more information about the services provided by PMC, call 606-218-3500.


PMC Head Chef Robert \Bob\ Bell

PIKEVILLE — National Food Safety Education Month highlights the importance of properly storing, preparing and serving food. In the Food and Nutritional Services department at PMC, appropriate steps are taken to store and prepare the food served in the cafeteria, Hobe’s Grill and to patients.

According to Food and Nutritional Services Director Sophia Chambers, the way food is stored is crucial to the food staying fresh and safe.

“All cold meats, dairy products, vegetables, juices and sodas should be stored at 41 degrees to 35 degrees Fahrenheit to prevent bacteria growth,” she said. “Cooked meats should be cooled to 70 degrees within two hours and 41 degrees within four hours to prevent bacteria growth.”

Chambers also stated that raw meats should be stored a certain way to prevent cross contamination.

“When storing raw meats, chicken should be placed on the bottom shelf, ground beef should be placed above chicken, pork above ground beef, fish above pork and all cooked meats should be stored above raw meats,” she said.

Chambers added the department uses the first in, first out (FIFO) rule when a delivery is made.

“For product freshness, we date any open product with the date the food expires,” she said. “We use FIFO for when we get our delivery, this is so we do not use outdated products.”

When prepping food, PMC Food and Nutritional Services’ employees must use different colored cutting boards for different foods.

All meat products, fruits and vegetables have their own cutting boards:

•Raw beef – Red 

•Chicken – Yellow 

•Fish and seafood – Brown 

•Cooked meats – Blue

•Vegetables – Green

•Dairy products – White

Fresh fruits and vegetables are washed in cool water to remove any dirt and debris while all frozen meats are thawed in running cold water or refrigerated three days prior to cooking.

“Our kitchen has separate prep areas located throughout so no cross contamination occurs,” Chambers said. “We practice safe food handling daily.”

All Food and Nutritional Services’ employees are required to wear gloves during food service times to prevent the spreading of germs.

“The employees must change their gloves every two hours unless they touch a foreign object away from the serving line,” said Chambers.

The food lines consist of temperature controlled food products. The hot food must stay at 140 degrees or higher and the cold food at 41 degrees or lower to prevent bacteria growth.

There are different temperatures for each type of food served:

Poultry must be cooked to an internal temperature of 160 degrees

Beef, pork, veal and lamb must be cooked to 145 degrees

Fish and shellfish must be cooked to 145 degrees

Eggs must be cooked to 160 degrees

Casseroles must be cooked to 165 degrees

“All food is handled with utensils to prevent cross contamination from foreign germs and bacteria,” Chambers said. “Temperatures of the food line, salad bar and taco bar are taken prior to each meal service and if the food temperature is incorrect, the employees are to reheat to the proper temperature.”

Chambers also emphasized the importance of hand washing and surface sanitizing.

“The employee’s hands are to be washed regularly and surfaces cleaned and sanitized regularly as well,” she added.

The PMC cafeteria is open seven days a week from 6:15 a.m.-10 a.m., 11:15 a.m.-2 p.m. and 4:30 p.m.-6:30 p.m.

Hobe’s Grill is open 24/7.

Medical Leader | Photo by Teddy Paynter

PIKEVILLE — Pikeville’s defense, fueled by an explosive offense, limited Letcher Central running back Jaylyn Williams to 156 yards and two scores as the Panthers cruised to a 49-12 win in the 31st annual Pike County Bowl finale played at Hillard Howard Field on Aug. 29.

Williams, who was forced to run out of the Wildcat formation because of injuries to a pair of Cougar quarterbacks, scored on TD runs of two and eight yards. He finished with 156 yards on 24 carries.

Meanwhile, running back Daric Pugh was solid again, rushing for 176 yards and four touchdowns on only seven carries as the Panthers improved to 2-0.

Quarterback Cody Dials completed 6-of-11 passes for 142 yards, including a 37-yard touchdown pass to Chatlin Jarrell to open the scoring with 11 minutes, 28 seconds to play in the first quarter.

Reserve running back Evan Rhodes added 73 yards on six rushes and wide receiver Andrew McNamee hauled in two catches for 80 yards and a score.

Pugh’s first touchdown run came from 17 yards out and extended the Panther lead to 14-0 with 6:10 left in the opening quarter.

After Williams scored on a two-yard run with 1:41 to go, Pugh added a three-yard scoring with 50 seconds left to push the lead to 21-7.

Pikeville put the game away on the strength of a 21-point second quarter as well, resulting in a running clock.

Pugh had TD runs of 77 and 8 yards and Jarrell returned an interception 59 yards with 2:34 to play before the break to make it 42-6. Pugh’s scores came with 10:01 left and 5:58.

Williams scored on an eight-yard run with 6:41 remaining in the third period to make it 42-12.

Pikeville’s final points came on Dials’ 38-yard scoring strike to McNamee with 1:53 left in the third quarter.

The Panthers will now travel to Paintsville (2-0) tonight to battle the Tigers while Letcher Central visits Hazard (1-1).

At Pikeville


LCC (1-1)…..............................6    0  6  0 – 12

PHS (2-0)….............................21  21  7  0 – 49


First Quarter

P – Chatlin Jarrell, 37-yard pass from Cody Dials (Denton Heffington kick), 11:28.

P – Daric Pugh, 17-yard run (Denton Heffington kick), 6:10.

L – Jaylyn Williams, 2-yard run (kick failed), 1:41.

P – Daric Pugh, 3-yard run (Denton Heffington kick), :50.

Second Quarter

P – Daric Pugh, 77-yard run (Denton Heffington kick), 10:01.

P – Daric Pugh, 8-yard run (Denton Heffington kick), 5:58.

P – Chatlin Jarrell, 59-yard INT (Denton Heffington kick), 2:34.

Third Quarter

L – Jaylyn Williams, 8-yard run (pass failed), 6:41.

P – Andrew McNamee, 38-yard pass from Cody Dials (Denton Heffington kick), 1:53.

Fourth Quarter

No scoring.

Next up: Pikeville (2-0) at Paintsville (2-0); Letcher Central (1-1) at Hazard (1-1), Sept. 4.

Medical Leader | Photo by TEDDY PAYNTER
OFF AND RUNNING: Belfry running back Derek Wellman breaks away on a first-down run during the 31st annual Pike County Bowl matchup with Tates Creek at CAM Stadium on Aug. 28.

GOODY — Belfry opened its run at a third straight Class 3A state football championship with a 55-38 win over Tates Creek in the 31st annual Pike County Bowl matchup played at CAM Stadium on Aug. 28.

Running backs Xondre Willis and Derek Wellman combined for over 160 yards each in the win and both scored three touchdowns each against the Commodores, now 0-2.

The Pirates rushed 61 times for 511 yards while Tates Creek quarterback Payton Burke passed for 259 yards and five scores.

The Creekers took the early 6-0 lead when Burke hit Curtis Zambrano with a one-yard touchdown pass with 5 minutes, 9 seconds left in the opening quarter.

Belfry went on top 7-6 on Willis’s 29-yard touchdown run and Austin Woolum’s kick with 3:51 remaining.

The Pirates extended their lead to 14-6 on Andrew Fletcher’s one-yard run with 11:35 left in the opening half. Woolum added the kick.

The Commodores pulled even on Burke’s three-yard pass play to Jackson Beerman with 6:35 to go. He then passed to Drew Ransdall to knot the score at 14-all.

Belfry took the lead for good on Wellman’s 15-yard touchdown run with 36.8 seconds left in the half. Woolum’s kick made it 21-14.

Willis scored on a seven-yard run with 10:45 to go in the third period to push the lead out to 28-14. Wellman’s six-yard TD run extended the lead to 35-14 with 7:04 left.

Back came Tates Creek.

Burke tossed a 19-yard touchdown pass to Beerman with 2:26 left and then ran in the conversion to make it 35-22.

Willis struck again for the Pirates. This time he ran 63 yards and Woolum added the PAT kick to make it 42-22 heading into the final 12 minutes.

Fletcher scored on a one-yard run with 7:57 to play to push the Pirates up 48-22.

Elijah Johnson scored on a hook-and-lateral play that covered 71 yards and Burke ran in the conversion to pull the Commodores to within 48-30.

Wellman added a one-yard TD run with 2:49 left and Burke tossed a 23-yard touchdown pass to Beerman with 1:35 left to close out the scoring.

Belfry will return to action tonight against Harlan County (1-1).

At Goody


TC (0-2)….................................6    8    8  16 – 38

BHS (1-0)...............................…7  14  21  13 – 55


First Quarter

TC – Curtis Zambrano, 1-yard pass from Payton Burke (kick blocked), 5:09.

B – Xondre Willis, 29-yard run (Austin Woolum kick), 3:51.

Second Quarter

B – Andrew Fletcher, 1-yard run (Austin Woolum kick), 11:35.

TC – Jackson Beerman, 3-yard pass from Payton Burke (Drew Ransdall pass from Payton Burke), 6:35.

B – Derek Wellman, 15-yard run (Austin Woolum kick), 36.8.

Third Quarter

B – Xondre Willis, 7-yard run (Austin Woolum kick), 10:45.

B – Derek Wellman, 6-yard run (Austin Woolum kick), 7:04.

TC – Jackson Beerman, 19-yard pass from Payton Burke (Payton Burke run), 2:26.

B – Xondre Willis, 63-yard run (Austin Woolum kick), 1:38.

Fourth Quarter

B – Andrew Fletcher, 1-yard run (poor snap), 7:57.

TC – Elijah Johnson, 71-yard hook and lateral (Payton Burke run), 7:34.

B – Derek Wellman, 1-yard run (Austin Woolum kick), 2:49.

TC – Jackson Beerman, 23-yard pass from Payton Burke (Drew Ransdall pass from Payton Burke), 1:35.

Next up: Belfry (1-0) at Harlan County (1-1), Sept. 4.